In brief: CMS backpedals on miscellaneous codes, posts DMEPOS data dump

Friday, October 9, 2015

BALTIMORE – CMS has scrapped plans to discontinue several codes for miscellaneous DME.

In a notice last week, the agency simply stated: “We appreciate the comments received on the proposed coding changes below and will continue to consider the issue further. Additional information will be provided on the status of these coding changes in the future.” 

The changes were slated to take effect Jan. 1, 2016.

In June, CMS proposed replacing HCPC codes E1399 and K0108 with six new codes to reflect more accurate payment of Medicare claims.

Industry stakeholders, particularly those specializing in complex rehab, raised objections, citing concerns over the accompanying reimbursement, which, in some cases, was based on payment amounts from the 1980s.

CMS posts DMEPOS data dump

WASHINGTON – CMS has posted a new data set that provides information on more than 385,000 physicians and other healthcare professionals who referred DMEPOS products and services.

In all, the data set represents more than 100 million claims and $11 billion in Medicare allowed amounts.

“The data set is part of a wider set of initiatives by the administration to achieve better care, smarter spending and healthier people throughout our healthcare system,” stated Andrew Slavitt, acting CMS administrator. “CMS is providing this data to support insight and innovations in healthcare delivery.”

The data set contains information on utilization, payment (allowed amount and Medicare payment) and submitted charges organized by NPI, HCPCS code and supplier rental indicator.

Based on the data, users can find out, for example, patterns of DMEPOS utilization and Medicare allowed amounts for the 10 largest referring provider specialties. Internal medicine tops the list with 87,107 referring providers and $29,954 average allowed amount; and family practice is not far behind, with 81,603 referring providers and $27,982 average allowed amount.

OIG once again highlights savings associated with bid program

WASHINGTON – Four states could have saved an additional $12 million on certain DME items by using pricing comparable to Round 2 of competitive bidding and the national mail-order programs, according to a recent report from the Office of Inspector General.

In previous audits, the OIG found the states could have saved $18.1 million with pricing comparable to Round 1.

“We determined that opportunities exist for these states to lower provider reimbursement rates, resulting in approximately $30.1 million in potential cost savings for the states and the federal government,” stated the OIG in its report.

The OIG has recommended that CMS seek legislative authority to limit state reimbursement rates to Medicare rates and to encourage a further reduction of state reimbursement rates through competitive bidding or manufacturer rebates. CMS agreed.

This isn’t the first time the OIG has encouraged states to use competitive bid pricing. In June, the OIG made similar recommendations after it found that New York could have saved $8.9 million on select DME items; in 2014, it found that California could have saved $3.9 million.

Medical Service Co. buys Clark’s RX Home Medical

CLEVELAND – Medical Service Co. has expanded its growing empire in Ohio. The company has acquired Clark’s RX Home Medical in Centerville, Ohio, also known as Dayton Home Medical, according to the Dayton Business Journal. Joel Marx, the company’s chairman and CEO, told the journal that he plans to double the size of the Centerville office, which has 10 employees, to grow its respiratory equipment business. “Clark’s was a perfect fit, the business has a strong pharmacy presence but wasn’t deeply invested in the medical equipment business,” he told the journal. Medical Service Co. has 23 offices and 250 employees, mostly in Ohio. Clark’s RX Home Medical operated under the Clark’s RX pharmacy chain, which has 16 locations in Ohio, Illinois and Missouri.

Convaid launches new dealer resource

TORRANCE, Calif. – Convaid has published the 2016 Seating and Mobility Guide for dealers. “Convaid knows that improved client outcome starts with application of rehabilitation principles in prescribing a pediatric wheelchair and seating system that is optimized for each child's specific mobility impairment,” it stated. The inaugural brochure features information on frame considerations, seating options, trunk and extremity positioning, and head support.

QS/1 introduces new look

SPARTANBURG, S.C. – QS/1 has revamped its image with a fresh new logo and website. “Rebranding is not something a company does lightly,” said Tammy Devine, president, in a release. “With growth and new products on the horizon, we felt this was the perfect time to release a new look to reflect the direction of the company.” The new website continues to feature industry news, product information and testimonials, but now offers easier navigation. 

ARI goes to work for Drive customers

MILWAUKEE – ARI Network Services will offer custom website and digital marketing services to Drive Medical customers, it announced Oct. 7. As part of the arrangement, ARI will offer branded websites, email marketing templates, Google optimization, and access to a library of graphics and other Drive Medical-branded marketing collateral, according to a release. “This program offers HME providers a distinct advantage by attracting online shoppers and driving qualified leads, ultimately resulting in increased online and in-store sales for Drive Medical’s provider network,” said Roy Olivier, president and CEO of ARI.

Philips reaches out to OSA patients

MURRYSVILLE, Pa. – Philips Respironics has launched a campaign to help OSA patients re-engage with their sleep therapy. The campaign centers on the company’s new Wisp mask, which is designed for minimal contact and improved patient adherence, according to a release. The campaign will include a mix of paid search and banner ads driving patients to the Wisp web page on

People in the news

Home Care Medical was recognized for several awards at the WAMES 2015 Convention this week. Jim Spellman, director of operations and 2015 WAMES President, received the Industry Excellence Award, as well as the Distinguished Service Award for his efforts on the WAMES Legislative Committee. Donna Smith, director of respiratory care, received the Outstanding Contribution Award for her efforts on the WAMES Respiratory Committee…Tina Roesler recently joined the Motion Composites team. Roesler will be responsible for expanding the manufacturer’s global and domestic markets…Stratice Healthcare, developer of eDMEplus, has hired Ken Majkowski as chief strategy officer and Jeff Benning as CFO...Beth Thieme, vice president and CEO of Amigo Mobility International, celebrates 40 years with the company this year. Under Thieme’s leadership, the DME manufacturer’s sales to retail stores have more than tripled over the last 10 years.