AAH Supplies Council: Simplify ostomy billing

Thursday, May 31, 2007

WASHINGTON - AAHomecare's Medical Supplies Council met at Medtrade Spring April 26 to organize its priorities for 2007. Topping its list: removing ostomy supplies from the Home Health Prospective Payment System (HH PPS), said Karen Kaczmarek, chairwoman of the council.
When a patient enters a Part A care facility, payment for ostomy supplies has to be billed as part of a flat rate for that episode of care, said Kaczmarek. Unfortunately, it is often difficult for a DME to verify that a patient is under Part A care.
"The patient may call their HME supplier as normal," said Kaczmarek. "The supplier could provide the products, even potentially get paid, except that eventually when a home health claim hits the system, Medicare sees through the audit process that the supplies should have been covered under Part A."
That leads to providers not getting paid or being asked to repay Medicare, sometimes several months later, said Kaczmarek.
The council plans to join forces with manufacturers that have begun initiatives seeking to get legislation introduced that would carve out ostomy supplies from the HH PPS.
Also on the council's agenda: supporting diabetes suppliers. With CMS's surprise decision in April to include mail order diabetes supplies in the first round of competitive bidding, the council plans to reach out to lawmakers, said Kaczmarek.
"We're going to support the AAHomecare Legislative Fly-In and educate Congress about the complexities of carving retail out and leaving mail order in," she said.
Formed at Medtrade in 2005, the council consists of about 25 members who meet regularly to discuss issues concerning home medical suppliers, manufacturers and distributors of diabetic, incontinence, ostomy, urological and wound care supplies. It currently has a survey posted on AAHomecare's site for diabetes suppliers.