Archive: December 2001
Medicare
December 31, 2001HME News Staff
WASHINGTON - Suppliers of diabetic shoes are predicting their sales could increase significantly in the wake of a decision by the Center for Medicare and Medicaid Services (CMS) to expand foot care coverage for some beneficiaries with diabetes.
CMS announced recently that beneficiaries suffering from diabetic peripheral neuropathy with loss of protective sensation (LOPS) may now receive two foot exams per year, providing they haven't seen a foot care professional for some other reason. Medicare...
Providers can expect UPIN edits
December 31, 2001HME News Staff
WASHINGTON - On the heels of an OIG report that states in 1999 Medicare paid $32 million for medical equipment and supply claims with invalid UPINs and $59 million for claims with inactive numbers, CMS has released a program memorandum requesting carriers review claims and update UPINs.
Carriers are instructed to do so by April 1, 2002.
Neither the OIG nor CMS say whether providers used the wrong UPINs intentionally or that the equipment and supplies they billed for were not medically necessary....
Study provides sobering look at Medicare billing problems
December 31, 2001HME News Staff
MEMPHIS, Tenn. - A new study that has aggregated remittance data from more than 240,000 Medicare claims has put ammunition behind HME claims that paperwork is the toughest part of being a provider.
For example, the RemitData study has found that:
- 6% of all claims are denied because they are duplicates of claims already adjudicated by the DMERCs.
- Medicare issues payment on 51.8% of claims submitted in 0-30 days. But almost 10% of all claims aren't paid until more than 181 days after the date...
HMEs predict Olympics won't boost biz too much
December 31, 2001HME News Staff
SALT LAKE CITY - When it comes to adding business during the Winter Olympics here next month, don't look for home medical equipment providers to break any world records.
"It'll be fun, but I don't think there will be disruption for the HME community or opportunity," said Joe Sansone, president of Pediatric Services of America, in Norcross, Ga.
Located just a pole vault or so outside Atlanta, Sansone experienced the 1996 summer Olympics first hand. So did Hayward Woodward, owner of the Medicine...
Rehab divisions could fall victim to Medicaid cuts
December 31, 2001HME News Staff
GREENVILLE, S.C. Budget cuts by the state legislature have resulted in Medicaid eliminating its co-payments and suppliers reconsidering their assignment decisions, especially for rehab equipment, according to the state DME association.
In October, Medicaid was forced to change its allowable so it equaled Medicare's 80%. Before, on a $100 item, Medicare paid $80 and Medicaid picked up the rest of the tab $20 or 20%. Now, if a supplier takes assignment, he is left to pay that difference because...
United prosposes beneficiary cost-sharing plan
December 31, 2001HME News Staff
MILWAUKEE - Due to what it calls inadequate federal reimbursement, Medicare managed care provider United Healthcare of Wisconsin has proposed implementing for the first time a 20% copayment for durable medical equipment in 2002.
United had considered exiting the Milwaukee market but decided it could afford to stay another year by implementing the DME copayment and other cost-sharing measures.
Citing continued inadequate federal reimbursements, Blue Cross and Blue Shield and United of Wisconsin's...
HMEvolution
December 31, 2001HME News Staff
It appears that the home medical equipment industry has reached a crossroads in its evolution - a juncture where HME providers face a decision of going one way or another to avoid hitting an abutment.
Industry navigators say the fork in the economic road branches out in two distinct and different flanks: one way points to the more familiar durable medical equipment or "bent metal" business; the other leads to uncharted territory in the clinical, or "white lab coat" field.
Traditional DME - beds,...
Extrapolation in Senate's hands
December 31, 2001HME News Staff
WASHINGTON - Now that the House has passed its version of regulatory and contracting relief, the Senate Finance Committee is looking at the issue under the guise of the Medicare Appeals, Regulatory and Contracting Improvement Act of 2001 (S. 1738).
Like its counterpart in the House, the Senate version would allow providers to delay providing refunds of disputed overpayments until after the first level of appeal. Unlike the House bill, the Senate bill does not address a carrier's ability to extrapolate...
Marketing
December 31, 2001HME News Staff
NEW ORLEANS - If what Arnold Palmer did for the popularity of golf has legs beyond the links, the home medical equipment industry is about to become the beneficiary of a whole new level of recognition.
At Medtrade, one of golf's most legendary figures, the man who brought legions to the game throughout the Fifties and Sixties as "foot soldiers" in Arnie's Army, kicked off his tenure as Invacare's worldwide spokesperson.
Invacare plans to start filming its first TV spot with Palmer in January....
New Year mysteries
December 31, 2001HME News Staff
At the end of the year, there are a lot of things afoot in the HME industry, or on its margins, that I just don't understand. To wit...
IBOT. Aka the stair-climbing wheelchair. J & J has spent $150 million developing technology that enables a power wheelchair to climb up stairs, power over curbs and maneuver off road. That's $150 million for a single product. Contrast that with Invacare's annual $40 million budget for R&D. Can $150 million be wrong? Is J&J's executive team rife with gamblers? Are...