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by: Theresa Flaherty - Friday, August 6, 2010

The MED Group's Kelly Riley wanted me to give her a call next week so she could bend my ear a bit on CPAP audits in region C.

As juicy as that sounds, I am going to be on vacation and really don't want to think about CPAP machines. (Note: I am staying with my parents who, at times, seem as though they are taking turns to see who can snore the loudest, so sleep apnea won't be completely out of mind).

I also don't want to think about home medical equipment while I sit on the beach overlooking Cape Cod Bay with a stack of fun reading material (I'll be leaving my copy of HME News in the office).

But of course, HME is everywhere. I'm sure I'll see it in the restaurants I eat in, during shopping excursions and anywhere else I go next week (a shout out here to Cape Medical Supply, which is probably responsible for the majority of HME I'll see next week).

But, I guess that's the point of HME isn't it? It's everywhere to make life more accessible for people and I hope while Congress is on recess, they too, will take note of how important HME is to many of their constituents.

Theresa Flaherty

by: Theresa Flaherty - Wednesday, August 4, 2010

Executive editor Mike wanted me to blog about a man with Type 2 diabetes whose dog ate his big, ulcerated toe. Turns out the man had blood sugars of over 500 (I assume he was undiagnosed, the article is unclear).

Yuck! Could you really every look at Fido the same way again? (I'd be sleeping with one eye open).

I would prefer to write about a study that targeted teens with diabetes and how text messages can lead to better self -management.  Dr. Jennifer Dyer, an assistant professor of pediatrics at The Ohio State University, sent specific treatment reminders and supportive messages to teen diabetes patients. Turns out, it was a great way to get their attention. The teens who received the texts were far more likely to stick to their treatment plans.

Practical. Inexpensive. Considerate of audience.

That's smart medicine. And smart business.

Theresa Flaherty

by: Theresa Flaherty - Tuesday, July 27, 2010

Lots of people with diabetes, particularly the Type 1 crowd, pass along comments and, more often, criticism of incorrect or misleading information when they come across it. It can be exhausting to keep up with educating the world one misinformed (or sometimes, lazy) reporter at a time.

Others of us have a soapbox known as  "The Blog." Allow me to call your  attention to a badly written article posted today on the, by an, I assume, young lady named Stephanie.

First, the headline: Diabetes supplies – do diabetics need to choose between dangerous drugs? Huh? Supplies are not drugs and drugs are not supplies. And, the rest of the piece doesn't back up this headline. (In all fairness, the writer may not have penned that clunker).

Second: Stephanie refers to the problems inherent in rushing "potential cures" out the door before they are properly tested.

True, but she uses Avandia as an example. Stephanie, a diabetes drug is not a cure. It is simply a treatment. And, apparently you haven't heard, but there is no cure for diabetes at this point in time. Maybe some day. But not today, probably not tomorrow either.

Third: "Insulin pens replace the need to inject insulin with needles." While I suppose technically the pens replace syringes, the pens themselves deliver the insulin via...a needle. And, while I have enjoyed the convenience of the pens in the past, the dosing has often been somewhat inaccurate. Oh, and the needle is sharp, no matter where it comes from.

Fourth: "Now technology has come up with battery power state of the art insulin pumps that when used in conjunction with glucose monitoring device can greatly improve the freedom a diabetic can now enjoy."

A little behind the 8-ball, here, Steph. Insulin pumps have been around for quite some time now and yes, they get better all the time. Glucose monitoring devices are not commonplace, though. And, quoting a study funded by a pump manufacturer, no matter how reputable, is kind of questionable. Of course, they are going to say their product is fantastic. It's called PR.

A little homework next time, please.

Theresa Flaherty

by: Theresa Flaherty - Friday, July 23, 2010

Editor Liz just sent me a link to an iPhone app (obviously, she is shopping instead of working this afternoon). It's called "FatBooth" and it allows users to add 100 pounds to their photos so they can see how they'd look if they partook of too many Luther Burgers.

The heck with calorie-counting or carb-tracking apps. This could be a true motivator to get or stay fit.

Gotta run. I need to find someone with an iPhone. Stay tuned.

Theresa Flaherty

by: Theresa Flaherty - Wednesday, July 21, 2010

"I'll call you back when I think of some good news," one provider told me yesterday when I called to see what's shakin' out there.

"Theresa, I just got word that Medicaid cut strips 26%," said another. "I can't talk now."

And so it goes, across the country.

These aren't folks in the round 1.2 bid area by the way. Just average providers in average towns. That's with the folks who answered the phone. Hopefully, the rest of you are just on vacation, not cowering under your desks.

Meanwhile, I shall continue to toil at my phone, looking for news stories (anyone?), and all I can say is stay cool everyone. You've survived this long. We all have.

"Good luck to us all," a West Coast provider said to me as we hung up. "If I don't last, neither will you. You won't have anything to write about."

Theresa Flaherty

by: Theresa Flaherty - Friday, July 16, 2010

I don't care to give this one-sided opinion piece in the Orlando Sun Sentinel any more press, but in case you've missed it, you should know how badly skewed the perception of the HME industry is, at least in areas where Medicare fraud is rampant.

There is so much to dislike about it, it's hard to decide where to start. I think, however, that my biggest issue with this piece is the way he keeps tying HME and competitive bidding in with fraud:

On the first full moon of the year, a group of medical-supply lobbyists and a group of Medicare bureaucrats meet at midnight. They put three pieces of folded paper in a hat -- 20 percent, 30 percent and 40 percent.

They pick one and add that to the cost of the wheelchair.

Then they put the paper back into the hat and move on to oxygen tanks and all the other equipment Medicare provides.

Meanwhile, down in Miami, the drug dealers who are out on parole get the updates. They set up medical-supply companies, submit the requisite fraudulent forms and open for business.

Pretty soon, dead people all over South Florida are buying wheelchairs. So are live people who don't even know it because their identities have been stolen.

Really? Where is he making the connection between someone like provider Rob Brant (sorry Rob, but I got to pick on someone) and drug dealers. Did I miss something?

Apparently, the writer has missed efforts to curb Medicare fraud, which the HME industry stands behind 100%. If Medicare is paying for a wheelchair for a dead man, that's a Medicare problem, not a provider problem. Hell, we've all heard stories of beneficiaries trying to report fraud or give back stuff they didn't order. But, Medicare don't want to know.

I close by saying that this piece (notice I have refused to call it an article, as there was no reporting involved) is so misinformed, so biased and so slanted (am I being repetitive) that I think even CMS would agree it's wrong.

Theresa Flaherty

by: Theresa Flaherty - Wednesday, July 7, 2010

As a fun follow up to my previous blog on the fattest states, here's something from Health magazine called the "50 Fattiest Foods in the States." It's a menu of shame comprised of a dish from each state. My personal pick for the worst: Georgia's Luther Burger, which consists of a bacon cheeseburger on two glazed doughnuts. Paula Deen (rhymes with "butter queen") gave it her own twist by adding a fried egg. Did I mention this thing is named after Luther Vandross, who suffered from Type 2 diabetes? And died of a heart attack?

I do have a tiny quibble with the article. For Maine, it lists the lobster roll. But it takes the nutritional info for the crustaceous sandwich from a fast food chain, which requires me to delicately point this out: No self-respecting Mainer (pronounced "Maine-uh") would get a lobster roll from a fast food joint. Last I checked, we don't even have a Red Lobster restaurant here (there was one, briefly, but it didn't last).

Granted, with all the butter and mayonnaise on lobster rolls, this sandwich is never going to get a "heart healthy" award from anyone. But at least it isn't served on doughnuts.,,20393387_11,00.html

Theresa Flaherty

by: Theresa Flaherty - Wednesday, June 30, 2010

What do all these states have in common (besides being Southern)? They are the current fattest states in the nation, with more than 30% of adults weighing in as obese. Mississippi, a frequent flyer on this list, tops it off at 33.8%. Are y'all trying for 40%?

Maine, where we live, isn't too much better, tied with Arizona at number 29 with a rate of 25.8% (ayuh). Sadly, only one state has less than 1/5 of its citizens classified as obese. Colorado, at 19.1%.

All this is included in the report, “F as in Fat: How Obesity Threatens America’s Future 2010," issued by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation.

I know, I know. Nutrition is hard. Fat/salt/sugar tastes good. All the diets are confusing. I'm gonna let you in on a little weight loss/control secret.

Eat less, move more.

Theresa Flaherty

by: Theresa Flaherty - Tuesday, June 29, 2010

This headline was in my inbox this morning: "Got diabetes? Do these things or you may go blind." Well, thanks, that's helpful. I hadn't heard a million times already that I need to control my blood sugar and eat well.

I had planned to blog about the above-mentioned when actual diabetes DME industry news started rolling in today. CMS has been a busy little agency, if you read the Federal Register last Friday (you know you didn't).

CMS published a proposed reg, open for public comment, that would exempt community Rx from having to competitively bid diabetes supplies, as well as become accredited. As you may (or not) know, there are currently bills pending on both of these issues. It seems the Rx industry is making some headway getting its message across.

It also appears, and this one is painful, folks, that CMS has redefined "mail order" to include "any item shipped or delivered to the beneficiary's home regardless of the method of delivery." Translated: It sounds like Bob's Diabetes Store can't make drop offs from the company van anymore.

I don't know how many DMEs deliver diabetes supplies, either via shipping or from behind the wheel, but this seems unfair.

It removes an opportunity to compete on service.

It removes an opportunity to preserve margins if they pack and ship rather than pay a driver and gas up a van.

It removes convenience for customers, many of whom may be unable to drive (see above headline: re "go blind").

I would guess this creates a slippery slope as well. Today, it's diabetes supplies. Tomorrow, it's enterals, followed by CPAP tubing, urologicals and so on.

Theresa Flaherty

by: Theresa Flaherty - Friday, June 25, 2010

Like other providers who submitted bids in Round 1.2 of competitive bidding, provider Randy Freeman, of Mediwell in Forth Worth, was feeling a little nervous yesterday.

"I had confidence last time," he said. "Now I am real concerned with where some of the nutjobs are going to bid."

He's right to be concerned. Anyone who remembers the hell that was Round 1 knows just how low those bids can go. But Freeman is a man with a plan. About 9 months ago he opened "the best retail store in the country" and says it's already meeting his expectations.

"I am fully sold on retail now," he told me. "Customers are far more willing to pay cash then people realize."

Sure, he loses the occasional customer who wants the retail store to bill their insurance company, but says its time for customers (and providers for that matter) to lose the "insurance mentality."

No matter what happens with the bid—Freeman bid on several categories—he says it's important not to overreact.

"No matter what happens, we are still going to be here," he said.

Theresa Flaherty