Archive: June 2011

WASHINGTON - So far, there's no word on whether Medicare spending for HME is part of heated discussions on Capitol Hill about raising the debt ceiling and cutting costs, say industry stakeholders. "It's all closed door discussions," said Cara Bachenheimer, senior vice president of government relations for Invacare. "The problem is, they are looking for money and everything is potentially on the table. We just don't know anything at this point." In a speech June 29, President Obama said Medicare...

WASHINGTON - Industry stakeholders are taking comfort that a Government Accountability Office (GAO) report on manufacturer-level competitive bidding for home medical equipment doesn't include strong language or even a recommendation. The report, which Rep. Pete Stark, D-Calif., forwarded to the Center for Medicare and Medicaid Innovation last week, explores existing manufacturer-level competitive bidding programs, like those in place at the Department of Veterans Affairs (VA). "The GAO uses pretty...

BALTIMORE - CMS announced last week that there have been "no changes in beneficiary health outcomes" due to the implementation of the competitive bidding program in the first quarter of 2011. The agency has been conducting real-time claims analysis to monitor the health status for three groups of beneficiaries in competitive bidding areas: original Medicare population in each of the CBAs; beneficiaries in the CBAs who are actively using one of the competitively bid products; and beneficiaries who...

ARLINGTON, Va. - RESNA in June published a provision guide that describes, step-by-step, what is involved in providing a wheelchair for a patient. "There were certain parts and pieces of this that existed in other places, but the basics of the provision process were nowhere," said Lauren Rosen, head of the Wheeled Mobility and Seating Special Interest Group for RESNA, the committee that originated the paper. "It's astounding that this didn't exist." RESNA brought together a group of experts, including...

BRENTWOOD, Tenn. - American HomePatient announced June 27 that it plans to open a new call center in Longview, Texas, to accommodate a "rapidly growing respiratory patient base." Employees at the facility, scheduled to open in August, will contact patients to monitor their therapy and provide ongoing support, according to a company release. AHP plans to invest about $80 million over 10 years into the call center, mostly for payroll and benefits for staff, according to local news reports. It plans...

ALEXANDRIA, Va. - AAHomecare has asked CMS to allow HME providers to use an advanced beneficiary notice (ABN) on the first day of CPAP therapy if they think the patient has a high likelihood of noncompliance. Currently, providers must wait until day 60 of CPAP therapy before they can give the patient an ABN. In a June 24 letter to CMS, AAHomecare states: "beneficiaries who are noncompliant in the first eight weeks of therapy typically are disinclined to pay out-of-pocket for the CPAP. Most refuse...

This article came out on June 13, but I just stumbled across it this afternoon. It's about, what else, competitive bidding, and, while it doesn't slam the HME industry like many mainstream articles do, it is clear the reporter doesn't understand the issue, or the industry. One needs only to read the first paragraph: After 18 years in business, little has changed in the way Hall-Moore Medical Supplies processes Medicare claims. The Jacksonville-based home medical equipment dealer simply bills Medicare,...

We always have a special report in our show issue, the one that you can find being passed around at Medtrade. They're usually fun (top providers under 40), important (Internet marketing strategies) or both (if you had $1 million, what kind of HME company would you create). Earlier this week, I was poking around for ideas, and I decided to find out the most-read stories for the first half of this year, January through June. My thinking: If there were numerous stories about the same topic, it might...

BALTIMORE - CMS announced today that there have been “no changes in beneficiary health outcomes” due to the implementation of the competitive bidding program in the first quarter of 2011. The agency has been conducting real-time claims analysis to monitor the health status for three groups of beneficiaries in competitive bidding areas: original Medicare population in each of the CBAs; beneficiaries in the CBAs who are actively using one of the competitively bid products; and beneficiaries...

WASHINGTON - A bill that seeks to get custom breast forms paid for under Medicare was reintroduced June 16. "Medicare covers custom prosthetics for every other body part except the breast," said Rhonda Turner, executive director of the American Association of Breast Care Professionals (AABCP). "There's a level of inequity there that we haven't figured out." Medicare already has a code and an allowable for custom breast forms, but local coverage determinations (LCDs) down code them as "not medically...