Zone Program Integrity Contractors to take over Program Safeguard Contractors.

Medicare is in the midst of naming its new fraud-fighting contractors. The agency recently announced its third Zone Program Integrity Contractor, Rockville, Md.-based AdvanceMed Corp., which will cover Zone 5: West Virginia, Virginia, North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas, and Louisiana. AdvanceMed is currently a Program Safeguard Contractor for 15 states and is a wholly owned subsidiary of Computer Sciences Corp.

The Centers for Medicare & Medicaid Services is awarding ZPIC contracts in seven zones. ZPICs will take over PSCs’ program integrity functions. CMS already announced the contracts for zones four (Health Integrity, covering Colorado, New Mexico, Oklahoma, and Texas) and seven (SafeGuard Services with subcontractor IntegriGuard, covering Florida, Puerto Rico, and the U.S. Virgin Islands). These contractors have already begun operating.

Last month, CMS issued a draft of its final solicitation for the remaining ZPICs in zones 3 (Minnesota, Wisconsin, Illinois, Michigan, Ohio, and Kentucky) and 6 (Pennsylvania, New York, Maryland, DC, Delaware, Maine, Massachusetts, New Jersey, Connecticut, Rhode Island, New Hampshire, and Vermont), according to the federal government’s Federal Business Opportunities Web site, which lists vendor contract details.

In other news…

• Ever since its 1997 report concluded that a North Carolina Marine base’s drinking water was safe, the Agency for Toxic Substances and Disease Registry has been under pressure from community activists who said the agency was sweeping a serious chemical-exposure problem under the rug.

The Camp Lejeune, N.C., system’s water was contaminated for 346 months between November 1957 and February 1987 by an off-base dry-cleaning firm, according to ATSDR. The 1997 report concluded the water was safe to drink.

Twelve years later, ATSDR no longer stands behind its study, according to a House committee press release. When the House Committee on Science and Technology reviewed the Lejeune study, the agency had lost many of the scientific documents and data upon which the agency had based its assessment.

Camp Lejeune activists have claimed ATSDR’s 1997 report used flawed data to support its conclusion that exposure to volatile organic compounds and other toxic chemicals, such as benzene, would not pose a health hazard for adults.

“I hope that the agency’s decision to rescind the public health assessment on Camp Lejeune is a sign that the leadership of ATSDR is now willing to acknowledge the agency’s past mistakes and take measures to protect the public’s health in the future,” said Brad Miller (D-NC), Subcommittee on Investigations and Oversight chairman.

            • CMS dropped a major bomb for skilled nursing facilities in the recently published proposed SNF PPS payment update for 2010. The rule unveils the new RUG-IV system, which determines how SNFs get paid for Medicare Part A stays. Changes include thirteen new RUGs, plus SNFs won't be able to capture preadmission services. Some experts even think SNFs won't be able to capture projected rehab therapy services. The RUG IVs are set to go into effect in October 2010.

Meanwhile, after some back and forth, the assessment form that rates SNF patients' acuity, the MDS, is seeing more attention. MDS version 3.0 preparation will be heating up again in October -- if the revised guidelines stay on track. CMS expects to publish the final MDS 3.0 data specifications, including RUGs, RAP triggers, and quality measures and indicators, in October 2009. It will also publish the MDS 3.0 data elements, which includes admission, quarterly, swing bed, and discharge MDSs. Providers should also look for publication of the MDS 3.0 RAI User's Manual.

The timeline calls for MDS 3.0 implementation on Oct. 1, 2010. Provides may review the entire revised timeline for MDS 3.0 by clicking on the "Downloads" section on the “MDS 3.0 for Nursing Home” Web page at: www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp  

• The HHS Office of Inspector General posted Recovery Act materials to its Web site on April 29. This is the same information that's on www.recovery.gov, but it's in a slightly different form, the OIG said. To see the first OIG Monthly Recovery Update Report, visit www.oig.hhs.gov/recovery/monthly_report.asp . This report accounts for Recovery Act funding, and both completed and planned actions, and the OIG will update this site on a regular basis.

Also posted in the Recovery Section of the OIG's Web site is information on the special Whistleblower Protections available under the Recovery Act: www.oig.hhs.gov/recovery/whistleblower.asp .

• Watch out for alfalfa sprouts. The Food and Drug Administration and the CDC warned consumers on April 26 not to eat raw alfalfa sprouts until further notice because the product has been linked to Salmonella serotype Saintpaul contamination. Michigan, Minnesota, Pennsylvania, South Dakota, Utah, and West Virginia have reported 31 cases of illness with the outbreak strain of Salmonella Saintpaul to the CDC.

The illnesses began in mid-March, and cases are still being reported. No one is aware of any deaths. The number of infected people may be higher than currently reported because some illnesses have not yet been confirmed with laboratory testing, the FDA warned.