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Home Health & Hospice Week

Industry Notes:

WAGE INDEX BILLING CONFUSION HOUNDS HOSPICES

Published on Mon Oct 17, 2005

Hospices continue to have trouble billing claims correctly after the switch to Core-Based Statis-tical Areas (CBSAs) from Metropolitan Statistical Areas (MSAs) Oct. 1 (see Eli's HCW, Vol. XIV, No. 36).

Hospices can find their CBSA codes in the Tables section of the 2006 Hospice Wage Index final rule at www.cms.hhs.gov/providerupdate/regs/CMS1286F.pdf, RHHI United Government Services reminds hospices on its Web site.

"When reviewing Table A, if your city on the list of Urban Areas has an asterisk (*) under it, you will need to review Table C for your designated CBSA Code," UGS warns.

Ignore error messages: UGS is also aware of a problem when hospices enter Notices of Election into the Direct Data Entry system, the RHHI says in another posting. Even though an error message generates when you enter an NOE, "the NOE is processing, so the NOEs do not need to be entered again," UGS instructs. "If you need to verify that the NOE went through, you can check the Claims Summary screen in DDE."

At RHHI Palmetto GBA, hospice claims were incorrectly suspending to status/location SB 0100 due to a change in the system edit order, the intermediary explains on its Web site.

The Fiscal Intermediary Shared System "has established Reason Code 37402 to take the place of Reason Code 38146 for claims with the receipt date of 10/01/05 or later," Palmetto says on its Web site. But "if the prior claim has not processed, then the current claim will Return to Provider (RTP) with Reason Code 37402," the intermediary cautions.

• Physicians will see their Medicare payment rates for home health and hospice certification and care plan oversight go down starting Jan. 1--unless Congress takes action.

The average rate before geographic adjustment for home health certification (G0180) will be $70.91 in 2006, down from an average of $74.28 in 2005, reports the National Association for Home Care & Hospice. The 2006 rate for home health recertification (G0179) is $54.27, home health care plan oversight (G0181) is $118.66, and hospice CPO (G0182) is $125.53, according to NAHC. A new service allowed for physicians, hospice evaluation (G0337), will have a Medicare payment rate of $70.18.
 • The DME industry is working to build support for the Hobson-Tanner bill modifying competitive bidding. The American Association for Homecare's State Leaders Council gathered at Medtrade in Atlanta to discuss ideas, which included identifying providers in each congressional district who could act as effective advocates. The group is also planning to assemble a list of best practices to be shared among the state associations.

Advocacy materials are available at www.aahomecare.org under "Advocacy Priorities."
• Almost Family Inc.'s profits have soared in the quarter ended in September, thanks to the sale of its adult day care business (see Eli's HCW, Vol. XIV, No. 28,). The Louisville, KY-based chain reported net income of $5.4 million on revenues of $18.5 million for the quarter, compared to a $404,628 profit on $16 million in revenues for the same period in 2005. The figures include a $5 million gain from the day care sale.

The seven-state chain also has announced its fourth Florida acquisition since October 2004. Almost Family has purchased the assets and business operations of St. Augustine, FL-based agency Community Home Health from Flagler Hospital for undisclosed terms.

This acquisition of the HHA that generated $2 million in revenues last year "gives us a new presence on the northeast coast of Florida," CEO William Yarmuth says. Almost Family "will continue to seek attractive [HHA] acquisition candidates in Florida and elsewhere."

 • VNA Home Care and Caritas Home Health in Louisville, KY have merged along with their parent hospitals, reports Louisville's Business First newspaper. The new agency, VNA Nazareth Home Care, will perform about 250,000 home health visits in 2005, serving 41 counties in Kentucky and Indiana, the paper says. VNA's sister company Southern Home Care was also merged into the new agency.

• Amedisys Inc. has acquired certain assets of an HHA operated by the Davidson County Health Department in Lexington, NC for $2.2 million in cash, the regional chain says. The purchase will expand Amedisys' presence in the certificate of need (CON) state, the Baton Rouge, LA-based company comments.

Amedisys also will buy a therapy staffing company in Oklahoma for $2.5 million, according to a release. "The acquisition of a therapy staffing company will enhance our ability to recruit qualified therapists in key markets," says CEO William Borne.
• DME suppliers are offering relief to the victims of the recent earthquake in Pakistan. Pakistani native Aurangzeb Pirzada, CEO of Medstar Surgical & Breathing Equipment Co. of College Point, NY, is coordinating delivery of DME and supplies to needy Pakistanis. Items include wound care supplies, wet and dry sanitary wipes, blood pressure monitors and urological and diabetic supplies, as well as saline, peroxide and alcohol. Several DME manufacturers and distributors are offering mattresses and wheelchairs.

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