Archive: 2005

YARMOUTH, Maine - Several rehab providers and state associations will take matters into their own hands and host programs in 2006 to educate physicians on CMS's transition from CMNs to prescriptions and notes for power mobility devices. A common theme in the industry's comments on CMS's interim final rule was the need for the agency to boost physician education efforts (See story page 23). But providers like Tarentum, Pa.-based Blackburn's Physicians Pharmacy and state associations like the Pennsylvania...

SAN JUAN, Puerto Rico - Hato Rey Medical Supplies avoided a sizeable overpayment recently by successfully using a defense that hardly ever leads a provider to victory. Palmetto GBA notified Hato Rey of a $131,420 overpayment this summer, charging the provider with supplying medically unnecessary power wheelchairs and accessories to 14 beneficiaries. Hato Rey appealed the decision, asserting the equipment was not only medical necessary but also backed by all the right documentation: CMNs, prescriptions,...

Q. I would like to change the terms of a local coverage determination (LCD). Is this possible and how? A. Yes, it is possible. Section 522 of the Benefits Improvement and Protection Act (BIPA) provides for both the creation of LCDs and establishes an "appeals process." Here's what you need to do: Do business in the DMERC's jurisdiction; clearly identify the language you want added to or deleted from the LCD; submit new evidence that may "materially affect the LCD's content or basis"; and submit...

WASHINGTON - AAHomecare blasted CMS's draft quality standards in late November, calling them "overly prescriptive" and similar to existing laws and regulations. The association submitted 24 pages of comments to the agency. The comments recommend, among other things, that CMS eliminate the product specific standards. Instead, AAHomecare suggests that providers be allowed to implement internal policies and procedures that are consistent with current standards of practice and state and federal requirements. "As...

WASHINGTON - Word on the street is that CMS won't release its national competitive bidding proposal until some time this month. The Office of Management and Budget, where the proposal is being reviewed, and CMS are "trying to work through issues," but the industry has "no idea" what those issues are, said Seth Johnson, director of government affairs for Pride Mobility. "We're hearing it could be a quiet December from a competitive bidding standpoint," he said last month. The industry has been waiting...

WASHINGTON - Not everyone has a bone to pick with CMS's proposed quality standards. The Scooter Store submitted comments in late November that support the standards and even recommend the agency strengthen them. The Scooter Store, which is accredited by the Accreditation Commission for Health Care (ACHC), gave a thumbs up to a long list of requirements outlined in the standards, including internal compliance programs, internal auditing and monitoring and enhanced home assessments. "Unfortunately,...

WASHINGTON - The OIG in early December reported $35.4 billion in healthcare savings and expected recoveries for fiscal year 2005, more than doubling its performance from the previous year. The office's activities included the exclusion of 3,806 individuals and entities from the Medicare program for fraud and abuse, including DME providers from numerous states. The OIG, part of the Department of Health and Human Services, made the claims in its semi-annual report to Congress. Broken down, the $35.4...

YARMOUTH, Maine - If Medicare eliminates the cap rental option for DME, providers will look to cut back on services and, in some cases, quality, according to the December HME NewsPoll. "Cheaper products and less service here I come," wrote in Joel Holland, president of Holland Medical Equipment in Nashville, Tenn. While 40% of the 209 poll respondents said they would lay off staff, services would take the biggest hit with 70% of respondents saying they would have to cut maintenance and another 43%...

MILPITAS, Calif. - When it comes to packaging blood pressure monitors, A&D Medical has a new take on what consumers desire, and it's not a box "flowered up with happy smiling faces of doctors and other healthcare providers," said Sarah Schiltz, director of marketing. "These consumers have either recently been diagnosed with high blood pressure or hypertension or they are poorly controlled," Schiltz said. "They are scared and want to have the package reflect ease of use and accuracy." The company's...

WASHINGTON - The National Coalition for Assistive and Rehab Technology (NCART) holds its second annual congressional fly in Feb. 6 and 7. The goal: lobbying legislators to carve out rehab from CMS's national competitive bidding proposal. The two-day program begins at 5 p.m. on the 6th with an industry update delivered by Rita Hostak, NCART president. The program continues on the 7th with a rehab fair and visits with legislators.