Archive: December 2003

Editor, HME News The news is grim. Congress has legislated competitive bidding. And a CPI freeze for DME. And a transition from the average wholesale price (AWP) to the average sales price (ASP) for respiratory medications. And FEHP cuts. Ad infinitum, ad nauseum. All of this comes on top of a power wheelchair scandal in Houston, front page derision of providers in mainstream newspapers all across America, a starring role for power wheelchairs in another NBC Nightly News ‘Fleecing of America'...

LEBANON, Tenn. - Although nationwide mandatory accreditation is finally becoming a reality, Darren Jernigan believes the push for state-held standards of care deserves no less attention. The key difference, he said, is that the state bills focus on individual certification while the Medicare Prescription Drug Act requires company accredidation. The state bills also apply to all providers, including those who do not count Medicare among their payers. Since the Medicare bill bassed, three states that...

NASHVILLE, Tenn. - The DMERCS will begin accepting stamped physician signatures Jan. 1 for orders on documents used in medical review. The new rule does not apply to CMNs. The individual whose name is on the alternate signature method bears the responsibility for the authenticity of the information being attested to, according to a statement issued by Region D DMERC Medical Director Robert Hoover. The statement advises physicians to check with their attorneys and malpractice insurers in regard to...

WASHINGTON - The first bruising punches of the Medicare Drug Act will come in January 2005 as a series of reimbursement hits to eight DME products that represent about two-thirds of CMS's DME expenditures. Seven of the reductions, based on the median price that private insurers reimburse for beneficiaries of federal employee health plans (FEHP), will range from 3% for the K0011 power wheelchair to 22% for the E0579 compressor nebulizer. The eighth reduction, for home oxygen, will be revealed after...

WASHINGTON - � While the new Medicare Prescription Drug Act contains plenty of reimbursement cuts, it is not without a few silver linings for DME providers. The bill's good news comes in the form of new provisions for appeals and overpayments, said Tim Webster, a healthcare attorney with Brown & Fortunato in Amarillo, Texas. 1. The law limits extrapolation. It says the DMERCs can't use extrapolation to determine the amount of an overpayment unless: (i)There is a sustained or high level of...

Well, it happened. President Bush has signed into law what may be the most damaging piece of legislation ever concocted by Congress. The damage done to the HME services industry is best illustrated by one fact: The combined market value of publicly traded providers dropped 30% within days of its passage. How did this happen? Let's keep in mind two things. First, the industry has more powerful enemies than friends. One House member, Dave Hobson, R-Ohio, stood his ground and said he would not vote...

WASHINGTON - The OIG announced Dec. 3 that its initiatives produced savings for American taxpayers of roughly $23 billion in fiscal year 2003, or approximately $1 billion more than last year's savings. This represents a return of $117 for each dollar spent on OIG audits, evaluations, investigations and other activities. The $23 billion in savings consist of $988 million in receivables from investigations,$405 million in audit disallowances and $21.6 billion in the implementation of OIG recommendations...

WASHINGTON - Lauded for his straight-talk approach, former CMS Administrator Tom Scully stayed true to character even when announcing his resignation from the agency's top spot. “I'm checking out of Dodge,” he said in an interview with the Washington Post. It was this frank and open communication style that first won Scully a place in the hearts of HME providers. Scully's keynote address on his plans to make the Medicare program more responsive - Making CMS Equipment More Durable -...

YARMOUTH, Maine - The Wheeler Dealer power wheelchair scam, which came to light in September, continues to haunt and dirty the reputations of legitimate providers. In mid November, the Associated Press penned and distributed a story highlighting Medicare's “fastest growing new swindle.” That story ran on the front page of newspapers all over the country. On Nov. 20, NBC Nightly News featured the Wheeler Dealer scam during its “Fleecing of America” segment. Both stories gave...

VA awards scooter contracts WASHINGTON - The Department of Veterans Affairs (VA) has split its $19.8 million contract (last fiscal year) for scooters among Electric Mobility (4-wheeled), Golden Technologies (3-wheeled) and Pride Mobility Products (compact). The contract is the first of national scope for scooters at the VA, which previously awarded the contracts on a regional and local basis. Golden Technologies has set up a VA network among its dealer base to handle the anticipated 8,000 to 9,000...