In brief: Humana prefers Apria, trio of HME cuts part of debt talks

Thursday, July 14, 2011

LOUISVILLE, Ky., and LAKE FOREST, Calif. - The word on the street last week: Humana has made Apria Healthcare the "provider of choice" to supply home medical equipment to its members. NAIMES reported the news in a bulletin to members last week, citing calls from providers who have been asked by Humana to turn over their patient rosters, so those patients can be transferred to Apria. A notice on Humana's website, headlined "Humana makes changes to home medical equipment provider network," stated: "Humana has established a long-term relationship with Apria Healthcare, making Apria our provider of choice for Humana members' home medical equipment needs...Please note that Humana's relationship with several home medical equipment providers is being terminated...Impacted Humana members will be informed of this change and encouraged to transition their services to Apria." The notice was not dated. Attempts to reach Humana by press time were not successful. HME News also contacted Lisa Getson, Apria's executive vice president of government relations; she was out of the office but said she'd get back to us.

Trio of HME cuts part of debt talks

WASHINGTON - Three cuts to home medical equipment are among the options in the ongoing deficit reduction negotiations, according a leaked document. The cuts: The application of Medicare competitive bidding rates to Medicaid payments in those states where competitive bidding is being eliminated, cutting $5 billion over 10 years; prepayment review for power wheelchairs, cutting $200 million over 10 years; and reductions to diabetic strip pharmacy payments. Industry stakeholders encourage providers to contact lawmakers and tell them "No more cuts to home care."

MK Battery sweetens pot for Power for Funding 2011

ATLANTA - MK Battery announced July 12 that it will match sponsorships to the Power for Funding event at Medtrade up to $50,000. The battery manufacturer, which is sponsoring the event with Medtrade, has already contributed $50,000 toward underwriting the event and making donations to AAHomecare, NCART and NRRTS. Sponsorship opportunities are available at levels ranging from $1,000 to $25,000. Net proceeds go to the three organizations. In addition to presenting checks to AAHomecare, NCART and NRRTS, the event will feature hors d'oeuvres and refreshments, music, a slideshow of nostalgic images and the presentation of the HME Excellence Awards by HME News. Tickets to the event, Oct. 25 from 5:30 to 8:30 p.m. at the Omni Hotel, are available to all providers. Contact Dennis Sharpe, for more information.

Otto Bock buys TriQuality

MINNEAPOLIS - Otto Bock US HealthCare announced last week that it has acquired TriQuality, a Sacramento, Calif.-based manufacturer of mobility seating. TriQuality and its 28 employees are now part of Otto Bock Company Group based in Duderstadt, Germany. Otto Bock has distributed TriQuality's Nu-Tec planar seating for seven years, a partnership that led to the purchase. Otto Bock makes more than 40,000 types of prosthetic and orthotic components and mobility and rehabilitation products.

GAO to CMS: Fully implement fraud tools

WASHINGTON - CMS needs to do a better job using the tools it has already implemented to detect fraud, according to a recent Government Accountability Office (GAO) report. CMS is using the Integrated Data Repository (IDR) and One Program Integrity (One PI) to, for example, detect duplicate claims, but the agency has not incorporated all data into IDR as planned and has not taken steps to ensure widespread use of One PI to enhance efforts, the GAO states. Additionally, CMS is not yet in a position to identify, measure and track benefits realized from using the systems, the GAO states. The GAO recommends that CMS take steps to finalize plans and schedules for fully implementing and expanding the use of the systems. CMS concurred. FMI.

CMS wrongly denying claims

BALTIMORE - A system glitch at the DME MACs has meant some providers are receiving denials due to their eligibility status. "It looks as if when they uploaded files from the accreditors there is some sort of problem with section B of the 855 form," said Walt Gorski, vice president of government affairs for AAHomecare. Section B is where providers indicate what products they provide and are accredited to provide. CMS has indicated it is aware of the problem and is working to fix it. At press time, it was unknown how the erroneously denied claims would be addressed.