Want Medicare To Pay For Home Care? See Your Doctor : Shots - Health Blog : NPR

Starting next month, seniors getting health care in their homes will have to see a doctor to make sure they actually need the service. Otherwise Medicare won't pay.

Sounds logical, right?

Not so, says a coalition of health providers and consumer groups that complains the rule is overly burdensome on seniors and doctors.

 

Home health agencies, doctor and consumer groups say frail, homebound seniors won't be able to get to a doctor's office because of their health status or lack of doctors in rural areas.

They also worry that many doctors are either unaware of the new regulation or won't know how to comply with its documentation requirements that call on physicians to certify they or another health care provider, such as a nurse practitioner, have seen a patient for the specific reason of certifying the need for home health care.

"There is a lot of confusion out there, and patients may lose access to their care," said Nora Super, an AARP lobbyist.

via npr.org

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Medical News: Operation Targets $225M in Healthcare Fraud - in Public Health & Policy, Medicare from MedPage Today

By Joyce Frieden, News Editor, MedPage Today Published: February 18, 2011

WASHINGTON -- The largest healthcare fraud operation in U.S. history has nabbed suspects accused of collectively defrauding Medicare of more than $225 million, according to officials from the Department of Health and Human Services (HHS) and the Department of Justice (DOJ).

The Medicare Fraud Strike Force charged 111 defendants in nine cities for their alleged participation in Medicare fraud schemes, officials announced on Thursday. Defendants included doctors, nurses, and healthcare company owners and executives, among others.

"With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country. We have safeguarded precious taxpayer dollars. And we have helped to protect our nation's most essential healthcare programs, Medicare and Medicaid," said Attorney General Eric Holder in a statement. "As [these] arrests prove, we are waging an aggressive fight against healthcare fraud."

More than 700 law enforcement agents from the FBI, the HHS Office of Inspector General, multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in the operation.

via medpagetoday.com

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Nurses: Believe What They Tell You in Nursing School, A Nurse Does Make a Difference | BonnieRN Blog

My world, in geriatric care management, primarily consists of interacting with many health care technicians, non-degree workers, and varied professionals. So, saying this another way, most of my contacts are not nurses. I can tell you, more than weekly, I must explain to those in the field of social and care-giving support, how beneficial it is to have a nurse on the team or committee for decision making. I still get surprised that family is often unaware that a trained and registered nurse is not a part of the team when very serious medical choices are being reviewed for their loved one.  A nurse on the health care team is a natural advocate for the patient.

It is true, and is what I was taught, that the nurse is the last line of deffense (often) for a patient in a facility (or elsewhere). Nurses, know when to contact physicians when there is a concern, check physician orders after they are written, call for questions, order the medication (if needed) from the pharmacy, and verify that it has been delivered and administer the medication (or intervention) to the patient. In home support, nurses assess, support the patient in physician monitoring, and implement change (usually via contacting the physician) when it is needed.

So, the next time a health care team approaches you or asks for a meeting, be sure to include the RN on the team. That RN is a built in advocate for the patient, the family, and will monitor the success of the intervention.

Your questions and comments are appreciated and encouraged.

via bonniern.com

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Pennsylvania Supreme Court rules that nursing companies must pay home health aides overtime | Markets | Market News | Canadian Business Online

The Pennsylvania Supreme Court said Wednesday a company must pay overtime to its home health care aides, saying an overtime exception only applies to people who pay for domestic services in their own homes.

The court unanimously upheld state Department of Labor and Industry regulations, ruling against Bayada Nurses Inc., which had asked the courts to settle the issue after the agency began looking into how it was paying the aides.

A state regulation that dates to 1977 provides an exception to overtime payments for domestic services in an employer's home. Bayada argued unsuccessfully that it should apply to its aides, who are largely supervised by the householder, and said the regulation would drive up the cost of services.

The company said its "householder clients" approve who will work in their homes, set their hours, control all aspects of services that will be provided and can terminate the relationship. In that respect, it said, the company and the clients jointly employ the aides.

Justice Debra McCloskey Todd wrote that the regulation was reasonable and consistent with the Legislature's intent in the Minimum Wage Act of 1968.

"Under the department's regulation, working for the householder employer permits an exemption from overtime requirements. Working for a third-party agency employer does not," Todd wrote.

Todd's opinion noted that unions and the AARP warned that failing to adequately pay home health care workers "will lead to an even greater shortage of these critical workers."

The court said Bayada was a Pennsylvania corporation headquartered in Moorestown, N.J., and that it had about 38 offices in Pennsylvania that employed more than 1,000 people. A 2008 Commonwealth Court ruling in the case, which the justices upheld, said the home health aides at issue in the litigation helped people with daily living and general companionship.

Labor and Industry spokesman Christopher Manlove said the department was pleased with the court ruling. A message seeking comment from Bayada was not immediately returned.

via canadianbusiness.com

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Doctors' house calls making a comeback - USATODAY.com

Dr. Ina Li walked down the seventh-floor hallway of a local apartment building recently, pausing at each door to check the number.

She finally found the one of her patient, Katherine Talmo.

It's easier for Talmo if Li, a geriatrician, comes to her. The 90-year-old doesn't get out nearly as much since she stopped driving nine years ago. But she is determined to stay in her home.

"If I was in a nursing home, I'd only live for one more year," she said. "But if I live at home, I'll live to be 100."

The notion of doctors making house calls harkens back to an era before HMOs, medical centers and outpatient surgery centers.

Those visits offer insights not available during a 15-minute office visit. Doctors learn more about a patient's lifestyle, eating habits, their ability to take medicine and exercise.

via usatoday.com

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