Medicare home health moratorium is lifted

New fraud and abuse procedures established

The Department of Health and Human Services (HHS) lifted the moratorium on enrolling new home health agencies in January, and according to HHS officials, new protections are now in place to prevent fraud, including a new requirement for surety bonds to protect consumers and Medicare.

President Clinton announced the moratorium Sep. 15, 1997, saying it would remain in effect while fundamental changes were made in the way Medicare does business with home health agencies. New regulations implementing many of these changes were published in January, and other actions have been put in place over the past three months.

Fraud and abuse efforts

At the same time, efforts to prevent fraud and abuse have already helped to slow home health spending growth.

The new regulations require all home health agencies serving Medicare to obtain surety bonds of $50,000 or 15% of annual Medicare payments received, whichever is greater. Agencies must obtain bonds covering them from the period beginning Jan. 1, 1998, and they must certify to Medicare that they have these bonds by Feb. 27, 1998. Surety bonds also soon will be required for durable medical equipment suppliers.

The regulations also establish minimum capital requirements to make certain that new home health agencies have enough funds to operate for at least three months before they start caring for Medicare patients.

FEBRUARY

1-28: Age-related Macular Degeneration (AMD) Awareness Month. AMD is the leading cause of blindness among older Americans, affecting more than 13 million. Contact: Prevent Blindness America, 500 East Remington Road, Schaumburg, IL 60173. Telephone: (800) 331-2020.

8-14: National Cardiac Rehabilitation Week. This week is to emphasize prevention in treatment of heart disease with special events held at hospitals, exercise facilities, and rehabilitation centers. Contact: Barbara Dimitroff, Member Services Department, The Alliance of Cardiovascular Professionals, 910 Charles St., Fredericksburg, VA 22401. Telephone: (540) 370-0102.

14: National Have-A-Heart Day. This celebration was conceived to increase consumer awareness about food choices and their consequences on the environment, world hunger, animal welfare, and heart disease. Contact: Vegetarian Awareness Network/VEGANET, P.O. Box 321, Knoxville, TN 37901. Telephone: (800) USA-VEGE or (800) 872-8343.

MARCH

1-31: National Kidney Month. National and local programs will be coordinated, highlighting kidney disease and donations. Contact: your local National Kidney Foundation affiliate or Ellie Schlam, National Kidney Foundation Inc., 30 East 33rd St., New York, NY 10016. Telephone: (800) 622-9010.

1-31: National Nutrition Month. This campaign, sponsored by the American Dietetic Association’s National Center for Nutrition and Dietetics, reinforces the importance of nutrition as a component of health with promotional posters, bookmarks, buttons, and other items available through the ADA. Contact: ADA, 216 West Jackson Blvd., Chicago, IL 60606-6995. Telephone: (312) 899-0040, ext. 4653. Fax: (312) 899-1739.

1-31: National Social Work Month. Contact: National Association of Social Workers Inc., 750 First St. NE, Suite 700, Washington, DC 20002-4241. Telephone: (800) 638-8799, ext. 436.

1-7: National Save Your Vision Week. Contact: Communications Center, American Optometric Association, 243 North Lindbergh Blvd., St. Louis, MO 63141. Telephone: (314) 991-4100.

15-21: National Pulmonary Rehabilitation Week. This week calls attention to pulmonary rehabilitation’s contribution to the lives of people with chronic obstructive pulmonary disease. Contact: Sheila Kirschbaum, American Association of Cardiovascular and Pulmonary Rehabilitation, 7611 Elmwood, Suite 201, Middleton, WI 53562. Telephone: (608) 831-6989. Fax: (608) 831-5122. E-mail: aacvpr@tmahq.com.

24: American Diabetes Association: Sound the Alert. This day is a "wake-up call" for the 8 million Americans who have diabetes but don’t know it. Special events and programs are held across the country. Contact: Karen McMillan, American Diabetes Association, National Center, 1660 Duke St., Alexandria, VA 22314. Telephone: (800) 232-3472, ext. 408 or 303, or (703) 549-1500, ext. 5506. Fax: (703) 549-6294.

30: Doctors’ Day. Celebrated since 1933, this commemorates the discovery of ether for painless surgery by Crawford W. Long, MD, of Jefferson, GA. Contact: Debbie Cotton, Southern Medical Association Auxiliary. Telephone: (800) 423-4992.

This calendar listing is provided courtesy of the Society for Healthcare Strategy and Market Development of the American Hospital Association. The organization, located at 1 North Franklin, 31st Floor, Chicago, IL 60606, sells an 89-page "Health Observances & Recognition Days" calendar (Catalog No. C-166858) for $15 for AHA members and $20 for nonmembers. Call (800) 242-2626 for more information.