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CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
Volume 26, Number 09SEPTEMBER 2010
IN THIS ISSUE
FEATURES:Home Care Providers
Indicted for Referrals
Kickbacks:P. 14
The CAHSAH Bulletin is brought to you by
McKesson Corporation.
Learn more by going towww.mckesson.com
CAHSAH Bulletin
As the end of the legislative session draws near with Governor Schwarzenegger’s
September 30 constitutional deadline to either sign or veto all bills, CAHSAH takes a step back to reflect on the legislative successes and challenges of 2010.
As has become expected in California, an enormous number of bills were introduced by both the state Senate and Assembly (2261 in total), and CAHSAH’s first task was to review every bill and determine whether or not it impacted the home care industry. The Policy, Advocacy, and Public Affairs (PAPA) Committee, chaired by Lucy Andrews of Heart of Home Care, impressively triaged these bills down to 50 priority items, with 16 marked as high priority. These bills involved issues varying from workers’ compensation to nurse training to licensing, and each have taken various paths to the Governor’s desk. In the end four out of the six priority bills that CAHSAH opposed died while the other two still await the Governor’s decision. The following is a highlight of a few of the priority bills and CAHSAH’s involvement with them:
2010 Legislative Wrap-UpAB 179 (Portantino): This bill was sponsored by CAHSAH and aimed to resolve the uncertainty surrounding weekly pay requirements that was created by SB 940. Specifically, the bill sought to allow home care companies to pay their employees every other week as opposed to every week. This bill encountered significant opposition from organized labor and especially from the California Nurses Association, and ultimately failed in the Senate policy committee.
SB 971 (Pavley): This bill focuses on the providers of blood clotting products, and in its original form would have made it nearly impossible for smaller home infusion providers to comply with the requirements. CAHSAH intervened and was able to get the author to agree to amendments that removed the onerous requirements, thus allowing our home infusion members to continue to provide this service.
AB 950 (Hernandez): CAHSAH supported this bill which would have changed the hospice licensing provisions to allow for the licensing of hospice facilities. The bill encountered concern and ultimate opposition from a few legislators in key positions on committees which killed the bill. CAHSAH intends to revisit this issue in 2011.
AB 1994 (Skinner): CAHSAH strongly opposed this bill, which would have presumed that a hospital was liable for all injuries of hospital employees regardless if the injuries happened at the hospital or not. If this bill passed CAHSAH fully expected the same proposal to be aimed at the home care industry in the following years. CAHSAH aligned itself with the CalChamber and was able to kill the bill in committee.
Selecting An Insurance Broker: P. 6
Cover Story: Exemption, continues on p. 4
Given recent lawsuits and proposed legislation surrounding the companionship exemption, it is no surprise that many home care owners are taking steps to make sure that they are paying their caregivers properly. CAHSAH has seen an increase in inquiries on how
to apply the personal attendant exemption, and how to structure wages for live-ins and caregivers who work more than eight hours in a day. CAHSAH has taken a strong leadership position at the state and federal levels with this issue and has developed this informational article in an effort to help answer some of our members’ questions.
Understanding the complex dynamics involved in the personal attendant exemption requires careful consideration of the provisions in Wage Order 15 - California’s Wage Order that regulates home care workers. CAHSAH educates owners who are new to the home care industry as to the law’s application, which allows an exemption from having to pay overtime.
Companion Care ExemptionUnder Close Examination
Extraordinary Executives (N.Y.): P. 12
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TWO
PA C K AG E S
A VA I L A B L EC H E X
C E x c h a n g e
WNU HeadlinesSEPTEMBER 6TH: CMS Continues ADR Probes for Home
Health and Hospice
CAHSAH members continue to bring to our attention the prevalence and severity of Additional Development Requests (ADRs) that CMS has been relentlessly pursuing. Last week, the CAHSAH Forum discussed the frequency and types of ADR probes that they have been experiencing.
Click here for the full article.
SEPTEMBER 13TH: U.S. Guidance Issued on Hospice Care for Children in Medicaid and CHIP
Last week, the Centers for Medicare and Medicaid Services provided guidance on removing the prohibition of receiving curative treatment upon the election of the hospice benefit by or on behalf of a Medicaid or Children’s Health Insurance Program (CHIP) eligible child under the Affordable Care Act, the new healthcare reform legislation.
Click here for the full article.
SEPTEMBER 20TH: The Medicare Agencies Call to Action!
Two very important bills have been introduced at the federal level in an effort to minimize the effect of the unprecedented payment cuts that are proposed in the CMS 2011 home health payment rule. S. 3315; H.R. 5803 also called the Home Health Care Access Protection Act were introduced by Senator Susan Collins and Representative James McGovern.
Click here for the full article.
SEPTEMBER 27TH: CMS Encourages HHCAHPS Survey Participation
Medicare-certified home health agencies are reminded that unless they qualify for an exemption from participating in the Home Health Care CAHPS (HHCAHPS) Survey for the 2012 Annual Payment Update (APU), they must conduct a dry run of the HHCAHPS Survey for at least one month in the third quarter of 2010... Click here for the full article.
Sponsorship
OpportunityHave you ever wondered how you can get the best
bang for your marketing bucks? How about becoming a sponsor at the Annual Conference or advertising in the pre-conference registration brochure? As
a conference sponsor, you’ll enjoy many benefits including broadening your competitive edge by gaining access to hundreds of home health and hospice professionals.
As a sponsor you will:
7uReach an expected target audience of 300-400 attendees
7uIncrease awareness of your company’s products and services
7uGain access to home care provider decision-makers
7uBe recognized as key sponsors of the premier home care conference in California
7uDemonstrate your company’s commitment to best practices in the home care industry
Click here for more information, or contact Richard Starks.
3www.cahsah.org
Chair’s Message Barry Berger
Making CAHSAH and Home Care More Visible
I hope everyone had a great summer. As the season changes to fall, it marks the beginning of two important events for all Americans, the start of the football season, and the
beginning of the fall election campaign. I hope all of you participate and support these activities.
Part of my personal mission over the next two years is to make CAHSAH specifically, and the Home Care Industry more visible within the health care and referral community. One of the ways we are accomplishing this, is to participate and exhibit in various trade shows. In October, CAHSAH will have a display at the Western Regional Chapter of the National Association of Private Geriatric Case Managers in Costa Mesa, and another display at The Ventura County Home Care Association annual one day conference.
We are hoping that we have the same success that we had when we exhibited at the Society for Social Work Leadership in Health Care last May. We had the opportunity to discuss CAHSAH with many of the department heads of Social Work at the major hospitals in Southern California. The participants were happy to receive the CAHSAH Resource Guide along with information regarding the CAHSAH Home Care Aide certification program. We will be happy to look into other trade shows as they come to our attention. Feel free to email me with any suggestions you may have.
September was a very busy month for CAHSAH. Our education committee reviewed over 80 proposals for speakers for our 2011 Annual Conference in May to be held in Ontario. I am pleased with the selection and variety of both Keynote and Breakout sessions the committee put together. Additionally, the education committee put the finishing touches on our Executive Home Care and Hospice Exams. A group of CAHSAH members spent over 4 days planning and writing the test. The end result is a product that will be administered around the country which will add to the reputation and credibility of CAHSAH.
Our legislative committee has been extremely busy this past month as they gear up for both the state and federal legislative sessions. Issues regarding all areas of CAHSAH from Home Care Aide, Hospice, and Medicare Certified are being discussed and strategy to address the areas are being planned.
During the month of September, a group of six providers met with Congresswoman Linda Sanchez to discuss her federal bill that will eliminate the companion exemption that currently allows the home care aide industry a reprieve from paying our employees overtime. Our goal with the congresswoman is to first educate her on the necessity to continue the exemption, and then work with her on the final draft of the bill.
Please call or e-mail me with any suggestions or concerns you may have. The Board along with the CAHSAH staff values the input from our members.
Respectfully,
Barry Berger
[email protected] x101
CAHSAH Bulletin Published by CAHSAH
Joseph H. Hafkenschiel, President
California Association for Health Services at Home
3780 Rosin Court, Suite 190 Sacramento, CA 95834Telephone: (916) 641-5795 Fax: (916) 641-5881
www.cahsah.org
For advertising and sponsorship information,
please contact:
Ranesh Maharaj, Bulletin Editor
E-mail: [email protected] (916) 641-5795 ext. 120
CAHSAH does not necessarily endorse any of the products, services or meetings advertised in the Bulletin. CAHSAH also does not endorse
the opinions, products or services of guest authors in the Bulletin.
4 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
UPDATE
P OL
I CY
Vital legislation is pending at the federal level that could rectify the unprecedented payment cuts which were proposed in the CMS 2011
home health payment rule. S. 3315; H.R. 5803 known as the Home Health Care Access Protection Act were introduced by Senator Susan Collins and Representative James McGovern to establish a fairer and more transparent process for evaluating case mix changes. A nationwide grassroots campaign composed of State home health associations, AARP and other community coalitions has been established to target each state’s congressional members. It is critical that these bills receive enough congressional members to add on as co-sponsors in order for the bills to receive a legislative hearing.
CAHSAH would like to thank those Medicare home health agencies that have already
sent e-mails through our Legislative Action Network asking their congressional members to co-sponsor the Home Health Protection Act. California agencies have sent over 400
electronic letters but we still have CA congressional members that have yet to be contacted and told how essential these bills are in preserving access to home health services. We need your help in getting every California congressional member to sign on to these bills. Talking points
and background information on the bills is here. A preformatted letter has been prepared which we encourage you to add your specific agency’s details. You can locate your congressional member and send the letter here. Please provide feedback to the CAHSAH office if you receive a response back from your congressional member. Tracking our grassroots efforts is vital to achieving our advocacy goals.
Reviving Up Grassroots Efforts for the Home Health Protection Act
Exemption, continued from p. 1Those who have been in the business for a longer period of time may still struggle to understand its complexities. Wherever you are in this spectrum, it is critically important to utilize the exemption carefully and appropriately.
First and foremost, caregiver job descriptions should be consistent with the Wage Order 15 definition for a personal attendant which is defined in Section 2(J) of the order as:
“Personal attendant” includes baby sitters and means any person employed by a private householder or by
any third party employer recognized in the health care industry to work in a private household, to supervise,
feed, or dress a child or person who by reason of advanced age, physical disability, or mental deficiency needs supervision. The status of “personal attendant” shall apply when no significant amount of work other
than the foregoing is required.
Another key to understanding this definition is the term “no significant amount of work.” CAHSAH was instrumental in receiving an opinion from the California Department of Labor Standards and Enforcement (DLSE) on exactly what is meant by “significant”.
The opinion (click here) clarifies the duties that may be performed and provides detail on the amount of household chores that are allowable under the exemption. Specifically, the opinion states that “any general housekeeping duties performed should not exceed 20 percent of the weekly working time spent by the personal attendant to maintain his or her exemption under IWC Wage Order 15.” Ensuring that your caregivers stay within the 20 percent rule requires accurate recordkeeping of caregivers’ daily tasks. This documentation will be very valuable in the event that a caregiver or other person or entity seeks to challenge your use of the exemption. If the caregiver does not meet this definition under Wage Order 15, home care owners should determine whether the employee may satisfy another exemption under Wage Order 4 or 5. Other exemptions include individuals who are qualified as “Administrative” or “Executive” employees, as those terms are defined in Section 1 of the Wage Orders.
Exemption, continues on p. 5
5www.cahsah.org
Answering your legislative & compliance questions
Ask Mary
Questions: When certifying /recertifying hospice patients, must a physician provide an oral narrative as part of an
oral certification /recertification, if the written certification /recertification cannot be completed within two calendar days?
Answer: From Medicare Hospice Center Q&A, the oral certification/recertification should state that the
patient is terminally ill with a life expectancy of 6 months or less, if the illness runs its normal course. Currently, we do not require the narrative to be provided orally at the same time as the oral certification /recertification. However, we would remind certifying/recertifying physicians and hospices, that while the narrative (verbal or otherwise) is not required as part of the oral certification/recertification, the essence of what the written narrative will ultimately entail in its explanation of the clinical findings that support a life expectancy of 6 months or less, is expected to be the basis for the oral certification/recertification. While a verbal narrative is not required as part of the oral certification/recertification, the written narrative is required prior to filing a claim.
Question: Is there a Medicare Condition of Participation regulation which requires a Medicare certified agency to
provide at least one skilled service in its “entirety” by employees of the agency and does it prohibit an agency from contracting with staff for that category of service?
Answer: From the Medicare Conditions of Participation §484.14(a) Standard: Services Furnished specifies: Part-
time or intermittent skilled nursing services and at least one other therapeutic service (physical, speech or occupational therapy; medical social services; or home health aide services) are made available on a visiting basis, in a place of residence used as a patient’s home. An HHA must provide at least one of the qualifying services directly through agency employees, but may provide the second qualifying service and additional services under arrangements with another agency or organization.
An HHA is considered to provide a service “directly” when the person providing the service for the HHA is an HHA employee. For purposes of meeting 42 CFR 484.14(a), an individual who works for the HHA on an hourly or per-visit basis may be considered an agency employee if the HHA is required to issue a form W-2 on his/her behalf. An HHA is considered to provide a service “under arrangements” when the HHA provides the service through contractual or affiliation arrangements with other agencies or organizations, or with an individual(s) who is not an HHA employee.
If the job description and job duties fall under the definition of Personal Attendant under Wage Order 15, then the employer may not have to pay overtime or provide meal and rest periods. The ability to provide twenty-four hour care to a client without overtime allows owners to preserve continuity of affordable care and establish good caregiver relationships with their clients. While the exemption removes the requirement of overtime pay for this classification of worker, an employer must still ensure that they are paying the caregiver for all hours worked at California’s current minimum wage of $8.00 per hour. This is another sticky area, with which employers struggle to structure wages for caregivers that provide live-in care or otherwise work more than eight hours a day. While Wage Order 15 does provide a definition for “hours worked,” that definition may be subject to differing interpretations. Wage Order 15 defines “hours worked” as “the time during which an employee is subject to the control of an employer, and includes all the time the employee is suffered or permitted to work, whether or not required to do so.” Some interpret “subject to the control of employer” as all hours that the caregiver is in the home; others interpret it as only hours actually worked. The Fair Labor Standards Act, the federal counterpart to the California Labor Code, also defines “hours worked” such that home caregivers are exempt from overtime and minimum wage. We hope to receive clarification from the California Department of Labor Standards Enforcement regarding this issue, and will update our members as soon as we have any additional information.
CAHSAH also has been working to preserve the federal companionship exemption, which is currently being questioned by Congresswoman Linda Sanchez (D-CA) and others in the federal government. Preserving the overtime exemption for home care workers has been a central issue of CAHSAH’s 2010 advocacy efforts. A workgroup, comprised of CAHSAH members and staff, has been formed to develop strategies and already has met with Congresswoman Sanchez. CAHSAH also has met with a Representative of George Miller’s office, Chairman of the Congressional Health, Education, and Labor Committee, to discuss CAHSAH’s concerns regarding a proposal from Labor Secretary Hilda Solis to remove the exemption through a proposed change to current regulations. Whether the issue surfaces in legislation or regulation, CAHSAH will continue to advocate for a solution that protects our members, their employees, and all home-care clients for whom continuity of affordable care is paramount. If you have questions about our advocacy efforts, please contact Jordan Lindsey, Policy Director at (916) 641-5795 ext: 123 or [email protected].
Elizabeth H. Murphy, Esq. is a CAHSAH affiliate and a specialist in home care employment issues and can be
reached at (213) 683-5276 or [email protected]
Exemption, continued from p. 4
In today’s work place, there are two decisions that every company faces when renewing their insurance: which carrier to select and more importantly, which insurance broker to use. Many consumers are under the false belief
that all insurance brokers are created equal and have access to the same insurance carriers and can obtain the same coverage and pricing from those carriers. While, in theory, insurance companies are supposed to provide the same coverage, pricing and rates to each broker, this is not always the case.
There are a variety of reasons why one broker might get better coverage and pricing than another broker for a particular insured. The major reasons include: brokers who specialize in your industry and whom have greater knowledge to provide a more comprehensive submission to the insurance company can negotiate better terms. Additionally, brokers who have exclusive or limited access programs not available to all brokers can drive down pricing and brokers who have stronger relationships with the carriers can utilize that relationship to the betterment of the client. It is important to determine if your broker has these advantages that will ultimately benefit you with better coverage and lower premiums. There are also other cost reducing services to consider that brokers can provide and implement, which I will touch on later in this article.
Some companies prefer to use a local broker, but when most buyers are asked how many times they see their broker, it usually ranges between 1-4 times a year, if at all. Another common response from consumers is they want to support the local community. While it might be nice to support your local economy and community, it should not be at the expense of having inadequate insurance protection at an inflated cost. There are many ways for your company to support the local economy and community which will help your company receive positive recognition while being a valuable marketing tool to you as well. If you do have a desire to select a local broker, it is imperative to
make sure you compare them versus a broker that has the corporate size, market access and industry knowledge to create competition during the quoting process so you can evaluate and compare the two options.
So how do you select the right broker? There are a few ways to go about it. One way is to interview a few brokers 4 to 5 months before your renewal date. Decide on which broker is best suited to handle your needs and also has specific industry programs, services, and attentiveness which you desire. The broker needs to be able to audit your operations and insurance coverage to ensure they align and there are no gaps in protection. The broker also needs to be able to prepare a comprehensive report to market your account to insurance carriers in the best light and provide the most competitive insurance quotations due to the presentation and relationship the broker enjoys with the carriers. The right broker should bring a few carrier options to the table at renewal time and include their opinions and input on the different quotes and companies, while letting you make the final decision.
Another approach is to select two of the brokers interviewed and let them select their markets/carriers and compete for your business. That way the brokers will each have several markets to work
with on your account and feel they have a reasonable chance of working with your company. By giving a broker a good opportunity to work with your company, they will invest the time, energy and commit the resources in creating the best product for your firm. Creating this competition and taking coverage, price and services into consideration, ultimately will land your company with the right broker and carrier. If you ask any insurance sales person, they will tell you that their brokerage firm is the best fit for your company. However, in addition to their experience and market clout, what really makes a broker the most valuable to your company are the services behind the scenes.
Three essential services should be offered by the most qualified brokerage firm; they are Loss Control, Claims
Management and HR Consulting.
Loss Control is crucial to prevent unwanted and “Lazy claims” that can arise by lack of knowledge and know how. Loss Control includes location review & assessments, review of employee hiring guidelines and handbooks, review of your Injury Illness Prevention Program and other policies, procedures and requirements that your company has in place for your employees. When properly implemented and maintained, a comprehensive Loss Control program will lower the number of claims that occur and increase employee awareness of safety in the workplace.
Selecting an Insurance Broker They’re All the Same, Right?
6 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
Essential, continues on p.7
By Steve Parkhurst, Heffernan Insurance Brokers
7
The second service your broker should offer is Claims Management. Claims Management is designed to monitor and expedite the closure of open claims while keeping an eye on reserve amounts to eliminate over reserves by the insurance company, as well as to push claims to close as quickly as possible. By monitoring claims reserves, which are sometimes over stated, you are assured that they are kept at the appropriate level and don’t negatively affect your company claims experience which can drive up your ultimate insurance costs. Aggressive claims management will help reduce your experience modification because it keeps the claims total cost down which is used in the calculation.
The third service that your broker should offer is HR consulting and hotline. This is a tool that can be a life saver for any company. When dealing with firing, hiring or sensitive employee issues the HR hotline can be called to make sure that the proper steps are utilized to prevent any retaliation or inappropriate HR decisions. All of these tools should be offered by your broker to ensure that you are getting the “bells & whistles” that go along with established brokers.
In addition to the three essential services described above, it is also very helpful for your broker to offer other ancillary services such as Health Benefits, 401-k and Retirement Plans, etc.
The bottom line is your broker needs to have the expertise, industry knowledge, niche programs and utilize their overall market clout to get the job done for you. Look for a broker that you trust and aligns with your company to offer the best options for your company year in and year out.
For more information on selecting the right broker, feel free to contact me at: [email protected] or visit our website at www.heffins.com
Let Heffernan take care of the insurance. So you can focus on what you
do best. Specialists in home care
insurance, offering workers comp,
liability and more, Heffernan has
worked with CAHSAH for over
15 years. Contact Melani Conti
at [email protected] or
John Prichard, Jr. at johnpjr
@heffgroup.com.
800.234.6787 heffgroup.com License #0564249
care ad.indd 1 3/16/09 3:37 PM
Considering Telehealth?
The Eddy Visiting Nurse Association, a not-for-profit home health care agency based in Troy, New York, recently completed a one-year pilot study that identified several significant benefits resulting from
the utilization of telehomecare intervention, including a dramatic drop in the rate of patient hospitalizations (55 percent), emergency room visits (29 percent), and total medical costs (42 percent).
They are now refining their telehomecare discharge plan and devising a way to empower patients with measurement tools to enhance patient compliance. Eddy VNA strongly believes in the potential of the program to benefit payers, providers and patients alike.
Click here for the complete article published in the July 2010 issue of Caring Magazine by the National Association for Home Care and Hospice (NAHC).
Essential, continued from p.6
www.cahsah.org
8
UPDATE
M E MB
ER
SH
IP
How long have you been in business?
SingleSource was established in 1995 and has been in business continually since then and now boasts over 2,300 established clients in all industries and geographies.
Where are you located?
SingleSource is headquartered in Jacksonville Beach, FL from where all clients are serviced. Our hours of operation are from 8am PST to 5pm PST.
Do you have existing home care clients?
SingleSource has clients nationwide in the healthcare industry in general and is especially proud to call over 200 Visiting Angels franchisees our clients. These include a number in California who have valued our quality and integrity for a number of years.
How can I best become familiar with your site for my most efficient use?
Request a demonstration and allow us to guide you through your specific question or concern.
How long does it take to set up an account?
Usually same day
What is progressive screening and how can I best use that to my advantage?
Normally our clients order a package for a background screening inquiry. This method allows for the process to be conducted search by search and can be used to cut costs if early inquiries produce information disqualifying the candidate.
Will you provide guidance so that we are not over-screening or under-screening?
Our packages were designed to provide the best opportunity to ensure a suitable care giver is hired. You will always be able to add
supplemental searches to a package if there are special requirements.
Do you provide training? Is software installation required?
Our system is a web based program and so no software downloads are needed. Our
team walks every new client through set up, ordering, and how to retrieve reports. A dedicated account representative can answer any question as it relates to reporting.
What about turnaround times?
99.9 percent of database searches are same day/next day. County level searches are promised within three days but
marginally this is exceeded due to issues beyond our control.
What about reports? Will we be able to customize for our specific locations?
Our system provides many standard reports, but each user has the ability to create and download custom reports to meet their needs.
How do you ensure accuracy and current information?
We check our research with “salted requests” – inquiries to which we know the answer. All records found are reviewed before submission to users. We monitor laws, and our system flags state and federal legal issues such as California’s laws relating to copies of reports.
Will CAHSAH have a key contact for every day questions or will I be sent to a customer service center?
Each account has a dedicated account representative from our team. We answer the phones with people, not technology.
Contact Information:
Carl Tremble, Director of Business Development800-713-3412, ext 111
www.singlesourceservices.com
CAHSAH’s NEW Group Purchasing Vendor for Background Screening
The following Q&A is the beginning of a series of articles to acquaint you with SingleSource and the services they provide and to provide background screening information and education.
Q
CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
9
When I joined Accredited over 11 years ago, I was always encouraged to develop relationships with my home care competitors. Accredited’s culture of working
with ‘friendly competitors’ comes from a belief that we can do more good for our community and our industry by working together than by working against one another. When I joined CAHSAH’s Board of Directors last year, I hoped to spread this philosophy amongst our
membership. Working with CAHSAH Staff and Committee Members, we developed RAMP (Referrals and Admissions for Member Providers). Basically RAMP is a concept to promote
member-to-member referrals, much like a Chamber of Commerce would hope to accomplish.
The RAMP Concept definitely works. Last year, Accredited admitted 22 patients and generated $109,240 from CAHSAH member referrals. Okay I won’t lie, the dollar figure is nice and is yet another incredible benefit of paying our CAHSAH dues,
but it is equally satisfying to know you’ve earned the trust and respect of other home care cohorts.
RAMP is a new CAHSAH program and we’d love to hear your success stories. We want to help you track and quantify this CAHSAH added-value. First, review your Inquiry/Referral Call logs every month. Second, identify all referrals
from other home care agencies. Third, check the CAHSAH website to see if these agencies are CAHSAH members. Fourth, every month calculate the revenue for these admissions. Fifth, share this information with CAHSAH.
This takes me about 30 minutes each month but it reinforces the value of being a member.
Of course, just joining CAHSAH isn’t a guarantee that referrals will come. Get involved. Meet your CAHSAH colleagues locally or as part of CAHSAH-sponsored events. And remember one of the Ten
Commandments of Networking – ‘Thou Shalt Give the First Referral’. Next year, we will report on the impact of RAMP for all members. Get involved now.
Neil Rotter, Vice President of Business DevelopmentAccredited Home Health Services
Contact CAHSAH group purchasing vendors directly:
Heffernan Insurance Brokers (800) 234-6787
Workers’ Compensation & Liability Insurance
Provista
(888) 538-4462National Supply Chain
Philips Telehealth Solutions (866) 554-4RPM
Telehealth Equipment
SingleSource Services (800) 713-3412
Background Screening
Strategic HR Services (800) 789-5655
Human Resources Services
CAHSAH Group
Purchasing Programs
If you are not currently participating in one or more of
CAHSAH’s group purchasing programs, you are missing out!
Take time to SAVE TIME and/or DOLLAR$ -- now and later!
“Heffernan Insurance Brokers approached us to offer a
quotation for our renewal. Since they are the CAHSAH
group purchasing vendor for workers’ compensation and
have specialized in home care for over 20 years, we gave
them a shot. We were more than pleased. They saved us over $14,000 and were
extremely easy to deal with. We have been very pleased with their customer service
and ongoing efforts to help us save money.”
Sharon NiederhausCompetent Care, Costa Mesa
A GPO Participant
‘Thou Shalt Give the First Referral’
www.cahsah.org
10
CAHSAH Welcomes New Members!
Please help us extend a warm welcome to those new members who have recently joined CAHSAH between
August 17, 2010 and September 21, 2010.
ProvidersAmdal In Home Care, Tulare, CAAuspice Home Care, Fresno, CA
Helping Hands, Pacheco, CAiCare Home Health Agency, LLC, Pinole, CA
NurseInstead Inc., Palo Alto, CARegency Senior Care, Los Alamitos, CA
Senior Assist of the Peninsula, LLC, Burlingame, CA
AffiliatesAshken Chglyan, Sun Valley, CA
Lori Butler, Rancho Palos Verdes, CASingleSource Services, Jacksonville Beach, FL
MEMBER SPOTLIGHT
CAHSAH truly appreciates your commitment of time and your passion for the home care industry!
At Your Home Familycare receives 2010 San Diego Awardfor the second consecutive year. At Your Home Familycare has been selected for the 2010 San Diego Award in the Non-Medical Home Care Services category by the U.S. Commerce Association (USCA).
The USCA “Best of Local Business” Award Program recognizes outstanding local businesses throughout the county, identifying companies they believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and community.
CAHSAH congratulates Laurie Edwards-Tate and her staff for their fine industry and community representation!
Gabriella Ambrosi, Sequoia Senior Solutions, Inc Barry Berger, Accredited Home Health ServicesKarrie Decker, Kaweah Delta Home Health AgencyDave Dial, Pro-Care Home Health ServicesKen Erman, Rx Staffing and Home CareCraig Falk, Craig CaresJason Grinstead, Care At Home
Thanks to our members who have supported CAHSAH’s recruiting and retention efforts, which include projects
such as phone calls, handwritten notes, task force participation, conversation with peers, testimonials:
Are You Displaying the MOST CURRENT CAHSAH Logo?
If you have a signed License Agreement with CAHSAH to use the CAHSAH logo on your website, stationery, brochures or as part of your promotional material, please be certain you are using the CURRENT logo. If you need an updated CAHSAH Logo, please contact Michele at [email protected] or (916) 641-5795, ext. 129.
If you would like to use the CAHSAH logo but do not have a signed License Agreement on file, click here. Please review, sign and either fax to (916) 641-5881 or email to Michele at [email protected]. A file of the logo will then be emailed to you.
Online Update CapabilityNext week each member agency will receive the link, ID and password, allowing our members to manage their organizational profile online at their convenience – i.e., agency name, address, phone number, e-mail, services, accreditations, key contacts, payment accepted, etc. The online Resource Guide is updated monthly and will reflect any changes made.
It’s easy. You just have to follow the instructions on the input screen. This will keep the online information and CAHSAH’s database current and will eliminate the summer push in preparation for the published copy.
Watch for your new ID and password, then Go online and take a look!
MEMBERSHIP UPDATES
CAHSAH’s YouTube ChannelBe sure to take a look! New videos are added on a regular basis – CAHSAH events, late breaking news, member testimonials, to name a few.
If you are interested in recording a CAHSAH testimonial, contact Ranesh at [email protected] for more information.
click here
CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
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www.cahsah.org
Extraordinary Executives Produce Extraordinary Results
Executive management is an important investment in the people who lead and execute your organizational
strategies. It is also something that often gets side-barred because business executives are busy and have numerous priorities. However, well-trained executives can enhance productivity, produce better alignment between business functions, improve retention of talented employees, and build overall morale in the agency. The results of Hospice and Home Care Executive Certificate Programs will filter through your agency and provide bottom line results and produce operational achievements. By attending these programs you will gain a sense of confidence and a practical working knowledge that will create the alignment needed to achieve extraordinary results.
Click here for more information on these certificate programs, or contact Richard Starks at: [email protected] or (916) 641-5795 ext. 117.
Dates and LocationHospice Executive Certificate Program
November 2-4, 2010 - New York, NY
Home Care Executive Certificate ProgramNovember 3-5, 2010 - New York, NY
Program brought to you by: CAHSAH with support of NAHC and
The Corridor Group
Program sponsored by: Care West Insurance Risk Management
and HospiScript
Is ADR on Your Radar?Sponsored by: Kinnser Software
If ADR isn’t currently on your radar, it should be! Many agencies have already experienced ADRs and quickly learned the effect of it. Home Health ADRs affect
sequential billing which means Medicare won’t pay that claim until it is resolved. Taking a risk by not educating yourself or staff may be critical to your cash flow.
Sign up for this upcoming course that will provide basic information on the Additional Development Request (ADR) process. From medical review to claim denials, and the appeal process, our expert faculties, Annette Lee and Sally Rosiello will supply you with helpful suggestions for responding to ADRs in an appropriate and timely manner.
Dates and LocationsDecember 6, 2010 - Sacramento, CA
December 7, 2010 - Ontario, CA
For more information or to sign up for this program, please visit our website.
The Insider’s Guide to Home Health Software
We all have many of the same questions about home health software:
How do I get started? Who do I include in the decision?What are people in my area using?
Attend this interactive one day workshop led by consultants Carol Anderson and David Tapia, to learn an effective process to both select the right software for your agency’s point of care, billing and administration needs as well as implement it to maximize the value of your investment. At the end of the workshop, stay and listen to a panel discussion which features representatives from various home health agencies discuss the variety of vendors on the market today. This workshop is recommended for any agency owner or administrator who is actively considering a software solution and/or any individual considering starting or buying a home health agency.
Dates and Locations November 16, 2010 – Ontario, CA
November 17, 2010 – Sacramento, CA
Program sponsored by Kinnser SoftwareFor more information please visit our website.
12 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
Don’t Leave Money on the TableSign Up for OASIS-C Training
Sponsored by: Kinnser Software
Often times, reimbursement issues tend to be overlooked when clinical training occurs. Diagnosis coding can also negatively impact reimbursement amounts if clinicians aren’t careful. The best thing an agency
can do is give their clinicians the training they need to ensure proper reimbursement. The upcoming OASIS workshop will dedicate an entire session to the review of the NRS calculation, reimbursement, orders requirements, as well as all “M” Items that will impact reimbursement. Other sessions will include review of administrative process changes, reporting of M0110, defining a correction policy and review of each section of the OASIS-C with specific instructions on completion of these items.
Workshop Dates and Locations:November 2-3, 2010 – Sacramento, CA
November 4-5, 2010 – Ontario, CA
The COS-C Exam will be offered following the workshop. Please visit www.oasiscertificate.org for additional details.
Exam Dates and Locations:November 3, 2010 – Sacramento, CA
November 5, 2010 – Ontario, CA
How to Produce Audit Proof Care Workshop Wrap Up
Arnie Cisneros P.T., of Home Health Strategic Management presented to over 150 attendees last month on “How to Produce Audit Proof Care”. The program was very well received, with high evaluation scores and rave reviews. Arnie addressed an important topic for Home Health providers currently facing audits and other refinements to the Medicare system which included how to modify care practices to address changes facing our industry. Audience members, consisting of owners, administrators, managers, and clinicians currently working in homecare, experienced a rousing session that included information on progressive topics such as a History of Medicare Reforms, S.U.R.C.H., A Utilization Review program for homecare and OBQI Case Conference. A new twist on an old model, strategies for the 2011 PPS Proposed Rule, and crowd-pleasing interactive exercises to help integrate the changes in philosophy required by the latest reforms. Whether you missed this program or want to educate your staff on the topic, this program is now available on audio CD.
PROGRAM Audio CD & HANDOUT FOR SALE:Members: $168.56 Non-Members: $331.69
For more information on ordering an audio CD of this workshop, please contact Kairsee Tacher at (916) 641-5795 ext. 113
“Excellent course.” “Great presentation.” “I wish I had my staff present so they could get it.”
Hospice and Home Care Administrator Program
The Hospice Administrator Certificate Program and the Home Care Administrator Certificate Program were once again resounding successes in Las Vegas. With over 150 people attending the sessions, it was
a fast-paced and information-filled three day program. Some participants were graduates of the HMCP and HCMCP, and others were experienced hospice and home health professionals looking for more education. But everyone enjoyed the interactive discussions, the excellent faculty and the Las Vegas venue.
The speakers in each program brought years of experience in the industry and leading edge, fresh information so the participants could strengthen their skill as administrators and help guide their programs to success in the changing regulatory and reimbursement environment.
Jeannee Parker Martin, RN, MPH, President of The •Corridor Group framed up each program with her updated presentation on trends in the industry and strategic positioning for success. Christine Lang, Senior Director of Product Strategy •for OCS provided insights into quality performance management and understanding the direct application of good measures and data analysis on successful hospice and home health providers.Christie Whitney, President and CEO of Hospice & •Palliative Care of Western Colorado, “wowed” the HACP attendees with her understanding of the hospice industry and also the application of strategic positioning fundamentals to successful growth.Teresa Craig, CPA, CEO of Suncoast Solutions, provided •an excellent framework for understanding hospice financials.Ken McNulty, CFO at VNA of Boston and Lynda Laff, •Associate of The Corridor Group, brought home the financial and clinical realities of managing a home health agency.Deborah Randall, Esq., of the Law Office of Deborah •Randall, provided a mini-law course on how your organization must be rigorous in all aspects of compliance to assure you don’t find you or your organization facing unnecessary penalties.
If you qualify for the Hospice or Home Care Executive Program, we are presenting an incredible program in New York from November 2 -5 with an exciting faculty: Bill Dombi from NAHC, Kathy Dodd from The Corridor Group, Pat Laff of Laff Associates and Lynda Laff of The Corridor Group, Chris Attaya of Partners Home Care and Hospice. The exciting format is a case study format, so don’t miss out!
For a list of graduates of these two programs, please visit the CAHSAH website at: http://www.cahsah.org/educational_events/Cert_Programs.asp
For more information on the Executive Programs and 2011 Manager and Administrator Programs, go to http://www.cahsah.org/educational_
events/Cert_Programs.asp for dates and locations.
Attendees comments included:
WRAP UP
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Home Care Providers Indicted for Referrals Kickbacks
Elizabeth E. Hogue, Esq.
On December 18, 2008 a federal grand jury indicted owners and employees of eight home health agencies in the Metro-Detroit
area on charges that they took part in a plan to solicit and pay kickbacks in exchange for Medicare patient referrals. This plan was devised by Rebecca Sharp, president of Continuing Senior Care, Inc. in Ypsilanti, Michigan, who allegedly received over $1.1 million in kickbacks.
According to the indictment, Sharp obtained potential home health patients by directing her staff to randomly telephone senior citizens in order to offer them medical services and chore workers. If any senior citizen was curious as to how Continuing Senior Care received his or her contact information, employees were instructed to state that this information came from Medicare. When a senior citizen agreed to the offer, employees would acquire patients’ Medicare information. Patients would then be visited by a doctor, employed by Sharp, who measured vital signs and prescribed home health care to all patients, whether or not it was medically necessary.
Following this, Sharp referred the Medicare patients to home health care agencies. She allegedly offered to refer eighty patients and Medicare numbers each week in exchange for a $250 fee per patient. In addition, Sharp claimed that the doctors whom she employed would sign plans of care regardless of patients’ actual medical needs.
With regard to the ramifications of this case, U.S. Attorney Terrence Berg stated that “when Medicare is abused by unscrupulous persons to pay for unnecessary treatment and to garner kickbacks, that conduct harms both legitimate Medicare recipients as well as the program itself.”
There is a federal law that prohibits illegal remuneration. This law is often called the anti-kickback statute. It generally says that anyone who either offers to give or actually
gives anything to anyone in order to induce referrals has engaged in illegal conduct. In this case, the payments allegedly made by home health agencies to Continuing Senior Care seem to have been made in exchange for referrals in direct violation of the anti-kickback statute.
In addition, it is important for providers to note that if the referrals were obtained illegally in violation of the anti-kickback statute and agencies submitted claims for services provided to patients referred by
Continuing Senior Care, such claims may also violate the federal False Claims Act. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services, the primary enforcer of fraud and abuse prohibitions, has clearly stated that claims submitted for services provided to patients who were referred in violation of applicable
prohibitions are “false claims.” Submission of false claims may also result in criminal prosecution and/or civil liability, amounting to many thousands of dollars and suspension or exclusion from participation in the Medicare and Medicaid Programs and other federal and state healthcare programs.
In addition to the necessity to avoid payment of kickbacks, therefore, providers must be scrupulous about avoiding all illegal strategies for obtaining referrals. When referrals are obtained by any unlawful means, the consequences can be extremely significant for providers.
Consequently, as part of the development of new marketing strategies, management must always explore the legal boundaries of proposed methods of marketing prior to implementation. In order to do so, marketing staff cannot be allowed to implement new marketing programs without review and approval by management. Review must include a thorough examination of whether the marketing program, as proposed, violates applicable prohibitions and, if so, whether it can be changed so that it passes muster.
©Copyright, 2010.Elizabeth E. Hogue, Esq. All rights reserved. No portion
of this material may be reproduced by any means without the advance written permission of the author.
www.cahsah.org
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General BusinessAB 1735 (Harkey)
Created a tax credit equal to 50 percent of the amount of costs paid or incurred in connection with additional career advancement or retention education and training.
Support Died in Revenue and Taxation Committee
AB 2334 (Salas)
Prohibits a medical provider, or health facility from charging, assessing, or collecting, directly or through a collection agency, or pursuant to any judgment, any interest on, or late fees or charges out of, any unpaid bill for medical services rendered.
Oppose Gutted and Amended to no longer impact home care
Health Care PracticesSB 971(Pavley)
Would impose specified requirements on providers of blood clotting products for home use used for the treatment and prevention of symptoms associated with bleeding disorders.
Neutral To the Governor’s Desk
HospiceAB 950 (Hernandez)
Would allow in-patient beds as part of a hospice’s current license and not require the hospice to have a separate facility license.
Support Died in Appropriations Committee
AB 2523(Nava)
Relaxes the congregate living health facility (CLHF) population requirement to allow for a CLHF in a population with 400,000 persons.
Support Died in Senate Appropriations
Health Care CoverageAB 2586 (Chesbro)
Would require a plan or an insurer that contracts with providers to obtain approval from its regulating dept. prior to implementing a health network modification.
Support Died in Appropriations Committee
LaborAB 179 (Portantino)
CAHSAH sponsored bill to remove the weekly pay requirement. Would permit employees of temporary services employers of health care services to be paid semimonthly.
Support Died in Labor & Industrial Relations Committee
AB 482 (Mendoza)
Prohibits an employer from obtaining a consumer credit report for employment purposes unless the information is substantially job-related.
Oppose Vetoed by the Governor
AB 1603 (Solorio)
Would require that an employee be deemed to be temporarily partially disabled during the period when the employee’s disability is permanent and stationary, no more than 60 days have elapsed after the date the employee was informed that his or her disability is permanent and stationary, the employer has not offered the employee regular, modified, or alternative work, and the employer has not informed the employee that it will not offer the employee regular, modified, or alternative work.
Oppose Died in Insurance Committee
AB 1994 (Skinner)
Would provide, with respect to hospital employees, that the term “injury” includes a blood-borne infectious disease, neck or back impairment, methicillin-resistant Staphylococcus aureus (MRSA), or H1N1 influenza virus that develops or manifests itself during the period of the person’s employment with the hospital.
Oppose Died in Appropriations Committee
AB 2187 (Arambula)
Creates a separate prohibition against a person or an employer who, willfully fails to pay all wages due to an employee who has been discharged or who has quit within 90 days of the date of the wages becoming due and would impose additional criminal penalties for such conduct.
Oppose Vetoed by the Governor
NursingSB 182 (Ashburn)
Would delete the limitation that temporary clinical nursing faculty be employed for not more than 4 semesters or 6 quarters.
Support Failed passage in Higher Education Committee
State Funded ProgramsAB 1260 (Huffman)
CAHSAH sponsored bill to achieve the budget objective of $5.3 million in savings associated with cuts to respite services without applying an arbitrary and excessively restrictive cap.
Support Gutted and Amended to become another bill
AB 1506 (Anderson)
Would require a state agency to accept, from any person or entity, a registered warrant or other similar evidence of indebtedness issued by the Controller endorsed by that payee, at full face value, for the payment of any obligations owed by that payee to that state agency.
Support To the Governor’s Desk
AB 1864 (Strickland, Audra)
Would provide that Medi-Cal providers be paid even when the state has not passed a budget for the current fiscal year.
Support Gutted and Amended to become another bill
SB 886 (Florez)
Would authorize the providers of specified in-home services to use electronic timekeeping for verifying tasks completed and ensuring quality home care for in-home recipients.
Support Died in Senate Appropriations
CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME
CAHSAH State Bill Tracking Priority A Legislation
CAHSAH BOOKSTORE Labor Law for the Non-Union Agency by John Gilliland, Gilliland & Markette LLP
Is your agency taking the necessary steps to remain “union free”? This guide helps explains the mechanics of union organizing and gives a realistic step by step approach on how to avoid becoming a target.
Members: $107.66 Non-Members: $216.41
California Wage & Hour Law for Home Care Aide Organizations An Overview
An overview to wage and hour law in California that may apply to your organization including wage orders, minimum wages, meal & rest periods, requirements for time sheets, maximum hours and days of work, violations, and enforcement. Designed to expose agencies to common wage and hour issues as well as how to comply with the
requirements of California wage and hour law.
Members: $168.56 Non-Members: $331.69
Wage & Hour and Labor Laws... All Available in the CAHSAH Bookstore!
*All prices include shipping, handling & tax. Call (916) 641-5795 ext. 113 or visit www.cahsah.org to order these essential resources!
Bill Number Description Position Location
15www.cahsah.org
Federal Bill ListBill Number Description Position LocationAbuseS 795(Hatch)
Creates an Elder Justice Coordinating Council and an Advisory Board on elder abuse, neglect and exploitation which will be responsible for coordinating public and private activities and programs related to elder abuse
Watch Referred to Finance Committee
Health Care CoverageH.R. 3590(Rangel)
Senate version of health care reform, referred to as the Patient Protection and Affordable Care Act (PPACA),
Watch Signed by the President
S. 3315(Collins)
Amends the Patient Protection and Affordable Care Act with respect to the prospective payment system for home health services and adjustments for case mix changes. Requires beginning 2011 and each subsequent year that any evaluation of case mix changes and any such adjustment be made using standards developed consistent with specified processes, taking certain criteria into account. Directs the Secretary to convene a Technical Advisory Group to advise on the development of such standards.
Watch Referred to Finance Committee
Health Care WorkforceH.R.468 (Schakowsky)S.245 (Kohl)
Expands training and support to all sectors of the health care workforce to care for the growing population of older individuals in the United States.
Watch Referred to House Education and Labor Committee
S 631(Kohl)
Establishes a pilot project to identify efficient, and economical procedures for long-term care facilities or providers to conduct background checks on prospective direct patient access employees on a nationwide basis under similar terms and sets requirements for states participating by requiring: searches of neglect registries and databases; searches of proceedings that may contain disqualifying information; searches of federal criminal history records, including fingerprint check and ways to reduce duplicative fingerprinting.
Watch Referred to Senate Finance Committee
S 1788(Franken)HR 2381(Conyers)
Requires the use of engineering controls to perform all lifting, transferring, and repositioning of patients and eliminates manual lifting of patients except where the use of safe patient handling practices can be demonstrated to compromise patient care.
Oppose Referred to Subcommittee on Health, Employment, Labor and Pensions
Home HealthHR 5803 (McGovern)S. 3315 (Collins)
Preserves access to home health services by establishing a more transparent process for evaluating case mix changes.
Support Referred to House Energy & Commerce Committee
HR 4993 (Schwartz)S. 2814 (Collins)
Allows Nurse Practitioners, Advanced Practice Nurses, and Physician Assistants to sign Medicare home health care plans.
Support Newly Introduced
HR 1094(Lewis)
Permits a home health agency to determine the most appropriate skilled service to make the initial assessment visit for an individual who is eligible for home health services under Medicare but does not require skilled nursing care as long as that skilled service is included as part of the plan of care for such services.
Watch Referred to House Energy & Commerce Committee
S. 1157(Conrad)
Would protect and preserve access for Medicare beneficiaries in rural areas to health care providers under the Medicare program and reinstate the 5 percent Medicare home health rural add-on for calendar year 2010.
Support Referred to Senate Finance Committee
H.R. 3030(Waltz)
Sets up pilot projects through the Dept. of Health and Human Services to provide incentives for home health agencies to use remote monitoring technologies and identifies various performance targets for participating home health agencies to meet and mandates that incentive payments be given to participating home health agencies based on having met performance targets.
Support Referred to House Energy and Commerce Committee
Home Infusion
HR 574 (Engel)S.254 (Lincoln)
Amends title XVIII of the Social Security Act to provide for the coverage of home infusion therapy under the Medicare Program.
Support Referred to House Ways & Means Committee
HospiceS.421 (Specter)
Imposes a temporary moratorium on the phase out of the Medicare hospice budget neutrality adjustment factor.
Watch Referred to Senate Finance Committee
S.1150 (Rockefeller)
Would make hospice a required benefit under Medicaid and the Children’s Health Insurance Program (CHIP), and for children, requiring concurrent coverage of both hospice and curative treatment.
Support Referred to Senate Finance Committee
Information Technology/TelemedicineHR 2068(Thompson)
Removes current geographic restrictions on the provision of telehealth services furnished via a telecommunication system by a physician to an enrolled individual. Authorizes payment of eligible telehealth providers or suppliers other than a physician or telemedicine practitioner.
Watch Referred to House Committee on Energy and Commerce, and Committee on Ways and Means
MedicareH.R.27(Biggert)
Amends title XVIII of the Social Security Act establishing additional provisions to combat waste, fraud, and abuse within the Medicare Program.
Watch Referred to House Judiciary
H.R.902 (Smith, A.)S.712 (Feingold)
Amends title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas.
Watch Referred to House Energy & Commerce Committee
H.R.1670 (Davis, D.)
Amends title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports.
Watch Referred to House Energy & Commerce Committee
UnionizationHR 1409(Miller)S. 560(Kennedy)
Amends the National Labor Relations Act to establish a check card system to enable employees to form, join, or assist labor organizations, to provide for mandatory injunctions for unfair labor practices during organizing efforts.
Oppose Referred to Subcommittee on Health, Employment, Labor and Pensions
Better Outcomes Through Standardized Patient CareNEW Automated Rules Management Feature
McKesson Supply Management Online now offers Automated Rules Management to help control costs while increasing efficiency.
The technology you already use, Supply Management Online, makes rules management easy for you. With this new feature, you can now enhance quality of care while monitoring and reducing unnecessary costs, all with a simple set-up.
Rules management is a tool for you to:
Supply Management Online helps you to execute your strategies and comply with Prospective Payment System (PPS) requirements simply while reducing waste and controlling costs.
To learn more about how to streamline patient care and simplify staff use of supplies, contact McKesson Medical-Surgical today at 888.822.8111.
McKesson Medical-Surgical8741 Landmark RoadRichmond, VA 23228888.822.8111
www.mckesson.com
©2008 McKesson Medical-Surgical Inc.2008-0077
Supply Management Online’s new rules management feature helps you:
Manage protocols according –to your pre-established guidelines Monitor appropriateness of –product use Track adherence to protocol –guidelinesAchieve cost savings –
Manage supply costs for patients – Control products purchased by clinicians –Avoid over-utilization of products –
Limit products purchased to –approved formulary Reduce chances of non-reimbursement –
