In brief: CMS puts finger on fraud, DME MACs remind docs about PECOS

Friday, December 20, 2013

WASHINGTON – Industry watchers expect CMS to select a contractor early next year to administer a new fingerprinting provision aimed at curbing fraud and abuse. An RFP seeking a contactor to handle the process has a submission deadline of Dec. 23 and an award date of late February, according to AAHomecare. The provision mandates that “high-risk” providers submit fingerprints for a background check through the FBI’s database. Those who will be subjected to the rule include newly enrolling DMEPOS providers and home health agencies; those with payment suspensions in the past 10 years; and those owning at least 5% of a company, directly or indirectly. The provision is part of a final rule published in 2011 setting screening levels for DME providers. The rule established three levels of risk—high, moderate and limited—to guide screening procedures. Re-enrolling providers are considered moderate risk, while physicians and skilled nursing facilities are of limited risk. AAHomecare said it “supports all efforts to curb fraud and abuse, and will work closely with CMS on the implementation phase.”

DME MACs remind physicians of PECOS rules

BALTIMORE – Beginning Jan. 6, CMS will withhold payments to providers who provide DMEPOS prescribed by physicians not enrolled in the Provider Enrollment, Chain and Ownership System (PECOS), the four DME MACs reiterated in a letter to physicians this month. Physicians must enroll and register in PECOS, and have a specialty that makes them eligible to order DMEPOS for Medicare beneficiaries. “Help your DMEPOS supplier to continue providing quality service to your Medicare patients by promptly enrolling in PECOS, or by updating your existing Medicare enrollment information if you have not done so recently,” the said in the letter.

VGM launches survey of referral sources

WATERLOO, Iowa – The VGM Group is conducting a survey of referral sources to document discharge problems related to competitive bidding. The group is supplying a set of questions to providers to give to local referral sources. Once providers have sent completed surveys to The VGM Group, it will collect the data, and distribute it to members and state associations to help them discuss discharge problems with lawmakers.

CMS updates DMEPOS fee schedule

BALTIMORE – Providers will see a tiny bump in the 2014 Medicare DMEPOS fee schedule. The 1% increase reflects the 1.8% Consumer Price Index-Urban update minus the 0.08% annual productivity adjustment for 2014, according to AAHomecare. The increase applies only to allowables in non-competitive bidding areas, the association says.

PHM on course for record revenue, profit growth

SAN FRANCISCO – Patient Home Monitoring, a company servicing patients with chronic diseases, expects to meet record revenue and EBITA figures for the quarter ending Dec. 31, according to a Dec. 18 news release. In October and November 2013, the company’s revenue exceeded $1.65 million, setting up the company for triple-digit quarterly revenue growth, according to the release. “We continue to focus our energies on cross selling and acquiring companies that can increase our patient database,” said CEO Bob Kusher. In the release, PHM announced its first acquisition, HHC, is now serving 30,000 patients in its pharmacy channel diabetes program.

CMS changes rule to combat mail-order waste

ALEXANDRIA, Va. – Effective Jan. 1, Medicare Part D prescription drug plans must obtain consent from beneficiaries or their caregivers before filling or refilling prescriptions, according to a Dec. 17 bulletin from the National Community Pharmacists Association (NCPA). Pharmacists have told CMS that patients are turning in large quantities of unused and expired medication, usually obtained through automated refill services. “We commend Medicare officials for acknowledging mail-order waste and for responding to the concerns of patients and community pharmacists by implementing this new policy,” said NCPA CEO Douglas Hoey in a statement. Medicare recently found it costs as much as 83% more to fill prescriptions through mail-order pharmacies than through community pharmacies.

With CareTouch, Argosy’s reorder rate soars

DENVER – By teaming up with CareTouch Communications, Argosy Group has realized a 78% reorder rate, CareTouch announced Dec. 18. Argosy was losing 40% of resupply orders because the company wasn’t in constant contact with patients, according to a release. “Utilizing CareTouch’s live-call team was critical to the early success of the program,” said Douglas Stallbaumer, Argosy partner, in the release. “The patient demographics, combined with the need to articulate the changes in the program, led to our decision to start all of the patients with a live call.” 

Science Channel features Sigvaris compression products

PEACHTREE CITY, Ga. – Tune into the Science Channel later this month to learn how Sigvaris compression socks and hosiery are made. The show “How It’s Made” visited the company’s Peachtree City manufacturing facility, getting a behind-the-scenes tour that will air Dec. 19, Dec. 20, Dec. 21 and Dec. 26. “We are excited to show America the steps taken to create our products, which not only look fashionable but also offer health benefits,” said Michael Leonard, North America product development manager, in a release.

FAA advances plan, rejects calls for rulemaking

WASHINGTON –The Federal Aviation Administration is skipping the rulemaking process and moving ahead with plans to test all overweight pilots for sleep apnea, news reports say. Because the plan enhances, not changes, existing policy, the agency says the rulemaking process is unnecessary. The screening policy will go into effect after the agency has completed its formal guidelines, probably in January, reports say. Pilots with body mass indices of 40 or greater must be screened for sleep apnea and if they suffer from the condition must be treated. If they do not submit to a screening within 60 days, pilots will be disqualified, the agency says.

Study ties COPD, cognitive impairment

ROCHESTER, Minn. – Patients with COPD are almost twice as likely to develop mild cognitive impairment (MCI), including memory loss, according to a study published in Mayo Clinic Proceedings. The risk of developing MCI grew the longer a person had COPD, according to the study. “COPD is reversible in early stages, especially in smokers,” said Balwinder Singh, the study’s first author, in a statement. “These findings are important because they highlight the importance of COPD as a potential risk factor for MCI and will hopefully lead to early intervention to prevent incidence or progression.” The Mayo Clinic study examined 2,000 people from 70 to 89 years old.

Short takes

Convaid has appointed Medix21 as the exclusive importer of its products in Australia. “We are expecting to see our product distribution in Australia grow considerably in the coming years,” President Chris Braun stated in a release. Medix21 has been the sole importer for Convaid products in New Zealand for more than 20 years…OxySure Systems has appointed Pacific Medical Systems to be the exclusive distributor of its products in Hong Kong and Macau. “What is unique about Hong Kong is that there is currently no mandatory medical device registration or approval process, which means we can get down to business right away,” CEO Julian Ross stated in a release. OxySure’s agreement with Pacific Medical is for three years, renewable thereafter…Numotion has acquired the rehab division of Myrtle Beach, S.C.-based Southeastern Health Plus, the company announced Dec. 18. Numotion Regional Vice President Neill Rowland said the purchase “allows Numotion to expand its complex mobility business throughout the state and provide greater access to rehab equipment to residents needing these products and services.” The deal frees Southeastern Health Plus to focus on expanding its orthotics and prosthetics business, CEO Ralph Lombardo said in the release…Veterans and longtime friends Cecil Raney and Jerry Keiffer have opened Nashville’s first 101 Mobility location with the hope of easing the stresses of at-home care, according to a Dec. 10 news release…Amenity Health’s Medcline Reflux Relief System, a sleep-positioning device to treat nighttime gastro-esophageal reflux disease (GERD), is now available through Apria Direct online, the company announced Dec. 18. Medcline allows people to sleep at an incline and on their sides, both positions that relieve GERD and acid reflux, according to the release.

People news

Christian Kiely is the new vice president of marketing and sales for Instant Diagnostic Systems (IDS), an independent diagnostic testing facility specializing in home-based testing, the company announced Dec. 16. Kiely, who has more than 10 years of experience in the homecare and sleep industries, most recently spent five years at Apria Healthcare, according to the release…Daniel Starck, CEO of Apria Healthcare’s respiratory and HME unit, has been appointed to the company’s board of directors, according to a Dec. 16 announcement. Starck joined Apria in April 2012 after serving as CEO of workers’ compensation company CorVel Corp. for five years. He previously held a variety of positions at Apria, according to the release…Paul Tobin has resigned as president and CEO of the United Spinal Association after 17 years. Among Tobin’s accomplishments: shepherding the association’s merger with National Spinal Cord Injury Association to create the largest SCI/D membership organizations in the United States, according to a release.