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HOme medical equipment

Massachusetts: Warning: Information you provide may be used against you

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08/26/2010

On July 1, BCBS sent out a confidential request for information (RFI) to providers. The 16-page document states: The information you provide may also be used to develop a limited or select network of affordable high quality DME providers focused on clinical outcomes, efficiencies and cost effective care.

'When one road gets closed, look for the next one'

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08/26/2010

The competitive bid amounts for Round 1.2 have sent HME providers in areas slated for Round 2 scurrying for advice on how to cut "huge amounts of cost" from their businesses, says consultant Wallace Weeks.

New Hampshire: Medicaid looks to drop cost-plus

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08/26/2010

New Hampshire may be the "granite state," but fortunately for providers here, recent Medicaid cuts weren't set in stone.
In mid-June, the state rescinded cuts that went into effect April 1 on most HME products. Those cuts, which were made without notifying providers, slashed Medicaid reimbursement by about 20% across the board.

Some relationship advice for CMS

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08/26/2010

Did you see the July 16 edition of "Mobility Matters," the bulletin that AAHomecare publishes to educate lawmakers and policymakers, among others, on the power mobility benefit?

OIG: HME accounts for 25% of errors

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08/26/2010

The Office of Inspector General (OIG) has analyzed errors in the Comprehensive Error Rate Testing (CERT) program for 2009 and found that, out of 99,480 claims, 19,754 had improper payments, valued at about $4.7 million. Of the six types of providers included, HME providers accounted for 25% of those improper payments. The most common error: insufficient documentation.

Readers to Mike Moran: Not so fast

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08/26/2010

Would it be totally off the wall to suggest that Medicare remove a bunch of HME products from the fee schedule? I’m not talking about oxygen and power wheelchairs and some of the bigger more expensive items that some seniors (but certainly not all) might have trouble paying for. I’m talking about stuff that could be considered a commodity. Things like walkers, commodes, cane handgrips, bedside rails, trays. That kind of stuff.

Not all auditors are created equal

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08/26/2010

"The ZPIC auditors are voracious," said Toscano, owner of Boca Raton, Fla.-based billing firm Professional Medical Administrators. "If a provider specializes in a particular item, they will get ZPICed for that item. I have seen up to 1,000 letters sent (to a provider) in a 30-day timeframe. It's a cash strangle and an administrative nightmare."

Competitive bidding: What are your options?

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08/26/2010

If I had been asked to come up with the most unworkable program imaginable, I could not have dreamed up competitive bidding. However, until the program collapses, we have to deal with it.

Out of the office, but not out of my mind

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Friday, August 6, 2010

The MED Group's Kelly Riley wanted me to give her a call next week so she could bend my ear a bit on CPAP audits in region C.

Good luck to us all

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Wednesday, July 21, 2010

"I'll call you back when I think of some good news," one provider told me yesterday when I called to see what's shakin' out there.

"Theresa, I just got word that Medicaid cut strips 26%," said another. "I can't talk now."

And so it goes, across the country.

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