Archive: June 2002

WASHINGTON - Each time Donald Taylor rolled into a Congressional representative or senator's office in his high-end, Permobil wheelchair, he told them he was breaking the law by visiting them. Under current law, durable medical equipment can only be used "in the patient's home'to qualify for reimbursement under Medicare Part B. "I could lose my eligibility for doing this," said Taylor. "It's un-American. This wheelchair is my legs. If I can't use it to come here or to go to work, I'm living in a...

WASHINGTON - A provision for a national competitive bidding program for durable medical equipment contained in a bill by the House Ways and Means Committee would save Medicare $7.7 billion over 10 years, according to the Congressional Budget Office. AAHomecare called the estimate "completely incredulous," arguing that the number is sheer speculation because the bill contains no clear definition of what items would be covered, nor what areas of the country would be included. The bill would authorize...

TALLAHASEE, Fla. - The state's providers have put the Agency for Health Care Administration (AHCA), which administers the Medicaid program, in the hot seat for competitively bidding oxygen equipment and supplies and hospital beds. They've fought the agency tooth and nail, even going so far as to file a lawsuit. Now that AHCA has released its "notice of intent to award" bids for the project, providers'disapproval has only deepened. As many providers feared, AHCA placed more emphasis on cost savings...

Competitive bidding: All's not lost WITH TOM CONNAUGHTON Q. What will be the impact of the House passing a Medicare prescription drug bill that requires a national competitive bidding program? A. Unfortunately, it is a virtual certainty that the House of Representatives will pass a bill with a national competitive bidding program in July. This is most unfortunate, but it is not the final word on this issue. The Senate has yet to consider Medicare legislation, and though there are some strong proponents...

WASHINGTON - Sen. Tom Harkin (D-Iowa) used an OIG analysis of Medicare and VA pricing for durable medical equipment to fan the flames of a Congressional proposal to launch a national competitive bidding program and to hurry CMS down the road toward the delivery of a final rule on inherent reasonableness. The OIG "letter report" compared the prices that Medicare and the VA paid for 16 common DMEPOS items, including semi-electric hospital beds, walkers and commodes, and found that Medicare could have...

WASHINGTON - A CMS official downplayed the industry's latest card in fighting the spread of competitive bidding at AAHomecare's Legislative Conference last month. Mark Wynn, a senior social science research analyst with CMS, told providers the administrative costs of running competitive bidding projects do not outweigh savings. In Polk County, for instance, CMS spent $4.2 million to save $7 million, he said. "And there were start-up costs in there," Wynn said. If rolled out nationally, the Office...

ATLANTA - Although CareCentric recently reported a loss of nearly $25 million on revenues of $21 million for its most recent fiscal year, the numbers intimate more dire financial straits than company officials say they're actually experiencing. For example, CareCentric had to write off nearly $12 million in an impairment charge. The company's senior vice president of sales and marketing, Mark Kulik, said a lot of that charge reflects the departure of workers whose employment at Mestamed and CareCentric...

LOS ANGELES - When it comes to selling retail home medical equipment, consultant Jack Evans has an amusing and illuminating story. In downtown Los Angeles, on the same street within a couple of blocks of each other, sit an older, traditional HME and a pharmacy that also sells medical equipment. The pharmacy grosses about $800,000 a year, about 75% of that in cash sales. The traditional HME grosses about $3 million a year, about 5% in cash. The owner of the HME wants nothing to do with retail. His...

WASHINGTON - The OIG is recommending that CMS drop its semi-annual maintenance payment for capped rental equipment and pay only for repairs when needed, according to a June report. Or, the OIG says CMS could drop its 15-month rental option altogether, which would effectively drop the payment. After tracking more than 3,500 pieces of capped rental equipment for five years, the OIG concluded that Medicare pays "substantially" more for maintenance on rented equipment than for repairs on purchased...

YARMOUTH, Maine - A month after the rehab industry hailed a program memo from CMS that says the DMERCs can't require providers to submit additional documentation for all POV and power wheelchair claims, a medical director is saying "it will not make a major difference in the way we do things." "Immediately, it won't have any noticeable affects on our review of claims," said Region B Medical Director Adrian Oleck, M.D. "It could have some affect on POVs but not on power wheelchairs." The rehab industry...