Archive: July 2003
A state of denial
July 31, 2003HME News Staff
SAN CARLOS, Calif. - Daryl Bowman can't figure it out.
Over the past few months, CMS has rejected a handful of claims and recouped from him about $2,000. It seems Bowman, who owns Bowman Medical in San Carlos, Calif., billed Medicare for some capped-rental items even though his patients had entered a skilled nursing facility (SNF).
That's a no-no.
Medicare doesn't want to pay twice for the same item, and as part of their reimbursement, SNFs provide most capped-rental items. (Technically, a provider...
OIG: Most ready for HIPAA
July 31, 2003HME News Staff
WASHINGTON - An OIG survey released last month found that 94% of Medicare Part B providers expect to meet the Oct. 16 deadline for implementing the HIPAA electronic transaction standards and code sets.
The survey, conducted between Dec. 2002 and Jan. 2003, evaluated the responses of 150 Part B providers, including 12 DME companies and 107 physicians. Almost all of the surveyed providers had submitted a compliance extension form, which gave them until October to achieve compliance.
At the time of...
Politics
July 31, 2003HME News Staff
The 2004 election and NCB for DME
With KAY COX
Q. What role does the 2004 election play in the Medicare debate currently going on in Congress? What does this mean for DME competitive bidding?
A. Medicare reform is an issue that brings out the most fundamental differences in the two parties, and while we enjoyed a short-lived bipartisan spirit with the Senate passage of S. 1, debate over Medicare legislation has quickly taken on a much more partisan tone as the 2004 election season has drawn closer....
Require accreditation? No Way!
July 31, 2003HME News Staff
Although accreditation doesn't come
cheap, the benefits realized through more efficient operation boost business and, partly, off-set those start-up costs.
Since our company became accredited by JCAHO in 1992, we've become more patient oriented. Our human resources (HR) department documents employee training and qualifications. Our patient file consistently improves. We comply better with government regulatory agencies and have a policy in place that enforces compliance with industry standards....
AAH Pres. Kay Cox lobbies for quality patient care
July 31, 2003HME News Staff
Government skepticism about the integrity of home medical equipment provision has historically been the impetus for Medicare reimbursement cuts and coverage cutbacks. And quality patient care isn't the first image legislators and agency administrators usually have of HME providers.
That mentality must change, says AAHomecare President Kay Cox.
As the debate over national competitive bidding reaches a fever pitch, Cox has been doing everything in her power to bury that perception. The key to winning...
Billing
July 31, 2003HME News Staff
Enteral struggles
With KAREN MOORE
Q. Region A is denying our enteral claims for overlapping dates of service when we deliver and bill using a start-date that is before the end-date of the previous claim. The overlapping dates of service occur frequently as enteral supplies/formula are delivered before the patient runs out. How can I resolve this billing issue and be compliant with proof of delivery requirements?
A. The problem you describe is unique to Region A, and CMS is working with the carrier...
Transitions
July 31, 2003HME News Staff
Association
Sue Mairena, who has more than 20 years of financial and managerial experience in a variety of industries, has been named chief operating officer (COO) of the American Association for Homecare (AAHomecare). As COO, Mairena will manage AAHomecare's day-to-day operations, human resources, accounting, monthly financials and yearly budget. In addition, she will evaluate the association's existing structure, such as its IT systems and accounting policies and procedures. Mairena most recently...
OIG: CMS missed $815M in DME savings
July 31, 2003HME News Staff
WASHINGTON - The OIG's 2003 Redbook, which was posted on June 2, suggests that CMS could have saved more than $815 million in the first half of the fiscal year, had it acted on the OIG's recommendations for DME.
The OIG posts the Redbook twice a year to highlight which of the office's cost-saving recommendations CMS has not fully implemented.
The largest missed opportunity for cost savings was improving medical reviews for home oxygen therapy ($268 million). Nearly one-quarter of the oxygen certificates...
JCAHO rewrites the book
July 31, 2003HME News Staff
OAKBROOK TERRACE, Ill. - Several months after JCAHO announced far-reaching changes to the way providers achieve accreditation, the organization is condensing its standards in an effort to reduce paperwork and renew focus on the way providers deliver patient care.
Starting Jan. 1, 2004, all providers - including HMEs - will comply with standards that are both fewer in number and less specific than those currently on the books. Although JCAHO cannot quantify the reduction for HMEs, hospitals will...
Rx association feels need to police itself
July 31, 2003HME News Staff
ALEXANDRIA, Va. - The National Community Pharmacists Association (NCPA) has developed a 40-hour program that trains pharmacists and allied health professionals, including DMEs, on how to properly fit therapeutic footwear.
The new course is in response to a CMS initiative to clarify ambiguous language regarding who can provide therapeutic footwear. Some fear the initiative could limit the provision of therapeutic footwear to podiatrists, pedorthists, orthotists and prosthetists. Currently, much of...