In brief: STOP fraud, ResMed earnings

Sunday, May 10, 2009

WASHINGTON - Making good on a promise made last year, Sens. Mel Martinez, R-Fla., and John Cornyn, R-Texas, re-introduced the STOP Act this week. The Seniors and Taxpayers Obligation Protection Act, S. 975, targets Medicare waste, fraud and abuse. AAHomecare pointed out in a release that many of the measures outlined in the bill mirror the association's 13-point plan for stopping fraud and abuse. Those measures include pre-enrollment visits and unannounced site visits for new HME providers, and real-time data analysis to identify and investigate unusual billing and ordering practices. Martinez and Cornyn introduced the STOP Act for the first time last year, vowing to fix in the next Congress a Medicare system they believe is riddled with Medicare fraud (See HME News, September 2008). The senators say Medicare and Medicaid fraud costs taxpayers an estimated $60 billion each year.

ResMed reports record earnings

SAN DIEGO - ResMed last week reported $227.9 million in revenues for the quarter ended March 31, 2009, an 8% increase compared to the same quarter last year. Net income was $39.3 million, a 32% increase. For the nine months ended March 31, 2009, ResMed reported $668.8 million in revenues, an 11% increase compared to the same period last year, and $101.1 million in net income, a 25% increase.

Senators introduce pharmacy companion bill

ALEXANDRIA, Va. - The fight to exempt pharmacists from Medicare's $50,000 surety bond requirement received Senate support May 1. Sens. Jon Tester, D-Mont., and Pat Roberts, R-Kan., introduced S. 956, a companion bill to the Preserve Patients Access to Reputable DMEPOS Providers Act of 2009, introduced in April. Supporters of both bills say pharmacists are licensed healthcare professionals who should be included on the list of exempt professionals like physicians, social workers and dieticians. Bruce Roberts, executive vice president and CEO of the National Community Pharmacists Association (NCPA), applauded the bills. "NCPA encourages the Senate and House to move these bills in an expeditious fashion," he stated in a release. "This will ensure that patient access to medical supplies is not endangered."

Register for PAOC

BALTIMORE - Providers who wish to attend the first meeting of Medicare's new Program Advisory and Oversight Committee (PAOC) on June 4, can register at The daylong meeting will focus on legislation changes mandated by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), as well as additional process improvements. 

Siblings swindle Medicaid

HOUSTON - A federal grand jury on Tuesday indicted brother and sister Benjamin and Rose Essien on charges of conspiracy, eight counts of healthcare fraud and two counts of aggravated identity theft for fraudulently filing claims to Medicaid, according to the U.S. Attorney's Office and the State Attorney General's Office. Between April 2004 and August 2006, the siblings allegedly billed Medicaid $1,782,861 for adult diapers and other incontinence supplies through their company, Logic World Medical. The supplies were either not delivered to Medicaid beneficiaries, delivered in fewer quantities than were requested in claims, or provided when not requested and not prescribed.