Archive: April 2005

BOSTON -- People with sleep apnea are more than twice as likely to die from cardiac arrest during sleeping hours than people without sleep apnea, according to study published in a March edition of the New England Journal of Medicine. For the general population, the reverse is true. People without sleep apnea are more than twice as likely to die between 6 a.m. and noon than during sleeping hours. The study's authors reached their conclusions after examining of the death certificates of 112 Minnesota...

BALTIMORE -- The migration from four billing codes for power wheelchairs to 49 has begun, and manufacturers say the journey promises to be anything but a cakewalk. CMS in March revealed that manufacturers had until Sept. 1 to test their fleet of power wheelchairs and scooters to determine which new code they fit into. That timetable has turned testing facilities into pressure cookers. While all manufacturers test their chairs to some extent, few if any have tested as rigorously as CMS now requires....

BALTIMORE -- Industry watchers expected CMS to release a final draft of its new coverage criteria for power and manual wheelchairs in late March, but as of mid April nothing had been issued. The official word from CMS is that the new criteria is in "clearance." That means officials at CMS, Office of Management and Budget and Department of Health and Human Services are still reviewing the final changes. Before the new criteria can be released, all three agencies must sign off on it. When that will...

REDDING, Calif. -- A federal judge in March issued a final ruling that CMS had been wrong to demand that Tom Lambert repay Medicare $600,000 for not supplying documentation beyond the CMN to prove medical necessity for power wheelchair claims. In his ruling, the U.S. District Court Judge Lawrence Karlton wrote: "any medical necessity information required from medical equipment suppliers may be submitted to the Secretary only by way of a Certificate of Medical Necessity, and not by other means, such...

ORLANDO, Fla. -- After cutting employees and other expenses over the past several years, Rotech now believes it has a "competitive cost structure" and can direct its efforts away from turnaround activities and toward growing revenue and patient care, the company announced last month. The company has coined the new slogan, "We Care About Patient Care", and expects revenue growth to come from, among other things, new branches, new clinical programs, a new pharmacy, increased mnanaged care business...

WASHINGTON -- Federal regulators appear poised to relax restrictions governing the use of medical oxygen on airplanes, and for Dexter Shultz, 72, the move can't come too soon. Because of problems he's had flying with his wife, who has COPD, Shultz has been on a mission to change the current rules that don't require airlines to provide oxygen to respiratory patients. The rules also forbid respiratory patients from carrying their own oxygen equipment onboard planes. "We are being discriminated against,"...

WASHINGTON -- As much as some providers may like to think it could happen, chances that lawmakers will scuttle national competitive bidding for DME are slim to none, say industry leaders. "Public law and Rep. Bill Thomas [R-Calif.] are behind it," said Michael Reinemer, AAHomecare's communications director. "There is no leader in Congress that is going to say, 'Oh, we changed our mind.' But there is a lot we are doing to make the best of a bad situation." CMS and its competitive bidding advisory...

Everyone in the industry should be interested in progress reports on HME relationships with Wal-Mart, but would also be well-advised to warily check some of their enthusiasm at the door. Like the chicken "involved" in production of the egg and the pig "committed" to the supply of bacon, HME companies may find themselves committed when they only wanted to be involved. Anyone that thinks "the opportunity that Wal-Mart is presenting the industry" is about anything other than Wal-Mart's self-interest...

Will the last company to leave the state please turn out the lights? The dark clouds hovering over the DME industry show no signs of letting up any time soon, leaving providers wondering if they will be able to ride out the storm. In New England, our struggle with Medicaid reimbursement cuts began two years ago in Connecticut. In 2003, the governor's budget proposed a change in reimbursement for non-coded items from list-less 15% to cost-plus 25%. With the help of a well-connected local lobbyist,...

CHICAGO -- Compounding pharmacies, slighted by recent bad press in USA Today and other national publications (See story on page 1), will have a new tool to bolster their images in May when surveyors for the Pharmacy Compounding Accreditation Board (PCAB) begin making site visits. The new accreditation board, created in April 2004 by a coalition of eight pharmacy-related professional and regulatory organizations, trained its initial two surveyors this April and began beta testing shortly thereafter....