Home Health & Hospice Week

Industry Notes:

ALJ TRANSFER TO HHS COULD LIMIT ACCESS, GAO WARNS

Video hearings not necessarily an adequate substitute for in-person hearings, report says.

Home care providers aren't the only ones worrying about administrative law judges' transfer to the Department of Health and Human Services.

HHS' plan to take the ALJs over from the Social Security Administration by Oct. 1 is still riddled with problems, the General Accounting Office says in a report released Aug. 1. Chief amongst them: video teleconferencing instead of in-person hearings.

HHS will have only four Medicare appeals hearing offices compared to the 141 maintained by the SSA and plans to rely heavily on video conferencing. However, HHS hasn't shown that appellants find video conferencing "an adequate substitute for in-person hearings." The agency also faces a "complex logistical task" in arranging for the many video hearings.

Other problems with the transfer include tight timeframes to hire and train ALJs and operational difficulties, the GAO says in the report requested by Senate Finance Committee Chair Charles Grassley (R-IA) and ranking member Max Baucus (D-MT).

"We need to stay on top of the transfer process to make sure the current failures by [HHS] do not continue," Grassley says in a release.

"Based on today's GAO report, I remain concerned about HHS' new Medicare appeals process," Baucus says in the release. "Many of the issues with the process remain unresolved, which effectively denies Medicare beneficiaries access to judges and due process."

The GAO report is at www.gao.gov/new.items/d05703r.pdf.  Almost Family Inc.is selling off its adult day care business and focusing solely on home care. The Louisville, KY-based company is selling its 19 medical day care locations to Active Services Inc. for $13.6 million in cash and assumption of $1.4 million in debt, it says in a release.

Following the pending transaction, Almost Family will consist of its Caretenders Medicare operations with current annual revenue of $43 million and its personal care unit with $35 million in annual revenues. The company, operating in Florida, Kentucky, Ohio, Connecticut, Massachusetts and Alabama, plans to use cash and credit to finance home care acquisitions in Florida and other states, it says.

"Our next milestone is to take the company past the $100 million mark in home health care revenues," CEO William B. Yarmuth says in the release.
  Amedisys Inc. earnings continue to grow. The Baton Rouge, LA-based powerhouse has announced income of $7.9 million on revenues of $80.1 million for the quarter ended June 30, compared to a $5.0 million profit on $56.9 million in revenues for the same period in 2004. The regional chain estimates revenues of $495 million and patient admission growth of 15 to 20 percent in 2006.

Amedisys, which recently finalized the acquisition of 66-location Housecall Medical Resources Inc., also has purchased HHA NCARE Inc. in Newport News and Chesapeake, [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.