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December 9, 2000, Saturday, Home Edition
Metro News
Bill Torpy, Staff
AJC
David Jayne, a Clayton County man who can only twitch three fingers, had his home health care re-instated this week. But to keep it, he still must prove to Medicare that he is "homebound." Healthfield Home Health stopped sending an attendant to Jayne's home Nov. 30 after determining Jayne probably did not meet Medicare's "homebound" definition. Medicare pays Healthfield $ 600 to $ 1,000 monthly to send a nurse to Jayne's home once a month and an attendant four mornings a week to help with the two-hour process of getting him out of bed and showered. Healthfield discontinued Jayne's home care after reading a Nov. 26 article in The Atlanta Journal-Constitution about Jayne's 13-year battle with Lou Gehrig's disease, or amyotrophic lateral sclerosis (ALS). Jayne leaves home to give inspiring speeches and traveled overnight with a college buddy to watch the Georgia-Florida football game. U.S. Rep. Mac Collins (R-Ga.) intervened this week, calling Medicare administrators, Healthfield officials and the Jayne family. He got Jayne to sign a waiver saying he would repay Healthfield for services if he loses an appeal to Medicare. Jayne had refused to sign that waiver but Collins told Jayne he would almost certainly win his appeal. "It's not 100 percent," Collins said in an interview. "But I talked to the (Medicare) people here (in Washington.)" Collins, who represents Jayne's hometown of Rex, about 15 miles south of Atlanta, said the House has passed a bill that would loosen up Medicare's homebound definition. That bill, now in the Senate, is attached to a wide- ranging tax bill that President Clinton has vowed to veto. After Congress in 1997 tightened Medicare reimbursement procedures, health care officials say, Medicare administrators have stringently investigated claims of homebound status to battle perceptions of fraud. Home health care providers have gotten gunshy, fearing they will lose government contracts if they bend those rules. That was the case with Healthfield and Jayne, said company CEO Tony Strange. Under Medicare rules, a person is homebound when "leaving home is a major effort," according to Medicare's Web site. "When you leave home, it must be infrequent, for a short period or to get medical care." The House bill would allow homebound patients to go to adult day care centers and church and to make other "infrequent" trips of "short duration." However, it would not address instances like Jayne's overnight football trip. Thomas Hoyer, director of chronic care for Medicare in Washington, conceded rules are "somewhat subjective" but "we try to have a reasonable policy." Collins said Congress is "moving the line" with the new bill. "And if we need to move the line again, we will," he said. Jayne, who breathes through a machine and speaks by typing into a computer synthesizer, said he knew the newspaper article might cost him his home care. But he wanted to bring the issue to light because "I am sick of being held captive (in my home)." | 
