In brief: Senators introduce home infusion bill, ASP remains steady

Sunday, September 21, 2008

WASHINGTON - Sens. Olympia Snowe, R-Maine, and Blanche Lincoln, D-Ark., introduced a bill Sept. 17 that would provide Medicare Part B coverage for home infusion therapy. Under the Medicare Home Infusion Therapy Coverage Act of 2008, Medicare would pay for services, supplies and equipment related to home infusion therapy under Part B. It pays for home infusion drugs under Part D. "We believe this is the most appropriate way to do this," said Russ Bodoff, executive director of the National Home Infusion Association (NHIA). "It is cheaper to treat people in the home than in the hospital." The bill mirrors legislation introduced in the House of Representatives in June 2007. Bodoff said both bills have wide support among lawmakers, industry groups and even CMS.

ASP remains steady
BALTIMORE -The latest average sales price figures for nebulizer medications, released last week, revealed only slight changes. Albuterol (J7613) and ipratropium (J7644) were each up 1 cent to 11 cents and 21 cents per dose, while budesonide (J7626) rose nearly 5 cents to $5.39 per dose. DuoNeb (J7620), on the other hand, continued its descent, dropping 27 cents to 31 cents per dose, while Xopenex (J7614) decreased from 58 cents to 53 cents a dose. Brovana (J7605) moved from $4.79 to $4.99 and Perforomist rose from $4.08 to $4.29.

Neighborhood expands
WOBURN, Mass. - Mail-order giant Neighborhood Diabetes acquired nearly 9,000 new patients when it acquired Brooklyn, N.Y.-based New York Diabetic Supply for an undisclosed sum, it announced last week. New York Diabetic Supply focused solely on diabetic products and prescriptions in the New York's five boroughs and several adjacent counties.

Fraught with fraud
LOS ANGELES - Federal and state investigators last week arrested 18 people allegedly involved in a $33 million Medicare scheme. One of the individuals arrested: A man accused of filing $3.1 million in false claims for wheelchairs, hospital beds, feeding supply kits and other items, according to the Los Angeles Times. The arrests were made by the Medicare Fraud Strike Force.

Diabetes provider hits revenue goal
NEW YORK - Global Medical Direct (GMD) reported net revenues of $9.99 million and net income of $672,750 for the fiscal year ended June 2008, its parent company, Healthnostics, announced Sept. 16. GMD has a new marketing initiative to thank for meeting its goal of $10 million in net revenues. The initiative "delivers pre-qualified diabetic patient leads in substantial numbers that were then converted and added to the GMD covered lives client base," according to a release. Healthnostics, a medical and biotechnology analytics company, acquired GMD in May.

MLN goes dark--temporarily
BALTIMORE - The Medicare Learning Network's Web-based training courses and product ordering page will be unavailable for seven to 10 days, starting Sept. 22. The reason: system maintenance and upgrades. Please send questions to

Paralympics athletes score
BEIJING - Last week, the last week of the Paralympic Games here, several HME manufacturers continued to support athletes. Otto Bock, a German manufacturer of O&P, had 136 technicians on site to keep equipment in working order. Athletes using Invacare Top End wheelchairs amassed 41 gold medals, including 33 gold medals in racing. They won 23 silver and 33 bronze medals.

Do you owe taxes?
BALTIMORE - CMS last week reminded providers that their Medicare payments could be reduced if the Internal Revenue Service (IRS) needs to collect overdue taxes from them. According to a Medicare Learning Network (MLN) Matters article: "Should you owe such taxes and your payments are reduced, your remittance advice will reflect a provider level adjustment code (PLB) of 'WU' in the PLB03-1 data field."

DME MAC issues wheelchair bulletins
FARGO, N.D. - Noridian Administrative Services reminded providers last week of the payment criteria for wheelchair headrests. Wheelchairs options and accessories have had a high comprehensive error rate testing (CERT) compliance error rate. Noridian also issued corrections to the local coverage determination (LCD) for wheelchair bases. The latest version of the LCD omitted four lines describing the criteria needed for coverage for K0003 and K0004 wheelchair bases. For more information, go to