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States from Rhode Island to

California are being forced to

curtail Medicaid, the govern-ment health insurance pro-

gram for the poor, as they

struggle to cope with the dete-

riorating economy.

With revenue falling at the same

time that more people are losing

their jobs and private health

coverage, states already have

pared their programs and many

are looking at deeper cuts for the

coming year. Already, 19

states and the District of Colum-

bia have lowered payments to

hospitals and nursing homes,

eliminated coverage for sometreatments and forced some

recipients out of the insurance

program completely.

Many states are halting pay-

ments for health care services

not required by the federal gov-

ernment, such as physical ther-

apy, eyeglasses, hearing aids

and hospice care. A few states

are requiring poor patients to

chip in more toward their care.

The Democrats, who hold ma-

  jorities in the House and the

Senate, are sounding sympa-thetic for now. They are consid-

ering close to $100 billion to

increase the share of Medicaid's

costs that the federal govern-

ment would pay during the next

two years.

Read the full story 

Source: Washington Post 12/26/2008

be effective October 1, 2008,

while implementation for other

rules will be deferred until 2009.

This Alert will review the high-lights of the new rules, which

are scheduled to be published in

the Federal Register on August

19, 2008.

The new Stark Law regulations

were posted by CMS as part of 

the hospital inpatient prospec-

tive payment systems ("IPPS")

rate regulations for fiscal year

October 2008 Compliance

Deadline for "Stand in the

Shoes"

New Stark Law regulations

posted on July 31, 2008 by the

Centers for Medicare and Medi-

caid Services ("CMS") revise

and expand the prohibition on

physician referrals for desig-

nated health services ("DHS") to

entities with which they have

financial relationships.

Some of the new final rules will

2009. Also posted on July 31st

were the Skilled Nursing Facil-

ity Prospective Payment System,

the Inpatient RehabilitationFacility Prospective Payment

System, and the Hospice Wage

Index rates. Generally, these

final rules are to be effective

October 1, 2008 for the new

federal fiscal year.

Read the full story. 

States Cut t ing Medicaid Coverage

CMS Stark Regulati ons Tight en Refer ral Rules

Why ICD-10 is Wor th t he Troub le

Page 2 Home Health Care Focus — Indura Systems

The Washington Post re-

ports that more states are

cutting Medicaid coverage.

The 30 year-old ICD-9-CM

code set is antiquated and can

no longer meet the demands of 

healthcare’s data needs. 

Both ICD-10-CM and ICD-10-

PCS offer greater details and

increased ability to accommo-

date new technologies and pro-

cedures. The codes have the

potential to provide better data

for evaluating and improving the

quality of patient care.

The US is the only industrialized

nation not using an ICD-10 – 

based classification system for

morbidity purposes. This makes

it difficult to share disease data

internationally at a time when

such sharing is critical for public

health. The US’s ability to track 

and respond to global threats in

real time is thus limited. It is

anticipated that ICD-10-CM will

open new opportunities in injury

research and trauma services

evaluation. It will provide much-

needed improvements in accu-

rately classifying the nature of 

injuries and correlating them

with cause, treatment, and out-

come.

www.ahima.org 

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Volume 1, Issue 1 Page 3

The Centers for Medicare &

Medicaid Services (CMS) an-

nounced in December 2008, it is

requiring certain durable medi-

cal equipment suppliers to post a

surety bond. In addition, CMS is

announcing that it has revoked

the billing privileges of more

than 1,100 medical equipment

suppliers in south Florida and

southern California and sus-

pending payments to home

health agencies in the Miami-

Dade, Fla. area.

―We know the majority of medi-

cal equipment suppliers and

health care providers want to

improve the health of Medicare

beneficiaries, but we also know

there are those who look for any

opportunity to take advantage of 

  beneficiaries and Medicare,‖

said CMS Acting Administrator

Kerry Weems. ―The steps we

are taking today provide us with

additional oversight of the sup-

pliers who furnish medical

equipment to Medicare benefici-

aries and those who provide

home health services in South

Florida.‖ 

CMS is continuing to fight

waste, fraud and abuse by home

health suppliers in the Dade

County, Fla., area by suspending

payments and taking other pay-

ment and review actions. On

Oct. 6, CMS initiated efforts to

address potential waste, fraud

and abuse by suspending pay-

ments to 10 home health agen-

cies and is continuing to review

claims and payments to other

agencies as resources allow.

Read the full story. 

Q: When I print my calendar, not all the services

scheduled are seen on the report.

A: There is a useful report in Igea named

“Caregiver Calendar by Certification Period” bywhich the configuration of the calendar can be

changed.

This report is located in the Reporting section,

Scheduling and Tracking, Caregiver Calendar by

certification period. Once you are in that section,

select the ―setting‖ button. 

A pop-up window will appear allowing you tochange the Visit configuration date and Day configu-ration. Then you press the save button.

Q: When I am making changes to the POC,

and then view the 485 Form and print it out, the

changes are not being reflected. Why is this?

A: It is because you are editing a Mod. Order, in-stead of the actual POC 485.

In order to make changes to the POC itself, first go

to the “Chronology Home” tab in this section, and

select the POC or Recert Order in which you want

to make changes.

After this, press edit and continue with the editing,

then hit save when you are done.

CMS St rengt hens Ef for t s to Fight Medicare

Fraud and Abuse

standing of Igea HHC and iPOC, allowing them to

work faster and smarter.

Indura Systems Customer Support is available dur-

ing normal business hours and can be contacted from

the Support button in your Igea HHC application, by

phone or email.

Indu ra Systems Customer Suppor tNow customer support is just a mouse-click away.

Igea users recently received the latest HHC update

from Indura Systems. Included in the update is a

―Support‖ button that gives users direct access to

Remote Assistance — live customer support at the

click of the mouse. In moments, a qualified cus-

tomer support representative will be available to

guide users through their operational problems, al-lowing the user to get back to full productivity in a

shorter time.

As the user can interact with the customer support

representative, they develop a more detailed under-

“...users develop a more

detailed understanding of Igea

HHC and iPOC, allowing them

to work faster and smarter…”  

Indura Systems Customer

Support—Igea experts—

home health care experts

Igea Quest ions and Answers

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Igea System is user friendly. It

covers every need in the Home

Health Industry and the Cus-

tomer Support team is always

there when we need them.

Ernesto Diaz - CEO - Samy

Nursing Corp. 

As of today we can truly echo

the sentiments of many. It is

user friendly and pleasing to

the eye. The menus are easy tonavigate. We have used the

support team and were very

pleased with the professional

and efficient help we received.

As well as these comments,

we regularly hear from cus-

tomers who have been able to

Thomas Campos - CEO -

TaCare Home Health

Agency I can honestly tell you that in

my 17+ years of being in this

industry. Igea is the best sys-

tem I have ever seen and the

response time from the Indura

Systems team is great!

Francisco Abreu - Adminis-

trator - Llerena HomeHealth Care, Inc 

I'm very happy with your cus-

tomer support team. They give

me VIP service.

Juan Parrado - CEO - The

Lakes Homehealth Corp 

reduce their back office staff 

overhead since implementing

Igea HHC. In many cases,

users of other HHC manage-

ment systems switch to Igea

because of the cost savings

available. It is not uncommon

for operating costs to be cut by

$50 ,000 — $100 ,000 / ye a r

based on staff salaries.

We also receive feedback 

about our OASIS and billing

capabilities which allowagency administrators to maxi-

mize their billing value while

reducing claim submission

errors. This results in im-

proved, reliable cash flow

which helps sustain a growing

business.

Join the Igea community to-

day! 

Customers Comment on Igea HHC.

Join t he happy communit y of

Igea HHC customers.

Benefit not only fr om a high

ROI, easy t o use, f ast t o im-

plement home health care

management system, but

also from a company where

staf f personally know t he

home health care business.

Igea HHC

Made to Manage Home

Healt h Care

851 Irwin Street, #300

San RafaelCA 94901

California Phone: (415) 226-1206

Florida Phone: (786) 871-6755

Texas Phone: (956) 205-0024

Fax: 888-251-9321

Igea HHC

Made to Manage Home Health Care

more information at

www.indurasystems.com

Indura Systems

Igea HHC is a leading enterprise management application

made specifically for home health care agencies.

With an established reputation in many U.S. locations, Igea HHC

and our point of care application, iPOC, are increasingly being

adopted by agencies that are tired of systems which are not

user-friendly, cause a demand for more, skilled back-office

staff, and do little to help an agency maximize billing accuracy

and value.

Igea HHC, from Indura Systems, helps home health care agen-

cies remain compliant, effective, and profitable.

For a free demonstration, contact Indura Systems today.

Come and see us at these shows, coming up in 2009:

March on Washington & Law Symposium—Washington, DC, March 22-25

Home Care & Hospice—Raleigh, NC, April 27-28

Home Care Association of NJ 2009 Conference—Iselin, NJ, April 30—May 1

Southwest & Gulf Coast Regional Conference—New Orleans, LA, May 5-6

CAHSAH Annual Conference—San Diego, CA, May 6-8

HCAF Annual Conference—Orlando, FL, June 24-25