Archive: May 2004
Paperwork burden beating providers to a pulp
May 31, 2004HME News Staff
HME providers have been slow to embrace the paperless initiative being championed by software companies, administrative specialists and financial advisors so far, but the movement may finally gain momentum with passage of the Medicare Prescription Drug Act's new reimbursement-slashing mandates.
While providers may hope that Medicare reform's intent to pattern Medicare Part B after the Federal Employee Health Benefit Plan system will eliminate certificates of medical necessity and other documentation,...
CMS initiatives give ‘stamp of approval’ to DSM
May 31, 2004HME News Staff
WASHINGTON - CMS in April began accepting applications for the Voluntary Chronic Care Improvement Program, a new initiative aimed at bettering the quality of life for people living with chronic illnesses.
The initial program will reach 150,000 to 300,000 beneficiaries in traditional fee-for-service Medicare and will focus on implementing programs for patients with congestive heart failure, complex diabetes and COPD.
Contracts will be awarded in each of the test areas, and the flexible model of...
Texas rehab providers strike out alone
May 31, 2004HME News Staff
HOUSTON, Texas - A rash of new associations and coalitions - including RAMP and NCART - have popped onto the national DME stage. Now, a new association in Texas has joined the act, but with a focus on state rehab issues and education.
The Greater Texas Rehab Providers' Council (TXRPC) launched in April as a way for the state's high-end rehab providers to address the issues and challenges the industry faces there. The organization evolved out of a Medical Equipment Suppliers Association (MESA) work...
Providers consider NCB Public Enemy No. 1
May 31, 2004HME News Staff
YARMOUTH - While a number of legislative and regulatory changes are jockeying for HME industry attention, respondents to last month's HME News Poll say nothing will sink the industry faster than national competitive bidding.
“The first round of competitive bidding is only the tip of the iceberg, and we all remember what happened to the Titanic!” said Leah Kennedy of Houston, Texas.
Competitive bidding dominated the concerns of 44% of 121 respondents who said it should rise to the top...
Briefs
May 31, 2004HME News Staff
Investigators key in on 155 potential schemes
WASHINGTON - The DMERCs have referred 155 potential cases of power wheelchair fraud to law enforcement since the eruption of the Wheeler Dealer scandal in Houston last September, according to CMS testimony at the Senate Finance Committee hearing April 28. About 10% of these cases have been closed already, and federal officials have recovered about $84 million in fraudulent claims since that time. The DMERCs also are looking into an additional 77 cases...
Setting sail into a stormy sea of change
May 31, 2004HME News Staff
The Medicare Prescription Drug Act has launched the HME provider into uncertain seas. Not since, the Balanced Budget Amendment of 1997 and the Six Point Plan of 1989 have HMEs faced such momentous change to their business. If the legislated changes are implemented, the cheese will not be exhausted, but it will be moved. The challenge? A new route to respectable profitability. Before reporting the following suite of stories, we asked HME providers for new opportunities and new ways to cut costs. Here...
Apria investigation still on
May 31, 2004HME News Staff
COSTA MESA, Calif. - Government officials still are investigating a claim that Apria fraudulently over billed Medicare and other federal program for millions of dollars - a claim, that if true, could result in $9 billion in penalties, Apria stated in a March filing with the Securities and Exchange Commission.
The investigation stems from a whistleblower lawsuit.
Apria has acknowledged that there may be errors and omissions in supporting documentation affecting some of the claims in question. However,...
Industry awaits DME standards committee
May 31, 2004HME News Staff
WASHINGTON - Look for an advisory committee to help CMS develop quality standards for DME to be assembled later this year, possibly by late summer.
Following development of the standards, CMS will incorporate them into a mandatory accreditation program for DME. Members of the standards committee could include providers and beneficiaries and other stakeholders in the Medicare program, say industry watchers.
“We have given them the association's name as a resource, and they have indicated that...
NSC backs off draconian enforcement
May 31, 2004HME News Staff
WASHINGTON, D.C. - Industry complaints that the National Supplier Clearinghouse has adopted a draconian or unreasonable approach to enforcing the 21 supplier standards have not fallen on deaf ears.
“We've heard supplier concerns about some of the standards and the site visit process, and we are working to address them without endangering the trust fund by lowering the bar too much,” a CMS source told HME News last month. “I think we have taken some reasonable steps.”
Typically,...
NYMEP turns up the heat
May 31, 2004HME News Staff
ALBANY, N.Y. - The New York Medical Equipment Providers Association in April hired its first full-time staff member, Executive Director Matthew Guilbault.
“We chose to move into a staff model because we felt with all the things coming down the pike and all that is happening as far as cuts in reimbursement that a lot of the issues needed a little more attention,” said NYMEP President Gloria Murray. “We wanted someone to be working for us on a constant basis all week long.”
Negri...