What Hospices Need to Know to do Business with VA

1. What Hospices Need to Know to do Business with VA Christine Cody, RCN, MSN Department of Veterans Affairs (114), 810 Vermont Ave. NW, Washington, DC 20420Christine.Cody@va.gov, 202-273-8537 Diane Jones, Project Administrator, HVP Program PO Box 844, Moorestown, NJ 08057djones@ethosconsult.com, 856-234-5878

2. Doing Business with the Federal Government • Get a Data Universal Numbering System (DUNS) number from Dun & Bradstreet • Register with Central Contractor Registration (CCR)

3. DUNS NUMBER • Unique 9-digit identification number provided by Dun & Bradstreet • Free for all businesses required to register with the federal government for contracts or grants • Each hospice location must have a separate DUNS number

4. How to request a DUNS number • On-line application • D&B DUNS Numbers for US Government Contractors & Grantees • http://fedgov.dnb.com/webform • Call (866) 705-5711

5. Central Contractor Registration (CCR) • What is CCR • Central vendor database for the federal government • Maintains electronic payment information • Allows VA to pay contractors and vendors such as hospice agencies • Registration is free to vendors • Annual renewal is required

6. Central Contractor Registration (CCR) • Why do hospices have register? • Federal regulation • Prerequisite to contracting with the government • How do hospices register? • Online registration at www.ccr.gov • You must have your DUNS number to register

7. General information you need to register • DUNS number • CAGE (Commercial and Government Entity) code • If you do not have a CAGE code, one will be assigned to you after you register with CCR • There is no fee to get a CAGE code http://www.dlis.dla.mil/CAGESearch/cage_faq.asp

8. General information you need to register • Company name • Federal Tax Identification Number • Location • Receipts • Website address

9. Other information you need to register • Organization or business type • Small Business Administration defined socioeconomic characteristics • NAICS (North American Industry Classification System) code • 62160 (hospice care services, in home) • 623110 (hospice, inpatient care)

10. Other information you need to register • SIC (Standard Industrial Classification) code • 80599905 Personal care home, with health care • 80599906 Rest home, with health care • 80820000 Home health care services • Product Service code • Service code Q – Medical services • FSC (Federal Supply Classification) code

11. Other information you need to register • Financial Information • Financial institution • American Banking Association (ABA) routing number • Account number • Remittance address • Lock box number • Automated clearing house (ACH) information • Credit card information

12. Other information you need to register • Point of Contact information • Principal and alternate points of contact • Electronic business, past performance, and government points of contact • Electronic Data Interchange (EDI) information • EDI point of contact and contact information • Optional – for businesses interested in conducting transactions through EDI

13. Doing Business with the Government • Getting started can be very emotional! • Once you have a DUNS number • Update only if there are changes in your business • Once you are registered with CCR • Annual on-line re-certification

14. VA Policy Hospice and palliative care is a covered benefit for all enrolled veterans, all settings "VA must offer to provide or purchase hospice & palliative care that VA determines an enrolled veteran needs." 38 CFR 17.36 and 17.38

15. VA Hospice and Palliative Care Mission To Honor Veterans’ Preferences for Care at the End of Life . . . . . . in all settings VA Paid and VA Referred Hospice VA Inpatient

16. VA Paid Hospice Care Average Daily Census FY04 – FY07

17. VA Purchasing Hospice Care • Purchased Home Health Care Services Handbook • Contract and clinical staff at facility and VISN level jointly develop processes • Broad array of home and community based care options • Veteran’s preference for specific resources

18. Purchasing (cont’d) • Services purchased from hospices that are licensed or otherwise state approved or certified by Medicare/Medicaid • Purchasing options • Basic Ordering Agreement – geographical area or low frequency of use • Bid Contract • best value approach • price, quality, service area coverage • Written agreements at facility, VISN, multi-VISN level

19. Statement of Work • Purpose – purchase comprehensive package of bundled services at a per diem rate for eligible veterans • Pricing – locally calculated Medicare Hospice Benefit rates as maximum • $2/day for physician services beyond scope of routine hospice care • Negotiated rates reflect fair market value for services

20. Statement of Work (cont’d) • Hospice responsibilities • Services • Hospice manages care plan • Request level of care changes • Contact VA to preauthorize inpatient admissions

21. Statement of Work (cont’d) • VAMC Procedures • Approve referral • VA physician certifies prognosis, encouraged to act as attending • VA sets recertification time frame and processes • Treatment issues identified and coordinated

22. Statement of Work (cont’d) • Communication/Coordination • Liaisons – facilitate collaborative efforts, streamline communication, promote coordination of services • Communication process – referrals, general information, physician, patient discharge, death • Quality Improvement • joint review of quality and appropriateness of services