Archive: May 2004

YARMOUTH, Maine - Respiratory medication providers in their first quarter earning statements reported the first, bruising blows of the 15% reimbursement reduction for drugs such as albuterol and ipratropium. The reimbursement rate that took effect Jan. 1 whittled Lincare's first quarter revenues by more than $12 million and cut Apria's by $9 million, according to financial results released in April. Both providers, however, did declare an overall increase in revenues - 16% and 5%, respectively,...

June 1, 2004 CHICAGO - If HME providers are singing the blues because of competitive bidding and other reimbursement cuts mandated by the Medicare Modernization Act, managed care companies must be whistling Dixie. An analysis of government data by the Commonwealth Fund found that payments to private plans in 2004 will average 8.4% higher than the cost of Medicare fee-for-service. That comes out to $552 more per recipient. MMA supporters backed the higher payments as a way to entice private payers...

WASHINGTON - The RAMP Coalition issued a 10-point plan to combat fraud and abuse April 28. 1. Organize a special fraud task force that includes CMS, OIG and reps from industry. 2. Establish clear national coverage policy for mobility products. 3. Accreditation for all Medicare/Medicaid mobility suppliers. 4. Require strict certification for high-end rehab suppliers. 5. Require corroborating PT/OT evaluation in addition to CMN. 6. Set up advisory council as sounding board for new policies and...

Managing Editor, HME News Do you know that Rotech CEO Philip Carter earned $716,346 in salary in 2003 and $175,285 in other compensation, according to a filing with the Securities and Exchange Commission. Or that moving to a new location and filing a change of address with the National Supplier Clearinghouse is easier said than down. (CMS addressed that in an April open door forum.) Or how are rehab providers adapting to the new codes for power seating and accessories - now that the codes have been...

If you were trying to solve a major problem, why wouldn't you accept an offer of knowledgeable assistance? If you had incurred significant damage that could have been minimized if only you had listened to others, why wouldn't you listen now? If you were looking to improve a system that all agreed needed strengthening, why wouldn't you actively include all key players from the start? These are some of the questions our industry needs to continue to ask CMS and Congress regarding the Medicare power...

California mulls 2nd DME fee schedule SACRAMENTO - California lawmakers are considering a bill that would order the administrator of the state's worker's comp program to develop a fee schedule for medical equipment not specified by the Medicare program, according to a report in the L.A. Times. Critics contend that the bill is a gift to one medical equipment company, Irvine-based VisionQuest, which makes cold therapy portable infusion devices. The state assembly's insurance committee passed the bill...

WASHINGTON - Weaknesses in Medicare's 21 supplier standards and failures by NSC inspectors opened the door to a deluge of fraudulent operators in Houston's Wheeler Dealer scandal, according to GAO testimony before the U.S. Senate The GAO identified three weaknesses in the current enrollment process: - Because NSC inspectors failed to verify documents necessary for a supplier number, wheeler dealers were able to get supplier numbers on falsified documents. - Inexplicit standards made it difficult...

June 1, 2004 ORLANDO, Fla. - A group of 23 clinicians, manufacturers and patients met here during the American Thoracic Society's annual conference in late May to jump-start a campaign to educate family physicians and other interested parties about issues in long-term oxygen therapy (LTOT). The group wants to fill a vacuum in advocacy for LTOT. While many associations push positions on oxygen therapy, the LTOT Network's organizer, Bob McCoy, said a non-biased approach is hard to come by. � “All...

HOUSTON, Texas - A rash of new associations and coalitions - including RAMP and NCART - have popped onto the national DME stage. Now, a new association in Texas has joined the act, but with a focus on state rehab issues and education. The Greater Texas Rehab Providers' Council (TXRPC) launched in April as a way for the state's high-end rehab providers to address the issues and challenges the industry faces there. The organization evolved out of a Medical Equipment Suppliers Association (MESA) work...

ALBANY, N.Y. - The New York Medical Equipment Providers Association in April hired its first full-time staff member, Executive Director Matthew Guilbault. “We chose to move into a staff model because we felt with all the things coming down the pike and all that is happening as far as cuts in reimbursement that a lot of the issues needed a little more attention,” said NYMEP President Gloria Murray. “We wanted someone to be working for us on a constant basis all week long.” Negri...