What is the venipuncture provision all about?
Medicare beneficiaries who currently meet home health criteria and need to have their blood collected may receive venipuncture as a qualifying service for the Medicare home health benefit.
The same patients also may receive other home health services that will be covered by Medicare. However, unless the Balanced Budget Act of 1997 is amended by Feb. 5, this will all change.
The new policy will no longer include venipuncture as a qualifying service under Medicare Part A, so venipuncture patients will cease receiving any additional services, such as home health aides, case management, counseling, and clinical assessment services. Also, Medicare will only cover venipuncture by lab technicians under Medicare Part B if venipuncture is the sole skilled service needed, according to the National Association for Home Care (NAHC) of Washington, DC.
Labs typically are reimbursed for blood monitoring at a rate of $13 to $16, says Eric Sokol, JD, NAHC assistant director for government affairs. Home care agencies now providing venipuncture typically are reimbursed $65 to $90 for the service. "No lab will go out and draw blood from a homebound patient for that little amount of money," Sokol says.
Congress targeted venipuncture because anecdotal evidence has suggested that some home health agencies were using it as a gateway to other home care services and, therefore, were abusing the system, Sokol says. "There are no studies or reports other than anecdotal evidence that supports this claim."
The NAHC is asking Congress to pass an amendment that would restore venipuncture as a home health qualifying service. The provision, H.R. 2912, also would require the Secretary of Health and Human Services to study potential fraud and abuse of venipuncture services under the Medicare program. "Our theory at NAHC is to identify the abuse and throw it out rather than throw the baby out with the bathwater," Sokol says.
NAHC has put together grassroots kits with sample letters to editors and Congress for beneficiaries and their family members to sign in support of H.R. 2912.
[For more information about obtaining these kits, call NAHC at (202) 547-7424.]
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