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Archive: May 2015


News

Providers to CMS: Yes, please drop CMNs

May 29, 2015Theresa Flaherty, Managing Editor

BALTIMORE - CMNs/DIFs are a burden HME stakeholders would like to see eliminated, they told CMS officials during an Open Door Forum last week.“There was a time and place for CMNs,” said Ronda Buhrmester, a reimbursement specialist for The VGM Group, during the forum. “Providers already have to gather that info in the progress notes and it is redundant. It's time to eliminate CMNs.”Currently, CMNs are required for oxygen, pneumatic compression devices, osteogenesis stimulators,...

CMNs, DIFs, electronic clinical template


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News

Bill provides ammo for audit reform

May 29, 2015Liz Beaulieu, Editor

WASHINGTON - HME stakeholders have accomplished the first of two goals in their bid to reform Medicare's audit program.Rep. Marsha Blackburn, R-Tenn., introduced a bill on May 19 that would require prior authorizations for certain high-cost DME, including oxygen. The bill would also exempt DME that has gone through that process from pre- and post-payment audits.“There are two components to reform: one is prior authorization, and the other is clinical inference,” said John Gallagher, vice...

aahomecare, H.R. 2437, prior authorization


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Mobility

Will the PMD demo expire?

May 29, 2015Liz Beaulieu, Editor

WASHINGTON - A demo project requiring prior authorizations for power mobility devices has been hailed a success by all those involved, yet it's due to expire Aug. 31.“We haven't talked to anyone who's opposed to it,” said Seth Johnson, vice president of government affairs for Pride Mobility Products. “The Hill likes it. CMS likes it. Providers like it. Consumers like it.”The demo kicked off in seven states in 2012 and expanded to an additional 12 states in 2014. In its most...

Cara Bachenheimer, PMD demo, Seth Johnson


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Specialty Providers

Lawmakers weigh in on O&P

May 29, 2015Theresa Flaherty, Managing Editor

WASHINGTON - Lawmakers recently sent a letter to CMS demanding the agency enforce long-established O&P licensure and certification requirements.The May 19 letter to Department of Health and Human Services Secretary Sylvia Burwell asks CMS to issue a proposed rule detailing its plans to allow only licensed and certified O&P providers to bill Medicare, as required by a law passed back in 2000.“It's been 15 years without anything being done,” said Tom Fise, executive director of the American...

AOPA, o&P, orthotics, prosthetics, Tom Fise


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News

In brief: AAH softens blow, Orbit agrees to settle

May 29, 2015HME News Staff

WASHINGTON - AAHomecare has successfully lobbied the House Energy and Commerce Committee to delay the start date for a provision reducing Medicaid payments to 2020 instead of 2016.The committee has included the provision, which would limit the federal portion of state Medicaid fee-for-service rates for HME to the Medicare competitive bidding rates, as a “pay-for” in its 21st Century Cures Act.“AAHomecare will continue to defend against the inclusion of these cuts to Medicaid HME...

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News

AAH softens blow of Medicaid cuts

May 29, 2015HME News Staff

WASHINGTON - AAHomecare has successfully lobbied the House Energy and Commerce Committee to delay the start date for a provision reducing Medicaid payments to 2020 instead of 2016.The committee has included the provision, which would limit the federal portion of state Medicaid fee-for-service rates for HME to the Medicare competitive bidding rates, as a “pay-for” in its 21st Century Cures Act.“AAHomecare will continue to defend against the inclusion of these cuts to Medicaid HME...

audits, cuts, medicaid


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E-SP

Asleep at the wheel

May 29, 2015Theresa Flaherty, Managing Editor

Making headlines this week, Tracy Morgan, who settled with Walmart over a crash last June that left him gravely injured. You may recall, Morgan was in a limo that was rear-ended by a tractor trailer driver for the retail behemoth. Two others were injured and one person was killed. The driver had been awake for more than 24 hours and fell asleep at the wheel. Who wouldn't? Preventable tragedies like these, especially those that involve the famous, serve to elevate the national conversation on things...

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On the Editor's Desk

Who do you want to rub elbows with?

May 29, 2015Liz Beaulieu, Editor

Health care is becoming less siloed. In my eyes, one of the larger goals of healthcare reform is to break down the barriers between different healthcare providers. A hospital can no longer operate in a silo. Because of the pressures to reduce readmission rates, it has to make it its business to know what patients are doing when they're outside of its four walls. To do that, it needs help from other healthcare providers. Skilled nursing facilities. Home medical equipment providers. The increasing...

education, healthcare reform, integration


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On the Move

Luke, I am not wearing a CPAP mask

May 29, 2015Tracy Orzel

Before I wandered into HME News' world headquarters nearly eight months ago, Medicare was an abstract concept that existed somewhere in the ether. I knew it was a federal health insurance program, but not much more than that. Same for CPAP devices, complex rehab and basically everything related to DME. I'd seen them before yes, but I didn't know the language or how difficult it could be to get them paid for. For example, a few years ago my friend Ryan was prescribed a CPAP mask. When he showed our...

cpap, Star Wars


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Also Noted

A/R Allegiance adds billing services

May 29, 2015HME News Staff

OVERLAND PARK, Kan. - A/R Allegiance Group has expanded its services to include medical billing, positioning the company to offer full revenue cycle management. The company's CollectPlus helps providers recover private pay collections and now ClaimCollect can do the same for insurance reimbursement. A/R Allegiance has packaged its services into a five-step revenue cycle management process to help providers grow and thrive: pre-billing documentation audits, billing all types of payers, collections,...

A/R Allegiance, billing, collections


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