Noteworthy:

FTC to Handle Health Care Antitrust Matters: Under an agreement with the Antitrust Division of the U.S. Department of Justice, the Federal Trade Commission now has responsibility for clearance procedures for antitrust matters involving health care. The agreement was announced March 7 and is expected to increase the efficiency and effectiveness of each agency's antitrust activities.

JCAHO Publishes Medication Use Standards Evaluation: The Oakbrook Terrace, Ill.-based Joint Commission on the Accreditation of Healthcare Organizations has made available online its field evaluations of medication use standards. Home care programs participating in the field evaluation are asked to complete those evaluations online by visiting www.jcaho.org, selecting “Top Spots,” and then selecting “Medication Use Standards Field Review — Home Care or BHC.” For more information, call Joyce Marshall in JCAHO's research division at (630) 792-5934.

JCAHO Receives M+C Deeming Authority: The Baltimore-based Centers for Medicare and Medicaid Services has granted deeming authority to the Joint Commission on the Accreditation of Healthcare Organizations, based in Oakbrook Terrace, Ill., for all Medicare + Choice organizations. M+C organizations that are licensed as health maintenance organizations and preferred provider organizations and are accredited by JCAHO may receive deemed status for M+C requirements in six areas, according to a notice CMS published in the Federal Register on March 22.

CMS Unveils Dragnet for Excluded Providers: In February, Medicare issued a wake-up call to excluded providers and to the organizations that hire excluded individuals. Beginning as early as May 2002, the Baltimore-based Centers for Medicare and Medicaid Services hopes to implement a simpler, more efficient exclusions database, designed to root out claims from excluded providers before the government makes unnecessary payments. The new database will be cumulative and will allow regional carriers to compare exclusion files against incoming billing files from providers, a CMS official told HomeCare. It also will provide a mechanism for determining which organizations employ excluded individuals, the Federal Register notice said. To read the notice, go to www.access.gpo.gov/su_docs/fedreg/frcont02.html, click on Feb. 26, and scroll down to the heading entitled, “Centers for Medicare and Medicaid Services.”

CMS Provides Tool to Handle Appeals Backlog: Almost everyone agrees that Medicare's current administrative appeals process needs reforming, but during the past month, government officials have disagreed publicly on how to implement those reforms. While the U.S. Department of Health and Human Services' Office of Inspector General urged Medicare to ask for more time to implement changes slated to go into effect in October 2002, the House Ways and Means Committee urged Medicare to implement the changes as scheduled. Meanwhile, on March 20 the Baltimore-based Centers for Medicare and Medicaid published a memorandum to help its contractors prioritize appeals cases. As soon as contractors realize that an appeals backlog is inevitable, the memo said, they should process existing cases in a specific order, outlined at www.hcfa.gov/pubforms/transmit/memos/comm_date_dsc.htm.

Regulatory:

CMS Expands Nutrition Therapy Coverage for Diabetics: The Baltimore-based Centers for Medicare and Medicaid Services has expanded coverage of medical nutrition therapy for Medicare beneficiaries with diabetes. Under the medical nutrition therapy benefit, a dietician or nutritionist will create an individualized meal plan for a beneficiary and track the beneficiary's progress. While the benefit does not cover dietary supplements, calendars or food, it does cover beneficiaries who also are receiving diabetes self-management training. For more information about the medical nutrition therapy benefit, go to www.hcfa.gov/coverage/8b3-ggg.htm.

New Oximetry Testing Policy Eases Burden for M+C Beneficiaries, Providers: A new policy from the Baltimore-based Centers for Medicare and Medicaid Services will drop the oxygen retesting requirement for beneficiaries transferring from the Medicare + Choice program to the fee-for-service program, a CMS official told HomeCare. After July 1, 2002, oxygen patients switching from M+C to fee-for-service can use the results from their most recent oximetry test to obtain initial certification, according to transmittals 1740 and 1742, published Feb. 13 and March 1 on CMS' Web site. In light of this information, Medicare's Region B durable medical equipment regional carrier, Administar Federal, has suggested that providers hold all oxygen claims for beneficiaries who are switching from M+C to fee-for-service until July 1. To read these transmittals, go to www.hcfa.gov/pubforms/transmit/transmittals/comm_date_dsc.htm.

CMS to Drop CMN Requirement for Sleep Device: A spokesman from the Baltimore-based Centers for Medicare and Medicaid Services told HomeCare in March that the agency currently is drafting a memorandum to eliminate the certificate of medical necessity requirement for continuous positive airway pressure devices. However, CMS still will require a detailed, written order to accompany all CPAP claims, the spokesman added.

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