In brief: Gov’t delays hearings, Cardinal highlights AssuraMed

Friday, November 1, 2013

WASHINGTON – The Office of Medicare Hearings and Appeals (OMHA) will defer assignments for hearings—possibly up to 28 months, according to a recent notice. Requests for hearings received after July 15, 2013, will be entered into the agency’s case processing system and held until there is room on an Administrative Law Judge’s (ALJ) docket for adjudication. When a request is assigned, a notice will be sent, according to the notice. The ALJs have been backlogged for more than a year, thanks to increased levels of audits and appeals. The notice also states that OHMA will continue to process Part D prescription drug denial cases that qualify for expedited status within 10 days and will screen all incoming requests to make sure beneficiary issues are prioritized.

Cardinal highlights AssuraMed in earnings report

DUBLIN, Ohio – Healthcare services giant Cardinal Health has reported revenue of $24.5 billion in the first quarter of 2014 compared to $25.9 billion for the same period in 2013, a 5% decrease. The company reported net earnings of $339 million for the quarter compared to $271 million for the same period in 2013, a 25% increase. Thanks to the 2013 acquisition of AssuraMed, a home medical equipment distributor, Cardinal’s medical segment saw revenues grow 13% to $2.7 billion. The acquisition also helped to boost profit 43% to $106 million. Revenue in Cardinal’s pharmaceutical segment, however, fell 7%. It’s a drop the company expected due to expired contracts with Express Scripts and Walgreens.

OIG finds payments for dead beneficiaries

WASHINGTON – Medicare paid $23 million in improper payments on behalf of deceased beneficiaries in 2011, according to an Oct. 31 report from the Office of Inspector General (OIG). Those payments account for less than one tenth of a percent of total Medicare spending, the report says. The OIG says auditors identified beneficiaries who died between 2009 and 2011, then found payments associated with those beneficiaries paid in 2011. It also found paid and unpaid Medicare Part B claims dated after beneficiaries were deceased. Specifically, the OIG found 251 providers that had high numbers of Part B claims dated after beneficiaries deceased. About 10% of the total improper payments were the result of missing or incorrect dates of death, the report says. The OIG called on CMS to tighten existing safeguards, act on improper payments, monitor paid and unpaid claims dated after a person’s death, and act on providers and suppliers with a high number of claims made after beneficiaries died.

CMS: Zero growth for Part B premiums

WASHINGTON – The Medicare Part B premium will not increase in 2014, CMS announced last week. The standard Medicare Part B premium will be $104.90 in 2014, the same as 2013, the agency stated. “We continue to work hard to keep Medicare beneficiaries’ costs low by rewarding providers for producing better value for their patients, and fighting fraud and abuse,” stated CMS Administrator Marilyn Tavenner in a press release. “As a result, the Medicare Part B premium will not increase for 2014, which is good news for Medicare beneficiaries and for American taxpayers.” CMS pointed out that the Medicare Part B premium has been less than expected or remained the same for the past three years. Additionally, the deductible will remain $147, the agency stated. To read CMS’s notice, click here.

CMS lowers interest rates

WASHINGTON – CMS has announced a 0.5% decrease in the interest rate on Medicare overpayments and underpayments, according to a recent AAHomecare bulletin. The rate is now 10.125%. Interest on overpayments and underpayments begins to accrue on the date a refund is first requested. Rates are assessed every 30 days and are not prorated when overdue payments are received in the middle of a 30-day period, according to the bulletin. Interest charged on overpayments is reimbursed through an approved schedule. The rate will remain constant unless a provider defaults on the repayment plan, in which case the rate may change to that day’s prevailing rate, according to the bulletin.

DME MAC puts nebulizers under review

INDIANAPOLIS – National Government Services, the Jurisdiction B DME MAC, plans to conduct a widespread prepayment review of nebulizers, related drugs, accessories and dispensing fees, it announced Oct. 29. The review is an expansion of a documentation review now being conducted on oxygen equipment and glucose supplies. Suppliers of selected claims will receive a request in the mail asking for copies of the signed and dated detailed written order, applicable dispensing orders, records supporting medical necessity and proof of delivery, according to a bulletin. Suppliers must respond within 45 days or the claim will be denied. If a claim is denied, the supplier may ask for a redetermination within 120 days of the initial denial, the bulletin states.

Judge tosses Scooter Store lawsuit

NEW BRAUNFELS, Texas – Senior U.S. District Judge Harry Lee Hudspeth has tossed a lawsuit filed by former employees of The Scooter Store seeking damages over the falling value of their stock ownership plan, the San Antonio Express-News reports. Filed last spring, the lawsuit called for restoring the value of their employee stock ownership plan, which tumbled from $36.9 million in 2008 to $8.5 million in 2009. Former employees alleged company founder Douglas Harrison, Principal Life Insurance Company and First Banker Trust Services breached their fiduciary duty by not diversifying the plan. The $7 million remaining in the fund will be disbursed to former employees, according to the Express-News.

AAH formalizes Manufacturers Work Group

WASHINGTON –AAHomecare has formalized its Manufacturers Work Group, the association stated in a recent bulletin. The group will now meet regularly to share information and facilitate cooperation, focusing on legislative and regulatory issues that affect HME manufacturers. It will also share sales and marketing best practices, and promote AAHomecare membership to other manufacturers and providers. David McCausland, senior vice president of government affairs and planning at The Roho Group, will serve as chairman, and Cara Bachenheimer, Invacare’s senior vice president of government relations, will be vice chairwoman. Membership is open to manufacturers who are AAHomecare members.

Eternity Healthcare, GMEA to merge

PHOENIX and VANCOUVER, British Columbia – Eternity Healthcare, a medical device company, announced Oct. 30 that its plans to acquire Global Medical Equipment of America (GMEA), a holding company focused on medical equipment, supplies and accessories. As part of the deal, Eternity’s headquarters will move to Phoenix and be led by GMEA’s management. “This is a great opportunity for GMEA to join the public market, having access to various forms of funding and, with that in mind, grow the company astronomically in a short period of time,” stated Harold Halman, GMEA president and CEO, in a press release. The companies expect to complete a share exchange agreement in the first quarter of 2014. Eternity Healthcare will issue GMEA and its shareholders about 40 million shares in exchange for all of the shares of GMEA and its shareholders, according to the release.

Exposure improves CPAP compliance, study finds

CHICAGO – Exposure therapy can help desensitize patients to the claustrophobia or intolerance they may experience when using CPAP machines, a new study suggests. The therapy helped patients who participated in a small study to use their machines for more minutes per night, according to researcher Patricia Dettenmeier of Saint Louis University. Working with a nurse practitioner, researchers had patients wear CPAP masks an hour a day while they were awake, before using the machines during hour-long naps. Eventually, patients were able to wear the mask for three to four hours each night, gradually building up to a full night’s use.

Short takes

Ottobock’sLondon “Passion for Paralympics” campaign has won the 2013 Econ Award for public relations excellence.  Ottobock has been promoting the Paralympics since the 1988 games in Seoul. In 2012, the Ottobock team included 80 technicians speaking 20 languages, according to a press release…Convaid recently donated four pallets of wheelchairs and parts to UCP Wheels for Humanity. The wheelchairs will be donated to people with physical disabilities in developing countries. UCP Wheels provides fitted wheelchairs to more than 6,000 people per year…Theravent’s sleep apnea treatments have now been used for more than 4.5 million nights. Theravent’s Provent Sleep Apnea Therapy and Theravent Advanced Nightly Snore Therapy use expiratory positive airway pressure to treat obstructive sleep apnea (OSA) and snoring…Family-owned Preston Pharmacy and Home Medical is reaching out to customers nationwide through a new online store. The store, which features everything from daily living aids to bathroom safety products, is accessible through the pharmacy’s websitePride Mobility Products and Quantum Rehab were recently recognized for their support of USA Cares, an organization providing financial assistance to and advocacy for military families. Quantum spokesman Bryan Anderson, a Purple Heart recipient who served two tours of duty in Iraq and became a triple amputee in 2005,speaks at USA Cares fundraising events…Numotion recently received the Community Service Award for Exceptional Volunteerism and Corporate Sponsorship from the southeastern Wisconsin chapter of the National Spinal Cord Injury Association (NSCIA)… Somnetics has rounded out its product offerings of portable sleep therapy devices with the Transcend Auto. The machine automatically adjusts therapy pressure during sleep, and can be used with the company’s heated humidifier and all Transcend accessories.

People news: Nonin, CareTouch, BOC

Minneapolis-based Nonin Medical has appointed Richard Eagle vice president of sales. Eagle has more than 30 years experience with Class II and Class III medical devices, and will help Nonin increase revenues by addressing changes in global sales, evaluating partnerships and refining strategies…Denver-based CareTouch Communications has hired Zuri Nance as sales manager. Nance will develop and nurture new client relationships. He has experience in research, client development and contract negotiation, and has worked three years in heath-related fields…Claudia Zacharias, president and CEO of the Board of Certification/Accreditation, International (BOC), has been named secretary treasurer of the board of directors of the Institute for Credentialing Excellence (ICE).