Archive: October 2002
OIG concerned about surrogate UPIN habits
October 31, 2002HME News Staff
WASHINGTON — A September report from the OIG estimates that 61% of Medicare claims for DME products that sport surrogate UPINs should have used permanent UPINs, and it suggests that CMS take a harder look at claims with surrogate numbers.
CMS Administrator Tom Scully has concurred with concerns raised by the OIG report, and has said that CMS will step up monitoring of UPINs, as well as educate suppliers and providers of their responsibility to make sure the proper UPINs appear on reimbursement...
Audits
October 31, 2002HME News Staff
SANDWICH, Mass. — A provider who spent roughly $50,000 fighting and winning a recoupment battle with Medicaid has upped the ante in his battle against the state's "scare" tactics.
Mark Sheehan, president of Cape Medical, has lined up a sponsor for legislation that would require the state to repay a provider's legal fees if he successfully defends himself against overpayment allegations.
"They've beat people to death with (audits) for years," Sheehan said. "They continue to blame pharmacies,...
Coding chaos?
October 31, 2002HME News Staff
IRVINE, Calif. - Just five months after getting new, more generous ostomy codes in April, providers began to hear disturbing news: Another set of ostomy coding changes may be on the way from CMS.
"It looks like they plan to eliminate the six pay codes they established in April for features of pouches and issue new codes that categorize pouches by which features they have specifically," said Linda Aukett, chairwoman of government affairs for the Irvine, Calif.-based United Ostomy Association (UOA).
Worst...
November elections may change dynamics on Capitol Hill for HMEs
October 31, 2002HME News Staff
It now appears that both Houses of Congress will go home to campaign without having acted upon Medicare issues as well as other important matters. They will reconvene on November 12 after the election. It seems that post-election or "lame duck" sessions are becoming the rule rather than the exception. This means that many members who are defeated on November 5 will be making laws a few weeks later that will govern us for some time to come.
This particular lame duck session could be very unusual....
Supplies giant ramps up growth strategy
October 31, 2002HME News Staff
MILFORD, Conn. — Byram Health Centers completed several acquisitions last month worth $2 million and has begun a full court press to increase its share of the medical supplies business.
In August, the $65-million company hired its first-ever director of acquisitions. What's more, to boost its referral business, Byram plans to increase its sales force by four every six months for the foreseeable future, starting in January, said Steve McCoy, vp of market development.
The company, which handles...
Apria is winner
October 31, 2002HME News Staff
That Apria has been anointed Best
Home Respiratory Provider in the United States in an awards program sponsored by this publication, AAHomecare and Medtrade has no doubt turned some heads in this industry. Conventional wisdom says the best provider is the local provider. Nationals are chump change when they're up against a local who's firing on all cylinders.
The 2002 awards notwithstanding, that sentiment is likely to rein in this industry. But Apria's selection is a remarkable choice, if only...
J&J seems poised to sell iBOT direct to consumer
October 31, 2002HME News Staff
NEW BRUNSWICK, N.J. — Since the world first learned in 1999 that Johnson & Johnson would be releasing a power chair with such features as the ability to climb and descend stairs and elevate the occupant to eye level with a standing person, there has been a lot of talk. Will there be a market for the chair? Can J&J recoup its investment? Will DME providers even be a part of the picture? But there haven't been many answers.
Johnson & Johnson and its subsidiary, Independence Technology—which...
Disease state management
October 31, 2002HME News Staff
WASHINGTON, D.C. - To prevent and manage chronic diseases and thus control soaring medical costs, the Center for Best Practices at the National Governors Association (NGA) convened high-ranking policymakers from eight states and one territory in late August to help them develop plans of action for disease management.
Disease state management (DSM) programs are gaining favor as a possible way to reduce healthcare costs. Though payers will not currently reimburse for DSM services, even some HME providers...
Courageous article
October 31, 2002HME News Staff
Congratulations on your courageous article on the K0011 billing situation and Medicare. Whether or not any "laws or rules" are being broken is not for me to decide. However, we hear from many of our members who believe that Medicare recipients are not well-served by providers who deliver product without evaluating patients for fit and environment and do not provide service after the sale. VGM has already verified several reports involving companies shipping K0011 chairs direct to customers without...
Remodeling spurs bathroom safety sales
October 31, 2002HME News Staff
When it comes to bathroom safety aids, the public is looking to the future. That is, even though many homeowners don't need assistive products right now, they are adding them to their bathroom remodeling projects because they know that day will come.
So, contractors need reliable suppliers and HME retailers are eagerly lining up to fill that void.
"We've been getting a lot of inquiries from contractors," said David Beaudette, president of McCord Sweeney Home Medical in Lowell, Mass. "I'm in a business...