Tag: Catheter
In brief: CMS makes advance payments, state AG sues Apria, OIG warns of cath scams
March 13, 2024HME News Staff
WASHINGTON – CMS on March 9 made available Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions.
The payments may be granted in amounts representative of up to 30 of claims payments to eligible providers and suppliers. The average 30-day payment is based on the total claims paid to the provider/supplier between Aug. 1, 2023, and Oct. 31, 2023, divided by three. These payments...
OIG publishes ‘Consumer Alert’ for cath scams
March 11, 2024HME News Staff
WASHINGTON – The Office of Inspector General is alerting the public about a fraud scheme involving urinary catheters. In a “Consumer Alert,” the agency says scammers are targeting Medicare enrollees through phone calls, Internet ads and text messages with offers of free services, medical equipment or gift cards upon confirming their personal information and eligibility for specific Medicare services. Often, the enticement for the individual is that they are “qualified”...
In brief: AAH on cath fraud & CCS on GLP-1s
March 8, 2024HME News Staff
WASHINGTON – AAHomecare has issued a statement affirming its support for the government to implement real-time monitoring of claims to detect potential fraud and abuse, in response to news reports of potential Medicare fraud by a handful of intermittent catheter companies.
AAHomecare's statement, which was shared with CMS and Capitol Hill, also reiterates recommendations for federal government initiatives to better monitor DME supplier billing practices and trends, including:
Increased...
DMEMACs clarify coverage for caths
December 5, 2023HME News Staff
WASHINGTON – Both CGS and Noridian have clarified that a high-level spinal cord injury (T3 and above) is an example of immunosuppression, meeting criteria #2 for coverage for closed-system catheters, Coloplast has announced. In October 2021, during a DME MAC council call, it was stated, “The example of high-level spinal cord injury patients (higher than T3) will be considered for coverage when conducting medical reviews of intermittent catheterization using a sterile intermittent catheter...
Avalon GloboCare acquires Merlin Medical Supply
September 14, 2023HME News Staff
FREEHOLD, N.J. – Avalon GloboCare, a developer of innovative precision diagnostics and provider of clinical laboratory services, has announced that Laboratory Services MSO has acquired Merlin Medical Supply, an HME company providing acute and non-acute medical supplies in Ventura County, Calif. Additionally, LSM has acquired Leading Edge Innovations, which owns the GeeWhiz External Condom Catheter, a patented, FDA-registered, in-market, male incontinence device, from the same owner. “MMS...
Bill introduced in Iowa addresses catheters made with DEHP
February 24, 2023HME News Staff
DES MOINES, Iowa – Democratic Iowa State Representative Josh Turek has introduced the Better Caths for Iowa Act (H.F. 387) to review the use and reimbursement of certain catheters under the Medicaid program, specifically urinary catheters made with the harmful chemical DEHP.
A four-time Paralympian who was born with spina bifida, Josh and his basketball team most recently brought home gold from the 2020 Tokyo Paralympics.
"Bladder cancer took the life of Dale Ericksen,...
OIG report on catheters: ‘Where are they getting their information?’
November 22, 2022Theresa Flaherty, Managing Editor
YARMOUTH, Maine – An Office of Inspector General report “understates” the actual cost of providing catheters, especially given the complexity of both Medicare’s documentation requirements and the needs of patients, say providers.
The report, released in September, found that Medicare payments for intermittent urinary catheters were 3.4 times supplier acquisition costs in fiscal year 2020 and recommended that CMS lower its reimbursement rates.
“I’d...
In brief: Philips recall, catheter payments, Pottery Barn play
September 9, 2022HME News Staff
PITTSBURGH – Philips Respironics is alerting users of certain CPAP or Bi-Level PAP therapy masks with magnetic headgear clips or straps that these devices should not be used by or near patients and their household members, caregivers and bed partners who have metallic implanted devices or metallic objects (such as metallic splinters) in the body.
The magnetic headgear clips are used to attach the headgear straps to the masks, a commonly used method in sleep therapy devices.
This...
OIG report: CMS should reduce cath payments
September 7, 2022HME News Staff
WASHINGTON – Medicare payments for intermittent urinary catheters were 3.4 times supplier acquisition costs in fiscal year 2020, according to a new analysis by the Office of Inspector General.
In total, Medicare allowed $407 million in payments for these items, while suppliers paid approximately $121 million to acquire them.
Each of the three billing categories for intermittent urinary catheters (straight tip, curved tip, and sterile kit) showed large differences between...
Doing business the ‘180 way,’ going on 20 years
August 26, 2022Theresa Flaherty, Managing Editor
OKLAHOMA CITY – 180 Medical was founded with the goal of providing top-notch service and education to its customers, says Mark Jassey, chief commercial officer.
This month, the national provider of catheters and ostomy supplies celebrates 20 years of doing just that.
“Education is one of our foundational pillars,” Jassey said. “We want to be able to provide the education and the choice when someone needs to use our products. It’s not something someone...