In brief: Bidding battle continues, bill seeks payment for home infusion therapy

Thursday, June 23, 2011

WASHINGTON - The HME industry last week brought its message that Medicare's competitive bidding program needs to be repealed to the president and Senate Majority Leader Harry Reid. AAHomecare on June 20 sent a letter to President Obama, restating the association's concerns that the program is having a negative affect on beneficiaries. The VGM Group, meanwhile, continued to "rattle cages," with John Gallagher, vice president of government relations, meeting Reid last week in Washington, D.C. "The senator is concerned about access to healthcare in rural areas," said Gallagher. "The thing that hurt this week was that (lawmakers) are not hearing from beneficiaries about problems (with the bidding program)." On bright spot: Senators are finally realizing that the program is flawed, Gallagher said. "Nobody is saying, 'Let's see what happens with Round 1,'" he said. "Nobody is seeing it as fraud (prevention). They are all saying it's a train wreck.'" H.R. 1041 picked up seven co-sponsors last week, bringing the total to 132.

Bill seeks payment for home infusion therapy

WASHINGTON - A bill that would close a payment gap for home infusion therapy was introduced June 15 in both the House and Senate. Sponsored by Sens. Olympia Snow, R-Maine, and John Kerry, D-Mass., and Reps. Eliot Engel, D-N.Y. and Tim Murphy, R-Pa., the Medicare Home Infusion Therapy Coverage Act of 2011, would require Medicare to pay for infusion-related services, supplies and equipment under Part B. Payment for the drugs--which Medicare already pays for--would remain under Part D. Similar bills were introduced in 2007 and 2008.

Investor owns 6.6% of Rotech

ORLANDO - Wynnefield Capital Management owns 1,682,427 shares or 6.6% of the common stock of Rotech Healthcare, it reported in a June 9 Securities and Exchange Commission filing. Wynnefield Capital, a New York City-based investor, specializes in "U.S. small cap situations that have a company or industry specific catalyst(s)," according to its website. Wynnefield's MO: "We seek out under-followed, unrecognized and undervalued companies that fit our parameters, which include minimal balance sheet risk and potential for micro or macro change." Wynnefield's holdings are worth $6.9 million, according to reports. Rotech announced June 14 that it plans to exchange up to $283.5 million in aggregate principal of its senior second lien notes due 2018 for private notes tendered by the holders of those notes. The exchange offer expires July 12.

The Scooter Store expands to more than 200 partnerships

NEW BRAUNFELS, Texas - The Scooter Store signed eight new agreements in 2011, bringing its total partnerships to more than 200, it announced June 22. The partnership contracts allow for more than 170 million people to obtain power mobility equipment from The Scooter Store through their insurance plans. Doug Harrison, founder, president and CEO of the company, called the news "an important milestone for the company."

AAH hires new membership director

ARLINGTON, Va. - AAHomecare has tapped Dan Smith for its newly created position of director of membership sales and marketing, it announced June 22. Smith has many years of experience in the home medical equipment industry, including 12 years at The MED Group, where he served as vice president of membership from 2002 to 2009. Smith has also held positions at MK Battery, Advacare Medical and Everest & Jennings. His most recent position was at OSI/Overland Solutions Inc., an outsource provider to the insurance market for audits, surveys, loss control and risk management.

Status quo for neb-med pricing

BALTIMORE - Average sales price figures for most nebulizer medications haven't changed much since last quarter. Albuterol (J7613) inched up to just under 17 cents per dose; levalbuterol (J7614) was up to 74 cents per dose; and ipratropium (J7644) stayed flat at 26 cents. However, budesonide (J7626) reversed last month's sharp plunge, rising 35 cents to $4.50 per dose. Also getting a boost: arformoterol (J7605), which was up 16 cents to $5.45 per dose; and Peforomist (J7606), which was up 6 cents per dose to $4.76.

Invacare ranks high

ELYRIA, Ohio - Invacare was ranked as one of the top employers in Northeast Ohio by the Cleveland Plain Dealer's Top Workplaces 2011 survey, the company announced last week. This is the second year in a row that Invacare has received the honor. Companies were selected for the honor based on leadership, compensation, direction, training, workplace flexibility and diversity.

Providers get 02 claims right half the time

FARGO, N.D. - Fifty percent of 2,451 claims submitted in Jurisdiction D for HCPCS codes E1390 and E0431 from February 2010 to May 2011 were denied, according to a widespread prepayment review by DME MAC Noridian Administrative Services. The top five reasons for denial: requested documentation was not provided within the allotted time frame; no office visit notes to determine medical necessity within 30 days of certification or 90 days within recertification were submitted; no/invalid qualifying blood gas study submitted; no documentation to support diagnosis; and no documentation to support alternative treatment has been tried/considered. Read the full update

Prosthesis legislation re-introduced

WASHINGTON - A pair of bills that would require Medicare to pay for custom breast forms were introduced in the House and Senate on June 16. The bills, S. 1217, introduced by Sen. Olympia Snowe, R-Maine, and H.R. 2233, introduced by Rep. Mike Ross, D, Ark., are similar to legislation introduced last year. Currently, the custom breast prosthesis is the only custom prosthesis not covered by Medicare.