In brief: Denials cost providers, HMEs summit

Saturday, March 28, 2009

FARGO, N.D. - Claims denied due to issues with certificates of medical necessity (CMNs) and DME information forms (DIFs) represent a whopping 35% of the appeals workload in Jurisdiction D, according to a recent analysis by DME MAC Noridian Administrative Services. The claims denials and resulting appeals aren't cheap, either, Noridian stated in a bulletin issued last week. The denials cost Medicare, on average, $1.4 million per year. Each appeal costs providers, on average, $36.74. This amount includes, but is not limited to, the costs of preparing an appeal and pulling supporting documentation, mailing/faxing paperwork, and employing staff to request and track appeals. "These denials are for services that include, but are not limited to, parenteral and enteral nutrition, infusion pumps, and oxygen equipment," Noridian stated. "A CMN or a DIF is required for these services for the initial claim and for revision and recertification situations." To minimize claims denied due to issues with CMNs and DIFs, Noridian offered tips like submit a CMN or a DIF with the initial claim and make sure all necessary information is present on the CMN or DIF. For more information, go to

Iowa healthcare summit: HME in the house

DES MOINES, Iowa - The HME industry was well represented at the regional healthcare summit here on March 23. Providers Julie Weidemann of Palmer Home Medical Supply and Matt Flatt of Hammer Medical Supply attended, along with John Gallagher and Mike Mallaro of The VGM Group. Though none of the HME contingency had the opportunity to speak during the two-hour summit, they were able to talk briefly with Sen. Tom Harkin, D-Iowa, one of the hosts, after the summit. "Harkin told the group that he felt preventative health care was important to allow mom to stay at home," according to a VGM Legislative Update. The HME contingency also handed Harkin a statement.

Ways and Means to hold healthcare reform hearing

WASHINGTON - House Ways and Means Chairman Rep. Charles Rangel, D-N.Y., announced Friday that the committee will hold a hearing on reforming the healthcare delivery system Wednesday. In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the committee and for inclusion in the printed record of the hearing. Anyone wishing to submit a comment can do so at

Quantum Rehab moves west

Exeter, Pa. - Pride Mobility's Quantum Rehab division will expand operations and begin manufacturing products in Las Vegas, Nev., in May. The move is designed to better serve patients and providers in the western United States by reducing delivery times and improving regional support services, company officials say. "This is a huge, huge move for us," said Cy Corgan, Pride's national sales director of retail mobility. "This is going to give us great ship time for all of our providers." Currently, it takes five to seven days to ship Quantum products from Pride's facility in Exeter, Pa., to Los Angeles. By expanding Quantum's operations to Las Vegas, that ship time will be reduced to one to two days, said company officials. Pride already manufactures lift chairs and other products in Las Vegas.

AAHomecare, Medtrade renew relationship

ARLINGTON, Va., and ATLANTA - AAHomecare and Nielsen Business Media, producers of Medtrade and Medtrade Spring, have signed a 15-year contract, effective next year, the two groups announced March 20. The contract guarantees "substantial monetary support to the association's advocacy programs," according to a release. Per the contract, AAHomecare will continue to endorse Medtrade and Medtrade Spring and will work with Nielsen to encourage association members to attend the shows. AAHomecare will also take on an expanded role in helping to shape future strategy by advising Nielsen on the issues surrounding the HME industry. AAHomecare and Nielsen first contracted with each other in 1988.

Smiths exits diabetes biz

ST. PAUL, Minn. - Medical device manufacturer Smiths Medical plans to discontinue its insulin pump and exit the diabetes market completely, the company announced March 25. The diabetes market has "little synergy with the rest of Smiths Medical's businesses," according to a press release. The Deltec Cozmo insulin pump was the company's only direct-to-consumer product and required separate staff. The company will lay off 51 employees. The company's exit from the market won't be immediate, because the company will fulfill warranty obligations to current pump users, a process that it expects to take about four years.