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Home Health & Hospice Week

Regulations:

Discharge Orders Not Required, CMS To Say In SOM Corrections

Published on Thu Sep 30, 2004

Flu vaccines, homebound demonstration details also revealed in forum.

Don't start revamping your policies and procedures just yet based on the online State Operations Manual.
 
The Centers for Medicare & Medicaid Services is making a number of corrections to the on-line SOM. When CMS switched from the paper to online manual earlier this year, the agency left out "strategic pieces" and made some typos, a CMS official acknowledged in the Sept. 22 Open Door Forum for home health.
 
One "major error" was "an omission of the Medicare conditions of participation at 484.10(e)(2) requiring a home health agency to notify patients verbally and in writing of any changes in their payment sources," the National Association for Home Care & Hospice notes on its Web site.
 
Another error apparently is the SOM's call for physician orders every time an HHA discharges a patient or reduces services before the end of the episode. "Nothing has changed," the official insisted in the forum that drew more than 200 participants.
 
CMS is working on a corrected and complete manual, the source added. The flawed version of the SOM is available at www.cms.hhs.gov/manuals/107_som/som107index.asp.
 
Other topics addressed in the forum include:

  • Homebound demonstration. The homebound demonstration, rechristened the "Home Health Independence Demonstration," will begin as scheduled in Massachusetts, Missouri and Colorado Oct. 4, CMS said (see Eli's HCW, Vol. XIII, No. 25, p. 196). CMS regional offices held meetings in Boston Sept. 14, Kansas City Sept. 27 and Denver Sept. 29. Regional home health intermediaries Associated Hospice Service and Cahaba GBA announced the Boston and Denver conference call meetings on their Web sites.
     
  • Vaccines. The Medicare allowable payment amount for influenza vaccine will be $10.10 this flu season. Medicare will pay $23.28 for pneumococcal vaccine, CMS disclosed. Last year's rates were $9.95 and $18.62, respectively, CMS says on its online "Immun-ization Quick Reference Guide" Web page at www. cms.hhs.gov/medlearn/refimmu.asp.

  • Chronic care program. CMS will award its first disease management contract under the Chronic Care Improvement Program by Dec. 8, an official noted. The CCIP program, whose projects will cover 15,000 to 30,000 beneficiaries with complex diabetes, congestive heart failure, and/or chronic obstructive pulmonary disease, was included in the Medicare Modernization Act passed last December (see Eli's HCW, Vol. XIII, No. 15, p. 119).
     
    CMS eventually will fund 10 to 12 projects under the program, the official said. And while other government-funded DM programs may overlap geographically with the CCIP projects, they won't overlap patient populations, the source assured listeners.     
     
  • Hospice COPs. The long-awaited conditions of participation are in the clearance process and are "imminent," a CMS official promised.

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