Archive: November 2006

ALEXANDRIA, Va. - With accreditation requirements almost a sure bet for pharmacies, the National Community Pharmacists Association is working with accrediting bodies on Rx-friendly quality standards. The NCPA has long argued that pharmacists are already highly educated and licensed and that additional accreditation requirements would place undue burdens on pharmacies and eliminate access for patients. "I think CMS is interested in addressing the standards and recognizing the value that pharmacy brings...

WASHINGTON - The FDA issued a warning in October that counterfeit blood glucose test strips, intended for use with Lifescan's OneTouch blood glucose monitors, were distributed nationwide. The counterfeit test strips are the One Touch Basic/Profile (lot numbers 272894A, 2619932 and 2606340) and the One Touch Ultra (lot number 2691191). Consumers who have the counterfeit test strips should stop using them and contact their doctor, the FDA said.

WASHINGTON - The OIG sent a shiver through the industry in October when it issued an advisory opinion that questioned the legality of the advertising assistance that some manufacturers offer providers. The opinion also irked a number of industry watchers who criticized the OIG for sticking its nose where it doesn't belong--in the free market. "The purpose of sales is to get sales, to induce people to buy your stuff," said healthcare attorney Ann Berriman. "They are saying that any activity in health...

IRVINE, Calif. - Assured Pharmacy will open a new branch in Portland, Ore.--its third in the area and sixth overall. The move is in line with the company's plans to expand in major metropolitan areas by locating new locations in or near medical facilities, with a focus on Arizona, Nevada and Texas. Assured is projecting $20 million in revenues for 2007. The company offers specialty pharmacy and full-line DME and has contracts with major health plans to provide compounding services.

During October, women's health providers pulled out all the stops to raise breast cancer awareness--and their business profile. "A lot of the retailers themselves are survivors and they have a passion for what they do," said Carla Fox, general manager at Marietta, Ga.-based Amoena. "They really get behind National Breast Cancer Awareness Month and do a lot of promotions in their store." Amoena creates a new pin every year that providers can sell or use as giveaways. A percentage of sales goes to...

Q. Medicare recently refused to pay a claim we filed, saying the equipment was not medically necessary. Why are we held liable when we relied on the opinion of the treating physician? A. Section 1879 of the Social Security Act includes a limitation of liability provision to protect providers who "did not know, and could not reasonably have been expected to know, that payment would not be made" for items or services that have been furnished to a beneficiary. While this law appears to support the notion...

PLANTATION, Fla. - MEDirect Latino launched a line of self-branded heating pads in October. The heating pads, manufactured in China, are geared toward the Hispanic marketplace, specifically the Medicare-eligible diabetic consumer. MEDirect expects the pads to generate revenues of $1.2 million annually. The company plans to offer more co-branded products over the next six months with diabetes testing supplies.

LAKE FOREST, Calif. - Acquisitions still aren't a priority for Apria--but that may change. "It's pretty difficult at this point in time to really get too excited about the acquisition business, because you're really not sure what reimbursement levels will be," CEO Larry Higby told investors during a question-and-answer session following the company's Oct. 26 earnings conference call. "If you're going to do an acquisition, you have to be able to predict a revenue stream and a margin. I think that's...

MIAMI - A Florida couple pled guilty Oct. 18 to defrauding Medicare of more than $4 million by billing the agency for undelivered or medically unnecessary DME. Jointly or separately, Rita Cardoso and her husband, Luis Delgado, owned Advance Equipment Supplies & Pharmacy, Millennium Medical Equipment Supplies and Health Medical Services of South Florida--all located in Miami-Dade County. As part of their scheme, they reportedly purchased patient signatures and fraudulent prescriptions from patient...

WASHINGTON - The rehab industry's lobbying efforts have paid off somewhat, with "significant" reimbursement increases for certain power mobility devices. CMS released a revised fee schedule Nov. 11 after industry officials successfully argued that the rate of inflation used to determine pricing for some PMDs was inconsistent with the rate used for others. "CMS addressed a lot of the changes we had been communicating with them about," said Don Clayback, who heads up The MED Group's rehab network. The...