Home Health & Hospice Week

Senate Finance Chair demands answers from CMS.

Federal lawmakers aren't happy with how some Medicare quality improvement money is being spent.

In a Jan. 6 letter to Centers for Medicare & Medicaid Services Administrator Mark McClellan, Senate Finance Chair Charles Grassley (R-IA) asks CMS to account for spending related to its employees' attendance at conferences held at "lavish resorts" sponsored by Quality Improvement Organizations.

The request follows on the heels of an August 2005 request from Grassley asking for various documents related to 15 QIOs, including travel expenses, performance audits, board compensation and more.  The Senate Finance Committee began looking into the QIOs after the Washington Post reported that QIOs' responses to beneficiary complaints were lacking, among other problems.

The QIOs also suffered a blow when an article in the June 15, 2005 issue of the Journal of the American Medical Association said hospitals participating in QIO programs showed no statistically significant differences in quality-of-care improvements compared to non-participating hospitals (see Eli's HCW, Vol. XIV, No. 25).

"Information and documents available to the Committee suggest that the [QIOs'] annual Tri-Regional conference held at the Don CeSar Beach Resort and Spa appeared to be more of a party than a diligent working meeting," Grassley said in the letter to CMS. Photos of the event "suggest a cruise ship atmosphere rather than that of a government working meeting to improve quality of care for Medicare beneficiaries."

"As you look at the photos of the Don CeSar event, you wonder if these contractors are going to luaus and playing golf instead of investigating patient complaints about poor Medicare quality," Grassley says in a release. "And then you have to wonder whether the federal employees who are supposed to make sure the contractors are doing the job we pay them to do are instead going to luaus and playing golf themselves."

The American Health Quality Association, a trade group representing the QIOs, fired back that the QIOs' conferences "are invaluable educational meetings" and that the resort locations are actually cheaper than urban conference sites such as Washington, DC.

Additionally, "AHQA has never inappropriately provided access to property or compensation to government officials," the association maintains. • Home care providers will get the final word on their 2006 rates if the House votes on the budget reconciliation package as scheduled Feb. 1. House Speaker Dennis Hastert (R-IL) has tentatively slated the vote for that day, according to press reports.

Provisions up for finalization are a freeze to home health agency payment rates, a one-year 5 percent rural add-on for HHAs, a 36-month cap on oxygen rentals and a 12-month cap on durable medical equipment rentals.

"Conventional wisdom holds that defeat of the package is very unlikely" despite mobilized opposition, notes the National Association for [...]