AAH says top priority in 2000 is eliminating additional HH cuts

By MATTHEW HAY

HHBR Washington Correspondent

ALEXANDRIA – The newly established American Association for Homecare (AAH; Alexandria, VA) laid out its legislative and regulatory agendas last week. "The first key government relations priority for 2000 is the elimination of additional reductions to the home health benefit," said AAH Board member Joel Mills at a Feb. 16 press conference. That means striking the additional 15% reduction scheduled for Oct. 1, 2001.

Reflecting the diversified composition of the group, AAH also plans to press for examination of the Health Care Financing Administration’s (HCFA; Baltimore) competitive bidding demonstration project for durable medical equipment (DME) in Polk County, FL. "The demonstration has the potential to eliminate market competition and harm beneficiary access to quality medical services and equipment and cause irreparable damage," charged Mills.

"Home oxygen equipment cannot be drop-shipped to patients," he added. "It requires therapeutic support that is crucial for a positive health outcome." He argued that when an "artificially low bid" is expected and the provider faces budget pressure, the first thing to go is services.

Mills said the group will also seek "fair and clear" implementation of HCFA’s inherent reasonableness authority. He said Congress should remain vigilante overseeing HCFA’s use of the tool.

Lastly, Mills said AAH will closely monitor the implementation of the home health PPS. He said Congress should urge HCFA to release PPS rates as soon as possible and closely oversee implementation of PPS.

"Home health agencies need as much information, including actual rates, to understand the implications of the new system," he argued.

The press conference also covered a range of other areas. AAH Board member Mario LaCute said many providers tend to overlook the fact that certification, which implies a set of compulsory standards, and licensure, which always involves the power of the state to engage in that business activity, are two very different things.

"We obviously support all of these initiatives that will improve the quality of services we provide to beneficiaries in their home," said LaCute. He said AAH will continue to work with HCFA to make these standards part of their ongoing quality improvement process.

AAH board member David Savitsky said the association plans to aggressively educate doctors, managed care organizations, and consumers about the full picture of home health services and medical equipment that are now available. "The opportunities to provide care at home are tremendous," he said. "But not everybody recognizes it."

Moreover, government sanctions have made physicians fearful about referring to home care. "We need to reeducate them about the necessity for it," said Savitsky, "and why institutionalizing their patients is often not the right thing to do." He said that includes having input into the Patients Bill of Rights and making sure that bill gives patients rights in the area of home care.

"The industry has certainly suffered a public relations problem and the idea that there is rampant fraud and abuse in home care is one that we have to work very hard to dispel," he added.

Mills set the new association will reach out to its executive board and board of directors in an attempt to raise money. "They will help us with different fundraisers as they did in the past," he said. "But probably the best way for us to increase our financial war chest is through membership."

He said the immediate membership goal is to double the current 1,000 members this year.