In brief: Denying wheelchair claims, repealing oxygen cap

Sunday, June 14, 2009

FARGO, N.D. - After monitoring claim activity for standard power wheelchairs, Noridian Administrative Services, the DME MAC for Jurisdiction D, found "documentation submitted (was) insufficient to support even the basic coverage criteria." In a posting last week, Noridian stated that documentation for K0823s lacked the following: mobility-related activities of daily living (MRADLs) limitations in detail; whether canes and walkers were insufficient; whether the beneficiary had sufficient upper extremity function to self-propel a manual wheelchair in the home to perform his or her MRADLs; whether a walker or manual wheelchair had been trialed and the results of that trail; and whether the beneficiary was unable to use a scooter. To read the bulletin:

NAIMES pushes oxygen cap repeal

WASHINGTON - The National Association of Independent Medical Equipment Suppliers (NAIMES) urged members last week to ask their legislators to co-sponsor a bill that would repeal the 36-month cap on Medicare reimbursement for oxygen. At press time on Friday, H.R. 2373, the Home Oxygen Patient Protection (HOPP) Act, had 45 co-sponsors. NAIMES aims to collect 218 co-sponsors, a majority in the House of Representatives.

Provider on NCB: "This should be a wake-up call"

WASHINGTON - Provider David Heaton called into C-SPAN's Washington Journal Program on June 5 to ask Washington Post reporter Ceci Connolly her thoughts on national competitive bidding. Connolly said competitive bidding will move forward. In response, Heaton, who owns First Class Medical Equipment in Houston, said: "This should be a wake up call to durable medical equipment companies and lobbying organizations that wish to have competitive bidding repealed. The efforts currently being made by the durable medical equipment industry to go it alone, have me believe that their comments will fall on deaf ears. The support of other healthcare related entities, such as hospital, home health, skilled nursing and physician representatives and organizations, opposing this issue will help unify all healthcare providers in their opposition to competitive bidding as a whole."

CMS schedules wound therapy meeting

BALTIMORE - CMS has scheduled a July 9 public meeting to give industry stakeholders the chance to add their two cents on the agency's recent coding decision for negative pressure wound therapy (NPWT). In April, CMS and the Agency for Healthcare Research and Quality released a study that indicated there was no need for additional codes for NPWT products because there are no significant differences between products.

Apria outsources IT

LAKE FOREST, Calif. - Apria Healthcare has contracted with Plano, Texas-based Perot Systems to manage its data center operations and applications solutions, the two companies announced last week. Per the 10-year contract, Perot will also provide consulting services. "Our alliance with Perot Systems will provide greater flexibility, quality and efficiency in our IT operations," stated Apria CEO Norman Payson in a release.

SCA launches virtual 'locker room'

PHILADELPHIA - SCA Personal Care North America has partnered with the Men's Health Network and Us TOO International to create, a virtual "locker room" that provides men with resources to help manage urinary incontinence, it announced last week. About 3.5 million men in the United States are affected by urinary incontinence, but few of them talk about it, SCA stated in a release.