In brief: CMS sends bid letters, addresses out-of-biz providers

Friday, August 23, 2013

BALTIMORE – CMS looks to be slowly working toward the Jan. 1 implementation date for the Round 1 re-compete. HME News has learned that some providers last week received bona fide letters asking them to provide supporting documentation to substantiate their bid amounts. CMS had planned to release the single payment amounts sometime in the spring and the names of the contract suppliers this fall. Meanwhile, stakeholders continue to lobby for H.R. 1717, which would replace competitive bidding with a market-pricing program. The bill currently has 150 co-sponsors, a number that is expected to rise once lawmakers return to Washington, D.C., the second week of September.

CMS addresses providers going out of business

WASHINGTON – CMS has announced that, effective immediately, it will allow the replacement of oxygen equipment when suppliers exit the business. In a bulletin this week, CMS stated that, under such circumstances, it will now consider the equipment lost and start a new 36-month rental period for the new supplier on the date the equipment is furnished. CMS noted that suppliers exiting the business without transferring patients to new suppliers are in violation of statutory and regulatory requirements.

Sleep vendors continue legal wrangle

SAN DIEGO – ResMed has announced that the International Trade Commission (ITC) has agreed to investigate BMC Medical, a Chinese medical device manufacturer, and its U.S.-based distributors, 3B Medical and 3B Products, for patent infringement. ResMed requested the investigation. It also filed a lawsuit against BMC in federal court in May. "We're encouraged by the ITC's action to investigate this case against BMC," stated ResMed Global General Counsel and Chief Administrative Officer David Pendarvis. "We invest over $100 million in research and development each year to fuel these advances and other companies should not be allowed to infringe ResMed's intellectual property by using our technology." ResMed filed a similar lawsuit against Apex Medical, a Taiwanese manufacturer, earlier this year. That action resulted in Apex consenting to an order barring it from bringing infringing products into the U.S. market. Apex, however, is fighting back. On Aug. 20, the company announced that it will challenge six of the seven patents involved in the lawsuit. It is doing so under a law that allows re-examination of patents if there is substantial invalidity evidence. 

HME companies make Inc. list

NEW YORK – A number of HME companies have made the Inc. 500/5000, an annual ranking of the nation’s fastest-growing private companies. Companies in the health category include Carolina’s Home Medical Equipment, A/R Allegiance, Roscoe Medical, Keen Healthcare, RemitData, Sunset Healthcare Solutions, Blue Dot Medical and Strategic AR. To view all the companies in the health category, go to

Home Health Depot sees Texas as ‘smart growth opportunity’

INDIANAPOLIS – Home Health Depot has opened a new branch location in Austin, Texas, expanding its reach to a total of six states. Initially, the new branch will focus on providing complex rehab equipment to patients in the greater Austin and San Antonio markets, according to a press release. “We continue to look for smart growth opportunities as the delivery of healthcare is quickly changing due to today’s economic realities,” stated President Nathan Feltman in the release. In addition to Texas, Home Health Depot has a presence in Georgia, Illinois, Indiana, Iowa and Michigan. Last year, Home Health Depot acquired Advanced Rehab Technologies in Iowa, the respiratory assets of RCS Management in Indiana, Medical Mobility in Indiana, and Genesis Healthcare Services in Atlanta. Home Health Depot offers a full line of products designed to meet the specific medical and functional needs of people with disabilities. 

Contract suppliers must be enrolled in Medicaid

WASHINGTON – Contract suppliers in competitive bidding areas can’t bill dual-eligible beneficiaries for co-pays if they’re not enrolled in the Medicaid program in the relevant state, AAHomecare has notified members in a bulletin. This extends to Medicaid managed care organizations. The association had sought clarification from CMS on the issue. Additionally, the prohibitions against billing dual-eligible beneficiaries for Medicare cost-sharing (i.e. deductible and co-insurance) apply under the program. The Medicaid statute considers payments from Medicare and Medicaid as payments-in-full for items provided to dual-eligible beneficiaries, according to AAHomecare. Beneficiaries are under no legal obligation to make further payment to providers. Providers who charge dual-eligible beneficiaries for cost-sharing could face penalties, the association says. States must pay providers for any Medicare cost-sharing for dual-eligible beneficiaries. To be paid, providers must be enrolled with Medicaid in each state in their service area.

Noridian reports overpayments on PMD rentals

FARGO, N.D. – Noridian Administrative Services has reported overpayments on some power mobility devices in Round 2 competitive bidding areas. Noridian says the problem stems from a system issue that led to DME MACs paying a higher rate than allowed under the program. Claims that meet the following criteria have been overpaid: processed on or after July 1, 2013, billed with the KJ modifier and submitted under a certain code. Noridian says it will adjust these claims to the correct payment amount and send suppliers overpayment notifications. 

Hasco Medical reports increased revenue

ADDISON, Texas – Hasco Medical, Inc. reported in a shareholder update on Aug. 20 that net revenue for the first half of the year increased $5.5 million compared to the same period last year. The company is in the process of purchasing Auto Mobility Sales, Inc., and has completed the liquidation and closure of Southern Medical and Mobility, Inc., a business not in alignment with its auto-division strategy. Hasco also reported that it has launched, a resource that connects those who need wheelchair-accessible transportation with crowdfunding financing options, and named Rick Fountain as vice president of service. The company sells, rents and provides parts for handicap-accessible vans in 16 locations from Maine to Florida. It also sells medical equipment and supplies in Florida. 

Medtrade highlights retail

ORLANDO, Fla. – Medtrade will go to new lengths to highlight retail-oriented products at this year’s event, Oct. 8-10. A panel of experts will select five products that will be featured in a conference session called “The Best New HME Retail/Cash Opportunities,” Oct. 9 from 1:30-2:30. During the session, which will be moderated by Jim Greatorex, owner of Black Bear Medical, manufacturers will have five to seven minutes to discuss their products. The products will also be featured in a window display in the Retail Design Center on the show floor. “I, and many others, go to Medtrade looking for the next great cash opportunity,” stated Greatorex in a press release. “This year, providers will have a chance to expand their business and in some situations be one of the first to promote a product.”

Len Serafino: ‘Keep Breathing’

YARMOUTH, Maine – Former homecare exec Len Serafino has released his second novel, “Keep Breathing,” the story of a road trip along the I-95 corridor taken by a man with idiopathic pulmonary fibrosis and his friend. Serafino will donate 20% of proceeds from the book, which is available on, to the Pulmonary Fibrosis Foundation. Serafino spent 16 years working in the HME industry for companies like Drive Medical, Chad Therapeutics and American HomePatient. He is also the author of the novel “Back to Newark” and a book on effective communications skills, “Sales Talk.”

CMS releases off-the-shelf codes

BALTIMORE – At long last, CMS has finalized its list of off-the-shelf (OTS) orthotics codes. In February 2012, the agency released an initial list and sought public comment. Federal law defines OTS as items that require “minimal self-adjustment.” At that time, industry stakeholders expressed concerns that the list included some items that should be considered custom devices not OTS, and therefore should only be provided by certified fitters or orthotists. View the finalized list of codes here:

Up for review: catheters

NASHVILLE, Tenn. – CGS, the Jurisdiction C DME MAC, will conduct a service-specific review of certain intermittent catheters (A4351, A4352 and A4353), it announced Aug. 20. Providers who receive letters requesting additional documentation may be asked to provide the following: Preliminary dispensing order (if items were dispensed prior to obtaining a detailed written order); detailed written order; medical records that support medically necessary to perform intermittent catheterization; request for refill; delivery documentation; any other pertinent records; and copy of advance beneficiary notice if one was obtained. The review is being done because of high payment error rates.

Demand for enteral feeding to grow

YARMOUTH, Maine – The global market for enteral feeding devices is expected to reach $2.45 billion by 2018 up from $1.64 billion in 2011, according to a new report released Aug. 18 by Transparency Market Research. Enteral feeding pumps accounted for 61% of total revenues in 2011 and are expected to grow at a CAGR of 6.1% from 2011 to 2018. North America and Europe are the biggest markets, accounting for 67% of total revenues in 2012. Dominant players in the market include Abbott Nutrition, Danone and Fresenius-Kabi, according to the report.

UN gives RESNA special status

WASHINGTON – RESNA has received special consultative status from the United Nations, allowing the organization to increase its international presence, says President Alex Mihailidis. RESNA now may actively work with the UN Economic and Social Council, adding items to its provisional agendas, submitting statements and attending meetings. The status also allows RESNA to send official representatives to UN events, conferences and activities, and to consult with the council on items of mutual interest. “We look forward to forging new relationships with other non-governmental organizations and entities within the United Nations that share our common interest of improving access to technology for people with disabilities,” stated Mihailidis in a prepared statement.

App could reduce COPD hospital readmissions, developer says

PHILADELPHIA – The use of an app called SmartScope could cut hospital readmissions of COPD patients by up to 40%, says its developer. By asking patients eight questions about their symptoms each day and reporting the answers to doctors, SmartScope could help physicians predict and prevent attacks of COPD up to a week in advance, says Futura mHealth, the Philadelphia company that developed the program along with Temple University. David Gulian, Futura mHealth CEO, told MobiHealthNews that each COPD episode can shave up to three years off a patient’s expected life span.

Short takes

3B Medical has hired Joe Toth to lead its sales team as national sales director. Toth will draw on 20 years with Puritan-Bennett and seven years as the co-owner of a sales and consulting company in the homecare industry…101 Mobility now has a corporate-owned location in Virginia Beach, Va. The location offers a full range of mobility products and installation services to the state’s Tidal Creek areas, including Norfolk, Hampton Roads, Newport News and Chesapeake Bay… Numotion, a provider of complex rehabilitation technology and products, announced the launch of its new website Aug. 19. The new website,, features industry, advocacy and company news.