Having spent (wasted) a good deal of time trying to get our Republican Representative, Todd Tiahrt, to understand the urgent need to reform the Interim Payment System (IPS), I've made the following observations:

1. He's not the sharpest knife in the drawer. 2. Got into the gene pool while the lifeguard wasn't watching. 3. A room temperature IQ.. 4. Got a full 6-pack, but lacks the plastic thingy to hold it all together. 5. A prime candidate for natural deselection. 6. Bright as Alaska in December. 7. Gates are down, the lights are flashing, but the train isn't coming. 8. So dense, light bends around him. 9. If brains were taxed, he'd get a rebate. 10. If he were any more stupid, he'd have to be watered twice a week. 11. Was left on the Tilt-A-Whirl a bit too long as a baby. 12. Wheel is turning, but the hamster is dead. 13. This man is depriving a village somewhere of an idiot.

To save Congress valuable time, I've summarized the Starr Report:

WARNING! WARNING! WARNING!

A prominent restaurant was so sure that its bartender was the strongest man in America that it offered $10,000 to anyone who could beat him in one task. The bartender would squeeze a lemon until all the juice ran out. Then, anyone who could get a single drop of juice out of it after that would win the prize. Many a burly man had tried and failed.

One day Bill Clinton came into the bar. “I’d like to try the bet” he offered. After the laughter died down, the bartender grabbed a lemon and squeezed away. Then he handed the rind to Clinton. To everyone’s amazement, Clinton squeezed another 10 drops into the glass. Stunned, the owner paid up, and then asked Clinton “ How did you manage to do that?” "It was easy," Clinton replied “I just pretended it was a home health agency.”

These days we hear a lot of people saying things like "Home care's a real joke!" But we never hear anybody laughing.

We think that humor's more important than ever in our industry so we're launching the first and only (as far as we know or care) web site dedicated to prospective payment humor.

Like the old line that "'Business Ethics' is the thinnest book in the library" this may remain one of the sparsest sites on the WWW. Enjoy, and send us any good ones that you hear.

• A speaker was asked to do a workshop on the Interim Prospective Payment program. He always opened his presentations with a joke or humorous story, but he had none on IPS. He decided to post a message to a home health mail list on the Internet. His short message read: "Anybody have any good jokes on IPS?" Days went by with no response. Finally one day his PC announced "You've got mail." Anxiously he opened his E-mail. There was one lone message in his mailbox. The administrator of a small nonprofit HHA had replied. Her message read: "What's IPS?" The speaker thought for a moment then responded: "It is what you are going to say to the Board when they ask you what happened to the agency -I Plead Senility."

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• It is true that HCFA bureaucrats can get into Heaven, but they have to post a surety bond equal to 50% of their Federal pensions.

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• A recently departed home health administrator had just finished her new entrant orientation to the hereafter when the Almighty asked if she had any questions. "Yes" she said, "I do." "Will there ever be a fair prospective payment system for home health agencies back on Earth?" she asked. The reply from the bright glow before her was "Yes, but not in my lifetime."

Thanks Russ and WHO.

[This release was somehow overlooked by the mainstream media and all legitimate home care newsletters, but we felt compelled to share it with the field.]

PRESS RELEASE

For Immediate Release
Date: 07/08/98

HCFA Announces New PIPP Program!!!

PIPP was hailed by Ima Putz of Home Care Faces Annihilation (HCFA), who stated: "We know the government sees a future for us, I think." This was seconded by NAAHC's (National Association Always Heralding Catastrophe) Fulla Itt: "The home care massacre is over, I guess." Similar sentiments were voiced by ACHE (Alliance Combating Homecare Extinction).

# # #

Thanks to Steven Richard
SUN Home Health Services
Northumberland, PA

We believe that each day more and more home care folks are doubling over in laughter as the inherent humor of IPS and PPS hits home. Heck, there's got to be a chuckle or two amidst all that absurdity. Let's wipe away the tears, push aside the despair, stave off the depression, discharge the anxiety, and fire back with some laughs.

MORE STUFF DOWN BELOW

Exclusive! Sources in Washington have provided the very first transcript from Clinton's testimony today before the grand jury. This is a world wide exclusive, ladies and gentlemen, and relevant parts are being brought to you from Clinton's comments about home health care. For a more detailed transcript call 1-800-PER-JURY and have a non-canceled credit card ready, or go to Internet Web page http://www.heh_heh_heh_ah_fooled_y'all_agin.html

Now to the transcript ....
Starr: What do you consider to be the greatest achievement of your Administration?
Clinton: I destroyed the home health care industry in America.
Starr: Why did you do that?
Clinton: Well, it was just full of liars. I mean the lies those people told .... you couldn't believe a single claim they sent in
Starr: How did you destroy the home health industry?
Clinton: Oh that was easy. I just made sure that they had so many audits - you know Wedge audits, cost report audits, surveys, claims audits, focused audits, focused reviews and so forth that by the time they had been at work for 10 minutes each day their heads were just spinning.
Starr: Is that what did it?
Clinton: Not just that ... I also made sure that the reimbursement was reduced way below the level needed to reimburse the cost of good care. We put in a new per beneficiary limit - boy was that a good one - that almost no one could live with and one that grotesquely discriminated against the efficient agencies.
Starr: But let's say that an agency was completely honest, did everything by the book and was cost effective. You couldn't put a finger on them could you?
Clinton: Ha, ha! You just don't get it, do you, Ken? Even if an agency was totally in compliance we would get 'em by deliberately sending in totally incompetent people to do a Wedge audit. These "reviewers" would come up with stuff that was totally bogus and we would throw it back at the providers as a "finding".
Starr: But surely the provider had the right to protest any false findings?
Clinton: Not the way we set it up Ken, baby. We'd send 'em a bill with the audit findings and told them if they didn't pay up we would have the same crew of incompetent and unqualified people audit every claim they ever filed.
Starr: So they paid up even though the audit findings were bogus?
Clinton: Yeah. So, you see, we could put anyone out of business by crunching their cash flow even if the withholdings we made were based on false findings.
Starr: I see. Some people might call that fraud ... even a lie?
Clinton: A lie? Ah deny that!
Starr: Now the rap on you is that in May 1996 you looked homecare association executives in the eye and said "I will protect the home health care industry". Then, in March 1997, you put in a moratorium on new agencies publicly describing the home health industry as "rife with fraud", and you and House & Senate Republicans negotiated behind the scenes to foist the ruinous IPS system on the industry. Now isn't there somewhat of a contradiction between your private assurances and your public pronouncements on the home health industry?
Clinton: You know - I knew yore Daddy. Wasn't he Bart Starrr, the quarterback of the Green Bay Packers back in the '60s?
Starr: Stop trying to change the subject. Did you tell home health the truth?
Clinton: Would ah lie to you, Ken, baby?
Starr: Yes or no? which is it?
Clinton: Hey, Ken. How 'bout you and me and couple of intern babes in the White House hot tub next time SHE's out of town?
Starr: What if we get caught?
Clinton: Ken, Ken, Ken. Haven't you learned anything? We lie - then we deny - then we lie about the lie. Then we confess and everyone forgives us. It's the greatest scam there ever was.
Starr: I think this is where I came in ...
There you have it, ladies and gentlemen. Clinton's responses when questioned about home health care. Judge Starr then went on to question Clinton on his plans for the new condo he will be living in after the impeachment and the divorce hearings.
Stay tuned ....this is a developing story.

Reporting live from cyberspace
Robin Bridges - Special Correspondent