Archive: May 2003
CMS prepares report on CB demos
May 31, 2003HME News Staff
LAKELAND, Fla. and SAN ANTONIO —CMS's competitive bidding demonstration projects are over, and reimbursement levels have returned to normal for participating providers. That said, many HMEs who took part still have a bad taste in their mouths.
“The day before it began, (CMS) called and asked if we had enough equipment, and if we were prepared,” said Mary Miller, president of Encore Respiratory, which took part in the Polk County demo. “His words were: ‘The flood gates are...
Reimbursement
May 31, 2003HME News Staff
New CPAP accessory codes
With Jane Bunch
Q: I am billing Medicare for continuous positive airway pressure accessories the way I always do, but almost all of my accessory claims of late are being denied. Am I missing something?
A: Be sure you are using the new “A” codes—A7030 through A7044—for CPAP accessories, which became effective April 1 as mandated by the Centers for Medicare and Medicaid Services.
The A codes replace the now defunct “K” codes—K0183...
A toll for thee
May 31, 2003HME News Staff
A bellwether is ringing in Tennessee. True, Georgia cast the mold when state Medicaid began to require that you had to either be a member of NRRTS or hold RESNA's ATP or ATS credential if you wanted to provide rehab to its beneficiaries. But Tennessee is the first state to make that law.
The legislation's boosters plan to export efforts to bring rehab credentialing to other states, ensuring that the people who provide high-end wheeled mobility have sat for a clinical exam that's no piece of cake....
CMS says: Mission accomplished
May 31, 2003HME News Staff
WASHINGTON — The competitive bidding demonstration projects in Polk County, Fla., went well for a number of reasons, despite provider grumblings to the contrary, say CMS officials.
First of all, they saved money, $4.8 million after administrative costs and other expenses. Secondly, by allowing fairly large numbers of providers to participate (not just the lowest bidders), the demos maintain market competition and ensured beneficiaries access to quality services.
“Everyone would like...
An unusual case of downcoding
May 31, 2003HME News Staff
PUERTO RICO — Here's an audit you don't see every day, although the result — it was overturned at the ALJ level — is becoming a rather ho-hum experience.
When it comes to DMERC audits and recoupments, most revolve around a lack of medical necessity or services allegedly not rendered. In the case of Home Orthopedics, one of the commonwealth's largest providers of orthotics and prosthetics, auditors seized on a perceived coding violation.
“Coding issues are usually cut and...
Selling PWCs to consumers: It’s a lot of work
May 31, 2003HME News Staff
The consumer market for power wheelchairs is big, so providers who want to compete must think big as well, mobility manufacturers say.
That means investing in advertising, hiring dedicated sales people, conducting extensive education for staff, offering comprehensive service and building a company image as an authority in power mobility equipment.
“Easy to say, but not easy to do,” said Jack Sheehan, director of sales and marketing for Oconomowoc, Wisc.-based Bruno Independent Living...
Legal
May 31, 2003HME News Staff
Re-evaluate your condo Rx deals
With Lisa Smith
Q: I've heard that recent guidance from the OIG is critical of “condo respiratory pharmacy” arrangements, and agreements between a DME company and hospital. What did the OIG say?
A: On April 23rd, the OIG published a Special Advisory Bulletin concerning contractual joint ventures. You can find the Advisory Bulletin on the OIG's web site at http://oig.hhs.gov/fraud/docs/ alertsandbulletins/042303SABJointVentures.pdf. In essence, the OIG...
RATC still focused on accreditation program
May 31, 2003HME News Staff
WASHINGTON — The pace has slowed but AAHomecare's Rehab and Assistive Technology Council (RATC) is still moving forward in its attempt to develop a rehab accreditation program.
“We are proceeding methodically,” said RATC secretary treasurer Gary Gilberti. “We want it to be right. It's got to be a good program.”
Originally slated to be operational by 2003, the council has slowed its pace to assure it has the support of the rehab industry.
Last year, the RATC awarded...
Briefs
May 31, 2003HME News Staff
Genesis spins off Rx/HME
BALTIMORE —Â Genesis Health Ventures, a skilled nursing and rehabilitation company with roughly $1 billion in annual revenue, will spin off its pharmacy and HME arm into a separate company. The split should be completed by year's end. Genesis bought NeighborCare in 1996 for $57.4 million. NeighborCare's 31 retail pharmacies in the Baltimore area represent only a small part of the company's business. Filing prescriptions for nursing homes provides the bulk of NeighborCare's...
After Rx drugs, AARP wants home care
May 31, 2003HME News Staff
WASHINGTON — Through a new AARP survey, more than 1,100 disabled seniors have made their opinions clear: they want more control over healthcare decisions and they want to be cared for at home.
While these preferences are hardly revelatory, the survey titled “Beyond 50 2003: A Report to the Nation on Independent Living and Disability,” confirms what the HME industry has been proclaiming for years: the need for home medical products and services is growing, insurance isn't adequately...