Home Health & Hospice Week

Newly passed Medicare bill a mixed bag for home health agencies.  It will take experts months to suss out the recently passed Medicare bill's overall impact on home health agencies, thanks to its 1,000+ pages and hundreds of provisions. But at first blush, HHAs appear to have both good and bad news contained in the massive piece of legislation. The Good News: No copay. The industry continues to celebrate its victory over the home health copayment that was proposed this session, which at one point looked inevitable. The bill, which the House approved Nov. 22 and the Senate passed Nov. 25, contains no mention of the much-hated proposal. Rural add-on. Although not as much as first proposed by the Senate, the one-year, 5 percent add-on for patients served in rural areas will add to agencies' bottom lines starting in April. Senate Finance Committee Chair Charles Grassley (R-IA) referred to payment increases to rural providers including HHAs as "dramatic improvements." Private-pay OASIS suspension. On the heels of Centers for Medicare & Medicaid Services Administrator Tom Scully's announcement that collection of OASIS data for non-Medicare, non-Medicaid patients was off, Congress passed a provision saying the same thing (see story, "OASIS"). The measure will chiefly help those agencies that serve many private-pay patients in addition to Medicare and Medicaid ones. Other more minor but still positive provisions include allowing nurse practitioners to be counted as "attending physicians" for hospice purposes. They would therefore be able to establish and review care plans. Physicians still must certify patients as terminally ill with a six-month prognosis to qualify for the hospice benefit, however, notes the Visiting Nurse Associations of America. While most other drugs' Medicare reimbursement rates will drop to 85 percent of average wholesale price under the bill, the program will continue to pay for flu vaccinations at 95 percent of AWP until a new pricing system takes over. The Bad News: Inflation update reduction. As expected, Congress passed a reduction of 0.8 percent to the home health market basket index, the factor used to update rates for inflation. The -0.8 percent factor will take effect in April, when HHAs will see their payment rates cut accordingly, and will continue through 2006. Inflation updates also will be moved from a federal fiscal year basis (starting in October) to a calendar year basis, trade associations report. Pennsylvania HHAs told the Wilkes-Barre Times Leader that the cuts in the legislation, estimated at $6.5 billion over 10 years, could force them to restrict services. "They're killing home health," said Debra Popovich, director of Personal Care Home Health Services in Kingston. "It's going to be very difficult." Background checks. "The most onerous components of the Senate-passed criminal background check legislation [...]