In brief: Officials testify on improper claims, MedPAC releases spending report

Thursday, July 28, 2011

WASHINGTON - The HME industry did not escape scrutiny when a House Subcommittee held a hearing last week on improper Medicare payments. Officials from the Office of Inspector General, CMS and the Government Accountability Office gave testimony on what contributed to the government paying out $47.9 billion in improper payments in 2010. "Some but not all improper payments are the result of fraud," Daniel R. Levinson, OIG's Inspector General told the subcommittee, in prepared remarks. Government officials pointed to power wheelchair claims as an area where there continue to be problems with billing incorrectly or billing for items that are not medically necessary.

MedPAC releases spending report

WASHINGTON - Medicare spending for DME has remained flat for the past 10 years, according to a new report issued by the Medicare Payment Advisory Commission (MedPAC). DME spending has stayed 2% of total Medicare spending from 2000 to 2010, according to the report. Medicare spent the most money on inpatient hospital services in 2010. Read the report. 

CMS turns off bad edit

BALTIMORE - CMS has instructed all four DME MACs to turn off the B7 edit that has caused claims to deny as if providers were not accredited. The root of the problem: An error in the supplier file information provided to the DME MACs. The DME MACs will reprocess all denied claims, and suppliers don't need to take any action. No date has been set for reactivation of the edit.

Industry to lose champion

WASHINGTON - Rep. Mike Ross, D-Ark., announced July 25 that he would not run for re-election to Congress. Ross, a former HME owner, has worked with the HME industry on competitive bidding and other issues. Ross has indicated he may run for governor in 2014.

Covidien enjoys sales increase

MANSFIELD, Mass. - Covidien on July 26 reported a 14% increase in net sales for its fiscal third quarter ended June 30, 2011. Net sales were $2.93 billion compared to $2.56 billion a year ago. Operating income was $615 million vs. $539 million. The company stated in a press release that growth segments included oximetry and monitoring, enteral feeding and incontinence products. Airway and ventilation sales were down in part due to the sale last year of its sleep therapy line to PH Invest.

On the way: Correction for custom prosthetic claims

BALTIMORE - Medicare will pay for certain custom prosthetic items under Part B when they are provided to a beneficiary during a non-covered Part A stay in a hospital or skilled nursing facility. These claims have been incorrectly denied since April 4. In a July 27 message, however, CMS stated it was issuing instructions to correct the problem, but that the correction would not be implemented until Jan 1, 2012. Until then, the DME MACs will reprocess any claims that were incorrectly denied when such claims are brought to their attention.

Invacare, VGM host Audit Roadshows

ELYRIA, Ohio and WATERLOO, Iowa - Invacare and the VGM Group have teamed up to present a series of provider audit-training programs. The one-day Audit Roadshows will cover RAC, CERT and ZPIC audits, and will include advice on reviewing documentation, mitigating the effects of an audit investigation and more. The Audit Roadshows will take place Aug. 2 in Fort Lauderdale, Fla.; Aug. 4 in Dallas; Aug. 10 in Houston; Aug. 11 in Charlotte, N.C.; and Aug. 16 in Tampa, Fla. 

Short takes: Invacare, Fastrack, Active Healthcare, CryoVation, Max-Wellness

Invacare will serve as a national host sponsor for the National Veterans Wheelchair Games. The 31st annual event takes place Aug. 1-6 in Pittsburgh...Fastrack Healthcare Systems announced July 28 that it is adding staff to accommodate growth. Revenue has been up more than 30% since January, the software vendor stated in a release...Raleigh, N.C.-based Active Healthcare has been named one of the 2011 Top 300 Small Businesses of the South by Business Leader magazine. The company was co-founded by Lisa and Steven Feierstein...CryoVation announced July 26 that it has launched an e-commerce site,, to allow customers to order parts and equipment for cylinder filling systems online...Max-Wellness opened a hospital retail store at West Medical Center in Cleveland July 25. Max-Wellness was founded by Michael Feuer.