In brief: Landauer and Allcare merge, AOPA vs. CMS

Friday, May 17, 2013

PLAINVIEW and MT. VERNON, N.Y. – Two New York-based DME providers, Landauer Metropolitan and Allcare Medical, have agreed to merge operations. The merger brings together two of the largest HME providers in the Northeast at a time when the industry is seeing significant consolidation due to competitive bidding, according to a press release. The newly merged company will be better equipped to handle the increased volume that will likely result from the program, the release notes. It will operate under the Landauer Metropolitan name. Lou Rocco, CEO of Landauer, will remain in that position, while Win Hayes, CEO of Allcare Medical, will become president of the company. Landauer serves patients in nine Northeastern and Mid-Atlantic states and the District of Columbia, while Allcare serves patients in New Jersey, New York and Pennsylvania.

Audits: AOPA vs. CMS

ALEXANDRIA, Va. ­– The American Orthotic and Prosthetic Association (AOPA) has sued CMS over what it calls “unfair and unauthorized” auditing activities, according to a press release. “Today, AOPA has stated emphatically that we will not stand by when government acts inappropriately to threaten either the quality of care we provide to our patients or the economic viability of the small businesses and providers that comprise the orthotics and prosthetics profession,” stated Thomas Kirk, president of AOPA, in the release. The impetus for the lawsuit: a “flawed, and in some respects amateurish, report (by the Office of Inspector General in August 2011) alleging fraud in the O&P field where there essentially was none.” The suit claims, among other things, that the report misunderstood important nuances of the patient-physician relationship with respect to prosthetics; created confusion about whether bi-lateral amputees should have both prostheses on a single claim; and jumped to conclusions about fraud while disregarding technological advances necessitated by injuries sustained by veterans of wars in Iraq and Afghanistan.

Pride/Quantum partner with Comfort Company

EXETER, Pa. – A new partnership allows the Comfort Company, a manufacturer of wheelchair seating and positioning products, to sell manual wheelchairs from Pride Mobility and Quantum Rehab, according to a press release. Working as a team, representatives from all three companies will be able to deliver onsite support and additional resources to providers to meet patient needs. The inside sales force at Pride and Quantum will continue to process and facilitate orders to provide an uninterrupted transition for providers. “This partnership will allow Quantum/Pride and Comfort Company to capitalize on additional opportunities and improve relationships with therapists and ATPs across the country,” stated Jay Brislin, vice president of Quantum Rehab, in the release.

ResMed settles with university

SAN DIEGO – ResMed agreed to pay the University of Sydney $AU25 million to settle a lengthy legal dispute regarding patent infringement, according to news reports. The university, where researcher Colin Sullivan invented a nasal mask to treat sleep apnea, had accused ResMed, its former commercial partner, of infringing its patent and failing to pay royalties. As part of the settlement, ResMed will fund two perpetual academic chairs: the ResMed Chair of Sleep Medicine; and the ResMed Chair of Biomedical Engineering. The company will also provide research funding in related areas, the release noted.

Strike Force takedown nets 89 medical professionals

WASHINGTON – The Medicare Fraud Strike Force has charged 89 individuals with about $223 million in false billings, according to a press release from the Department of Justice (DOJ) on May 14. Strike Force operations in eight cities resulted in charges against doctors, nurses and other licensed medical professionals for alleged fraud schemes involving, primarily, home health care, but also mental health services, psychotherapy, physical and occupational therapy, DME and ambulance services, the release noted. The coordinated takedown was the sixth of its kind nationally since the strike force was initiated. Operated jointly by the Department of Health and Human Services (HHS) and the DOJ, the strike force has charged nearly 600 individuals with about $2 billion in false billings. 

Sleep Nation launches live call service

NASHVILLE, Tenn. – Sleep Nation, a provider of CPAP supplies, has bundled its call center, insurance eligibility and fulfillment teams into a live call service for providers, according to a press release. The provider is pitching the services to other providers looking to increase their re-supply businesses. “Live callers perform better than automated options and provide for better patient communication and care,” stated Richardson Roberts, CEO of Sleep Nation, in the release.

CMS adds three new DME codes

WASHINGTON – CMS has added three new codes for custom DME, according to an announcement. The additions, which are only to be used for items that meet the definition of “customized items,” are: K0008 (custom manual wheelchair/base); K0013 (custom motorized/power wheelchair base); and K0900 (custom durable medical equipment, other than wheelchairs). Effective July 1, claims for items billed using these codes will be manually processed and evaluated to ensure the items furnished meet Medicare’s definition of customized items.

Study links sleep apnea, obesity

MADISON, Wis. – A new study suggests that the near 55% increase in sleep apnea cases over the past two decades may be linked to a higher incidence of obesity. The study, published by researchers at the University of Wisconsin-Madison, examined more than 600 adults between the ages of 30 and 70 who were tested for sleep apnea between 1988 and 1994, with some continuing to take part, along with hundreds of new participants, from 2007 and 2010. Researchers estimate that the number of cases of sleep apnea rose from 14% from 1994-1999, to 55% from 2007-2010. Study author Paul Peppard believes that between 80% to 90% of the increase is attributable to the obesity epidemic.

Vendor short takes

The Board of Certification/Accreditation (BOC) recently changed its prerequisites for becoming a certified orthotist or prosthetist by adding both a graduation and residency requirement…Invacare sponsored the Buckeye Wheelchair Games May 16-18 at the Spire Institute in Geneva.

People news

In a rare display of bipartisanship, the U.S. Senate confirmed Marilyn Tavenner as the first full-fledged administrator for CMS since 2006, according to multiple reports. Senators voted 91-7 to back President Barack Obama’s nominee…AAHomecare has recognized two HME providers for their contributions to government affairs on behalf of the industry. Georgie Blackburn of Tarentum, Pa.-based Blackburn’s, and Jackie Bolt of Greenville, S.C.-based Carolina Homecare Medical Equipment Center, have received this year’s Legislative Advocate Award…InnoMed Technologies has named Ron Richard its new CEO…CCS Medical has appointed Michael Sicuro to be its interim CEO.