In brief: Support for bill grows, wheelchair denials continue

Sunday, November 8, 2009

WASHINGTON - A bill that would eliminate national competitive bidding had 61 co-sponsors at press time on Friday. H.R. 3790, introduced by Rep. Kendrick Meek, D-Fla., would eliminate the program in exchange for a mix of pay-fors, including a 0.25% reimbursement cut in 2010-12 and a 0.5% cut in 2015. The state association with the highest percentage of co-sponsors at press time was the Ohio Association of Medical Equipment Services (OAMES)--50%. The VGM Group has offered the executive director who gets 100% of the representatives in his or her state(s) to co-sponsor the bill free registration to its Heartland Conference next year, as well as a free plane ticket and hotel stay.

DME MAC: 97.7% of power wheelchair claims denied

FARGO, N.D. - Noridian Administrative Services, the Jurisdiction D DME MAC, conducted a service specific prepayment probe review for K0823 and found that 114 out of 117 claims for standard power wheelchairs were fully denied. The claims were denied due to inadequate medical necessity (79.5%) and no documentation (15.4%), according to bulletin last week from the DME MAC. The top issues causing these denials: not responding to a request for documentation letter in the required 30 days; no valid written order; no or insufficient medical records submitted to justify need; and required documentation not submitted in full or not complete.

Apria forms partnership with alarm company

LAKE FOREST, Calif. - Apria Healthcare and American Medical Alert joined forces to provide personal emergency response systems (PERS) and monitoring services as an Apria-branded service, it was announced Nov. 4. Apria will offer the service to its more than 2 million patients nationwide. American Medical Alert will be Apria's exclusive provider of PERS products and services. PERS services enable older adults to remain in the home and provide emergency response in the event of a fall or accident. In 2000, direct costs related to fall injuries exceeded $19 billion in the senior population.

FTC delays Red Flags Rule

WASHINGTON - The Federal Trade Commission (FTC) has delayed its Red Flags Rule again. The rule, which requires businesses, including HME providers, to have processes and procedures in place to prevent identity left, is now slated to take effect June 1, 2010. It was first slated to take effect Aug. 2, 2009, then Nov. 1, 2009. The reason for the delay: Congress is considering an amendment that would exempt businesses with fewer than 20 employees from the rule.

ResMed sets revenue record

SAN DIEGO - ResMed posted record revenues and income for its first quarter, and donated $1 million to the ResMed Foundation, which funds research on the negative medical consequences of untreated sleep apnea, the company reported Nov. 5. For the quarter than ended Sept. 30, ResMed's revenue rose 13% to $247 million over the same period last year. Income jumped 44% to $52.7 million. In addition to donating $1 million to the foundation, in October ResMed teamed up with Respironics on an initiative to help educate primary care physicians on the dangers of obstructive sleep apnea. Both companies contributed $500,000 to this effort.

KCI gears up for Japanese market

SAN ANTONIO, Texas - Japan gave Kinetic Concepts, Inc. (KCI) the go ahead to market and sell its V.A.C. Therapy System in its country. KCI has filed an application with the Japanese government that, if approved, would allow the government to reimburse the company when physicians prescribe the device. The company has begun preparations, including employee hiring in anticipation of receiving reimbursement approval from the Japanese government during the first half of 2010.