Archive: October 2003

HOUSTON - As rehab suppliers laud wheelchair manufacturers like Invacare and Pride Mobility for steering clear of business with unscrupulous dealers here, providers are asking whether manufacturers in general should play a more vigilant role when it comes to their customer's customers. The issue is tricky. While dealers are loathe to submit their companies to additional scrutiny or standards not mandated by law, there is a recognition that Medicare business is a special case. “A manufacturer...

TALLAHASSEE, Fla. - Florida Medicaid officials have delayed kicking off a new competitive bidding program in order to get a waiver from CMS that would allow the state to limit patient freedom of choice. The state originally planned to issue a request for proposal Oct. 1 but pushed that date back to Oct. 26, said Joan Cross, president of the Florida Association of Medical Equipment Supplies. Florida wants to hold the pilot competitive bidding program in Miami or one of the state's other metropolitan...

MURRYSVILLE, Pa. - Jim Liken, the longtime home respiratory provider who took over as president and CEO of Respironics in 1999, is stepping aside to make room at the helm for John Miclot, now the company's chief strategic officer. Liken will continue to work with Respironics in an advisory and consulting role as vice chairman of the board. The move, effective Dec. 1, opens a door whose hinges Liken started greasing when he went to the board one year ago and got approval on a plan of succession. Following...

MIAMI - Healthcare fraud in south Florida is the worst in the nation, charged a duo of federal law enforcement officials who compared the problem in the Sunshine State to the wild west. The U.S. Attorney's Office of the Southern District of Florida's Chief of Economic Crimes Section Angel Cortinas and U.S. Attorney David Frank made the comments as part of a September interview in the Miami Herald. The investigators told the Herald that durable medical equipment fraud is going through the roof and...

PORT WASHINGTON, N.Y. - Drive Medical Design and Manufacturing acquired Wenzelite, a manufacturer of rehabilitation equipment, in a deal announced Sept. 5. The company's principal, Aaron Goldstein, will stick with the 20-year-old Brooklyn-based maker of rollers and seating and positioning products as Drive expands its business into higher-end rehab. “Were going to take that line and try to improve it even further, and try to add a lot of other products around it,” said Harvey Diamond,...

YARMOUTH, Maine - The power mobility business garnered lots of attention in the weeks and months leading to the early-September Wheeler Dealer announcement by CMS Administrator Tom Scully. Chatter in the industry spread like wildfire to the mainstream media, with a bevy of power wheelchair fraud headlines hitting major news stands across the country. The following is a digest of some of the stories that appeared in major newspapers in the weeks before CMS focused its spotlight in the issue of power...

SALEM, Ore. - After beating back attempts by Oregon Medicaid to slash DME reimbursement by 20% across the board earlier this year, providers in the Pacific Northwest are now waging another campaign to keep the state's Office of Medical Assistance Programs from cutting two rehab miscellaneous codes, E1399 and K018, by 20%. In Washington, the state's Medicaid program wants to cut reimbursement by 25% across the board on all DME products. Since the states wanted to enact the new reimbursement rates...

EAST ST. LOUIS, Ill. - A federal investigation recently indicted two individuals for Medicare fraud in connection to a feeding tube scam, the second such scam uncovered by the investigation this year. The indictment by the U.S. District Court in southern Illinois alleges that Jo Ann Carroll and Brian Denny defrauded the government by persuading customers to sign long-term contracts for feeding tubes and formula to be used by Medicare recipients. The pair won the contracts by providing customers...

WASHNGTON - Many small HME companies breathed a collective sigh of relief when, just three weeks before the Oct. 16 deadline for HIPAA electronic transaction and code set standards, CMS announced it would accept noncompliant electronic transactions after the deadline. CMS decided to go ahead with the extension to ensure that claims would be processed from the thousands of providers who were having trouble meeting the new HIPAA standards. Statistics showing unacceptably low numbers of compliant claims...

Follow the money with Corrine Parver Q: Why is the OIG so intent on routing out health care fraud and abuse? A. Follow the money! In addition to its health information privacy component, HIPAA also established a national Health Care Fraud and Abuse Control Program, under the joint direction of the Department of Justice and HHS, acting through its OIG. This program is designed to coordinate federal, state and local law enforcement activities with respect to health care fraud and abuse. Now in its...