In brief: New enrollment provisions, new partnership

Friday, December 5, 2014

BALTIMORE – CMS has tightened its enrollment guidelines in a final rule issued Dec. 3. New provider enrollment provisions include: adding the ability to deny the enrollment of providers, suppliers, and owners affiliated with an entity that has unpaid Medicare debt; adding the ability to deny the enrollment or revoke the billing privileges of a provider or supplier if a managing employee has been convicted of certain felony offenses; and permitting CMS to revoke billing privileges of providers and suppliers that have a pattern or practice of billing for services that do not meet Medicare requirements. In August, CMS announced that it would begin implementing fingerprint-based background checks for certain providers in the high-risk category.

Pharmaceutical firm partners with AAHomecare

WASHINGTON – Sunovion Pharmaceuticals is now a Silver Level Corporate Partner with AAHomecare, the association announced today. Sunovion specializes in treatments for central nervous system and respiratory disorders. “Sunovion brings a depth of experience in patient care, and we value the support that leading companies bring to the homecare community,” said Robert Steedley, chairman of the AAHomecare Board of Directors. AAHomecare has 11 corporate partners, including Invacare, Brightree, Drive Medical and Apria.

Respiratory provider settles allegations

WASHINGTON – North Atlantic Medical Services, DBA Regional Home Care, has agreed to pay $852,378 to settle allegations that it violated the False Claims Act, according to a release from the Department of Justice (DOJ). The company was accused of billing Medicare and Medicaid for respiratory services provided by unlicensed personnel from September 2010 to January 2013. Regional Home Care is based in Massachusetts, which requires respiratory therapists to be licensed.  “To safeguard patient health and ensure that taxpayer money is spent well, Medicare and Medicaid require providers of respiratory care services to follow state licensure rules,” said Special Agent in Charge Phillip M. Coyne for the U.S. Department of Health and Human Services Office of Inspector General.  “Companies seeking to boost profits by using unlicensed personnel will be held accountable for their actions.”

CPAP website gets facelift

ASHVILLE, N.C. – is showing off its new and improved website. “The new site will further advocate the mission of and Aeroflow Sleep Apnea,” said Josh Hill, director of business development. The new interface features an intuitive shopping layout, easier site navigation, a centralized blog, advanced shopping cart, and optimized search functions. In 2012, the site was updated with new images, content and inventory.

Jurisdiction B reviews for power wheelchairs and catheters

INDIANAPOLIS –A claim review of power wheelchair-related options and accessories (K0820-K0829) from July 1, 2014, to Sept. 30, 2014, showed a denial rate of 81%. In the previous quarter, the rate was 84%. The most common reasons for denial:The face-to-face examination did not support why a manual wheelchair or a power operated vehicle wouldn't meet the beneficiary's mobility needs in the home; face-to-face examination did not support the beneficiary's mobility limitation…Also under claim review arecatheters (A4353) for same time period, and which showed a denial rate of 93%. In the previous quarter, the rate was 91%. The most common reasons for denial: The beneficiary did not meet one out of five criteria per local coverage determinations (LCD) for coverage of intermittent catheter kits (A4353); the supplier did not document a valid refill request from the beneficiary.

Exhibitors lining up for Medtrade Spring

LAS VEGAS – More than 150 manufacturers and providers have registered for the three-day conference, which is slated for March 30–April 1 at the Mandalay Bay Convention Center in Las Vegas. Registration opened last week. Among the 150 exhibitors already signed up is Ontario-based Broda. “From a regional perspective, we are quite interested in meeting with customers all across North America,” said Sue Wilson, vice president of customer care, in a press release. This year’s format has been redesigned to reduce overlap between conference sessions and expo floor time, by moving a majority of educational sessions to Monday, allowing attendees to browse the expo floor most of Tuesday and Wednesday.

ResMed unveils AirCurve 10

SAN DIEGO – ResMed debuted its new AirCurve 10 series, which includes three bilevel devices and an adaptive servo-ventilation device for patients with central sleep apnea or Cheyne-Stokes respiration. "We've developed the AirCurve 10 series for patients who need truly personalized support," said Greg Peake, president of ResMed’s sleep-disordered breathing global business unit. The AirCurve 10 includes built-in wireless connectivity and works with ResMed’s patient monitoring software, ResMed’s Airview.

NHIA opens registration for annual event

ALEXANDRIA, Va. – Early bird registration has opened for the 2015 National Home Infusion Association’s (NHIA) Annual Conference & Exposition. The event takes place March 23–26 in Phoenix. It will feature a full slate of educational programs, including an executive pre-conference, roundtables, networking and an exhibit hall. For more information, call 703-838-2663 or email

Inogen to hold investor meeting

GOLETA, Calif. – Inogen will host an investor and analyst meeting and live webcast Dec. 15, from 11:30 a.m. to 3 p.m. EST. The meeting will include presentations from company executives and industry expert Thomas Williams, founder and managing director of Strategic Dynamic, according to a release. The webcast begins at noon and can be accessed at