In brief: SMRC warns of audit risk, AAH monitors CareCentrix

 - 
Friday, January 10, 2020

ATLANTA – The SMRC is holding ordering practitioners accountable and acknowledging that provider payments for DMEPOS are reliant on their documentation, the van Halem Group reports.

The requirement for practitioners to comply with a provider’s request for documentation has been part of the Program Integrity Manual for some time, but in its most recent project detail for diabetic test strips, the SMRC says:

“If a practitioner doesn’t respond to a supplier’s request for documentation to support the DTS billed, CMS is concerned that the practitioner may also have other services that are not supported by documentation. Therefore, we are now auditing those practitioners’ claims for evaluation and management services.”

This is a win for providers, the van Halem Group says.

“Suppliers have long communicated to CMS and its contractors the imbalance in documentation requirements and audits when reliant on the ordering practitioner,” it stated in a blog. “The A/B and DME MACs often work together to educate providers on the importance of documenting for DMEPOS orders. Unfortunately, the MACs have not shown any further collaboration besides education...until now.”

The van Halem Group recommends that providers share this notification with “difficult” referral sources.

AAHomecare monitoring CareCentrix policy change

WASHINGTON – CareCentrix is withholding payments to providers on PAP and PAP supply patients with co-pay balances more than 180 days old, AAHomecare reports. The new policy takes effect in March. The association registered concerns with CareCentrix and the provider of post-acute care management services responded by developing potential impact reports for individual providers and offering one-hour online training sessions on Jan. 9, Jan. 14, Feb. 6 and Feb. 12. Providers can refer to the CareCentrix provider portal or contact their network manager for additional information, AAHomecare says. “(We) will continue to monitor the rollout of this policy change and provide feedback to CareCentrix on how it is impacting the HME provider community,” the association states. 

Osceola Capital acquires Healthcents

TAMPA, Fla. – Osceola Capital, a private equity firm focused on services businesses, has acquired Healthcents, Inc., a provider of medical reimbursement and related services. Founded in 1994, Austin, Texas-based Healthcents consults small and medium healthcare providers across the United States on payer portfolio and growth strategies by strengthening or entirely outsourcing traditional managed care departments. “Healthcents has successfully positioned itself as a leader in the highly complex payer contracting space over the course of its 25-year existence,” said Ben Moe, managing partner at Osceola Capital. “We are extremely pleased with this opportunity to enter the healthcare space and look forward to working with the leadership team to expand the customer base and continue building upon the company’s strong foundation.” Armando Cardoso will serve as CEO. He most recently led a national team at Ascension, on of the largest health systems in the country.

Medtrade Spring: Advance rates in effect

LAS VEGAS – Advance Rates for Medtrade Spring, which takes place March 3-5, are in effect and valid though Feb. 22. “Medtrade Spring is a bit earlier in the new year than in the past, and that has several advantages,” says Mark Lind, show director, Medtrade Spring. “There is no conflict with March Madness, spring break, or Easter, and attendees get a quicker chance to jumpstart their year.” This year’s show will again be at the Mandalay Bay Convention Center in Las Vegas.

PHS expands in Texas

ROSEVILLE, Minn. – Pediatric Home Service has partnered with The Care Group, a provider of respiratory care and enteral nutrition, to expand its offerings in Texas. The Care Group, which has locations in Houston and Dallas, will transition over the next several months to the PHS name. “We are now in a position to expand our mission of helping children with medical complexities achieve their best lives at home and in their communities,” said PHS CEO Cameo Zehnder. “We look forward to continuing the great services The Care Group has been providing to the Texas community and will be working to add even more services to support this population.” PHS, a provider of pediatric homecare services founded in 1990, announced in late 2018 that it had partnered with InTandem Capital Partner, a healthcare services-focused private equity firm, to expand its existing service lines and gain a national presence.

VGM hosts bidding forum

WATERLOO, Iowa – VGM Business Forum on Jan. 28 will host a daylong event with HME leaders on the competitive bidding gap period—which continues until Jan. 1, 2021—at its headquarters here. Discussions will include federal and state licensure and managed care organization issues; the projected future of the HME industry; and options and solutions for this year. Registration is $30 per person. FMI or to register.

Combo rollator wins award

SANTA CLARA, Calif. – The Free2Go Rollator, which combines the benefits of a raised toilet seat, safety frame and rolling walker, has won a TravelAbility Launchpad award. The competition included 15 disability product entrepreneurs and potential investors. “The Free2Go beat the competition because it identified and solved a common problem: finding a portable, discreet and dignified way to use the toilet independently,” said Jake Steinman, founder and CEO of TravelAbility’s Launchpad. Lesli Wang designed the Free2Go for her mother, who was looking for a toilet product that she could use safely and independently outside of her home. “If a raised toilet seat and/or toilet safety frame are needed inside the home, wouldn’t they be needed outside the home,” said Wang, president and CEO. “Many customers have written to me directly to thank me for filling a gap sorely needed by people with compromised muscles or joints.”

NRRTS schedules four webinars for January

LUBBOCK, Texas – NRRTS has released its educational offerings for January, including “The ‘W’ word: One family’s story of finding hope and acceptance” on Jan. 14. Carol Shrader, a mother of adult triplets, two of whom have cerebral palsy, will host this webinar. The other webinars: “Entering the world of power assist for manual wheelchairs: who, when, why?” with Christie Hamstra on Jan. 15; “Adapting the home for wheelchair use” on Jan. 16; and “Your voice: Our story” with Unite4CRT on Jan. 23. Click here for more details.

Broda funds seating research

KITCHENER, Ontario – Broda has committed to contributing CA$15,000 to fully fund the Canadian Occupational Therapy Foundation Research Grant in 2020. “This is a special opportunity to work with an outstanding organization to advance the level of knowledge in an often-overlooked area that desperately needs rigorous research,” said Nick Hoffmeyer, vice president of marketing. Proposed research objectives include demonstrating the care benefits of tilt wheelchairs in long-term care; demonstrating the care benefits of pressure reduction wheelchairs; comparing the care efficacy of tilt wheelchairs vs. standard slingback wheelchairs and/or geriatric chair seating; and comparing the care efficacy of Broda’s Comfort Tension Seating to wheelchair cushions, basic padding and slingback wheelchair seats. The deadline to apply for the funding is Feb. 28.