Medicare Compliance & Reimbursement

• You no longer have to think of clinical staff work preparing vaccines as a freebie service. CMS had originally said that it would not pay for clinical staff time spent for vaccine administration quality assurance, noted Amy Bassano, MA, director of CMS hospital and ambulatory policy group in the presentation, "Medicare Physician Payment Schedule 2009 Changes and Beyond" at the CPT and RBRVS 2009 Annual Symposium in Chicago. "But when we looked at other similar services, we realized the relative value units included that time," she said. So CMS added that into immunization administration codes 90465, 90467, 90471, and 90473. Before you say "So what? I don't charge Medicare for vaccine administration," rest assured the increase will benefit you. Medicaid and others set their payment rates based on the Medicare physician fee schedule values, explains Bassano. For instance, code 90465 gets a 0.02 added practice expense boost to bring its total RVUs in 2009 to 0.58 effective Jan. 1. • The cost of diabetes continues to climb, as does the number of people who have it. Diabetes in 2007 cost the U.S. $218 billion in direct medical care and indirect costs, according to a report authored by the Lewin Group and commissioned by diabetes drug manufacturer Norvo Nordisk. The $218 billion accounts for about 10 percent of all U.S. health care spending by the government and public,says the Associated Press. "Diabetes has not seen a decline or even a plateauing,and the death rate from diabetes continues to rise," Dana Haza, of the National Changing Diabetes Program launched by Norvo, tells AP. "The numbers just keep going higher and higher." • Trying to keep up home health aides' wages has put one Washington home health agency under. Seattle-based anti-poverty advocacy group Solid Ground is closing the doors of its home care program Dec. 31, it says in a release. "For years, Home Care has cost more to operate than we receive in contracts for its services " due to the fact that we have consistently paid our community aides the highest wages in Washington State," Solid Ground executive director Cheryl Cobbs says in a release. "This has been a dilemma for Solid Ground for two decades, trying to keep the home-care program going and at the same time offering decent wages," Cindy Schu of the OPEI Union Local 8 tells the Seattle Times. "They've had a commitment to doing that, and they just weren't able to do it any longer. It's sad." Solid Ground's patients and staff will transition to other providers before the closure date, it says.