In brief: Medicare 'fails,' Rep. Paulsen intros tax bill

Thursday, April 22, 2010

WASHINGTON – In its Mobility Matters bulletin to lawmakers last week, AAHomecare blasts Medicare for not only denying a mobility claim for a double amputee but also targeting him for a neglect investigation. The bulletin features a Yucca Valley, Calif., man named John, who has no legs and only one “good” arm, and his and his provider’s efforts to get him a new wheelchair to replace his badly worn out wheelchair. The problem: John has only had his wheelchair for three years and Medicare will only replace wheelchairs after five years. Still, John and his provider, Esta Willman of Medi-Source Equipment & Supply, believed their claim would be approved on appeal due to extenuating circumstances. Instead, Medicare denied the claim and began investigating John for abusing his wheelchair. “It’s about flaws in how people are treated by a government program that President Lyndon Johnson created as a centerpiece of his Great Society,” stated AAHomecare President Tyler Wilson in a release. “He envisioned health safeguards for the most vulnerable people in America—the elderly and people struggling to live with disabilities. But today, sadly, Medicare is failing people like John.”

Rep. Paulsen leads fight against medical device tax

WASHINGTON – Rep. Erik Paulsen, R-Minn., and 26 other original co-sponsors have introduced a bill to repeal the medical device tax, AAHomecare reported last week. The 2.3% tax, part of the recently passed healthcare reform bill, is slated to go into effect in 2013. The language of the bill isn’t available yet, but Paulsen’s office stated “the Defend Medical Innovation Act would immediately repeal the job-killing $20 billion medical device tax.”

Association hopes pictures are worth 1,000 words

DORAL, Fla. – The Florida Alliance of Home Care Services (FAHCS) seeks to put a face on the HME industry—literally. The association is asking every provider in the state of Florida to gather its employees and take a picture of the group in front of its offices. FAHCS recommends making sure the company name is visible and asks that the photo include a sign with the number of patients the provider cares for. The association will compile the photos for circulation to state lawmakers. Send photos, along with company name, service area, number of years in business, types of services provided and patient population to

VGM Insurance marks two decades of service

WATERLOO, Iowa – VGM Insurance marks 20 years of service this year. The company started out in the mid-1980s and was incorporated by Van. G. Miller in 1990. VGM Insurance specializes in liability insurance for the medical device industry—including HMEs, pharmacies, manufacturers and distributors—through independent insurance agents or directly with medical equipment companies. It is part of the VGM Group, which includes more than 25 separate companies. “VGM Insurance is excited about the future and the commitment we bring to the industry,” stated John Spragle, president of VGM Insurance, in a release.

PAP claims getting wrongly denied

NASHVILLE, Tenn. – Cigna, the Jurisdiction C DME MAC, issued a bulletin April 19, blaming a system issue for incorrect denials on PAP claims. According the to bulletin, certain claims for PAP accessories/supplies have been denied incorrectly as over-utilization. The affected accessories/supplies include HCPCS codes A4604, A7027-A7039, and A7046. Cigna has identified the problem and will automatically adjust any affected claims. Once the claims have been adjusted, corrected remittance advices will be issued.

Bill seeks to cover custom breast forms

WASHINGTON – Sen. Blanche Lincoln, D-Ark., and Olympia Snowe, R-Maine, introduced a bill April 22 that would require insurers to pay for custom breast prostheses. The Custom Fabricated Breast Prosthesis Act of 2010, S. 3255, would amend federal law, said the American Association of Breast Care Professionals. "Women who have survived breast cancer should have access to options for post surgical treatment," stated the association in a release.