Say what? Who's on first at HCFA?

Just who is Nancy-Ann Min DeParle, anyway? Readers will recall a discussion led by attorney Elizabeth Hogue last month in Hospital Home Health regarding Min DeParle's letter to home health providers. It seems the same letter from the new administrator of the Health Care Financing Administration drew the attention of another health care attorney, John C. Gilliland II of Crestview Hills, KY. Gilliland notes,"Does HCFA's left hand know what its right hand is doing?"

Min DeParle warned home health agencies in February against terminating care for Medicare beneficiaries. She wrote, "HHAs are not free to reduce the amount of care ordered for patients by physicians."

At the same time, HCFA's intermediaries are holding agencies responsible and liable for alleged lack of medical necessity, which, of course, is the very essence of the physician's judgment.