In brief: Super committee deadlocks?

Friday, November 18, 2011

WASHINGTON – With its Nov. 23 deadline looming, the deficit reduction super committee appears no closer to agreeing on a plan to cut at least $1.2 trillion over the next 10 years. That could trigger an automatic spending cut, including a 2% across-the-board cut to all Medicare providers effective Jan. 1, 2013. There's been a tight lid on negotiations, but HME industry stakeholders agree that if the committee does come up with a plan, it's likely to include cuts to HME. One rumored proposal: Apply competitive bid rates to Medicaid. Stakeholders have also targeted the committee's plan as a possible vehicle for the industry's market pricing program to replace competitive bidding.

Small biz group offers competitive bidding bill support

WASHINGTON – The National Federation of Independent Business (NFIB) voiced its support for H.R. 1041 in a Nov. 14 letter to Reps. Glenn Thompson, R-Pa., and Jason Altmire, D-Pa. The letter states, in part: "This bipartisan legislation to end the DMEPOS program is critical to providing the certainty necessary for America’s small businesses to survive and continue to meet the needs of the communities who depend on their services." According to CMS, approximately 85% of HME providers are small businesses. Thompson and Altmire introduced H.R. 1041 in March; the bill currently has 164 co-sponsors.

Power For Funding raises $70K for industry groups

ATLANTA – NCART, NRRTS and AAHomecare received more than $70,000 after MK Battery's Power For Funding Reception at Medtrade. Wayne Merdinger, MK’s vice president of business development and international sales, called the event "a huge success" and stated in a release that he hoped it would act as "a catalyst for a new tradition of solidarity at Medtrade." MK Battery hosted the event in conjunction with Medtrade. Additionally, HME News gave out its annual HME Excellence Awards during the event.

NCART to host separate benefit call

WALSENBURG, Colo. – The steering committee working to create a separate benefit for complex rehab technology will offer an update via conference call this month. Callers may dial in at 11:30 a.m. EST Monday, Nov. 28, or 5 p.m. EST Tuesday, Nov. 29, to hear a review of where the effort stands and what lies ahead. There will also be a Q&A period. To attend, dial 1-773-897-3003 (Nov. 28) or 1-215-383-1013  (Nov. 29). To view a presentation during the call, go here. (Nov. 28) or here. (Nov. 29). 

Reviews continue for catheters, diabetes supplies

WASHINGTON – National Government Services, the Jurisdiction B DME MAC, will continue to conduct prepay reviews for intermittent sterile catheter kits (A4353), it announced last week. As of Sept. 30, 166 claims have been reviewed, with an 89.8% error rate. The top two reasons for denial: no documentation received (48%) and denied as non covered (40%). Also in Jurisdiction B, prepay reviews will continue for glucose test strips for three to eight units of service. As of Sept. 30, 3,685 claims have been reviewed, with a 90.4% error rate. The top two reasons for denial: medical necessity not established (63%) and documentation submitted did not establish medical necessity for over-utilization.

USM becomes Rehab Specialist

RALEIGH, N.C. – United Seating and Mobility (USM) announced Nov. 17 that it will acquire The Rehab Specialist's complex mobility business. USM/TRS will continue to provide services in the Raleigh-Durham, N.C., area. USM President and CEO Bob Gouy stated in a press release that the addition strengthens USM's position in what he called "a growth market." 

Short takes: Overpayments, CPAPs and Alex Bennewith

Starting Dec. 15, providers in Jurisdiction B will have to use new fax numbers to submit overpayment requests. The new fax number to submit non-Medicare Secondary Payer (MSP) overpayment related requests will be 317-595-4873. The new fax number to submit MSP overpayment related requests will be 317-841-4480…CGS Administrators, the Jurisdiction C DME MAC, reminds providers that CPAP accessories and supplies have maximum utilization parameters as outlined in the LCD. Supplies in excess of those parameters will be denied as not reasonable and necessary.  Read more. 
…Alex Bennewith has been named the new director of government relations at United Spinal Association beginning Nov. 28. Bennewith's previous experience as AAHomecare's senior manager of government affairs, along with her previous advocacy work, will be an advantage for United Spinal, President and CEO Paul Tobin stated in the release.