In brief: AMEPA targets Texas for H.R. 1041, Teleconference town meeting draws 14,000 seniors

Thursday, August 18, 2011

HOUSTON - Members of the Accredited Medical Equipment Providers of America (AMEPA) and the Texas Alliance for Home Care Services (TAHCS) visited lawmaker's offices in southern Texas Aug. 16-18 to seek support for H.R. 1041. The meetings were held in San Antonio, Austin, Houston, and Beaumont-Port Arthur--all metropolitan statistical areas. The group was able to meet with district directors and some Washington staff who were in the district office during the recess period. In July AMEPA joined providers in California, Oregon and Washington in a series of in-district meetings on the West Coast. The bill, which would repeal competitive bidding, has 145 co-sponors.

Teleconference town meeting draws 14,000 seniors

KANSAS CITY, Mo. - When People for Quality Care and the Midwest Association for Medical Equipment Services called seniors in the Kansas City competitive bidding area on Aug. 16, 14,000 picked up the phone. Listeners participated in a teleconference featuring a panelist discussion about competitive bidding and were then invited to ask questions. Listeners were also polled during the call. Of those who participated in the poll questions, 66% had been forced to change providers, while 84% reported they were never notified that Kansas City was part of this program and changes would occur. 158 callers opted to "press-through" and connect with their congressional office to ask Kansas and Missouri legislators to support H.R. 1041.

Responsibility for demand letters to shift to Medicare contractors

BALTIMORE - Starting Jan. 3, 2012, Medicare's Recovery Auditors will no longer issue demand letters, according to a recent MLN Matters article from CMS. Instead, when the auditor finds improper payments, it will submit claims adjustments to the provider's Medicare claims processing contractor. The contractor will then send demand letters for any overpayment. The contractor will follow the same process it uses to recover any other overpayments from a provider. The processing contractor will be responsible for fielding questions and concerns from providers, such as timeframes for payment recovery and the appeals process. However, the demand letter will include the name and contact information of the initiating Recovery Auditor for audit-specific questions. To see the official instruction (CR7436), go here.

Prepay reviews continue for glucose testing supplies

WASHINGTON - National Government Services (NGS), the Jurisdiction B DME MAC, continues to conduct prepay reviews for glucose testing supplies for certain Medicare beneficiaries. As of June 30, NGS captured 13,955 claims for testing supplies billed with the KS modifier (non-insulin treated beneficiaries) for review. Of those, a total of 4,390 claims have been reviewed and processed, with 4,224, or 96%, denied. Reasons for denial: no documentation received (66%); not medically necessary (22%); and services reduced to policy parameters (3%). Suppliers can review the glucose monitor local coverage determination here.

CPAP still a good option for patients

ROCKVILLE, Md. - CPAP remains a highly effective therapy for the treatment of obstructive sleep apnea, says a new report from the Agency for Healthcare Research and Quality (AHRQ). The report, Diagnosis and Treatment of Obstructive Sleep Apnea in Adults, compared the effectiveness of different treatments for OSA. It found that CPAP showed the strongest evidence of being effective. Also effective: mouthpieces worn at night, weight loss and surgery. The report and companion guides for clinicians and consumers are available at www.effectivehealthcare.ahrq.

Liberator Medical reports sales increase

STUART, Fla. - Liberator Medical's sales increased by 25.3% for its third fiscal quarter, the provider announced Aug. 16. For the three months ended June 30, sales were $13,309,000, compared to $10,619,000 a year ago. Gross profit for the quarter was $8,167,000, up 17.6% from the same period a year ago. Liberator Medical is a mail order provider of diabetes, catheter and ostomy supplies.

Member group to offer seminars

WATERLOO, Iowa - The VGM Group will host a series of seminars this fall. "The Ins and Outs of Competitive Bidding Round 2 and How to Make Money in an Uncertain Reimbursement Environment" is a two-day seminar that offers information about competitive bidding, as well as ideas to help providers streamline their operations and seek out non-Medicare opportunities. "Our businesses must change to adapt to the realities of changing reimbursements, changing payer focus, patient and physician preferences and product category lifecycles," stated Mike Mallaro, CFO, in a release. To register: For more information, call 1-800-642-6065.

Reminder: It's 5010 Testing Week.

WASHINGTON - This week is National 5010 Testing Week, CMS reminded providers in a message last week. Testing Week will allow participants to test compliance efforts already underway. Real time desk support will be available. CMS encourages all providers, clearinghouses and vendors to participate. For more information: