In brief: Providers meet, task force brainstorms

Sunday, December 28, 2008

HALIFAX, Va. - An ounce of prevention would go a long way in fixing the nation's healthcare crisis, according to the healthcare providers and consumers who attended a Dec. 22 town hall meeting hosted by the National Association of Independent Medical Equipment Suppliers (NAIMES). The forum was held in response to president-elect Barack Obama's call for public input on healthcare reform. About a dozen people, including HME providers, consumers and hospital staff, attended the forum in South Boston, Va. "Everybody felt that applying quality prevention planning at the front end and mandating the use of preventive care will substantially reduce long-term costs," said Wayne Stanfield, president of NAIMES. Other issues raised by the group: Move toward integrated electronic health records; reward healthy behavior; and reduce waste, fraud and abuse.

New task force assembled
LUBBOCK, Texas - While people were heading home for the holidays last week, nearly a dozen members of The MED Group from around the country met to develop a solution for oxygen providers whose patients relocate after their benefits cap. Providers and stakeholders have clamored for more details from CMS on how certain provisions of the cap, which kicks in this week, are supposed to work. Although the industry is lobbying hard on several fronts to delay the cap, it could be February before providers see any legal remedy, said Kelly Riley, director of MED's National Respiratory Network. "Until we get some relief from CMS, we need to show that we are in compliance with the regulations as they are written today," said Riley. Lisa Smith, an attorney with Amarillo-based Brown & Fortunato, also met with the group to provide legal advice.

Sleep policies clarify adherence monitoring
YARMOUTH, Maine - The four DME MACS issued revised sleep policies just before the holidays. There were no major changes for providers, but they did clarify adherence monitoring. In a nutshell: As long as the equipment can show that the patient uses CPAP four or more hours per night on 70% of nights during a consecutive 30-day period, it is OK to use. Machines that simply record hours of use do not meet the requirement. The original policy, issued in July, stated that compliance must be tracked by a downloadable device, which not all CPAP providers use. To read the complete FAQ posted on the Jurisdiction D Web site:

Medicare message sent in error
HARRISBURG, Pa. - The Pennsylvania Association of Medical Equipment Suppliers (PAMS) has received word that the DME MACs are sending out Medicare Remittance Notices with the code N371--"Alert: title of this equipment must be transferred to the patient"--for oxygen patients. "We have been in touch with NHIC and have been assured that this notice is in error, that CMS is aware of the error, and that providers should ignore it," said John Shirvinksy, PAMS executive director. Shirvinsky spoke with an NHIC official who said the messages are part of some verbiage that has not been updated yet. While Shirvinsky only spoke with the Jurisdiction A MAC, he warned that all four jurisdictions probably had the same error.

Japanese provider conquers Europe
TOKYO - Teijin Pharma Limited announced last week that it has partnered with Laboratorios del Dr. Esteve S.A., a major pharmaceutical company in Spain, to provide home respiratory therapy to patients in Europe. Per the partnership, Teijin will acquire Esteve's 51% stake in Oximeplus S.A., a provider of home respiratory services in Spain. In 2008, Teijin acquired several home medical equipment providers in the United States, including Associated Healthcare in Amherst, N.Y. "With operating bases in Europe and North America, as well as growing business in Asia, Teijin Pharma looks forward to offering comprehensive healthcare solutions in pharmaceuticals and home healthcare contributing to the quality of life among a broadening scope of customers worldwide," Teijin stated in a release.

It's not too late
BALTIMORE - Today is the last day to comment on the new oxygen cap guidelines. Providers can submit comments at Enter file code CMS-1403-FC, click "send a comment or submission," fill in the required information and include the file code in your comments.