Home Health & Hospice Week

About a year from now you'll have to be accredited to supply durable medical equipment under Medicare, unless you're not a traditional DME supplier.

The Centers for Medicare & Medicaid Services "has issued an exemption for virtually every professional group except respiratory therapists, registered nurses, and pharmacists," the Na-tional Association of Independent Medical Equipment Suppliers notes in a message to members. The exempt list includes physicians, physical therapists, occupational therapists, and many more specialties.

The American Podiatric Medical Associa-tion and the American Physical Therapy Associa-tion are praising CMS' exemption decision. "This is a huge victory," APTA's R. Scott Ward says in a release. "Physical therapists already provide care of the highest quality, so these unnecessary requirements would have been overly burdensome, costly and could have created obstacles for patients needing these services."

NAIMES opposes the exemptions, the trade group says in a letter to CMS. "The mandatory accreditation requirement [is] a vital element in the fight against fraud, abuse, and billing errors in DME," it says. The move exempts more than 45,000 National Supplier Clearinghouse-listed suppliers from the requirements.

"Exempting nearly half of the holders of supplier numbers goes against the intent of Con-gress," NAIMES argues. "These exemptions open another avenue for fraud that should be closed."

And the decision discriminates against the industry. "This broad exemption seems to imply that DME suppliers are the only provider group with a fraud and abuse problem, however the facts do not support this premise," the trade group maintains.

• Home care providers in the path of Hurricane Ike are dealing with many of the same problems Hurricane Gustav victims have faced -- power outages, short supplies and evacuations.

To prepare for the storm, the Department of Health and Human Services activated the National Disaster Medical System to help with medical evacuations, special needs shelters and other related issues. A new Emergency Pharmacy Assistance Program provided a 30-day supply of replacement prescription medications and certain DME such as wheelchairs and canes, HHS said in a release.

In advance of the storm, HHS declared a Texas public health emergency that relaxes regulations for Medicare providers in affected areas. For example, it suspends the requirement that patients receive home care services in their own homes, HHS noted in a separate release.

CMS is also working with the Federal Emergency Management Agency to manage lost, stolen, or abandoned DME, HHS added.

More information is online at http://www.hhs.gov/disasters/emergency/naturaldisasters/hurricanes/ike/actions.html.

Home oxygen providers across the state prepared for Ike to hit, says the Council for Quality Respiratory Care. "The effects of a hurricane can wreak havoc on home oxygen patients, leaving thousands of oxygen users in need of emergency respiratory assistance to access life-saving oxygen therapy," noted the coalition of the nation's largest oxygen companies.

Oxygen suppliers made pre-storm deliveries and had extra cylinders on hand for emergencies, the CQRC said.

HHAs also prepared for the storm. Austin-based Girling Health Care told both employees and patients to call the local office phone number, because phone lines had been rolled over to a remote location that could handle calls. Employees and patients were also given the company's toll-free number as an alternative.

Home care employees were volunteering their time at Lufkin, TX's special needs shelter, according to The Lufkin Daily News. Home care nurse Patricia Jones noted the shelter's improvement since Hurricane Rita. "Since Rita we've gotten a big, new generator and a handicapped shower," Jones told the newspaper.

Members of Angel Staffing in San Antonio attended to patients, each nurse wearing at T-shirt that read "Relax ... an angel has arrived," the Daily News reported.

• The influential Medicare Advisory Pay-ment Commission may be taking a look at DME pricing this year, and the results aren't likely to be good for suppliers. "Medicare prices are often several hundred percent higher than Internet prices for the same items," said MedPAC staffer David Glass in the Sept. 4 meeting of the influential advisory body to Congress. "Because many items are commodities with little service element to them, this could be evidence of inaccurate pricing."

"MedPAC got it wrong again with their comparison of the services provided by DME suppliers and prices on the Internet," blasts the National Association of Independent Medical Equipment Suppliers. "Since the task of the commission is to insure that taxpayer money is spent wisely and that beneficiaries get value for their money, NAIMES feels that the commission should focus on the rest of the healthcare community and not the less-than-2-percent share attributed to DME."

None of MedPAC's 17 members have a home care background, NAIMES points out.

The industry needs more specific product codes and an assurance that accreditation will insure quality, said commissioner William Scanlon, formerly with the Government Accountability Office.

• Lawmakers are taking action on background checks for long-term care workers, but nothing may come of the issue in this session.

The Senate Finance Committee passed a bill that would expand Medicare's recent background check pilot program nationwide by 2010. A companion bill is pending in the House.

"Lawmakers should support efforts to establish a national registry and background check system ... for all health and LTC workers, including independent providers who provide direct care to patients," says the National Association for Home Care & Hospice. "Such a system should be voluntary until an efficient and accessible background check system is in place. Federal and state background check requirements should not be duplicative."

With the congressional session ending Sept. 26, time may run out on the legislation this year, observers predict.

• Now that you have your National Pro-vider Identifier number squared away, don't just forget about it. You are responsible for keeping your National Plan and Provider Enumeration System records -- which support your NPI -- up to date, CMS reminds providers in a message.

You should check your NPPES data for accuracy and reset your account passwords annually, CMS recommends. You can view and update your NPPES information at https://nppes.cms.hhs.gov/NPPES/Welcome.do.

Tip: If you've forgotten your password, you can enter the User ID and click the "Reset Forgotten Password" button, CMS advises. But if you enter the wrong login information three times, you'll be locked out of your account and have to call the NPI Enumerator for assistance.

• Home health agencies may be in for some of the regulatory scrutiny DME suppliers have been getting. Sen. Charles Grassley (R-IA) has asked the HHS Office of Inspector General to investigate the HHA Medicare payment error rate.

Recently the OIG blasted CMS for lowballing the DME payment error rate in the Comprehensive Error Rate Testing (CERT) report (see Eli's HCW, Vol. XVII, No. 31, p. 242). A big decline in the HHA error rate when CMS switched calculation methodologies is a red flag, says Grass-ley, who is chair of the Senate Finance Committee.

"Is the lower HHA error rate the result of program improvement or underreporting?" Grassley asks in a recently released July 24 letter to the OIG.

• Signature Home Health & Home Care of Eugene, OR is expanding to include a hospice business line, the home health agency says in a release. "Many people in the community have had to wait as long as two weeks to receive hospice services," Signature president Trey Malicoat says. "We believe this is a tragedy! Terminally ill pat-ients should live comfortably with as little pain as possible!"

• LHC Group Inc. has teamed with West Tennessee Healthcare to provide home nursing services, effective Oct. 1, the Lafayette, LA-based HHA chain says. "This joint venture includes three agency locations in the certificate of need (CON) state of Tennessee," LHC says. "These locations are located in Jackson, Bolivar and Trenton."

The agencies' annual revenue is about $3.8 million, LHC says in a release.