In brief: RAC audits test strips, Medicare overpays for PSG

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Friday, June 21, 2019

WASHINGTON – Performant, the national RAC for DME, received approval from CMS on June 14 to audit blood glucose test strips (A4253) nationwide.
“The quantity of glucose test strips that are covered depends upon the usual medical needs of the diabetic patient,” reads an announcement on the RAC’s website. “Documentation will be reviewed to determine if the utilization guidelines for glucose test strips were met.”
The RAC will be reviewing claims that have a “claim paid date” that is less than three years prior to the additional documentation request.

Ascension forms post-acute care division
ST. LOUIS – Ascension has formed a new Post-Acute Services Division and named Daniel “Danny” Stricker as its president, according to McKnight’s Senior Living. Stricker is COO of subsidiary Ascension Living. Effective July 1, he will provide strategic and operational leadership to the new division, which will include Ascension Living’s post-acute services—independent living, assisted living, memory care, skilled nursing, short-term rehab—as well as home health, hospice, palliative care, home infusion and HME services. Ascension Living has more than 50 senior living communities across 11 states and the District of Columbia. In all, Ascension operates more than 2,600 sites of care.

Aeroflow is ‘Great Place to Work’ certified
ASHEVILLE, N.C. – Aeroflow Healthcare has been certified as a “Great Place to Work.” The certification recognizes outstanding workplace culture, employee experience and leadership behavior. Businesses earn the certification by gathering validated employee feedback and applying Great Place to Work’s “For All” methodology to confirm at least seven out of 10 employees have consistently positive experiences at the company. In coordination with the certification, Aeroflow announced its new mission statement: “to provide innovative home healthcare solutions that allow for more time to be spent at home while lowering healthcare costs and improving quality of life.”

PHS names former US congressman to board
ST. PAUL, Minn. – Pediatric Home Service has appointed a new board member: Erik Paulsen, a former representative for Minnesota’s 3rd Congressional District in the U.S. House of Representatives. “Erik’s experience and leadership on health care, while serving in Congress and in the Minnesota House, will be a strong complement to our board and a welcome asset to our team at PHS,” said CEO Cameo Zehnder. Paulsen served in Congress from 2009-19 and held the positions of chairman of the Bicameral Joint Economic Committee; member of the House Committee on Ways and Means, including the Health Subcommitee; and co-chairman of the House Medical Technology Caucus. He served in the Minnesota House from 1995-2009. Zehnder said Paulsen’s expertise will help PHS as it works to establish a formalized pediatric center of excellence to ensure that children with medical complexities receive the specialized care they need in their homes and communities.

OIG: Medicare overpaid for PSG services
WASHINGTON – Medicare made payments to providers for polysomnography services that did meet billing requirements, according to a new report from the Office of Inspector General.
Of 200 randomly selected Medicare beneficiaries, payments were made for 117 that met billing requirements with 276 corresponding lines of services, and for 83 that did not meet requirements with 150 corresponding lines of services, resulting in net overpayments of $56,668, according to the OIG. Based on the sample results, the agency estimates Medicare made overpayments of $269 million for polysomnography services during the audit period.
The OIG recommends that CMS instruct the MACs to recover the portion of the $56,668 in overpayments that are within the four-year reopening period. It also recommends that CMS work with the MACs to conduct data analysis that allows for targeted reviews for polysomnogrpahy services and for educating providers on proper billing.
CMS concurred with the recommendations.

ITEM Coalition adds voice to vent concerns
WASHINGTON – The ITEM Coalition has sent a letter to CMS Administrator Seema Verma to express its concerns about including non-invasive vents in Round 2021 of the competitive bidding program. The coalition is comprised of consumer organizations like The ALS Association, which represents individuals with neuromuscular conditions who may need the life-saving devices. “CMS’s decision sets an alarming precedent by forcing patients to rely upon the lowest DME bidder to receive life-saving ventilators and associated services in the home,” states the letter. “We believe that CMS’s expansion of competitive bidding to include non-invasive ventilators will jeopardize patients’ ability to receive care that best meets their unique medical and functional needs.”

Nominate an HME Woman of the Year
WATERLOO, Iowa – Nominations for the 2019 HME Woman of the Year are now open. The award, now in its fourth year, recognizes a woman who has made significant contributions to her company, community and the HME industry. “The HME Woman of the Year award provides recognition and visibility for exceptional leaders in our industry,” said Clint Geffert, president of VGM & Associates. “Whether through advocacy work, sharing expertise at industry meetings or by being innovative to grow business or streamline operations, this award recognizes a woman who is blazing a path for the future.” The winner will be announced at Medtrade. Last year’s winner was Georgie Blackburn. Nominations are open to all women who work within the industry. Nominations are due Aug. 9 and can be submitted online.

Medtrade: Take advantage of lowest rates
ATLANTA – SmartSaver rates for Medtrade 2019 are in effect. Attendees can now purchase an Educational Conference Pass for $109, which provides access to all educational sessions and the expo hall. A SmartSaver Expo Pass can be purchased for $25. SmartSaver rates are the lowest rates available for this year’s show, which takes place Oct. 21-23 at the Georgia World Congress Center in Atlanta. Click here to register.

eSolutions buys Practice Insight
OVERLAND, Kan. – eSolutions, a provider of healthcare and analytics solutions, has acquired Houston-based Practice Insight, a clearinghouse and RCM software provider with 68,000 users. The acquisition enhances eSolutions’ commitment to providing revenue cycle management products to clients, including physicians, home health, hospice and durable medial equipment providers. “At eSolutions, we are committed to delivering transformative products that help our clients grow and strengthen their revenue health,” said Gerry McCarthy, CEO of eSolutions. “With this acquisition, we add complementary claims processing, workflow management capabilities, and analytics that enhance our revenue cycle suite of solutions.” eSolutions acquired RemitData in 2017.

Permobil re-ups ALS partnership, closes location
LEBANON, Tenn. – Permobil and the Permobil Foundation have renewed their partnership with the ALS Association to support the association’s local Walk to Defeat ALS events across the country. Since 2000, these events have raised more than $318 million. Permobil also collaborated with the association on its recent advocacy efforts on Capitol Hill. “Our ongoing support of The ALS Association is unfaltering, as is their fight to find a cure for this devastating disease,” said Ashley Davis, executive director of the Permobil Foundation. “We remain passionate about supporting the association in their efforts to find treatments and one day a cure for all of those affected by ALS, until that day comes we hope that we can continue to help with the gift of mobility”…Permobil has announced it will close its Bozeman, Mont., location on June 28. Many of its current team memebers will continue to work remotely or relocate to the Lebanon, Tenn., office. The closure is not expected to impact customers.

Southeastern HME holds Expo for complex rehab
LUMBERTON, N.C. – Southeastern Home Medical Equipment held its first Education Expo at the Southeastern Lifestyle Center for Rehabilitation on June 7, according to The Robesonian. The event featured education on complex rehab power and manual wheelchairs, custom seating and other mobility related devices, and vendor exhibits. “We held this event to get more awareness in our community about our complex mobility and seating program,” Zachary Stamper, manager, told the newspaper. “This program requires a team of passionate and knowledgeable professionals to assure the best outcomes for our clients.” Thirty-eight clinical professionals attended the event, according to the newspaper. Exhibiting vendors included Sunrise Medical, KiMobility, Permobil/Comfort Co/ROHO, Quantum Rehab, Pinnacle Mobility and VGM.

PHS hosts healthcare professionals from Japan
SAINT PAUL, Minn. – Pediatric Home Service on June 12 hosted heatlhcare professionals from Japan to educate them on current trends in healthcare delivery in the U.S. and help familiarize them with American culture. The professionals included physicians, administrators and healthcare management consultants. “We were thrilled to give our guests from Japan an overview on transitioning medically complex kids from hospital to home,” said Tamara Schafer, outreach manager at PHS. “To be able to interact with and educate healthcare providers across the globe on the importance of home care is an amazing honor.” Among the topics covered during the visit: nurse education, community involvement and research being conducted by PHS’s medical director, Dr. Roy Maynard. The professionals spent two days in the Twin Cities touring various healthcare organizations and also visited Washington, D.C.

Philips sleep headband takes flight
AMSTERDAM, the Netherlands – The SmartSleep Deep Sleep Headband from Royal Philips will be used in research funded by the Translational Research Institute for Space Health (TRISH), a virtual institute empowered by the NASA Human Research Program, for two studies evaluating the relationship between sleep and cognitive performance for behavioral health. The two-year initiative will use the headband to determine if sleep can be improved during deep space exploration by using a variety of auditory stimulation protocols and, thereby, maximizing cognitive function. TRISH, in collaboration with researchers from the University of Wisconsin-Madison and the Perelman School of Medicine at the University of Pennsylvania, has begun the following studies: Optimizing Auditory Stimulation to improve cognitive performance (24 subjects will use the headband at home for two months, performing a NASA-validated cognitive test battery daily) and Improving Efficiency and Restorative Quality of Sleep (a seven-day lab trial replicating the challenging sleep conditions experienced during spaceflight will study 12 subjects wearing the headband).