In brief: CMS issues NCB guidance, AAH begs to differ

Sunday, July 27, 2008

WASHINGTON – In two bulletins issued last week, providers received guidance on claims processing and beneficiary cost-sharing waivers, now that national competitive bidding has been delayed. In the first bulletin, CMS stated it will begin processing all incoming claims under standard fee-for-service rules no later than July 28. It will process any claims that were held no later than Aug. 4. As much as possible, CMS stated it will automatically reprocess claims that “were paid under the competitive bidding program and those claims denied based solely due to program rules.” In some cases, however, providers will have to alert contractors to claims that should be adjusted. CMS stated more information is on the way, in the form of contractor instructions and MLN Matters articles. In a second bulletin, the Office of Inspector General stated that providers will not be subject to administrative sanctions if they waive retroactive beneficiary cost-sharing amounts connected with the delay’s increased payment rates. The following conditions apply: To read the full bulletin, go to

AAHomecare disagrees with CMS on accreditation
WASHINGTON – AAHomecare opposes CMS's recent decision to cancel the Jan. 14, 2009, accreditation deadline for providers in the 70 competitive bidding areas in Round 2 of the program, it stated in a release last week. AAHomecare issued the release in advance of a Senate hearing scheduled today on Medicare fraud. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) mandates a Sept. 30, 2009, deadline for all DME providers. "If the federal government wants to get serious about preventing fraud and preventing theft of taxpayer dollars, it should use tools like accreditation more aggressively and use its ample, existing authority much more effectively,” stated Tyler Wilson, AAHomecare president and CEO in a release.

CMS sticks with Palmetto
COLUMBIA, S.C. – Palmetto GBA will continue on as Medicare’s National Supplier Clearinghouse (NSC) for home medical equipment providers, the contractor announced last week. CMS awarded Palmetto a one-year base contract with four, one-year options. In all, the contract is worth about $76 million. Palmetto has held the NSC contract since 1993. Its responsibilities include issuing and revoking Medicare billing privileges to ensure that only accredited, qualified providers are enrolled in the program. It also establishes and maintains programs to prevent and detect fraud.

NAIMES launches ‘Win at Home 2008’
HALIFAX, Va. – The National Association of Independent Medical Equipment Suppliers (NAIMES) wants to help you help industry advocates win elections on Nov. 4. Through a program launched last week called “Win at Home 2008,” NAIMES will provide information and analysis for key races where important industry advocates are in jeopardy. The association will also provide guidance to providers on how to become involved in the fall election campaigns. Other aspects of the program: motivational seminars to state associations and provider groups on the importance of getting involved and building relationships; and “talking papers” about what it takes to show legislators the “true face” of the industry. Go to for more information.

GE Healthcare buys Vital Signs
TOTOWA, N.J. – GE Healthcare has acquired Vital Signs, an international provider of medical products in care areas that include anesthesia, respiratory, sleep therapy and emergency medicine, the companies announced July 24. As part of the deal, Vital Signs will become part of GE Healthcare’s Clinical Systems business, which provides patient monitoring, anesthesia delivery and acute respiratory care technologies. The deal will allow GE Healthcare to grow in the area of clinical systems and improve patient care by increasing hospital access to new technologies.

SeQual launches ‘Mark’s Breathe Easy Tour’
SAN DIEGO – SeQual Technologies announced last week that it has partnered with the American Lung Association of California and Seton Medical Center to support a chronic obstructive pulmonary disease survivor as he bikes more than 500 miles of the California coast to raise awareness about COPD. “Mark’s Breathe Easy Tour,” sponsored by SeQual, will follow 65-year-old Mark Junge over the course of a 12-day ride on a bicycle fitted with an Eclipse 2, a portable oxygen concentrator.