HIDA spearheading efforts to kill consolidated billing provision
By MATTHEW HAY
HHBR Washington Correspondent
BALTIMORE The Health Industry Distributors Association (HIDA; Alexandria, VA) is spearheading an effort to repeal the home health consolidated billing provision that was included in the Balanced Budget Act of 1997 (BBA). Erin Bush, HIDA’s associate director for government relations, said this is HIDA’s "top legislative issue" because it stands to wreak havoc on billing for durable medical equipment (DME) suppliers, as well as home health agencies.
According to the consolidated billing provision included in the BBA, items or services furnished to an individual who is under the plan of care of a home health agency will have to be made to the agency regardless of whether the item or service was furnished by the agency. The provision will go into effect Oct. 1, 2000, along with the prospective payment system for home health unless Congress or the Health Care Financing Administration (Baltimore) delay its implementation or repeal it.
In testimony submitted to the Senate Permanent Subcommittee on Investigations on behalf of the Home Care Coalition earlier this month, HIDA argued that the rationale for the provision is unclear and pointed out that there have been no public hearings or industry consultations on the issue. According to HIDA, "This provision ignores the inherent complexities of the home health market and separate reimbursement systems established by Medicare" for home health agencies and DME suppliers.
Because HIDA is not certain there will be any legislation to attach an amendment eliminating the provision, it is taking its case to Congress and asking members to urge HCFA to delay implementation of the provision. On June 10, Rep. Charles Canady (R-FL) urged Department of Health and Human Services Secretary Donna Shalala to do just that. "These new duties will be costly, particularly since home health agencies are not always prepared to handle Part B DME reimbursement," said Canady.
Sen. Bill Frist (R-TN) made a similar request to Shalala on May 26. "There is fear that this measure would negatively impact those small businesses that concentrate on home medical equipment," said Frist, while home health agencies would be forced to assume "new costs and obligations."
HIDA argues that consolidated billing will likely create an unnatural break in the delivery of services by shifting Medicare payments back and forth between DME companies and home health agencies.
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