In brief: CMS fails to report 'adverse actions,' CRE takes on AARP

Thursday, September 23, 2010

WASHINGTON - CMS hasn't been doing such a good job reporting "adverse actions" by healthcare providers to the Healthcare Integrity and Protection DataBank, according to a report published by the Office of Inspector General (OIG) last week. CMS failed to report 148 adverse actions imposed against labs in 2007 and 30 actions imposed against managed care and prescription drug plans between Jan. 1, 2006, and July 31, 2009. Additionally, at the time of the OIG's review, CMS had failed to report any adverse actions against DME suppliers taken after 2008; as of April 30, 2009, however, it had reported 5,125 adverse actions against DME suppliers between 1998-2008.To read the OIG's report, go to

Competitive bidding: CRE vs. AARP

WASHINGTON - The Center for Regulatory Effectiveness (CRE) last week called the AARP on the carpet for supporting competitive bidding, a program that the CRE and others believe will harm seniors. In its written testimony to the Health Subcommittee of the Energy and Commerce Committee, which held a hearing on competitive bidding on Sept. 15, the AARP stated: "If the competitive bidding program achieves the goal of setting more appropriate payment amounts for DMEPOS items, it will result in reduced beneficiary out-of-pocket expenses, as well as savings to taxpayers and to the Medicare program." The CRE points out, however, that it has received phone calls from hundreds of seniors who are concerned about what competitive bidding would mean for access to DME. In a press release, the CRE calls on the AARP to listen to these seniors and retract its support of competitive bidding.

New neb-med pricing: No peaks, no valleys

BALTIMORE - There were few changes and no surprises in the latest average sales price (ASP) figures for nebulizer medications released last week. The biggest drop: budesonide (J7627), which continued its downward slide, from $4.85 to $4.29 per dose. Other prices were as follows: albuterol (J7613), 14 cents per dose; DuoNeb (J7620) .225 cents per dose; Brovana (J7605), $5.19 per dose; and Perforomist (J7606), $4.70 per dose.

CMS reschedules pharmacy forum

BALTIMORE - CMS's Special Open Door Forum, "Medicare Provider & Supplier Enrollment--Pharmacy Focused," has been rescheduled to Wednesday, Oct. 13, from 3:30 p.m. to 5 p.m., the agency announced Thursday. The call will review how CMS plans to implement Section 3109 of the Affordable Care Act for pharmacies; and answer questions related to pharmacies that voluntarily gave up their billing numbers last year. To participate: Call 1-800-837-1935 and use reference conference ID 98955726.

Something to watch: GAO report on oxygen

WASHINGTON - The Government and Accountability Office (GAO) plans to publish a report on the cost of providing home oxygen therapy, AAHomecare announced last week. The GAO asked AAHomecare to review and comment on the draft report, but it asked the association not to discuss the details. The GAO expects to publish the report in November.

Brightree and Fastrack: Don't sweat CEDI change

Brightree and Fastrack customers should have no fears about filing claims electronically once CMS shuts down all direct dial-up connections to the Common Electronic Data Interchange (CEDI) Gateway early next year. In separate releases last week, both companies stated that their software products can handle the change at no extra cost. CMS announced earlier this month that providers, third-party billers, software vendors and clearinghouses must start using one of six network service vendors to access the CEDI Gateway by April 30, 2011.

Survey says: Majority of providers satisfied with Medicare contractors

BALTIMORE - Sixty-nine percent of fee-for-service Medicare providers are satisfied or very satisfied with their contractor's overall performance, CMS announced last week. For the full results from the Medicare Contractor Provider Satisfaction Survey (MCPSS), go to

It pays to be a DME MAC

BALTIMORE - CMS has tapped National Government Services, a subsidiary of WellPoint, to continue on as the DME MAC for Jurisdiction B, it was announced last week. The value of the new contract, which consists of a base year and four, one-year options: $86.7 million.

Obesity helps fuel double-digit growth in diabetes market

NEW YORK - It doesn't look like the market for diabetes supplies is going to slow down anytime soon. In 2009, the worldwide market for these products grew by 16.4% to $24.9 billion, and this growth level should continue for "at least the next two years," according "The World Market for Diabetes Treatments," a new report by Kalorama Information. The major factors fueling the growth: increasing obesity and an aging worldwide population.

MED, Genadyne Biotechnologies partner

LUBBOCK, Texas - Members of The MED Group now have access to negative pressure wound therapy systems from Genadyne Biotechnologies, the companies announced last week.