Sunday, December 21, 2008
Thursday, December 18, 2008
Post-Acute Providers Are Not Vendors
Post-Acute Providers Are Not Vendors
Elizabeth E. Hogue, Esq.
Office: 877-871-4062
Fax: 877-871-9739
E-Mail: ElizabethHogue@ElizabethHogue.net
Some hospitals and skilled nursing facilities (SNF’s) refer to post-acute providers as “vendors” and require them to follow the policies and procedures related to “vendors.” These may include, for example, a requirement for representatives of post-acute providers to sign in when they arrive at hospitals and SNF’s to coordinate services in hospitals’ Purchasing Departments.
On the contrary, post-acute providers; such as home health agencies, home medical equipment (HME) companies, hospices and private duty home care agencies; are not “vendors” and should not be treated like “vendors.” They are, instead, fellow providers. Vendors are manufacturers and distributors of supplies and equipment that are utilized by hospitals and SNF’s on the premises of institutions. Post-acute providers rarely sell equipment and supplies that are used by facilities on the premises. In fact, the users of post-acute providers are patients, not hospitals and SNF’s.
When hospitals and SNF’s lump post-acute providers in with equipment and supply vendors they are, at the least, being disrespectful of these types of providers. Such treatment may be demeaning to post-acute providers.
Some hospitals are asking post-acute providers who are categorized as vendors to pay fees to hospitals in order to appear on a vendor list. Such payments are likely to constitute illegal kickbacks in exchange for referrals and cannot be required.
In addition, restrictions that hospitals and SNF’s may appropriately put on the activities of vendors while on the premises are inapplicable to post-acute providers. Vendors may, for example, be prohibited from going to other areas of institutions besides purchasing departments unless they are accompanied by staff of facilities.
No such restrictions should be applied to post-acute providers. In fact, it is inappropriate to restrict the activities of post-acute providers who:
- Have received referrals of patients; or
- Cared for patients immediately prior to their admission to institutions
Under these circumstances, post acute providers should be permitted access to patients, their families, and information about them as part of the discharge planning process.
It is important to note that referrals for post-acute services do not have to come from physicians. They may come from patients, their families, physicians, case managers/discharge planners, or other sources. Referrals may also be received by post-acute providers, either verbally or in writing. When post-acute providers are acting on verbal referrals, they should, however, document the name of the person who made the referral and the date and time at which it was received.
Of course, patients have the right to freedom of choice of providers. This right to freedom of choice of providers includes the right to self-refer to any type of post-acute provider. There are a number of sources of this right, as follows:
1) All patients have a common law right, based upon court decisions, to control the care provided to them, including who renders it. Thus, when patients, regardless of payor source or type of care, voluntarily express preferences for providers, their choices must be honored.
2) Federal statutes of the Medicare and Medicaid programs guarantee Medicare beneficiaries and Medicaid recipients the right to freedom of choice of providers. (Medicaid recipients may have waived this right if they participate in a waiver program.) Consequently, when Medicare patients and non-waiver Medicaid patients voluntarily express a preference for a home health agency, these choices must be honored.
3) The Balanced Budget Act of 1997 (BBA) requires hospitals to develop a list of home health agencies that are:
a) Medicare certified;
b) Provide services in the geographic areas where patients reside, and;
c) Ask to be on the list.
In addition, if a hospital places the name of an agency on the list in which it has discloseable financial interests, the relationship between the hospital and the agency must be disclosed on the list.
This list must be presented to all patients who may benefit from home health services, regardless of payor source, so that they can choose the home health agency that they wish to provide services to them.
4) Hospital Conditions of Participation (COP’s) that became effective on October 1, 2004, include the basic requirements of the BBA described above.
5) Court decisions, such as the opinion in Assured Home Health, Inc. v. Providence Health System, also support patients’ right to freedom of choice of providers. In this case, Assured claimed that the hospitals in the System regularly violated patients’ right to freedom of choice and “steered” patients to agencies owned by the System. This case was settled when the System agreed to institute additional safeguards to protect patients’ rights, including monitoring of the hospital’s practices by outside third parties.
A patient who received services from a post-acute provider immediately prior to admission to an institutional setting may, of course, choose to receive services from a different provider upon discharge. If a patient does not choose another provider, his or her care should be continued by the same provider with which the patient is likely to have a continuing provider-patient relationship.
Likewise, patients who are referred to post-acute providers may, of course, choose different providers any time they wish to do so.
Patients greatly value the services that post-acute providers offer. Hospitals and SNF’s, therefore, should not treat them like “vendors.”
©Copyright, 2008. Elizabeth E. Hogue, Esq. All rights reserved. No portion of this material may be used in any form without the advance written permission of the author.
Elizabeth E. Hogue, Esq.
Office: 877-871-4062
Fax: 877-871-9739
E-Mail: ElizabethHogue@ElizabethHogue.net
Some hospitals and skilled nursing facilities (SNF’s) refer to post-acute providers as “vendors” and require them to follow the policies and procedures related to “vendors.” These may include, for example, a requirement for representatives of post-acute providers to sign in when they arrive at hospitals and SNF’s to coordinate services in hospitals’ Purchasing Departments.
On the contrary, post-acute providers; such as home health agencies, home medical equipment (HME) companies, hospices and private duty home care agencies; are not “vendors” and should not be treated like “vendors.” They are, instead, fellow providers. Vendors are manufacturers and distributors of supplies and equipment that are utilized by hospitals and SNF’s on the premises of institutions. Post-acute providers rarely sell equipment and supplies that are used by facilities on the premises. In fact, the users of post-acute providers are patients, not hospitals and SNF’s.
When hospitals and SNF’s lump post-acute providers in with equipment and supply vendors they are, at the least, being disrespectful of these types of providers. Such treatment may be demeaning to post-acute providers.
Some hospitals are asking post-acute providers who are categorized as vendors to pay fees to hospitals in order to appear on a vendor list. Such payments are likely to constitute illegal kickbacks in exchange for referrals and cannot be required.
In addition, restrictions that hospitals and SNF’s may appropriately put on the activities of vendors while on the premises are inapplicable to post-acute providers. Vendors may, for example, be prohibited from going to other areas of institutions besides purchasing departments unless they are accompanied by staff of facilities.
No such restrictions should be applied to post-acute providers. In fact, it is inappropriate to restrict the activities of post-acute providers who:
- Have received referrals of patients; or
- Cared for patients immediately prior to their admission to institutions
Under these circumstances, post acute providers should be permitted access to patients, their families, and information about them as part of the discharge planning process.
It is important to note that referrals for post-acute services do not have to come from physicians. They may come from patients, their families, physicians, case managers/discharge planners, or other sources. Referrals may also be received by post-acute providers, either verbally or in writing. When post-acute providers are acting on verbal referrals, they should, however, document the name of the person who made the referral and the date and time at which it was received.
Of course, patients have the right to freedom of choice of providers. This right to freedom of choice of providers includes the right to self-refer to any type of post-acute provider. There are a number of sources of this right, as follows:
1) All patients have a common law right, based upon court decisions, to control the care provided to them, including who renders it. Thus, when patients, regardless of payor source or type of care, voluntarily express preferences for providers, their choices must be honored.
2) Federal statutes of the Medicare and Medicaid programs guarantee Medicare beneficiaries and Medicaid recipients the right to freedom of choice of providers. (Medicaid recipients may have waived this right if they participate in a waiver program.) Consequently, when Medicare patients and non-waiver Medicaid patients voluntarily express a preference for a home health agency, these choices must be honored.
3) The Balanced Budget Act of 1997 (BBA) requires hospitals to develop a list of home health agencies that are:
a) Medicare certified;
b) Provide services in the geographic areas where patients reside, and;
c) Ask to be on the list.
In addition, if a hospital places the name of an agency on the list in which it has discloseable financial interests, the relationship between the hospital and the agency must be disclosed on the list.
This list must be presented to all patients who may benefit from home health services, regardless of payor source, so that they can choose the home health agency that they wish to provide services to them.
4) Hospital Conditions of Participation (COP’s) that became effective on October 1, 2004, include the basic requirements of the BBA described above.
5) Court decisions, such as the opinion in Assured Home Health, Inc. v. Providence Health System, also support patients’ right to freedom of choice of providers. In this case, Assured claimed that the hospitals in the System regularly violated patients’ right to freedom of choice and “steered” patients to agencies owned by the System. This case was settled when the System agreed to institute additional safeguards to protect patients’ rights, including monitoring of the hospital’s practices by outside third parties.
A patient who received services from a post-acute provider immediately prior to admission to an institutional setting may, of course, choose to receive services from a different provider upon discharge. If a patient does not choose another provider, his or her care should be continued by the same provider with which the patient is likely to have a continuing provider-patient relationship.
Likewise, patients who are referred to post-acute providers may, of course, choose different providers any time they wish to do so.
Patients greatly value the services that post-acute providers offer. Hospitals and SNF’s, therefore, should not treat them like “vendors.”
©Copyright, 2008. Elizabeth E. Hogue, Esq. All rights reserved. No portion of this material may be used in any form without the advance written permission of the author.
Wednesday, December 17, 2008
Facing Deadly Ice Storms, Home Medical Equipment Providers in New England Mobilize to Protect Oxygen Patients
From marketwatch.com
ARLINGTON, Va., Dec 16, 2008 /PRNewswire-USNewswire via COMTEX/ -- Home oxygen providers in New England prepared for the deadly ice storm that struck last week and have responded with extra visits and contacts with patients receiving home oxygen therapy. An oxygen patient who uses an oxygen system that runs on electricity must have a back-up supply of oxygen. Oxygen therapy is critical to more than one million Americans who suffer from respiratory illnesses such as chronic obstructive pulmonary disease (COPD).
On Friday, December 12, with no electrical power or telephone service at the Home Care Specialists, Inc. facility in Haverhill, Mass., the company implemented its disaster response program. With the help of a generator, the company was able to handle patient calls using cell phones and deliver more than 100 emergency backup oxygen cylinders to patients without power. The following day, the company delivered and serviced more than 60 emergency backup oxygen cylinders and another 30 were serviced on Sunday, December 14.
William E. Desmarais, a respiratory therapist, is co-owner of Home Care Specialists, which provides durable medical equipment and services to northeastern Massachusetts and southern New Hampshire. The company cares for more than 800 oxygen patients who were forced to rely on backup emergency gaseous cylinders provided by HCS following the power failures caused by the New England ice storms on December 11 and 12.
"In many cases, home oxygen companies provide home oxygen service over and above what is required by accrediting agencies and by the Centers for Medicare and Medicaid Services," said Desmarais.
"We have heard similar stories from many of our members who provide home oxygen equipment," said Karyn Estrella, executive director of the New England Medical Equipment Dealers Association. "One of our members, Clinical 1 Home Medical in Hingham, Mass., delivered oxygen to a nursing home whose back-up generator failed and they ran out of tanks. They also transported oxygen to an ambulance company in Worcester who had exhausted their supplies."
The typical Medicare home oxygen user is a 73 year-old who suffers from late-stage COPD. Approximately 12 million Americans have been diagnosed with COPD. An estimated 12 to 15 million more remain undiagnosed. The American Association for Homecare represents durable medical equipment providers, manufacturers, and other organizations in the homecare community. Website: www.aahomecare.org.
SOURCE American Association for Homecare http://www.aahomecare.org
ARLINGTON, Va., Dec 16, 2008 /PRNewswire-USNewswire via COMTEX/ -- Home oxygen providers in New England prepared for the deadly ice storm that struck last week and have responded with extra visits and contacts with patients receiving home oxygen therapy. An oxygen patient who uses an oxygen system that runs on electricity must have a back-up supply of oxygen. Oxygen therapy is critical to more than one million Americans who suffer from respiratory illnesses such as chronic obstructive pulmonary disease (COPD).
On Friday, December 12, with no electrical power or telephone service at the Home Care Specialists, Inc. facility in Haverhill, Mass., the company implemented its disaster response program. With the help of a generator, the company was able to handle patient calls using cell phones and deliver more than 100 emergency backup oxygen cylinders to patients without power. The following day, the company delivered and serviced more than 60 emergency backup oxygen cylinders and another 30 were serviced on Sunday, December 14.
William E. Desmarais, a respiratory therapist, is co-owner of Home Care Specialists, which provides durable medical equipment and services to northeastern Massachusetts and southern New Hampshire. The company cares for more than 800 oxygen patients who were forced to rely on backup emergency gaseous cylinders provided by HCS following the power failures caused by the New England ice storms on December 11 and 12.
"In many cases, home oxygen companies provide home oxygen service over and above what is required by accrediting agencies and by the Centers for Medicare and Medicaid Services," said Desmarais.
"We have heard similar stories from many of our members who provide home oxygen equipment," said Karyn Estrella, executive director of the New England Medical Equipment Dealers Association. "One of our members, Clinical 1 Home Medical in Hingham, Mass., delivered oxygen to a nursing home whose back-up generator failed and they ran out of tanks. They also transported oxygen to an ambulance company in Worcester who had exhausted their supplies."
The typical Medicare home oxygen user is a 73 year-old who suffers from late-stage COPD. Approximately 12 million Americans have been diagnosed with COPD. An estimated 12 to 15 million more remain undiagnosed. The American Association for Homecare represents durable medical equipment providers, manufacturers, and other organizations in the homecare community. Website: www.aahomecare.org.
SOURCE American Association for Homecare http://www.aahomecare.org
Friday, December 12, 2008
Online Healthcare Degrees
Healthcare professionals are always in a great demand. Read on to find online degrees in different healthcare disciplines from popular institutions.
According to the labor statistics bureau, healthcare job sector is on the rise in almost all the countries and especially in the U.S. Hence, the need for healthcare degree programs is also on the rise. Persons who wish to pursue a degree in healthcare can also do it through the healthcare online degree programs. Information on the same are be available online from various websites. Various specialization programs might be available in healthcare such as nursing, administration, psychology, human services, health informatics, pharmacy, physical therapy and many more.
The great thing about online degree programs is that the university or college offering the course need not be in the same locality or state or nation where the student is residing but can be located anywhere in the world. This avoids the need to commute to the college or university and stay there physically that the expenses towards them are saved.
Healthcare careers and opportunities are very open and easy to obtain that when the person is clinically inclined, he has various options. Students who wish to take up the healthcare online degree programs can get the necessary information from the websites that they can choose the online university or college according to their choice and suitability. Moreover, they can also gain easy access to the classmates, courses, computer support and professors all the day of the week when pursuing it online.
http://educationonline-101.com/healthcare-online-degree-programs/
According to the labor statistics bureau, healthcare job sector is on the rise in almost all the countries and especially in the U.S. Hence, the need for healthcare degree programs is also on the rise. Persons who wish to pursue a degree in healthcare can also do it through the healthcare online degree programs. Information on the same are be available online from various websites. Various specialization programs might be available in healthcare such as nursing, administration, psychology, human services, health informatics, pharmacy, physical therapy and many more.
The great thing about online degree programs is that the university or college offering the course need not be in the same locality or state or nation where the student is residing but can be located anywhere in the world. This avoids the need to commute to the college or university and stay there physically that the expenses towards them are saved.
Healthcare careers and opportunities are very open and easy to obtain that when the person is clinically inclined, he has various options. Students who wish to take up the healthcare online degree programs can get the necessary information from the websites that they can choose the online university or college according to their choice and suitability. Moreover, they can also gain easy access to the classmates, courses, computer support and professors all the day of the week when pursuing it online.
http://educationonline-101.com/healthcare-online-degree-programs/
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