News from the End of Life

Awards given for palliative and end-of-life care

Ten health care organizations were honored at the American Hospital Association (AHA) and Health Forum’s annual Leadership Summit in San Diego on July 26 for their innovative palliative and end-of-life care programs. Receiving the 2004 Circle of Life Award are Hope Hospice and Palliative Care of Fort Myers, FL; St. Mary’s Healthcare System for Children of Bayside, NY; and University of Texas M.D. Anderson Cancer Center of Houston. The three winners, chosen from nearly 70 nominees, each will receive a $25,000 prize. Seven other organizations also will receive Citations of Honor.

"These programs share overriding themes of compassion and dedication and find new ways to expand the reach of palliative and hospice services," said AHA President Dick Davidson. "They provide excellent models any community can adapt." Awarded annually since 2000, the Circle of Life Awards are supported by a grant from the Robert Wood Johnson Foundation and are sponsored by the AHA, the American Medical Association, the National Hospice and Palliative Care Organization, and the American Association of Homes and Services for the Aging.

CMS purposely slower to pay noncompliant claims

On July 6, 2004, the Centers for Medicare & Medicaid Services (CMS) began to treat electronic claims that were not in compliance with Health Insurance Portability and Accountability Act (HIPAA) standards as paper claims. "The great majority of electronic claims we are receiving meet the required HIPAA standards, but, for those still not in compliance, there is going to be a delay in getting their money," says Mark B. McClellan, MD, PhD, administrator of CMS. "We are hoping this will motivate more filers to get into compliance soon," he adds.

Under a modification to its HIPAA contingency plan announced in February, noncompliant electronic claims will still be accepted by CMS, but their payment will take 13 additional days, which is the same payment time frame as that for paper claims. Currently, 90% of all electronic claims comply with HIPAA standards, says McClellan. "A two-week delay is an important further incentive to get to 100%," he says.

WV plan helps elderly stay in their homes

A West Virginia plan to help elderly and disabled people remain in the community and out of institutions has been approved by the Centers for Medicare & Medicaid Services (CMS). Approval of this home-and-community-based waiver program will provide elderly and disabled people in certain public housing facilities with adult residential care services and allow them to "age in place" rather than be moved to a skilled nursing facility as their conditions deteriorate.

The experiment will apply to 150 people in each year of the waiver’s initial three-year term. The plan targets people who otherwise would require care in a nursing facility. People served under the waiver will receive a package of adult residential care services that include personal care, homemaking, chores, attendant care, companion services, medication oversight, therapeutic social and recreational programming, transportation, and periodic nursing evaluations. These are all services that would be provided in a licensed community care facility. The program will be pilot-tested in four areas in West Virginia: Huntington, Moundsville, Williamson, and Wheeling.