Archive: June 2003
Politics
June 30, 2003HME News Staff
New Medicare legislation
With John Gallagher
Q. The recent Medicare reform legislation from the U.S. Senate Finance Committee contains more than just a DME CPI freeze. This bill also contains a provision requiring accreditation for HMEs. What exactly is being proposed and why?
A. The Senate version of this year's Medicare legislation, under section 421 (a) requires that the CMS secretary establish a requirement for accreditation to get and keep a Medicare number. It calls for the establishment...
Congress considers alternatives to long-term care
June 30, 2003HME News Staff
WASHINGTON - Congress is considering legislation that would fund community-based attendant services programs as alternatives to institutional care.
The Medicaid Community-based Attendant Services and Supports Act of 2003 (MiCASSA) offers a choice in long-term care for individuals eligible for nursing facility services.
For HME companies, the consequences of MiCASSA are plain: Fewer patients in facility-based care means more home care.
“It's the No. 1 consumer issue,” said Dave Williams,...
Reimbursement
June 30, 2003HME News Staff
BOWLING GREEN, Ky. - Last December, David Fields moved his office 30 feet to a new warehouse suite and messed up his Medicare cash flow for close to 45 days.
How's that, you ask? The owner of Kentucky Home Care didn't pay attention to a Medicare bulletin issued about a year ago telling providers that, as a safeguard, starting in October 2002 payments would be stamped with “Do Not Forward.” As a result, filing a change of address form with the U.S. Post Office no longer cuts it. You've...
Scam lands mom in jail
June 30, 2003HME News Staff
MIAMI - A 39-year-old South Florida mother has been sentenced to 10 years in prison for her role in a COPD scam that involved doctors, pharmacists and pharmacy owners, according to a May 22 report in the Miami Herald.
The woman, Idania C. Arias, ran an HME company that persuaded doctors to sign hundreds of blank prescriptions and recruited others to pay Medicare beneficiaries $50 to be falsely diagnosed with COPD.
The company then billed Medicare for nebulizers in a scam that eventually reaped...
RESNA credentials:
June 30, 2003HME News Staff
ARLINGTON, Va. - With Tennessee's recent legislation requiring RESNA's ATS and ATP credentials for rehab providers in the state, the 23-year-old association is gradually becoming synonymous with the quality standards industry leaders are driving to instill.
“It's gaining momentum,” said United Seating and Mobility President Bob Guoy. “It's approaching a level where enough people are aware of it and are getting licensed.”
While RESNA's rehab credentialing exam has only been...
Ex-Rotech employees rant, rave, plot and post
June 30, 2003HME News Staff
CYBERSPACE - A Web site for former Rotech Healthcare employees advertises itself as a place to “Rant, rave, plot and post.”
And then there's stuff you can't print in a commercial newspaper.
If there's any doubt that CEO Phil Carter angered more than a few when he kicked off his restructuring plan by laying off hundreds of employees in January, look no further than the Yahoo! Group: Rotechbacklash (http://groups.yahoo.com/group/rotechbacklash/).
In addition to spewing personal insults...
Accreditation for HMEs?
June 30, 2003HME News Staff
WASHINGTON - The Senate Finance Committee passed legislation June 12 that calls for durable medical equipment providers to become accredited by an independent accreditation organization. The legislation would also freeze CPI increases for DME and certain orthopedics for seven years.
While the industry has known for some time that the Senate Finance Committee, chaired by Charles Grassley (R-Iowa), was likely to propose a multi-year freeze on DME in its Medicare reform legislation, the call for new...
House makes push for NCB
June 30, 2003HME News Staff
WASHINGTON - The House of Representatives introduced legislation June 13 that would phase in competitive bidding for durable medical equipment, respiratory meds and medical supplies in 2005 and 2006.
The legislation closely mirrors the House call for competitive bidding last year, but the new bill departs from its predecessor in several notable directions:
- Congress would eliminate inherent reasonableness in areas subject to competitive bidding. But Congress specifically grants CMS the right to...
DesignAble sails as market sours in Massachusetts
June 30, 2003HME News Staff
WEST BRIDGEWATER, Mass. - An unattractive climate for rehab providers in Massachusetts is working in DesignAble's favor.
With fewer providers willing to commit to the dismal reimbursement market, sales have been climbing at the 16 year-old company, which employs 35. When the company moved into a new facility in May, it stretched its wings in a 20,000-square-foot location that is twice as big as its previous home.
“We're expecting a significant increase in the Massachusetts rehab market,”...
Legal
June 30, 2003HME News Staff
Obtaining an OIG advisory opinion
With Lisa Smith
Q: I'm a supplier interested in entering into a business venture with another healthcare provider; however, in light of the recent OIG Special Advisory Bulletin on contractual joint ventures, I'm worried that the OIG might attack the arrangement even though we intend to structure it conservatively. What can I do to protect myself against a future OIG enforcement action?
A: The best way to ensure that an existing or proposed arrangement won't be...