President Barack Obama’s detailed budget is scheduled for release on Thursday, May 7, and Medicare and Medicaid fraud and errors are a focus. According to the Wall Street Journal article “Budget Target Fraud and Errors in Social Programs,” by Jonathan Weisman, the White House estimates every dollar spent by the department of Health and Human Services to combat health-care fraud yields about $1.60 in savings. The budget will include a request for a total of $1.7 billion over five years for Obama’s health-care fraud initiative.
The American Association for Homecare has proposed 13 specific recommendations to stop fraud and abuse in the homecare sector. The steps would eliminate most of the Medicare fraud attributed to the home medical equipment sector by attacking the problem at the front of the process rather than relying on the “pay-and-chase” approach to stopping fraud.
For the full article which includes other agencies and programs expected to be mentioned in the budget, visit: http://online.wsj.com/article/SB124147959792585159.html
On May 6, the American Association for Homecare will submit a statement outlining the Association’s 13-point anti-fraud plan to the Senate Special Committee on Aging which will hold a hearing on Medicare waste, fraud, and abuse.
Tuesday, May 5, 2009
Monday, May 4, 2009
Three-quarters of Home Medical Equipment Providers Have Prepared for Flu Pandemic
In a survey of approximately 1,500 home medical or durable medical equipment providers conducted by the American Association for Homecare, more than half (53 percent) have formal plans to respond to a pandemic flu and another 23 percent have stockpiled N95 masks or other supplies related to a flu pandemic.
Eighteen percent said they are working on a formal plan and expect to have one in place within the week. Two-thirds say they are coordinating or communicating with other organizations in their communities to prepare for a pandemic.
“Home-based care is a centerpiece of the national pandemic flu response and in a pandemic situation, home medical equipment personnel will be on the front lines,” says Tyler J. Wilson, president of the Association.
The survey, which was conducted on April 30 and May 1, included responses from 147 homecare providers, collectively serving more than 2.5 million patients through more than 1,000 branch locations across 50 states.
Some homecare providers have had pandemic flu plans and training dating back several years. Pat Northheimer, clinical director at Cole Care in Coudersport, Pa., commented, “We had a pandemic flu drill three years ago that involved hospitals and local EMS. Projections were made with a scenario that worsened each day. It was very helpful in showing us just how bad things could get if the projections were accurate. The drill went into great detail.”
Apria Healthcare, a national home medical equipment and service provider headquartered in Lake Forest, Calif., tests emergency preparedness plans in its 500 locations at least annually and consults with local or state disaster preparedness authorities.
Bob McLellan, general manager of Pacific Coast Medical Supply, which operates one branch, in Astoria, Oregon, said, “We have notified local hospital, law enforcement, fire departments, and our local am radio station of our status and availability of services during emergencies.”
For further results and information about the survey or home medical equipment providers preparations for emergencies, please visit the Newsroom at www.aahomecare.org.
Eighteen percent said they are working on a formal plan and expect to have one in place within the week. Two-thirds say they are coordinating or communicating with other organizations in their communities to prepare for a pandemic.
“Home-based care is a centerpiece of the national pandemic flu response and in a pandemic situation, home medical equipment personnel will be on the front lines,” says Tyler J. Wilson, president of the Association.
The survey, which was conducted on April 30 and May 1, included responses from 147 homecare providers, collectively serving more than 2.5 million patients through more than 1,000 branch locations across 50 states.
Some homecare providers have had pandemic flu plans and training dating back several years. Pat Northheimer, clinical director at Cole Care in Coudersport, Pa., commented, “We had a pandemic flu drill three years ago that involved hospitals and local EMS. Projections were made with a scenario that worsened each day. It was very helpful in showing us just how bad things could get if the projections were accurate. The drill went into great detail.”
Apria Healthcare, a national home medical equipment and service provider headquartered in Lake Forest, Calif., tests emergency preparedness plans in its 500 locations at least annually and consults with local or state disaster preparedness authorities.
Bob McLellan, general manager of Pacific Coast Medical Supply, which operates one branch, in Astoria, Oregon, said, “We have notified local hospital, law enforcement, fire departments, and our local am radio station of our status and availability of services during emergencies.”
For further results and information about the survey or home medical equipment providers preparations for emergencies, please visit the Newsroom at www.aahomecare.org.
American Medical News Reports White House Gives Green Light on Medicare DME bidding program
Despite the home medical equipment sectors deep concerns over the flawed competitive bidding program, the American Medical News reports that the Obama Administration has giving the “green light” for CMS to conduct the program, which will start in 2010.
The White House delayed the effective date of the interim final rule for the program in February this year, but CMS announced the April 18 effective date would not be delayed further. This decision allows the agency to begin re-bidding for Round One of the program in 9 metropolitan statistical areas.
"We are very disappointed that CMS has moved forward with this program without allowing more opportunity to examine it. As designed, the program will eliminate approximately 90% of suppliers in any marketplace. We believe that is unacceptable, especially when all efforts by the [Obama] administration and Congress are aimed at job promotion and creation," Walter Gorski, vice president of government affairs for AAHomecare, told American Medical News.
If Congress had not stopped the program in July of 2008, it would have limited Medicare coverage of selected equipment in 10 metropolitan areas to suppliers that submitted winning bids.
Despite the final rule, CMS said it will have no immediate effect on how Medicare patients obtain durable medical equipment, prosthetics, orthotics and supplies. Beneficiaries may still use current suppliers.
Gorski said suppliers will continue to work with Congress on legislation to repeal the program, and they are hopeful that its language will be included in any health system reform bill that might be introduced this year. "We remain cautiously optimistic that we can show this program will not yield the results anticipated."
To view the full story, visit: http://www.ama-assn.org/amednews/2009/05/04/gvsd0504.htm
The White House delayed the effective date of the interim final rule for the program in February this year, but CMS announced the April 18 effective date would not be delayed further. This decision allows the agency to begin re-bidding for Round One of the program in 9 metropolitan statistical areas.
"We are very disappointed that CMS has moved forward with this program without allowing more opportunity to examine it. As designed, the program will eliminate approximately 90% of suppliers in any marketplace. We believe that is unacceptable, especially when all efforts by the [Obama] administration and Congress are aimed at job promotion and creation," Walter Gorski, vice president of government affairs for AAHomecare, told American Medical News.
If Congress had not stopped the program in July of 2008, it would have limited Medicare coverage of selected equipment in 10 metropolitan areas to suppliers that submitted winning bids.
Despite the final rule, CMS said it will have no immediate effect on how Medicare patients obtain durable medical equipment, prosthetics, orthotics and supplies. Beneficiaries may still use current suppliers.
Gorski said suppliers will continue to work with Congress on legislation to repeal the program, and they are hopeful that its language will be included in any health system reform bill that might be introduced this year. "We remain cautiously optimistic that we can show this program will not yield the results anticipated."
To view the full story, visit: http://www.ama-assn.org/amednews/2009/05/04/gvsd0504.htm
Thursday, April 30, 2009
Associated Press Outlines HME Communities Preparations for Swine Flu Pandemic
Apria Healthcare, a national home care provider of oxygen therapy and other durable medical equipment, recommended employees wear surgical masks when working in areas that have been impacted by swine flu, Executive Vice President Lisa Getson told the Associated Press. The company is also keeping N95 respirators for all employees dealing with patients showing symptoms of the swine flu.
Experts predict nearly 10 million patients could be admitted to hospitals and 1.5 million would need intensive care in a worst-case scenario. They also believe 750,000 people would need mechanical ventilators to continue breathing. This is a high end item provided by home care companies and one that may see high demand should things worsen. Mechanical Ventilators are primarily used to treat patients with severe lung injury, chronic pulmonary disease and neurological problems that disrupt. The devices use a tube inserted through the nasal passage to force air into the lungs.
The AP article titled Swine flu drives demand for face masks, mentions mechanical ventilator manufacturers Respironics as well as Cardinal Health. Cardinal Health’s spokesperson said, “it's too early to know if that will translate into a meaningful increase in actual demand." Last year the company sold 1,850 portable ventilators to New York Department of Health as part of its flu preparedness program.”
Currently in high demand is masks and other protective items, drugstore chains such as Walgreens and CVS has explained. While the Centers for Disease Control (CDC) has not recommended people wear masks claiming limited evidence that they are effective, the increase in sales has not faltered.
The CDC does suggest hand washing and covering one’s mouth when coughing or sneezing
The American Association for Homecare helped develop a guide for the durable medical equipment community to deal with a pandemic flu. View the text at http://www.pandemicflu.gov/plan/healthcare/homehealth.html.
To read the full Associated Press article as published in the New York Times, please visit: http://www.nytimes.com/aponline/2009/04/29/business/AP-US-Swine-Flu-Masks.html.
Experts predict nearly 10 million patients could be admitted to hospitals and 1.5 million would need intensive care in a worst-case scenario. They also believe 750,000 people would need mechanical ventilators to continue breathing. This is a high end item provided by home care companies and one that may see high demand should things worsen. Mechanical Ventilators are primarily used to treat patients with severe lung injury, chronic pulmonary disease and neurological problems that disrupt. The devices use a tube inserted through the nasal passage to force air into the lungs.
The AP article titled Swine flu drives demand for face masks, mentions mechanical ventilator manufacturers Respironics as well as Cardinal Health. Cardinal Health’s spokesperson said, “it's too early to know if that will translate into a meaningful increase in actual demand." Last year the company sold 1,850 portable ventilators to New York Department of Health as part of its flu preparedness program.”
Currently in high demand is masks and other protective items, drugstore chains such as Walgreens and CVS has explained. While the Centers for Disease Control (CDC) has not recommended people wear masks claiming limited evidence that they are effective, the increase in sales has not faltered.
The CDC does suggest hand washing and covering one’s mouth when coughing or sneezing
The American Association for Homecare helped develop a guide for the durable medical equipment community to deal with a pandemic flu. View the text at http://www.pandemicflu.gov/plan/healthcare/homehealth.html.
To read the full Associated Press article as published in the New York Times, please visit: http://www.nytimes.com/aponline/2009/04/29/business/AP-US-Swine-Flu-Masks.html.
Monday, April 27, 2009
Swine Flu Outbreak Underscores Role of Homecare
The swine flu outbreak, which reportedly has spread from Mexico to several states in the U.S., is a vivid reminder of the key role of homecare in responding to a pandemic flu and importance of disaster planning for the home medical community. Health experts believe that a serious, pandemic flu outbreak is a question of “when” not “if.” On Sunday, President Obama declared a public health emergency, a step that puts federal resources in motion to deal with the outbreak of the swine influenza A (H1N1) virus.
Federal health officials in the United States place homecare at the center of a planned response to pandemic flu. In a pandemic event, hospitals will quickly be overwhelmed by a surge in patients and the vast majority of infected people will remain in their homes. Pandemic flu is defined as a virulent human flu that causes a global (pandemic) outbreak of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.
“The nation’s infrastructure of home medical equipment providers represents a critical piece of any front-line response to pandemic flu,” said Tyler Wilson, AAHomecare president. The Association has also argued that home medical providers must be given first-responder status during emergencies when it is critically important to reach patients in their homes.
Two years ago, the American Association for Homecare participated, with the Centers for Disease Control and other federal agencies and with home health associations, in a two-day expert panel to advise the federal government about the role of homecare in a pandemic flu. The chief result of that panel is the publication, “Home Health Care during an Influenza Pandemic: Issues and Resources,” prepared by the Agency for Healthcare Research and Quality, which contains useful links to resources and detailed discussion of key issues related to planning, patient care, community and business response, legal questions, and workforce challenges. View the text at http://www.pandemicflu.gov/plan/healthcare/homehealth.html. The report summarizes what homecare workers can expect during a pandemic:
“What to Expect During a Pandemic. In the event of an influenza pandemic, because of anticipated shortages of health care professionals and widespread implementation of social distancing techniques, it is expected that the large majority of individuals infected with the influenza virus will be cared for in the home by family members, friends, and other members of the community - not by trained health care professionals. Given these circumstances, home health care workers can expect to be called on to provide care for two main populations of patients:
• Those medical and surgical patients, not hospitalized because of the pandemic, who are well enough to be discharged early from hospitals to free up hospital beds for more severely ill patients.
• Patients who become or already are dependent on home health care services (predominantly elderly persons with chronic disease) and will continue to need in-home care during the influenza pandemic whether or not they become infected with the influenza virus.
• The demand for home health care services during a pandemic influenza outbreak is likely to exceed the home health care industry's current capacity to respond. Indeed, the overall surge capacity and preparedness levels of the home health care sector that will be necessary to respond effectively to a public health emergency such as pandemic influenza are significant unknowns.”
Also the main pandemic flu website is a good resource as well: www.pandemicflu.gov. Guidance for clinicians and public health officials can be found at: http://www.cdc.gov/swineflu/guidance/.
Federal health officials in the United States place homecare at the center of a planned response to pandemic flu. In a pandemic event, hospitals will quickly be overwhelmed by a surge in patients and the vast majority of infected people will remain in their homes. Pandemic flu is defined as a virulent human flu that causes a global (pandemic) outbreak of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.
“The nation’s infrastructure of home medical equipment providers represents a critical piece of any front-line response to pandemic flu,” said Tyler Wilson, AAHomecare president. The Association has also argued that home medical providers must be given first-responder status during emergencies when it is critically important to reach patients in their homes.
Two years ago, the American Association for Homecare participated, with the Centers for Disease Control and other federal agencies and with home health associations, in a two-day expert panel to advise the federal government about the role of homecare in a pandemic flu. The chief result of that panel is the publication, “Home Health Care during an Influenza Pandemic: Issues and Resources,” prepared by the Agency for Healthcare Research and Quality, which contains useful links to resources and detailed discussion of key issues related to planning, patient care, community and business response, legal questions, and workforce challenges. View the text at http://www.pandemicflu.gov/plan/healthcare/homehealth.html. The report summarizes what homecare workers can expect during a pandemic:
“What to Expect During a Pandemic. In the event of an influenza pandemic, because of anticipated shortages of health care professionals and widespread implementation of social distancing techniques, it is expected that the large majority of individuals infected with the influenza virus will be cared for in the home by family members, friends, and other members of the community - not by trained health care professionals. Given these circumstances, home health care workers can expect to be called on to provide care for two main populations of patients:
• Those medical and surgical patients, not hospitalized because of the pandemic, who are well enough to be discharged early from hospitals to free up hospital beds for more severely ill patients.
• Patients who become or already are dependent on home health care services (predominantly elderly persons with chronic disease) and will continue to need in-home care during the influenza pandemic whether or not they become infected with the influenza virus.
• The demand for home health care services during a pandemic influenza outbreak is likely to exceed the home health care industry's current capacity to respond. Indeed, the overall surge capacity and preparedness levels of the home health care sector that will be necessary to respond effectively to a public health emergency such as pandemic influenza are significant unknowns.”
Also the main pandemic flu website is a good resource as well: www.pandemicflu.gov. Guidance for clinicians and public health officials can be found at: http://www.cdc.gov/swineflu/guidance/.
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