Apria Aids New York and DC Victims
In the wake of the September 11 World Trade Center and Pentagon attacks, home care providers rushed to help. One of the largest was Apria Healthcare, Costa Mesa, Calif.

Among Apria’s 370 branch offices across the United States, one is located in New York and its employees witnessed the World Trade Center attack, says Bob Fary, Apria’s corporate director of Respiratory/ HME Services.

The branches in the New York City and Washington, DC, metropolitan areas immediately implemented the company’s disaster plan and contacted their local emergency management agencies and state medical equipment associations to offer support and products.

“Through the first week of the crisis, all Apria patients were serviced, and many hospitals were also provided needed equipment, such as hospital beds and nebulizers,” Fary says.

Apria also donated hundreds of nebulizers, oxygen masks, and other needed supplies to the Red Cross and local American Lung Association chapters.

“Apria’s branch associates worked tirelessly,” Robert Fary says. “Our employees reacted famously…I am more proud to be an American and an Apria employee because of the tremendous commitment of my Apria associates.”

Medicare’s Budget Surplus May Be Needed for Military Expenses
The federal budget surplus of last year had largely disappeared prior to the September 11 terrorist attacks due to declining federal tax collections and President Bush’s $1.35 trillion tax cut. With added military expenses looming, legislators could tap the remaining surplus dollars earmarked for Medicare.

Included in the current Medicare surplus is $14 billion that was set aside last year to eliminate the 15% cut in home health Medicare reimbursements over the next 10 years.

However, Congress has yet to pass the legislation (HR 975) necessary to eliminate the cut. If legislators do not receive friendly reminders as to how important this topic is, the 15% issue may be out of sight and out of mind, says Thomas A. Connaughton, president and CEO of the American Association for Homecare.

The more cosponsors the bill has, the greater the chance that the 15% cut will be eliminated. For a list of key Congressional members to contact, visit www.aahomecare. org/govrelations/gr-tools.htm.

“We need to keep it on the agenda,” Connaughton says.

HHS Proposes New Medicaid Managed Care Regulation
Health and Human Services (HHS) Secretary Tommy G. Thompson has proposed regulations to give Medicaid beneficiaries in managed care plans the same types of protection that participants in private managed care plans would receive under the patient rights’ legislation now pending in Congress.

The regulations will guarantee Medicaid beneficiaries access to emergency department care, a second opinion when needed, a timely right to appeal adverse coverage decisions, and other essential patient protections.

The proposed regulations replace a rule put forth by the Clinton administration last January. Under the new regulations, states will have more flexibility to decide how to provide patient protections and use managed care in their Medicaid plans.

The proposed regulation is available online at www. hcfa.gov/medicaid/omchmpg.htm.

AAHomecare Weighs in on CPAP
The American Association for Homecare (AAHomecare) has asked the Centers for Medicare and Medicaid Services (CMS) to expand its definition of obstructive sleep apnea to allow patients who suffer less than 30 episodes of apnea in 6 to 7 hours to receive continuous positive airway pressure (CPAP) therapy. AAHomecare also recommended that CMS expand coverage to more sleep apnea ancillary products, such as full-face masks, and increase the use of home sleep diagnostic devices to compensate for the shortage of inpatient sleep laboratories.

Homebound Restrictions May Loosen
A House bill may allow home care patients to leave their homes more often than what Medicare now permits. Bob Dole, chairman of the National Coalition to Amend the Medicare Homebound Restriction, is supporting a bill (HR 1490) that would drop the standard “homebound” definition for paraplegics and other seriously disabled people who require skilled nursing care.

Dole says that the bill “will not expand the Medicare system; it will merely prevent thousands of individuals…from having to choose between losing vital medical services or remain under house arrest.”

2002 PEN Fee Schedule Coming
The Centers for Medicare and Medicaid Services (CMS) plans to release a new fee schedule for parenteral and enteral nutrition (PEN) items and supplies. The Durable Medical Equipment Regional Carriers (DMERCs) will need to make changes in their systems to allow for payment based on this new schedule to go into effect in January 2002.

Medicare Telehealth Validation Act Introduced
Rep Doug Ose (R-Calif) has introduced a bill to improve the provision of telehealth services under the Medicare Program and provide grants for the development of telehealth networks. The “Medicare Telehealth Validation Act of 2001” (HR 2706) would broaden coverage and improve care by linking rural hospitals, health care providers, and patients with resources usually available only in large metropolitan areas.

Easing the Nursing Shortage
The nursing shortage is beginning to affect America’s health care system. To rectify this situation, US Senators Sam Brownback (R-Kan), Bob Graham (D-Fla), and Jesse Helms (R-NC) have introduced a bipartisan bill to remove barriers to immigrant nurses from entering the country. The bill is entitled “Rural and Urban Health Care Act of 2001” (S 1259).

State Watch

California—Gov Gray Davis signed a bill on September 5 to expand Medi-Cal coverage of home care for severely disabled children. The legislation creates a new type of private duty nursing agency (PDNA), which will be exempt from the requirement that all state-licensed agencies must satisfy Medicare conditions of participation, even if they do not treat Medicare patients. Under the new law, PDNA nurses caring for children will only need to fill out paperwork applicable to the children’s care.

Florida—Two meetings were held by the Centers for Medicare and Medicaid Services (CMS) to discuss the results of Round II of the competitive bidding demonstration for HME in Polk County. The meeting educated the winning bidders and beneficiaries on the competitive bidding process. A total of 16 companies submitted winning bids for this round.

Indiana—Medicaid rates are increasing for home health care providers, announced the Office of Medicaid Policy and Planning of Indiana. Providers should review claims paid on July 12 and 13 because all claims filed prior to July 13 will be adjusted. Some providers have reported being paid at the new rate for overhead and the old rates for the hourly staff codes on July 12 and 13, according to the Indiana Association for Home and Hospice Care.

Oregon—The Americans with Disabilities Act was designed to help disabled people function independently. However, people in Portland say that the ADA requirements accommodate only standard wheelchairs. It is estimated that 15% of people who use wheelchairs use larger models, thus hindering them from wheeling past the fare box on Portland’s new streetcars or getting through the 32-inch-wide disabled entrance to City Hall. Jan Campbell, disabilities project coordinator, is lobbying for changes but states that without laws, change will be difficult to achieve.

Pennsylvania—Twenty-one wheelchair-bound members of American Disabled for Attendant Programs Today (ADAPT) were arrested when they chained themselves to the iron gate of Gov Tom Ridge’s mansion on the morning of September 6, 2001. The group was protesting the state’s lack of spending on programs that help the disabled move from institutional settings to community-based residences. The advocates, before being arrested for disorderly conduct, demanded to meet with the governor but he was out of town.

News In Brief

Coram Leaves JCAHO for ACHC
Coram Healthcare Corporation, Denver, a national leader in providing home infusion therapy, announced that it has entered into a relationship with the Raleigh, NC-based Accreditation Commission for Health Care Inc (ACHC). Coram will end its 6-year relationship with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Oakbrook Terrace, Ill, in December.

Industry Loses a Pioneer
In August, Jerry Biloris passed away. He was the founder and president of Eastern Medical Inc, a manufacturer’s representative firm that served the New England and upstate New York markets from 1970 to 1994. Biloris was a charter member of the Health Industry Representatives Association (HIRA) and later served on its board of directors.

Gentiva Expands Rehab Program
Gentiva Health Services Inc, Melville, NY, expanded its “Rehab Without Walls” program, a neurological and cognitive-based rehabilitation service for patients in homes or community-based settings. The new locations include Boston, Chicago, Minneapolis, and Miami.

The program also won a 3-year accreditation from CARF...The Rehabilitation Accreditation Commission.

Home Infusion Company Acquisition
drkoop.com Inc, Santa Monica, Calif, has acquired the operating assets of IVonyx Group Services Inc, a Detroit-based home infusion service provider. IVonyx will change its name to drkoop LifeCare Inc, and will operate as a wholly owned subsidiary, continuing to offer home-based medical treatments.

Med Diversified Acquires TLCS
Med Diversified has signed an agreement to acquire Tender Loving Care Services Inc (TLCS), Lake Success, NY, an 100-location home health agency founded by AAHomecare chairman David Savitsky and his brother Steve. The deal is subject to various approvals, including the boards of both companies and the TLCS shareholders.

JCAHO Prepares for HIPAA
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Oakbrook Terrace, Ill, is developing a model Business Associate Agreement for JCAHO-accredited organizations in preparation for the April 2003 effective date of the Health Insurance Portability and Accountability Act (HIPAA). The JCAHO internal HIPAA Work Group is developing a model agreement that will meet all HIPAA requirements and will provide a uniform agreement for JCAHO’s more than 18,000 accredited organizations. It will be ready for distribution by the end of 2002.