Home Health & Hospice Week

Your cash should flow freer come October.

Requests for Anticipated Payment (RAPs) won't be caught up in the fiscal year-end payment hold mandated by the Deficit Reduction Act.

The Homecare and Hospice Financial Management Association, an affiliate of the National Association for Home Care & Hospice, successfully challenged the inclusion of RAPs in the payment hold that will take place Sept. 22 to 30, NAHC reports.

"While seemingly innocuous, the DRA provisions actually shift billions of dollars of FY 2006 expenditures to FY 2007 and affect all Medicare Part A and Part B payments," NAHC criticizes.

In an earlier transmittal, the Centers for Medicare & Medicaid Services said the postponement would apply to RAPs (see Eli's HCW, Vol. XV, No. 8). But now CMS will issue a revision to the transmittal, the trade group adds.

• Orthotic and prosthetic suppliers have a unified voice, thanks to the formation of a new trade group alliance. The new coalition brings together the American Board for Certification in Orthotics and Prosthetics, the American Academy of Orthotists & Prosthetists, the American Orthotic & Prosthetic Association and the National Association for the Advancement of Orthotics and Prosthetics.

The groups will maintain their separate structures. They plan to work together for the purpose of working on federal and state government affairs, according to a statement released in March by the new partnership, the Orthotic & Prosthetic Alliance.

• House lawmakers broke for a two-week Easter recess without voting on a fiscal year 2007 budget resolution. Disagreements between conservative and moderate Republicans over items including Medicare and Medicaid cuts stalled the legislation after it was passed without Medicare cuts by the House Budget Committee.

Whether the House will take up the budget resolution when it returns from recess is unclear. President Bush says he will veto any budget legislation that does not include cuts his Administration recommended earlier this year, including reductions to home health agency and hospice payment rates (see Eli's HCW, Vol. XV, No. 6).

• CMS plans a series of special meetings starting this month to discuss coding changes for DME and accessories. On the table: payment and coding determinations related to DME, orthotics and prosthetics and related supplies.

The first event focuses on DME and is scheduled for April 25 in Baltimore. A two-day meeting specific to HCPCS for orthotics and prosthetics will be April 26 to April 27.

A HCPCS meeting on supplies and other related items will be May 4 to May 5. More information is at www.cms.hhs.gov/medhcpcsgeninfo.

• Are home health advance beneficiary notices (ABNs) more trouble than they're worth? HHAs that want a chance to comment on the ABN burden can refer to the March 24 Federal Register at www.access.gpo.gov/su_docs/fedreg/a060324c.html for instructions on how to submit feedback--scroll down to the first CMS entry. Comments are due by May 23.

• CMS' methodology for calculating the Medicare payment error rate through the Comprehensive Error Rate Testing (CERT) program is adequate, the Government Accountability Office found in a recent report (GAO-06-300). CMS found a total error rate of 9.3 percent for Medicare claims in 2004.

• Regional chain Amedisys Inc. has purchased an HHA in Horry County, SC for $2.75 million in cash and a half-million-dollar promissory note payable over one year. Baton Rouge, LA-based Amed-isys expects the agency to contribute about $3.5 million in annual revenues.

The company touts the acquisition in the certificate-of-need state and says it is on the lookout for similar strategic buys.

• A Texas federal court has dismissed the shareholder class action lawsuit against Odyssey HealthCare Inc. filed in April 2004. Shareholders filed suit against the for-profit hospice chain, charging the Dallas-based company with securities fraud and misleading shareholders. The suits accused Odyssey of admitting patients ineligible for the Medicare hospice program, providing below-standard care due to heavy workloads, exceeding Medicare per beneficiary caps, and hiding high labor and drug costs and negative cash flow (see Eli's HCW, Vol. XIII, No. 18).

"We are extremely pleased with the decision of the Court," CEO Robert Lefton says in a release.

• Almost Family Inc. has purchased an Ocala, FL HHA that also has a branch in Palm Coast, FL. The home nursing chain's acquisition, made for undisclosed terms, is the Louisville, KY-based company's fifth in Florida in the last 18 months, it says in a release. The acquired agency generated about $1.7 million in revenues last year, the 56-location chain says.

• Sen. Hillary Clinton (D-NY) has introduced legislation that would help state Agencies on Aging develop a community-based long-term care system. The bill, which aims to keep seniors at home and out of nursing homes, calls for a matching grant program that would help seniors pay for things like home care and medical equipment under a consumer-directed model.