In brief: Providers protest bid program; DeVilbiss raises prices

Thursday, December 16, 2010

ORLANDO -- Roughly 40 HME providers walked the picket line here last week to protest Medicare's competitive bidding program. The protest occurred outside a closed and bankrupt HME that had won bids in multiple product categories, said Rob Brant, president of Accredited Medical Equipment Providers of America (AMEPA), which organized the protest. "We hope to get legislators to realize that this program was put together improperly--it is flawed," Brant said. "You've got bankrupt bid winners. You've got bankrupt and closed companies that created this bid rate while local providers that didn't win are closing their offices. This is going to be a real problem for hospitals, doctors and patients come January 1, and no one seems to be aware of it or care."

DeVilbiss raises prices, reduces warranty

SOMERSET, Pa. - DeVilbiss Healthcare plans to raise prices and reduce warranties on certain products next month to counter the "extreme changes in the oxygen market" over the past several years, the company announced in a release last week. DeVilbiss will reduce the warranty on its 5-Liter Compact Concentrator 525 series from five years to three years on new products sold on or after Jan. 4, 2011, in North America. The company also will raise prices 5% on selected service and repair parts used in its oxygen product line. This price increase is needed to offset component cost increases that have not been passed on to customers over the last several years, the company stated. "We understand the pressures that are being placed on our oxygen provider partners and we have done our best to absorb the steady incremental price increases," Craig Haba, vice president of sales and marketing for respiratory solutions," stated in the release. "Unfortunately, we can't keep that up if we want to maintain a sustainable business model in oxygen,"

HME providers get "Red Flag" exemption

WASHINGTON - HME and other healthcare providers caught a break last week when the House of Representatives passed a bill that exempted them from the Federal Trade Commission's "Red Flag Rule," an identity theft measure that requires creditors to implement prevention programs. The Senate approved its version of the bill, which will narrow the scope of who is considered a creditor, the previous week. HME providers, physicians and other healthcare providers were considered creditors because they typically don't collect full payment upfront.

CMS eliminates least costly alternative

BALTIMORE - Medicare contractors may no longer make partial payment for claims based on a "least costly alternative" (LCA) determination. In a listserv message, National Government Services, the Jurisdiction B DME MAC, stated that, for claims on or after Feb. 4, 2011: if the local coverage determination (LCD) states that an item will always be paid based on the allowance for the least costly items, then under the new policy, claims for that item will be denied as not medically necessary; if the LCD states that an item will be paid in full when specific additional coverage criteria are met but will be paid based on the allowance for the least costly item if coverage criteria are not met, then under the new policy, the claim will be denied as not medically necessary.

Jury convicts former HME owner of fraud

TAMPA - A former HME provider faces more than 20 years in federal prison after being convicted of Medicare fraud along with his son and daughter-in-law, the Tampa Tribune reported last week. A jury found that Ben, Gregory and Tracy Bane conspired to submit false bills to Medicare through Ben Bane's former oxygen and medical equipment company, Bane Medical Services. Ben Bane ran the company until December 2004. At that time, Lincare acquired the company for an undisclosed amount.

Fill out those surveys

BALTIMORE - It's that time of year again. CMS is gearing up to conduct its annual Medicare Contractor Provider Satisfaction Survey (MCPSS). Starting mid-month, the agency planned to send the survey to a random sample of about 30,000 fee-for-service providers and suppliers. The survey, which takes about 20 minutes to complete, seeks feedback on seven areas: provider inquiries, provider outreach and education, claims processing, appeals, provider enrollment, medical review and provider audit and reimbursement. For more information:

VGM ramps up advocacy efforts

WATERLOO, Iowa -- People for Quality Care is ramping up efforts to get Medicare beneficiaries involved in HME industry advocacy efforts. The organization, an outgrowth of VGM Advocacy, now has a website, and a Facebook page. Informational packets for industry stakeholders should be available in January. The packets will include tips on how individuals can become advocates, as well as a copy of a 30-minute DVD, "Medicare: What You Don't Know Will Make You Sick," which was produced by VGM Advocacy.