In brief: Exec to leave Invacare, Rotech appoints new boss
ELYRIA, Ohio – Carl Will will leave his post as Invacare’s senior vice president of global commercial operations by the end of this year. When asked who will replace Will, Lara Mahoney, director of investor relations and corporate communications, told HME News that Oscar Meyer will run the HME division and that the company’s different global and commercial leaders will report directly to Gerry Blouch, president and CEO. Meyer is vice president of marketing and business operations for North America. With Meyer leading operations efforts, Doug Harper, group vice president, sales and market development, North America, will lead sales efforts. “Carl has been with us for eight years, and he’s made a lot of great contributions to the company,” Mahoney said. “We wish him well.”
Rotech appoints new boss
ORLANDO, Fla. – Rotech Healthcare announced Dec. 10 that it has named COO Steven Alsene president and CEO. Alsene succeeds Philip Carter, who announced his retirement in June. “Mr. Alsene has interacted closely with the board for many years, has earned the respect of the board and was the natural choice to become chief executive officer,” stated Arthur Reimers, chairman, in a press release. Alsene has been the COO at Rotech since January 2012. Before that, he was CFO and treasurer, vice president of finance, and vice president of internal audit. He has been at the company since 2003. Rotech provides home respiratory and home medical equipment through 420 locations in 49 states.
CMS releases 2013 fee schedule
WASHINGTON – CMS on Dec. 13 posted the 2013 fee schedule on its website, and most HME providers will see a tiny increase next year. Medicare bases its formula on the Consumer Price Index-Urban (CPI-U), plus or minus a productivity value. This year, the productivity adjustment was a decrease of 0.9% and the CPI-U increased 1.7%, resulting in a net increase of 0.8% for non-bid providers. The rates are adjusted for inflation. CMS also updated the monthly payment amount for stationary oxygen equipment (HCPCS codes E0424, E0439, E1390, and E1391): $177.36, up from last year’s $176.06. The payment amount for maintenance and servicing for oxygen equipment also increased, from $67.51 to $68.05. The new rates are effective Jan. 1, 2013.
Sleep Nation buys five DME providers
FRANKLIN, Tenn. – Sleep Nation, a provider of CPAP equipment, recently acquired five DME companies, according to a press release. The move reflects the company’s strategy of further expansion into the sleep apnea market through acquisitions, it stated. “These acquisitions will greatly increase our ability to service thousands of more CPAP patients nationally,” stated Richardson Roberts, CEO of Sleep Nation. “We partner with our acquisitions to provide them cash to grow their business.”
Prism Medical buys Medcare’s manufacturing assets
TORONTO – Prism Medical, a DME provider based here that focuses on mobility equipment and services, recently acquired the manufacturing assets of Medcare Products for $10 million in cash, according to a press release. Based in Burnsville, Minn., Medcare is a manufacturer and supplier of floor lifts, ceiling lifts, car extractors, slings and transfer aids. As part of the acquisition, Prism Medical has entered into a 10-year agreement to exclusively supply all the products that Medicare sells in the moving and handling industry. Prism also invested $450,000 to acquire 49% of Medcare, which will remain a sales and service company focused on expanding its U.S. customer base.
GAO publishes report on Medicaid audits, prepay edits
WASHINGTON – The Medicaid Integrity Group’s (MIG’s) hiring of separate review and audit contractors was “inefficient and led to duplication because key functions were performed by both entities,” according to a new study by the Government Accountability Office (GAO). Because both types of contractors had to determine whether payments were improper under state Medicaid policies, it doubled the burden of states in ensuring that policies were correctly applied…Use of prepayment edits saved Medicare at least $1.76 billion in fiscal year 2010, but they could have saved even more had they been more widely used, according to a new study by the GAO. The GAO found $14.7 million in payments in fiscal year 2010 that were improper and could have been prevented through automated prepayment edits. It also found that more than $100 million in payments that were inconsistent with three selected local coverage determinations (LCDs) could have been identified using such edits.
Probe finds 98% error rate for enteral
WASHINGTON – A prepayment probe by the Jurisdiction D DME MAC found that 98 of 100 reviewed enteral claims were denied because of various primary documentation errors, according to a CMS bulletin. Twenty-four percent of claims were denied because of invalid beneficiary exhaustion, meaning suppliers did not receive refill requests from beneficiaries prior to dispensing. Fourteen percent of claims were denied because they lacked a detailed written order (DWO) either written or reviewed by the ordering physician. Thirteen percent of claims were denied due to lack of documentation, while 11% were denied because a detailed written order was not received by the supplier before the claim was submitted. Based on the high error rate, Noridian Administration Services will close the review and begin a widespread targeted review on enteral claims.
Gov’t makes conviction on $6.7M fraud scheme
WASHINGTON – The owner and operator of Joy Supply and General Services in Shreveport, La., was convicted Dec. 14 by a federal jury for his role in a $6.7 million Medicare fraud scheme, according to a press release from the Department of Justice. Kenny Msiakii, 44, of Houston, was convicted of eight counts of healthcare fraud. He purportedly used Joy Supply’s Medicare number to submit fraudulent claims to Medicare for HME, including medically unnecessary orthotic devices, which, in some cases, were never provided. At a sentencing scheduled for Feb. 28, Msiakii faces a maximum sentence of 80 years in prison.
Bidding short takes
Connecticut came out on top during the Dec. 4 and 5 “Shutdown the Switchboard” event, according to a bulletin from The VGM Group. The states with the most reported calls were Connecticut (132), North Carolina (95), Alabama (94), New York (92) and Minnesota (79). Because the New England Medical Dealers Association (NEMED) reported the most calls, VGM will reward Karyn Estrella, executive director, by bringing her to VGM’s Heartland Conference in June…AMEPA has launched a patient advocacy line to help facilitate patients, caregivers, and providers calling their representatives and asking them to co-sponsor the market-pricing program (MPP), according to a bulletin from the group.
Provider short takes
Sen. Richard Blumenthal, D-Conn., met with ATG Rehab customers and executives on Dec. 12. Gary Kuchachik and 11-year-old Lexi Charbonneau, two individuals whose lives depend on complex rehab, told the senator how important it is to have appropriate seating and control modifications to remain independent and functional. Blumenthal also toured company headquarters with Paul Bergantino, ATG Rehab’s president and CEO, and Frank Biondello, division president, who urged Blumenthal to support H.R. 4378, a bill that would create a separate benefit for complex rehab…Peoples Medical & Peoples Pharmacy Express, a provider of respiratory and home medical equipment, is moving its administrative offices to a new building that’s 17,6000 square feet, twice the square footage of the current location.
Vendor short take
Mediware Information Systems, a provider of healthcare IT software solutions, has acquired MediServe. Mediware plans to leverage and expand MediServe’s Alternate Care Solutions product line, which was formed to provide workflow, billing and reimbursement support for home infusion, home medical equipment and home health agencies.