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Volume 1, Issue 1

January 2009

Investors Turn To Home Health Care
In a time of economic gloom, the home health care industry is standing out as a magnet for investors. The news is full of reports about the poor state of the economy. Retailers are reporting record declines in holiday sales. Car dealers are closing due to lack of business. Manufacturers are laying off staff as orders are canceled. Yet through all this, health care, and in many cases, specifically home health care, is attracting the attention of investors. Why is this? Financial institutions see it this way: the U.S. population is aging. Our ―baby boomers‖ are retiring and living longer. More seniors are looking for opportunities to stay in the comfort and privacy of their own homes. Even if hospitals were less crowded, the cost of hospital beds, for longer-term treatment, is a strain on Medicare and Medicaid, as well as commercial carriers. So it is better for all to adopt home health care as the primary means of providing care and support to seniors. Investors are looking for opportunities to invest in the home health

Home Health Care

An Indura Systems publication Each issue includes:
      Industry Headlines Home Health Care Updates and Guidelines Event News Customer Support Igea Product News Home Health Care Comments

Addressing the needs of home health care agency professionals throughout the United States.

Inside this issue:
Investors Turn to Home Health Care TennCare Patients Ruling States Cutting Medicaid Coverage ICD-10—Worth It? Referral Rules Update CMS on Fraud Prevention Igea Customer Support 1 1 2 2 2 3 3

care industry, but they are not throwing money at any prospect. They need to see that a business is established, is being managed well, is on a growth path, and that investments have been made in resources and systems to maximize productivity and track the performance of the business.

Ruling lets TennCare patients stay home
TennCare patients who were in danger of losing their home health care have been granted a temporary reprieve from a federal judge. U.S. District Judge William Haynes Jr. has ordered that the state maintain the home healthcare benefits for the 20 plaintiffs who sued the state and the TennCare bureau over planned cuts. The TennCare policy change in question could end round-the-clock home care for some of TennCare's adult patients and move them instead into more cost-efficient nursing homes. "We're trying to review everyone to see if (home care or a nursing home) would be more efficient and costeffective," said Lola Potter, spokeswoman for state Department of Finance and Administration. "We think very few of them will be moved." Read the full story.
Source: The

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Home Health Care Focus—Indura Systems

States Cutting Medicaid Coverage
States from Rhode Island to California are being forced to curtail Medicaid, the government health insurance program for the poor, as they struggle to cope with the deteriorating 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 Columbia have lowered payments to hospitals and nursing homes, eliminated coverage for some treatments and forced some recipients out of the insurance program completely. Many states are halting payments for health care services not required by the federal government, such as physical therapy, eyeglasses, hearing aids and hospice care. A few states are requiring poor patients to chip in more toward their care. The Democrats, who hold majorities in the House and the Senate, are sounding sympathetic for now. They are considering close to $100 billion to increase the share of Medicaid's costs that the federal government would pay during the next two years. Read the full story

The Washington Post reports that more states are cutting Medicaid coverage.

Source: Washington Post 12/26/2008

Why ICD-10 is Worth the Trouble
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-10PCS offer greater details and increased ability to accommodate new technologies and procedures. 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 muchneeded improvements in accurately classifying the nature of injuries and correlating them with cause, treatment, and outcome.

CMS Stark Regulations Tighten Referral Rules
October 2008 Compliance Deadline for "Stand in the Shoes" New Stark Law regulations posted on July 31, 2008 by the Centers for Medicare and Medicaid Services ("CMS") revise and expand the prohibition on physician referrals for designated health services ("DHS") to entities with which they have financial relationships. Some of the new final rules will be effective October 1, 2008, while implementation for other rules will be deferred until 2009. This Alert will review the highlights 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 prospective payment systems ("IPPS") rate regulations for fiscal year 2009. Also posted on July 31st were the Skilled Nursing Facility Prospective Payment System, the Inpatient Rehabilitation Facility 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.

Volume 1, Issue 1

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CMS Strengthens Efforts to Fight Medicare Fraud and Abuse
The Centers for Medicare & Medicaid Services (CMS) announced in December 2008, it is requiring certain durable medical 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 suspending payments to home health agencies in the MiamiDade, Fla. area. ―We know the majority of medical 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 suppliers who furnish medical equipment to Medicare beneficiaries 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 payment and review actions. On Oct. 6, CMS initiated efforts to address potential waste, fraud and abuse by suspending payments to 10 home health agencies and is continuing to review claims and payments to other agencies as resources allow.

Read the full story.

Indura Systems Customer Support
Now 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 customer support representative will be available to guide users through their operational problems, allowing 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…”

standing of Igea HHC and iPOC, allowing them to work faster and smarter. Indura Systems Customer Support is available during normal business hours and can be contacted from the Support button in your Igea HHC application, by phone or email.

Igea Questions and Answers
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, instead 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. 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” by which 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 to change the Visit configuration date and Day configuration. Then you press the save button.
Indura Systems Customer Support—Igea experts— home health care experts

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 agencies remain compliant, effective, and profitable. For a free demonstration, contact Indura Systems today.

Indura Systems
851 Irwin Street, #300 San Rafael CA 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

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

Customers Comment on Igea HHC.
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 system I have ever seen and the response time from the Indura Systems team is great! Igea System is user friendly. It covers every need in the Home Health Industry and the Customer Support team is always there when we need them. reduce their back office staff overhead since implementing Igea HHC. In many cases, users of other HHC management 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/year based on staff salaries. We also receive feedback about our OASIS and billing capabilities which allow agency administrators to maximize their billing value while reducing claim submission errors. This results in improved, reliable cash flow which helps sustain a growing business. Join the Igea community today!

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 to navigate. We have used the support team and were very pleased with the professional and efficient help we received.

Join the happy community of Igea HHC customers. Benefit not only from a high ROI, easy to use, fast to implement home health care management system, but also from a company where staff personally know the home health care business.

Francisco Abreu - Administrator - Llerena Home Health Care, Inc I'm very happy with your customer support team. They give me VIP service.

Juan Parrado - CEO - The Lakes Homehealth Corp

As well as these comments, we regularly hear from customers who have been able to

Igea HHC Made to Manage Home Health Care