Archive: January 2016

It was my turn this Tuesday to write up some briefs for the Also Noted section of our website. (In case you don't know already, we update this section with news almost every day—check it out while you eat your lunch!) In the queue to write up was CMS's recently released instructions on how to bill for accessories for complex power wheelchairs. Accessories for complex power wheelchairs got a reprieve from the wrath of competitive bidding last year when lawmakers wisely passed a bill delaying...

New Braunfels, Texas - Humana opened its first community pharmacy in Texas at the Partners in Primary Care medical practice. The new pharmacy, an extension of Humana's mail-order prescription drug service, will provide clinical support and full pharmaceutical services to Humana customers. The insurance company intends to open a second pharmacy in Texas and four more in Florida over the next few months.

ALEXANDRIA, Va. - The National Community Pharmacists Association has provided Senate Finance Committee leaders a range of proposals aimed at improving care for the panel's Chronic Care Working Group. “Our recommendation is to include pharmacists as essential health care providers on chronic care teams and the designated lead in coordinating safe and effective medication management,” wrote the NCPA in a letter to the committee. The NCPA also suggested improving care management services...

WASHINGTON - With only the first of two planned cuts in effect, industry stakeholders say a freeze of current rates in regional and rural areas is their best bet.“It's hard to put the genie back in the bottle,” said Tom Ryan, AAHomecare president and CEO. “The cuts are here so our champions believe that this is our best alternative.”On Jan. 1, Medicare began paying for HME in regional and rural areas based on a 50/50 blend of the previous fee schedule amounts and the bidding...

WASHINGTON - Stakeholders were flabbergasted last week when CMS issued billing instructions for accessories for Group 3 power wheelchairs.In the instructions, CMS says it will use an adjusted fee schedule based on competitive bidding rates for these accessories,despite a law passed in 2015 delaying that change for one year. The reason: The agency says it can't adjust its claims processing systems for at least six months.“CMS has implemented these kinds of payment changes for doctors and other...

WASHINGTON - CMS has put physicians and HME providers on alert that they must soon comply with a face-to-face rule for Medicaid recipients.Starting July 1, physicians must document that they've conducted face-to-face visits with Medicaid recipients no more than six months prior to those patients receiving certain home medical equipment and services, according to final regulations published last week.“When the Affordable Care Act was enacted (in 2010), the face-to-face rule applied to Medicaid,...

YARMOUTH, Maine - Industry stakeholders are weighing the recent shake up in the DME MACs.For the first time ever, there will be two contractors handling claims processing for all four jurisdictions: CGS Administrators and Noridian Healthcare Solutions.“This is definitely a big change,” said Wayne van Halem, president of The van Halem Group. “The four jurisdictions have been around since 1993 and there have always been four unique companies doing it. (CGS and Noridian) have become...

GREENSBORO, N.C. - ConvaTec, a manufacturer of wound care and ostomy products, will begin closing its manufacturing facility here, resulting in 250 layoffs, according to news reports. It expects to complete the closure during the first quarter of 2017. The company announced in 2014 that it would shutter its office in Skillman, N.J., resulting in 118 layoffs from its sales, marketing and human resources division. ConvaTec is owned by Avista Capital Partners and Nordic Capital. The firms have been...

WASHINGTON - CMS this week published final regulations for implementing a face-to-face rule for Medicaid.Starting July 1, physicians must document that they've conducted face-to-face visits with Medicaid recipients no more than six months prior to those patients receiving certain home medical equipment and services.CMS will delay compliance with the rule for up to two years, according to the regulations, which will be published in the Federal Register on Feb. 2.CMS implemented a face-to-face rule...

BRENTWOOD, Tenn. - American HomePatient plans to close a regional billing center in Buffalo, N.Y., in April, eliminating 42 jobs, according to Buffalo Business First. A company representative told the news agency that the move will not affect AHP's branch locations in the area and the employees who work there providing HME. “We have been working on initiatives to drive cost out of our organization,” the representative said. The representative also told the agency that the move is not...