In brief: CMS revisits accreditation, Medtronic expands

Sunday, January 4, 2009

MIAMI - Members of the Accredited Medical Equipment Providers of America (AMEPA) last week were weighing the pros and cons of suing CMS to stop the 36-month oxygen cap. AMEPA hired the Washington, D.C.-based law firm Greenberg Traurig in December after the Small Business Administration agreed with the association that CMS had failed to consider the cap's impact on small businesses, something it must do per the Regulatory Flexibility Act. Greenberg Traurig is one of the largest legal firms in the country, said Rob Brant, AMEPA president. The cost of such a suit could be several hundred thousand dollars, he said. "We would have to get the full industry behind it to pay for the lawsuit," said Brant. "We couldn't go it alone." The VGM Group, Airsep, Invacare, Respironics and The MED Group have all donated money to get the ball rolling.

Apria to close billing offices

HANOVER TOWNSHIP, Pa. - Due to a substantial cut in Medicare payments for home oxygen therapy, Apria Healthcare will close a billing office here and consolidate it with another facility in Tennessee, according to a local newspaper. Apria will begin closing the office in April, affecting 55 employees. The provider also plans to close two other billing centers in Seattle and Houston. Apria told a newspaper that it will make every effort to place affected employees in other jobs within the company. A private equity firm, The Blackstone Group, bought Apria last year for an estimated $1.6 billion.

Surety bond: VGM, AAHomecare offer help

WATERLOO, Iowa - The VGM Group and AAHomecare announced last week that they offer "bond solutions" for providers. A recently released final rule requires Medicare providers to obtain $50,000 surety bond by Oct. 2. VGM also offers a telephone hotline: 866-497-0472.

Snorers beware

WASHINGTON - Sleep apnea can cause stroke by decreasing blood flow, raising blood pressure and harming the brain's ability to modulate these changes, Reuters reported last week. A team at Yale University tested the blood pressure of 48 middle-aged men and women--22 of whom had sleep apnea--while they were squatting and then standing suddenly. Researchers found that the patients with sleep apnea had more difficulty compensating for the change in blood pressure, resulting in decreased blood flow to the brain. Researchers, whose work appeared in the Journal of Applied Physiology, plan to test whether statin drugs, known to reduce inflammation, can restore lost brain function in sleep apnea sufferers. They also plan to use CPAP therapy to treat them.

Contractors issue alerts

YARMOUTH, Maine - National Heritage Insurance Co., the Jurisdiction A DME MAC, reminded providers last week that they must now use the KE modifier to identify accessory HCPCS codes that can be furnished in competitive and non-competitive bidding product categories...As a result of a recent post-pay probe of therapeutic shoes (A5500, A5501, A5512, and A5513), National Government Services, the Jurisdiction B DME MAC, has adjusted claims and generated demand letters for those paid in error.

Providers wanted for advisory committee

WASHINGTON - National Government Services, the Jurisdiction B DME MAC, seeks providers, trade professionals and supplier billing organizations to join its 2009 Provider Outreach and Education Advisory Group (POE AG). The advisory group offers recommendations for provider education and training, and makes suggestions for communication methods and forums. The POE AG also works with the Jurisdiction B staff to discuss industry trends and concerns. Candidates must commit to one year and participate in quarterly meetings. Deadline to apply is Feb. 2. For more information:

Fraud continues

YARMOUTH, Maine -The owner of a recycling plant in Knox, Ind., has pleaded guilty to selling defective glucose test strips, according to news reports last week. William Greg Kroa, owner/president of Nor Am Plastics Recycling, was paid $8,000 by Bayer to dispose of the strips, which were voluntarily recalled in 2007. Instead, Kroa sold them on the Internet...Medicare fraud suspects wanted in Florida continue to escape punishment by fleeing to Cuba, according to an article in the Miami Herald. Former provider Alcides Garcia, who is charged with submitting $10.7 million in false claims for powered air mattresses, feeding pumps and other equipment that was never delivered to patients, is the latest suspect among dozens to escape to Cuba. Garcia, who fled the country in September, collected $2.2 million in Medicare payments from 2002 to 2004.