Archive: January 2003
OIG: Reduce reimbursement for beds
January 31, 2003HME News Staff
WASHINGTON - Medicare rates for semi-electric hospital beds are “substantially higher” than other payer rates, and CMS should reduce them, the OIG concluded in a December report. The OIG found that fee schedule amounts were excessive when compared to combinations of other fee schedule amounts that should have been used in many cases. The use of two alternative billing code combinations could result in savings of approximately $34.3 million per year, consisting of $25.9 million in rental...
Montana Medicaid cuts budget, O&P
January 31, 2003HME News Staff
BOZEMAN, Mont. - The state Legislature has not only cut its Medicaid budget by 7%, it has also cut orthotics and prosthetics (O&P) from its list of covered services, in an “emergency” move to keep its 2003 budget in check.
Because most other states have already made across-the-board cuts to their Medicaid budgets, the cuts in Montana didn't come as a surprise.
The Legislature predicts cutting its Medicaid budget by 7% will save the state more than $1.4 million. It predicts cutting O&P...
Politics
January 31, 2003HME News Staff
Where to save money
With Martin Szmal
Q. Where should Congress look to save money on healthcare expenditures?
A. According to the Centers for Medicare & Medicaid Services (CMS), healthcare spending in the United States rose to $1.4 trillion in 2001, an 8.7% increase over the previous year.
Due in part to increases in reimbursement to hospitals, home health agencies and nursing homes that were implemented in 2001 through BIPA, Medicare spending on health care increased by 7.8%. Medicaid spending,...
Profits beyond their wildest dreams
January 31, 2003HME News Staff
LYNBROOK, N.Y. - Early last year Ed Walsh and Seth Lane bet that if they started a company that provided only adult and pediatric respiratory services, referral sources would welcome them with open arms. They never thought that those open arms would close into an affectionate bear hug.
“When we started, our original goal was to break $500,000 for the year,” said Walsh, who like Lane has 25 years in the HME industry, but never as an owner. “Breaking even would be fine. We never...
Briefs
January 31, 2003HME News Staff
Bowman relocatesto larger location
SAN CARLOS, Calif. - Bowman Medical has relocated to a 4,500-square-foot location here from a 2,000-square-foot location in Hayward, Calif. The new location will give the company much needed “breathing room,” said owner Daryl Bowman. Now it can showcase more products, especially lift chairs and wound care products, he said. The company, which specializes in bread-and-butter HME like low-air-loss mattresses and hospital beds, can also look into adding...
Medicare HMOs up and down
January 31, 2003HME News Staff
WASHINGTON - If the momentum to privatize the Medicare program accelerates under the leadership of incoming Senate Majority Leader Bill Frist (R-Tenn.), HME providers see advantages and disadvantages to moving off the fee schedule and into the hands of private payers.
The first, most obvious benefit, say many, is a reduction in the administrative burden. “I can take less money if you can reduce my work,” said Jim Clark, president of Clark Respiratory and Medical Supply in Catskill, N.Y....
Company looks for fresh start with HME
January 31, 2003HME News Staff
OGDEN, Utah - Pacific Alliance Corporation, a bankrupt publicly traded company that's looking for a fresh start, signed a “letter of intent” in December to acquire Classic Health Systems, an HME company with offices in Michigan and Florida.
The final agreement between Pacific and Classic Health should be signed early this year, according to a release issued by Pacific.
Pacific Alliance is currently inactive. The company, which filed for Chapter 11 bankruptcy on June 23, 1995, previously...
Follow up
January 31, 2003HME News Staff
MURRYSVILLE, Pa. - Respironics' bold claims for its new C-Flex CPAP technology is prompting some to question the extent to which pressure reduction upon exhalation will prove to be a major boon to compliance.
In a press release last month, Respironics CEO Jim Liken said he believed C-Flex has the potential to largely replace the traditional CPAP therapy product. By lowering blower pressure on exhalation - like a bi-level device though not quite as precipitously - Respironics believes patients will...
Influential director leaves CMS
January 31, 2003HME News Staff
WASHINGTON - Tom Hoyer, a longtime CMS administrator deemed by some to hold more sway over Medicare's HME program than any other, retired last month.
As CMS's director of chronic care purchasing policy, Hoyer was the CMS chief who converted legislative ideas, like inherent reasonableness, into working policy, rules and regulations.
Named one of the 10 most influential people in the HME industry by HME News in 1999, Hoyer's retirement caps a 31-year career at the 37-year-old Medicare program. Replacing...
Gallagher’s politicking adds punch to VGM’s lobbying
January 31, 2003HME News Staff
The Van Miller Group would have been hard pressed to find a more natural candidate than John Gallagher for the newly created position of government affairs director.
He is a native of Waterloo, Iowa - VGM's home turf.
He grew up in a political environment.
He knows health care and worked as a VGM vendor.
He has lobbied against competitive bidding in another industry.
Essentially, he has the background, skills and experience to hit the ground running in a position that is complex and demanding....