In brief: AAH softens blow, Orbit agrees to settle
WASHINGTON – AAHomecare has successfully lobbied the House Energy and Commerce Committee to delay the start date for a provision reducing Medicaid payments to 2020 instead of 2016.
The committee has included the provision, which would limit the federal portion of state Medicaid fee-for-service rates for HME to the Medicare competitive bidding rates, as a “pay-for” in its 21st Century Cures Act.
“AAHomecare will continue to defend against the inclusion of these cuts to Medicaid HME rates in any future iterations of this bill,” the association stated in a bulletin.
The change in the start date reduces the value of the “pay-for” to $2.8 million instead of $2.8 billion.
As part of negotiations, the committee asked AAHomecare for a budget neutral proposal that would improve the HME benefit.
“A nationwide prior authorization process would help address audit problems, and AAHomecare is working to have prior authorization language added to the Cures Act before it reaches the House floor,” the association stated.
Earlier this month, Rep. Marsha Blackburn, R-Tenn., introduced a bill that would require prior authorizations for high-dollar DME. H.R. 2437 would also exempt DME that has gone through this process from pre- and post-payment audits.
The full House is expected to vote on the Cures Act in June. If it makes it through the House, it’s unlikely it will make it through the Senate, according to AAHomecare.
“The Senate’s never going to pass a bill this big,” Rep. Fred Upton, chairman of the committee, told the association.
Upton expects the Senate to pass something broader, according to AAHomecare.
Orbit agrees to $7.5 million settlement
WASHINGTON – Orbit Medical and its partial successor, Rehab Medical, have agreed to pay $7.5 million to settle allegations that it altered and forged physician prescriptions and supporting documentation for power wheelchairs and accessories, the U.S. Department of Justice announced last week.
Orbit Medical says it fully cooperated and offered full transparency during the DOJ’s four-year investigation.
“We are relieved to close this chapter and move forward growing our business,” the company said in a statement to HME News.
A False Claims Act lawsuit alleged that Orbit Medical sales reps changed or added dates to physician prescriptions and chart notes to falsely document that physicians examined beneficiaries within 45 days of the face-to-face exam; changed prescriptions to falsely establish medical necessity; created or altered chart notes and other documents to falsely establish medical necessity; and forged physician signatures on prescriptions and chart notes and added facsimile stamps to supporting documentation.
“The resolution of this case helps to restore funds taken from the Medicare trust fund through the use of falsified records and billings,” said Carlie Christensen, U.S. attorney of the District of Utah.
The lawsuit was filed by former Orbit employees, Dustin Clyde and Tyler Jackson. Under the False Claims Act, a private party can sue for false claims on behalf of the government and share in any recovery. Both employees will receive $1.5 million of the settlement.
Mi-Med Supply expands on West coast
DALLAS – Mi-Med Supply has acquired Spokane, Wash.-based Peaks & Plains, according to Generational Equity, a mergers and acquisition firm that advised Peaks & Plains. Peaks & Plains offers diabetes supplies, compression hosiery, ostomy, urology and wound care products. “As a family company with longstanding roots in the Pacific Northwest, Peaks & Plains Medical was the perfect platform for Mi-Med Supply to expand their retail offering on the West coast," said Andres Ochoa, an affiliate with Generational Equity, in a release. Founded in 1999 and based in Vista, Calif., Mi-Med Supply offers urology, incontinence, ostomy and wound care supplies. The deal closed April 30.
A/R Allegiance adds billing services
OVERLAND PARK, Kan. – A/R Allegiance Group has expanded its services to include medical billing, positioning the company to offer full revenue cycle management. The company’s CollectPlus helps providers recover private pay collections and now ClaimCollect can do the same for insurance reimbursement. A/R Allegiance has packaged its services into a five-step revenue cycle management process to help providers grow and thrive: pre-billing documentation audits, billing all types of payers, collections, ongoing support, comprehensive reporting and additional services like process consulting.
PFQC recruits for cause
WASHINGTON – People for Quality Care is recruiting patients for the COPD Foundation’s new COPD Patient-Powered Research Network. The network’s purpose is to give COPD patients a place to share how the disease has impacted their lives and to support each other. Information from the network, which is stored in a secure database, will be used for research purposes and to better understand the disease. “As someone living with COPD, I consider the COPD PPRN a huge step forward in terms of the level of research that is needed to refine testing and diagnosis, improvements and find a cure,” said John Walsh, president and co-founder of the COPD Foundation in a release. To enroll, click here.
Quantum Rehab launches website
EXETER, Pa. – Quantum Rehab has launched a dedicated website featuring its iLevel power seat elevation technology. The website offers users information on how the technology improves health, safety, functionality and independence, according to a press release. “We realized through the users’ eyes the life-changing characteristics of iLevel, and sought a website and content that conveys the extraordinary impact,” said Megan Kutch, director of marketing at Quantum Rehab. Quantum Rehab released iLevel in February.
Groups host contest
ATLANTA – People with disabilities are being encouraged to “Get Out & Enjoy Life” this summer. The five-year-old event is sponsored by UroMed’s nonprofit program Life After Spinal Cord Injury, At Home Medical’s iPush Foundation, Sports ‘N Spokes Magazine and online community Wheel:Life. All four groups will feature daily listings of accessible vacation spots, outdoor programs and other events. The event kicks off June 1 with a photo contest. Contest details and official rules viewable at: http://pvamag.com/sns/article/6923/2015_goel_rules
Short takes: HOMES, Comfort Medical, BioCorrect, Sizewise
HOMES elected its new board of directors at its recent annual meeting. Gary Sheehan of Cape Medical Supply is chairman, Peter Tallas of Charm Medical Supply is vice chairman, Jason Morin of Home Care Specialists is treasurer and Chris Henry of The Medical Store is secretary…Comfort Medical Supply has opened in Fredericksburg, Va. Owners and RTs Larry Filkowski and Sean Magill told a local newspaper that they opened the upscale retail store because the equipment and supplies recommended by insurance companies don’t meet the needs of their patients…Agility Health’s subsidiary BioCorrect, an orthotics provider, has been accredited by the American Board of Certification of Orthotics, Prosthetics and Pedorthics…Yankee Alliance, a healthcare group purchasing organization, has a contract with Sizewise Worldwide, a global manufacturer, to provide long-term care equipment like therapeutic support surfaces, beds, wheelchairs and other mobility items for its provider members.