Provider 'carefully racheting up' Medicare biz

Monday, October 31, 2005

HOUSTON - A custom rehab provider with an office in Houston is still taking baby steps to increase its Medicare business, years after Wheeler Dealer hit Harris County.
Adorno Mobility was released from medical review last spring, but it's still in the process of re-building its Medicare business. (Harris County providers have been under 100% review since Wheeler Dealer; when they reduce their denial rates to an appropriate level, they're released.)
"[Once we got the letter], we didn't jump on it with both feet and start billing Medicare right away," said Jack Jacobs, chairman. "We were like a burnt child afraid of fire."
Adorno's hesitancy isn't surprising, with scams continuing to beleaguer Harris County. Most recently, an unlicensed Houston doctor allegedly cheated Medicare and Medicaid out of nearly $10 million by prescribing medically unnecessary power wheelchairs.
Although CMS is "satisfied the situation is under control, [it] continues to monitor the situation and look for any surges or inappropriate billing," said Julia Lothrop, a spokeswoman in the agency's regional office in Dallas.
As a result, Adorno is "carefully ratcheting up" its Medicare business month by month, so it doesn't "cause alarm," Jacobs said. The company is confident in the way it does business, especially because physical and occupational therapists play a big role, but it hasn't forgotten the sting of the past. During the thick of Wheeler Dealer, CMS was 180 days past due on $500,000 of Adorno's claims, Jacobs said.
"When Wheeler Dealer hit, we were collateral damage," he said. "They weren't aiming at us, but they put a bell jar on the market, and they didn't do anything until they were at the bottom of it."
Adorno managed to weather the storm, thanks to the viability of its other offices - several others in Texas and one in Tennessee - and funding from private investors, including a round of bridge funding, Jacobs said. Now Medicare is processing and paying the company's claims "much the same way that they're paid in other markets and prior to Wheeler Dealer," he said.