GOA, MedPAC and HHAs finally agree. In the General Accounting Office's Feb. 27 report to the House Ways & Means Committee, the GAO points out a problem the home care industry has recognized for some time: readjustment of case mix categories. The GAO urges the Centers for Medicare & Medicaid Services to improve the accuracy of its PPS case mix adjuster soon. Meanwhile, the Medical Payment Advisory Commission in its March 1 report to Congress said it "and others should examine the payment sys-tem to determine whether refinements might promote access to care for all types of eligible beneficiaries." In response to the GAO report, CMS notes substantial "refinement research" currently is in progress. The National Association for Home Care and Hospice hopes Congress will direct CMS to fine tune PPS payments, "or there's no telling when case mix adjustment will happen," says William Dombi, vice president for law with NAHC's Center for Health Care Law. This brings the total number of patients studied using this therapy to 2,000, says Anodyne Therapy LLC in Tampa, FL. After receiving ten 40-minute treatments, 59 percent of the patients in the recent study showed normal sensory response, reports Dr. J. Joseph Prendergast, who conducted the study. "This new information will be very beneficial to providers who have questioned if it is permissible to bill for services in cases where they failed to comply with the regulations," says NAHC. The two most troubling scenarios for HHAs have been whether they can bill when a therapist performs the start-of-care OASIS when nursing is ordered, or when assessments aren't completed in the five-day SOC or recertification window, NAHC says.