In brief: Industry shifts gears on first-month purchase option, lawmakers seek competitive bidding carve out for diabetes

Thursday, May 6, 2010

WASHINGTON - Instead of repealing the provision to eliminate the first-month purchase option for standard power wheelchairs, industry stakeholders are working with lawmakers to delay it. "We've been told that our repeal is not going to happen prior to implementation due to the current make-up of Congress," said Seth Johnson, vice president of government affairs for Pride Mobility Products. "The Democrats aren't willing to change anything in the healthcare reform bill." The provision eliminates the first-month purchase option for standard power wheelchairs but not complex power wheelchairs staring Jan. 1, 2011. Stakeholders seek to delay the provision anywhere from six months to three years. For more details:

Bill seeks diabetes carve out

WASHINGTON - Reps. Peter Welch, D-Vt., and Mike Rogers, R-Mich., last week introduced a bill, the Medicare Access to Diabetes Supplies Act, that would exempt diabetes supplies that are furnished at small community pharmacies from national competitive bidding. "The current competitive bidding program favors larger healthcare providers at the expense of smaller ones," stated Bruce Roberts, executive vice president and CEO of the National Community Pharmacists Association. The exclusion would apply to pharmacies that have annual sales of $7 million or less, according to the NCPA. Also last week, AAHomecare asked CMS to include a diabetes patient survey as part of its evaluation of the bidding program. The Medicare Modernization Act of 2003 requires CMS to provide an evaluation to Congress in 2011.

Acquisition allows Fastrack to form billing division

PLAINVIEW, N.Y. - Fastrack Healthcare Systems has acquired Newnan, Ga.-based Prometheus Group, a billing and technology management service for HMEs, physicians and sleep labs, the company announced last week. The move will allow Fastrack to establish a billing division. "Adding the Prometheus team to Fastrack is very exciting as it will allow us to offer even more services to our clients," stated Fastrack President/CEO Spencer Kay. Prometheus employees in Georgia, South Carolina and India will remain with the new Fastrack division.

Oxygen rules apply in bid areas

BALTIMORE - CMS reminded providers that if they are the oxygen provider of record in month 36, they are responsible for making arrangements with a contract supplier in a competitive bidding area for beneficiaries who travel or temporarily relocate to a CBA. For more information:

Rule outlines enrollment requirements

BALTIMORE - CMS published an interim final rule (IFR) in the Federal Register May 5 that details the Medicare requirements for national provider identifier (NPI) numbers, supplier enrollment and other provisions in the new healthcare reform law. It implements the provision that requires all providers to include their NPI on all applications for enrollment and on all claims for payment. The rule also requires physicians to be enrolled in Medicare. Additionally, it requires providers and physicians to provide documentation on referrals to programs at high risk of waste and abuse. There is a 60-day comment period on the IFR.

Code of ethics takes shape

ALEXANDRIA, Va. - AAHomecare plans to preview a Code of Business Ethics at Medtrade Spring during a panel discussion May 12 at 3 p.m. A task force within the association has been working to create a code of ethics for providers who must meet compliance and ethics requirement as part of the recently passed healthcare reform bill. The compliance and ethics requirements will be developed by the U.S. Department of Health and Human Services.

Report inaccurate view of bidding issues

ALEXANDRIA, Va. - AAHomecare takes issue with a report just released by Congressional Research Service (CRS) that relies on demonstration projects in Florida and Texas in 1999 and 2001 that suggest the program will not reduce access to HME. Instead, the CRS should have studied the two-week period in 2008, when the program went live, to review problems with access and quality, the association stated in a release.