In brief: CMS fails, McCain wins, ATG grows

Sunday, November 2, 2008

MIAMI - Medicare allowed 90% of medical equipment providers that were shut down by the agency last year to reopen, according to a report released last week by the federal inspector general. The providers were allowed to reopen despite having no offices or employees. Among the reinstated companies: 15 South Florida providers later implicated in multimillion-dollar fraud investigations, according to Miami Herald. "Our findings suggest that a more critical review of the types of evidence submitted by suppliers is warranted to ensure that fraudulent suppliers are not reinstated," stated Daniel Levinson, inspector general in the U.S. Department of Health and Human Services in the report. In a letter, Kerry Weems, Medicare's acting administrator, agreed with Levinson, saying the agency "should consider establishing guidelines" for evidence during appeals and asked for "specific suggestions" from the inspector general.

McCain wins industry vote
ATLANTA - If it were up to Medtrade attendees, Sen. John McCain would be the nation's next president. The National Association of Independent Medical Equipment Suppliers (NAIMES) hosted a straw election at its booth last week, and 64% percent of the 183 voters picked McCain; 30% picked Sen. Barack Obama; and 6% were undecided. McCain may have garnered the most votes, but 69% of voters said the Democrats will win the White House. NAIMES also asked voters how the HME industry might fare under the next administration: Do you think the DME industry will fare better under a Democratic administration? 44% yes; 56% no. Do you think having a Republican administration and a Democratic Congress is better for the DME industry? 50% yes; 50% no. Do you feel the Republicans have a tarnished image after the last eight years? 80% yes; 20% no. Do you feel that the next Congress will repeal competitive bidding? 47% yes; 53% no. Do you feel that the oxygen cap should be repealed in light of recent cuts? 60% yes; 40% no. Does your representative know you by name and face? 53% yes; 47% no.

ATG Rehab comes up for Air
ROCKY HILL, Conn. - ATG Rehab's acquisition tear continues. The company announced Oct. 10 that it has acquired Air Products Seating and Mobility, a division of Air Products Healthcare. With the acquisition, ATG Rehab gains coverage in new areas including Maryland, Pennsylvania, Georgia and Illinois. "This acquisition provides ATG Rehab with the additional reach to expand our demographic and market coverage, allowing us to serve even more individuals who will benefit from our high level of customer care and expertise," said David Law, ATG's vice president of operations. For its part, Air Products Healthcare is "pleased to have found a buyer who recognizes our reputation for caring and knowledgeable employees who provide quality service to patients," said Phil Sproger, vice president and general manager of Air Products Healthcare.

Apria stock skyrockets
LAKE FOREST, Calif. - Shares of Apria Healthcare climbed $7 or 50% to $20.99 after the provider closed its $1.7 billion sale to The Blackstone Group, the Los Angeles Times reported last week. "Many people were concerned the deal wouldn't get done," an analyst told the newspaper. Blackstone plans to merge Apria with its Sky Merger Sub Corp. unit. Apria's stock had fallen 2.7% this year, according to the newspaper. Now a private company, Apria's stock has been delisted.

Familiar face leads Respironics
MURRYSVILLE, Pa. - Don Spence becomes CEO of Philips Home Healthcare Solutions this month, replacing John Miclot. "I have large shoes to fill, but I have big feet," said Spence, formerly president, sleep and home respiratory, at Medtrade. Miclot will join CCS Medical, a Florida-based provider of medical supplies.

PMD forms don't pass the test, CMS warns
WASHINGTON - The DME MACs last week sent letters to physicians, advising them to record visits and exams for power mobility devices in their own medical record-keeping format. "Many suppliers provide forms for you to complete," the Oct. 31 letter states. "Suppliers often try to create the impression that these documents are a sufficient record of the in-person visit and medical evaluation. Based upon our auditing experience, most of them are not." The reason: "These documents do not record a complete medical exam and thus do not provide enough detailed information to adequately describe the medical necessity for the power mobility device in the patient's home," the letter states. The DME MACs state that suppliers, manufacturers and even physician groups like the Texas Academy of Family Physicians and the Florida Academy of Physicians have developed such "home-grown" forms. To read the complete letter, go to

Nebulizer payment: Not so fast
WASHINGTON - The DME MACs last week withdrew a plan to pay for brand-name respiratory medication DuoNeb at the same rate as generic ipratropium and albuterol. The policy was supposed to go into effect Nov. 1. In March 2006, CMS proposed a least costly alternative method for paying for respiratory medications, including DuoNeb and Xopenex. That raised concerns among industry stakeholders that it was akin to Medicare practicing medicine. Wayne Vega, senior vice president of sales for Harvard Drug Group, said the decision was likely just a logical one. "They probably don't want to change the reimbursement in the middle of a quarter," he said. The other provisions of the policy remain in effect.