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Archive: September 2011


On the Editor's Desk

Considering the circumstances...

September 30, 2011Liz Beaulieu, Editor

Next week, we'll be hosting a webcast on audits. Webcasts about audits seem to be a dime a dozen these days, and it's no wonder with all the activity in this area, but this webcast is different. This webcast, presented by Stephanie Morgan Greene and Lisa Bargmann of The Audit Team/Harrington Management, is more about your operational strategy toward audits. When it comes to audits, many providers are focusing on how to avoid them. That's important, don't get me wrong, but it's probably wishful thinking,...

audits, On The Editor's Desk, planning, webcast


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Will some areas be impossible to bid?

September 29, 2011Elizabeth Deprey

PHILADELPHIA - State lines might just be marks on a map to CMS, but for providers looking to bid in the Philadelphia competitive bidding area (CBA), they're presenting real boundaries. To submit a bid in the Philadelphia CBA, providers will need to meet state licensure requirements in not only Pennsylvania but also Delaware, Maryland and New Jersey. The Allentown CBA also includes part of New Jersey. Providing HME across state lines means providers need to learn the nuances of each state's programs,...

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Accreditation: Medicare's requirement not foolproof

September 29, 2011Liz Beaulieu, Editor

YARMOUTH, Maine - WellPoint, a health plan that owns and administers Blue Cross Blue Shield (BCBS) plans in 14 states, has thrown a monkey wrench into the operations of certain HME providers. WellPoint recently notified providers in Georgia that to remain part of its network they must be accredited by one of these three accreditation agencies by March 1, 2012: The Joint Commission, ACHC and CHAP. Though it only notified providers in Georgia, industry stakeholders say the requirement is a “national...

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Specialty Providers

Draft LCD could complicate wound care

September 29, 2011Theresa Flaherty, Managing Editor

BALTIMORE - Suction pumps and negative pressure wound therapy devices (NPWT) need consistent coverage criteria to ensure patient care, AAHomecare told the four medical directors in a Sept. 23 letter. In August, the DME MACs released draft local coverage determinations (LCDs) that would create separate coverage criteria for pumps. They would add a not reasonable and necessary statement for wound suction pumps (K0473) and related supplies (K0744—K0746); and add new coverage criteria for gastric...

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Hill-Rom settles massive fraud claim

September 29, 2011HME News Staff

KNOXVILLE, Tenn. - Hill-Rom Company has agreed to pay $41.8 million to settle claims that it allegedly violated the False Claims Act and other federal regulations. The settlement, which does not include an admission of guilt, is the largest civil fraud recovery for the Eastern District of Tennessee, according to a press release. Hill-Rom was accused of submitting Medicare claims for support surfaces for patients who didn't need them, or who had died. The claims were submitted between 1999 and 2007....

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Countdown to Medtrade: Long-time speakers reflect

September 29, 2011Elizabeth Deprey

ATLANTA -Medtrade's longest running speakers have one thing to say about the HME industry: It's always changing. "It's always an exciting new journey," said Neil Caesar, an industry attorney who has been speaking at Medtrade since the mid-1990s. "Every year we're rounding a new bend in the road to see what's waiting for us." One of the biggest ways the industry has changed: The way it has adopted various technologies. "We were an unsophisticated business and there are some fun advantages to that,"...

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In brief: Americans favor home care, many ABNs fail to meet criteria and more

September 29, 2011HME News Staff

WASHINGTON - A majority of Americans (61%) say they favor investment in community- or home-based care to improve cost-effective health care, according to a new Harris Interactive poll. A majority (79%) say they also favor the government strengthening access to home medical equipment and services. In mid-September, Harris Interactive, on behalf of AAHomecare, conducted an online poll of 2,000 adults about federal spending priorities for health care. Are your ABNs up to snuff? BALTIMORE - Many advance...

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Providers

Hill-Rom settles massive fraud claim

September 28, 2011HME News Staff

KNOXVILLE, Tenn. - Hill-Rom Company has agreed to pay $41.8 million to settle claims that it allegedly violated the False Claims Act and other federal regulations. The settlement, which does not include an admission of guilt, is the largest civil fraud recovery for the Eastern District of Tennessee, according to a press release. Hill-Rom was accused of submitting Medicare claims for support surfaces for patients who didn't need them, or who had died. The claims were submitted between 1999 and...

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Will some areas be impossible to bid?

September 28, 2011Elizabeth Deprey

PHILADELPHIA - State lines might just be marks on a map to CMS, but for providers looking to bid in the Philadelphia competitive bidding area (CBA), they're presenting real boundaries. To submit a bid in the Philadelphia CBA, providers will need to meet state licensure requirements in not only Pennsylvania but also Delaware, Maryland and New Jersey. The Allentown CBA also includes part of New Jersey. Providing HME across state lines means providers need to learn the nuances of each state's programs,...

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On the Editor's Desk

Spike in power wheelchair utilization? Not exactly.

September 27, 2011Liz Beaulieu, Editor

If you're like me,  and you follow the Medicare Market Marker on our Databank page each month (mostly because I have to put it together, but partly because I find it interesting), you probably raised an eyebrow while reviewing the September issue. For K0823, your standard power wheelchair, the number of allowed beneficiaries skyrocketed. For example, in Region C (why haven't we changed that to Jurisdiction C, by the way), that number increased from 5,411 (February) to 9,498 (March) to 12,525...

data, On The Editor's Desk, power wheelchairs, utilization


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