Archive: October 2007

AUSTIN, Texas - A council of rehab providers in Texas has convinced the state's Medicaid program to make "significant" adjustments to the reimbursement rates for power wheelchairs. The Texas Health and Human Services Commission now pays comparable rates to Medicare, said Tom Hafford, secretary/treasurer of the Greater Texas Rehab Providers' Council (TXRPC). "That's a significant increase, when you consider, before, we were below the Medicare allowable by 10% to 15%," said Hafford, president of Mobility...

In what some might see as an ironic paradox of fortune, HME providers have greater financing opportunities today even though they face formidable challenges. Despite the potential difficulties posed by Medicare competitive bidding, the lending community is more bullish than ever toward the HME industry, financial observers say. "Providers aren't really facing many challenges compared to five or six years ago," said Wallace Weeks, president of the Melbourne, Fla.-based Weeks Group. "At that time,...

SACRAMENTO, Calif. - Providers who believe Medi-Cal, the state's Medicaid program, has given them mixed signals over power wheelchair reimbursement now have the support of a legislative committee. A 12-member Joint Legislative Audit Committee held a hearing in August and voted unanimously to audit Medi-Cal for charging rehab providers with violating an obscure upper billing limit rule. The audit--which will consume 1,740 hours and cost $147,000, said Tom Lambert, president of Maximum Comfort in Redding,...

COLUMBIA, S.C. - The denial rate for the K0823 power wheelchair was a whopping 88% in Jurisdiction A and 93% for Jurisdiction B from Dec. 1, 2006, through March 31, 2007, according to the results of a pre-payment probe review by TriCenturion, the program safeguard contractor (PSC) for those jurisdictions. As a result, in jurisdictions A and B, all claims for K0823, a new code comparable to the infamous K0011, will be subject to review, TriCenturion stated in a September coding bulletin. "I think...

Kathy Hester owns Plaza Drug along with her pharmacist husband. The community pharmacy, in London, Ky., provides therapeutic shoes and inserts, selling an average of two dozen pairs each month--not bad in a rural area where new shoes can be as much a luxury as a necessity. In the six years since the pharmacy opened, it has been voted best in the county six times. HME News: You offer diabetes supplies but what made you get into shoes, as well? Kathy Hester: Shortly after we opened, my husband's...

FRANKLIN LAKES, N.J. - Medco Health Solutions bought PolyMedica for $1.5 billion, the companies announced in August. Medco is the largest manager of drug benefits in the country and, according to wire reports, provides prescriptions to 2.8 million diabetes patients. PolyMedica's Liberty Healthcare division currently offers home delivery of medicines, strips and meters to about 1 million customers. Medco has been handling prescriptions for PolyMedica's customers since 2006.

VALDOSTA, Ga. - Acute Rehab will hold its eighth annual Able Disable Hunt Nov. 3. A total of about 40 adults and children in wheelchairs will hunt during morning and afternoon sessions, said Mike Daniels, owner of Acute Rehab. "We will make room for more children up to where it's still safe," he said. "We don't want to turn away any child." In other news, the Joint Commission accredited Acute Rehab in August.

NAPA, Calif. - Drug makers Dey Laboratories and Sepracor face off in court Dec. 12. Dey sued Sepracor in April over the development of Brovana, which Dey said infringes on its Performist Inhalation Solution. Performist received Food and Drug Administration approval in May, while Sepracor's Brovana was approved last October. Both drugs are long-acting beta 2 agonists taken twice daily for COPD and are expected to go head-to-head in the rocky nebulizer medication market (see HME News, July 2007).

OAKLAND, Calif. - If Accreditation Helper lives up to its billing, the start-up Internet company will cut the cost of becoming accredited almost in half and make the process a whole lot friendlier. Company CEO Jack Anderson doesn't see why that won't be the case. He's used the Web strategy to great effect in the office based surgery market, and with CMS now mandating accreditation, the time is right to expand into home medical equipment. "We've been doing this for six years and know how to do it,"...

TOPSHAM, Maine - Majors Mobility plans to ramp up advertising for its retail products, says Tyrrell Hunter, president. "We've been in retail since 1999, but we're becoming--not more aggressive--more retail-oriented," she said. "We're starting a more organized advertising effort. Before, it was, 'Let's do this and try that.' Now we're starting a real advertising campaign." Rather than focus on power wheelchairs, Majors plans to use more general ads publicizing all products. It already does some TV...