AAHomecare Stays the Course in Tucson
The priorities of the federal government, the budget surplus, and even the association’s membership had changed since the American Association for Homecare’s last Leadership Conference, a little less than a year ago. But AAHomecare stuck to the same message it developed then—that home care is the cost-effective, patient-preferred method of care.

Todd Richter (left) of Banc of America Securities and Ross Miller, MD, of CIGNA Healthcare discuss the value of home care.

“Some, mostly the press, have questioned whether AAHomecare’s focus is going to change now,” David Savitsky, AAHomecare’s chairman, told the members gathered at the Loews Ventana Canyon Resort in Tucson on February 20-22. “To that, I have an emphatic answer: No! Our mission remains the same—unchanged in focus, on target. We represent every aspect of the home care industry, only that now, we’ve got more troops to fight for our unified cause.”

With new members from the American Home Care Association (which merged with AAHomecare in late December) swelling the association’s ranks and pushing the meeting’s attendance to the highest ever—more than 130—the conference stressed past association accomplishments, future goals, and strategic planning. Sessions included a panel on demonstrating the value of home care and a meeting on the future of home care reimbursement.

New board member Michael Caracci, CEO of Sta-Home Health Agency of Jackson, Miss, and an 18-year veteran of home health care, says he was impressed by the conference. “And I don’t impress easily,” he added.

Priorities for next year will include fighting the 15% home health cut, resisting competitive bidding, Medicare reform, continued relationship building, and forming alliances with associations that represent Medicare beneficiaries, says Tom Connaughton, AAHomecare’s CEO.

“Things are changing,” added Jim Pyles, JD, the association’s lobbyist from Powers, Pyles, Sutter & Verville. “You are getting a much better image on [Capitol] Hill, and it is easier to get meetings [with key lawmakers].”

The next AAHomecare conference will be in Washington, DC, on June 24-26. For more information, visit the association’s Web site at www.aahomecare.org, or call (703) 836-6263.

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Bush’s Budget Causes Alarm
The $2.13 trillion budget President George Bush sent Congress may indeed enable the United States to win the war on terrorism. But with a $48 billion rise in military spending and a doubling in expenditures for homeland security to $38 billion, what is left for the home care industry?

Not enough, say many home care industry advocates, including the American Association for Homecare (AAHomecare).

Not only does the President’s budget retain the 15% cut in Medicare home care rates planned for 2002, it also pushes for national competitive bidding for HME. “Medicare pays too much for medical equipment, such as hospital beds and oxygen, as well as for prosthetics and orthotics,” the proposal says. Bush wants “a nationwide competitive bidding system for this equipment to encourage suppliers to provide services and supplies at lower prices than what Medicare currently pays.”

Tom Connaughton, president and CEO of AAHomecare, is concerned about the effect the budget proposal will have on HME suppliers. “Competitive bidding systems, if administered as in the pilot programs, fail to recognize the importance of services that HME suppliers pride themselves in providing their patients,” he says. “Indeed, these services are recognized and required by private insurance companies, but the pilot projects not only fail to recognize them, they also threaten to squeeze service out of the system.”

Other health industries are being affected as well. The budget cuts nursing home rates, failing to address the drop-off of temporary Medicare rate increases that Congress gave nursing homes in 1999 and 2000.

“These cuts amount to nearly $60 a patient per day,” says Charles H. Roadman II, MD, president and CEO of the American Health Care Association.

Rehabilitation providers are also criticizing Bush’s budget. Nineteen organizations sent a letter to Bush asking him to permanently repeal the $1,500 outpatient therapy cap.

“While we realize that the horrible events of September 11 have resulted in a necessary reprioritization of domestic policies, we ask that you consider this crucial health care issue and support the repeal of this arbitrary cap which has the potential to significantly impact Medicare beneficiaries nationwide,” the letter reads.

The budget is only a proposal, but it demonstrates the industry’s need to further educate policymakers about the value of home care, AAHomecare states.

To view the President’s proposal, visit www.whitehouse.gov/omb/budget/fy2003/bud15.html.

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Medtrade Spring Is in the Air
The home health care industry’s largest West Coast trade show is just around the corner. From April 22 to 24, thousands of HME providers and distributers will converge on the Sands Expo and Convention Center in Las Vegas for Medtrade Spring 2002, produced by VNU Expositions. Nearly 60 seminars will cover the latest government programs, technological developments in home health care, and other industry issues.

“Medtrade Spring 2002’s diverse roster of speakers and training sessions will put attendees on the inside track for future trends, while the expo offers the latest technologies and products,” says Cory Smith, Medtrade’s group show director.

For more information, call (800) 933-8735 or visit www.medtradespring.com.

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Legislative News

New Law Improves TRICARE Benefits
On December 28, 2001, President Bush signed into law the Reauthorization Act of 2001, which addresses the Department of Defense health care program, TRICARE. The benefit package, serving active duty military, their dependents, and retirees, will better meet the needs of enrollees with disabilities and chronic illnesses.

Previously, the TRICARE benefit only covered wheelchairs, hospital beds, and iron lungs. The new law, in addition to these three categories, will include coverage for “any durable medical equipment (DME) that can improve, restore, or maintain the function of a malformed, diseased, or injured body part, or can otherwise minimize or prevent the deterioration of the patient’s function or condition.” The law also covers “any DME that can maximize the patient’s function consistent with the patient’s physiological or medical needs.”

Clarification of Home Oxygen Requirements
On April 1, 2002, revisions to the Medicare Carriers Manual affecting beneficiaries and home oxygen claims will go into effect. Section 9051, “Beneficiaries Previously Enrolled in Managed Care Who Return to Traditional Fee for Service (FFS),” will clarify requirements for oxygen patients who return to FFS after disenrolling from an HMO.

The revision states, “If a beneficiary begins taking oxygen while under a Medicare HMO, the supplier must obtain an initial CMN and submit it to the DMERC at the time that FFS coverage begins. However, the beneficiary does not have to obtain the blood gas study on the CMN within 30 days prior to the date on the CMN, but the test must be the most recent study the patient obtained while in the HMO under the guidelines specified in DMERC policy.”

Modifier Revision for DME Documentation on File
Starting July 1, 2002, the DMERCs must discontinue the use of claim modifier ZX, “documentation on file,” and implement KX, “specific required documentation on file,” the new level II national modifier. This new modifier, as opposed to the older ZX, does not need to be used on every claim, only on those for which medical policy mandates its use.

The program memorandum to the DMERCs requires them to publish the change in their next supplier bulletins and alter all medical policies that require the modifier. The CMS transmittal, B-02-003, is available at www.hcfa.gov/pubforms/transmit/B02003.pdf.

New Representative for Atlanta Region
On January 28, US Department of Health and Human Services (HHS) Secretary Tommy G. Thompson announced that Constantinos Miskis will be the Secretary’s regional representative for Region IV, based in Atlanta. The area includes the states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

“We are extremely pleased to gain an accomplished administrator such as Constantinos Miskis at HHS,” Thompson says. “His professional health care experience, particularly in the areas of Medicaid and older Americans, will be an asset for the Southeast.”

Region B DMERC Hires Saini and Sanders
Karin Saini and Denise Sanders are the two new ombudsmen for Region B DMERC Adminastar Federal. Saini is the new ombudsman for Indiana and Wisconsin, and Sanders is the new ombudsman for Virginia, Maryland, and the District of Columbia.

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News in Brief

Advances In MED Group’s Management
Jason Mitschke joins The MED Group, Lubbock, Tex, as an information systems specialist. Promotions within The MED Group include Chris Cockfield to supervisor of member service management and Fred Arthur to director of customer service.

Knoll Patient Supply Earns Better Business Bureau Torch Award
The Better Business Bureau Torch Award for Marketplace Ethics is given annually to northeast Kansas businesses that consistently set high standards of business practices in serving their customers. Knoll Patient Supply Inc, Topeka, was one of the recipients.

“There is no greater honor than to be recognized by one’s peers,” says Steven Knoll, president of Knoll Patient Supply and chair-elect of the American Association for Homecare (AAHomecare).

e-Medsoft.com Changes Name
HME and home health care provider e-Medsoft.com, Andover, Mass, has changed its name to Med Diversified Inc to better reflect its diversification and overall growth strategy, says Frank P. Magliochetti, Jr, company chairman and CEO. “We are proud that the company has been able to continuously expand its products, services, and geographic reach,” he says. “We intend to continue to follow that path.”

The company’s common stock will trade under the new corporate name and will continue to trade under the ticker symbol MED on the AMEX. For more information, visit www.meddiversified.com.

Gentiva Aligns Its Pharmaceutical Services
Gentiva Health Services, Melville, NY, recently entered into a definitive agreement with Accredo Health Inc to sell the assets and business of Gentiva’s specialty pharmaceutical services for approximately $415 million in cash and stock consideration, subject to certain conditions. The transaction is estimated to close in April 2002.

Home Care Medical Hires Managed Care Coordinator
Home Care Medical, New Berlin, Wis, a provider of HME and supplies, infusion therapy, and respiratory care, recently hired Nate Spielman as managed care coordinator. Spielman has more than 14 years of managed health care experience. He will be responsible for identifying, negotiating, and maintaining agreements with subcontractors.

VNAA 20th Annual Meeting
The Visiting Nurse Associations of America® (VNAA) will hold its 20th Annual Meeting and Exhibition on April 24 to 26 at the San Francisco Marriott.

For meeting information, contact Event Innovations International, PO Box 460096, Glendale, CO 80246; (303) 355-9904; eventinnovationsintl@msn.com. Additional information about VNAA can be obtained by visiting www.vnaa.org.

International Trade Fair
On April 10 to 12 the Telemedicine & Telecare International Trade Fair at the Foires Internationales de Luxembourg (FIL) in Luxembourg will focus on telemedicine, telecare, telehealth, and e-health. For more information, visit www.telemedicine.lu.

Lewarski Receives Home Respiratory Care Award
Joseph S. Lewarski, BS, RRT, the national respiratory director for The MED Group, received the Invacare Excellence in Home Respiratory Care Award from the American Respiratory Care Foundation at the American Association for Respiratory Care’s International Congress held in San Antonio this past December.

Apria Gets New CEO
Apria Healthcare Group Inc has appointed former president and COO Lawrence M. Higby to the position of CEO. He replaces Philip L. Carter, who is leaving the company.

“Higby brings a solid understanding of Apria and the home health care industry to his role as CEO,” says Ralph V. Whitworth, chairman of the board. “We are pleased to have such an experienced and demonstrated leader to take over the helm of the company.”

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