Archive: January 2004
Leading HME provider revamps management
January 31, 2004HME News Staff
RAYMOND, N.H. - One of the nation's premiere independent HME providers has revamped its upper management, a move intended to streamline operations, improve efficiencies and prepare the company for growth in a hostile reimbursement environment.
April Mason
“One of the things I recognized over the past nine months was that the structure that brought us to one point in revenue was not going to propel us to the next level,” said Lifeplus President April Mason. “The premise wasn't to...
Women’s buying group adds services
January 31, 2004HME News Staff
OXFORD, Mich. - Recognizing the all-important HME service component, Essentially Women, a niche buying group for women's health products, has been busy adding new services to its recently created strategic partnership membership category.
Separate from the participating vendors' category, the strategic partners offer specialized services to the group's nearly 600 members.
“We want to help our members distinguish themselves, to be a step above the competition,” said Cindy Ciardo, manager...
Billing
January 31, 2004HME News Staff
What's new in PWC claims
With Peggy Walker
Q. Power chairs - What has changed?
A. Basic coverage criteria is the same as it was in 1993, so how did all those fraudulent claims get paid?
The electronic billing system allows claims to be paid with wording from the CMN. This was developed as a way for suppliers to bill without having to send a hard copy.
A person never saw the claim unless there was something that stopped it. That is why the CMN is called a “processing” tool. The system...
Friedman enters brave new world
January 31, 2004HME News Staff
Timing is everything
NEW ORLEANS - As a former hospital executive, Jeff Friedman has learned that part of his job is to “work around whatever reimbursement changes come along.”
Jeff Friedman opened his New Orleans HME, Total Health Solutions, Dec. 8, the same day President Bush signed into law the Medicare Prescription Drug Act.Jeff Friedman opened his New Orleans HME, Total Health Solutions, Dec. 8, the same day President Bush signed into law the Medicare Prescription Drug Act.
That's...
CMS flip flops on 2004 respiratory HCPCS codes
January 31, 2004HME News Staff
WASHINGTON - CMS rolled out an extensive revision to the coding for respiratory drugs in December and then quickly pulled it back.
The new HCPCS code J7621, which went into effect Jan. 1, covers all combinations of albuterol sulfate and ipratropium bromide (namely DuoNeb) administered through a DME,
The original J7621 code announced in December was going to include compounded solutions of the two respiratory drugs as well, however, January's revision said compounds should continue to be billed...
Boomers are threat
January 31, 2004HME News Staff
WASHINGTON - The Congressional Budget Office warned in mid-December that escalating health care costs and aging baby boomers are threatening to overburden future generations with debt and taxes.
“Unless taxation reaches levels that are unprecedented in the United States, current spending policies will probably be financially unsustainable over the next 50 years,” CBO stated in a long-term budget forecast.
The CBO looked at scenarios that forecast total federal spending for Medicare...
Briefs
January 31, 2004HME News Staff
Florida man sentenced in 'mammoth' fraud case
MIAMI - A man convicted of health care fraud and conspiracy will spend the next nine years in prison and the rest of his life repaying the U.S. government $36.5 million he grossed from one of the largest Medicare fraud scams in history, reported the Miami Herald. Alfredo Omar Rodriguez, 38, was sentenced in January after he pleaded guilty to health-care fraud and conspiracy charges in September. Rodriguez masterminded a mammoth operation, overseeing...
'I just hired a top-notch finance person'
January 31, 2004HME News Staff
YARMOUTH, Maine - Providers may be spooked about all the reimbursement cuts for DME included in the Medicare Prescription Drug Act, but few, it seems, are running scared.
“One of the silver linings in this cloud is that it is not coming next week,” said Clark Robichaux, president of Oxy Care Equipment Company in Wilmington, N.C. “It will be spread out over six or seven years, and a lot can happen in that time.”
In addition to adopting a wait-and-see approach, proactive providers...
U.S. health care spending hit $1.6 trillion in 2002
January 31, 2004HME News Staff
BALTIMORE - Health care spending in the United States rose to $1.6 trillion in 2002, up from $1.4 trillion in 2001 and $1.3 trillion in 2000, according to a report issued last month by the Centers for Medicare & Medicaid Services (CMS).
The growth rate of 9.3% for 2002, the latest year for which actual spending figures are available, compared to 8.5% in 2001 and marked the 6th consecutive year in which health spending grew at an accelerated rate.
Health expenditures per person averaged $5,440 in...
Medicare Drug Act, aka ‘A Fleecing of the DME Industry’
January 31, 2004HME News Staff
Stewart Pace
The January issue of HME News contained a considerable amount of information and commentary regarding the recently passed Medicare Prescription Drug Act. The remaining questions, after the fact seemed to be: ”How did this happen?” “Where do we go from here?” While I can agree with most of the industry pundits as to many of the root causes, I must state that the degree to which we find ourselves mired in this quagmire was an exacerbation of our industry's propensity...