Archive: July 2004
Who else might deliver neb-meds?
July 31, 2004HME News Staff
YARMOUTH, Maine - As the uncertainty over respiratory medication reimbursement persists and more companies threaten to quit the product line, some industry watchers suggest that retail pharmacies could step up as the new distribution channel.
“[The ASP] could leave a huge gap,” said Bill Bonello, a Wachovia Securities analyst. “It certainly leaves a gap in terms of patients being able to get their medication in a way they are accustomed to getting them, which is delivered to the...
Sunrise loses a standard-bearer in Ken Yannerella
July 31, 2004HME News Staff
LONGMONT, Colo. - Ken Yannerella, a mainstay in sales at Sunrise Medical and Guardian Products since 1978, died of a heart attack in his home June 10. He was in his early fifties.
Yannerella's untimely death is the latest in a string of similar misfortunes for Sunrise Medical. Two other executives - Harvey Diedrich, the company's vice president of marketing, and Alan Small, vice president of quality engineering - also passed away last year.
At Sunrise, Yannerella shared responsibilities as senior...
No filibuster
July 31, 2004HME News Staff
I am writing in response to your article published in the June issue of HME News, “Davey and Goliath: Doc slings doubt at sleep academy.” The article suggests that the position of the American Academy of Sleep Medicine (AASM), the American Thoracic Society and the American College of Chest Physicians, as represented in the position statements published last year, represents a “filibuster” against the use of portable monitoring. This view is both inaccurate and, I believe,...
Study: CPAP could reduce car crashes
July 31, 2004HME News Staff
WESTCHESTER, Ill. - Nearly 1,000 deaths annually could be avoided if drivers suffering from obstructive sleep apnea were treated with CPAP, according to the authors of an article published in the May issue of the journal Sleep.
The study reports that OSA-related car crashes cost the country $15.9 billion in 2000. If 70% of those drivers had been compliant with their CPAP therapy - at a cost of $3.18 billion annually - the study's authors conclude that Americans would save $11 billion.
The study...
CMHM: ‘We have to grow - we don’t have a choice’
July 31, 2004HME News Staff
BOLIVAR, Mo. - Deep reimbursement cuts in what Medicare pays for respiratory drugs and possibly for home oxygen equipment may rattle some providers, but not Citizens Memorial Home Medical Equipment.
The hospital-owned company put the pedal to the metal in June, opening a new 2,000-square-foot HME location in Buffalo, about 25 miles east of Bolivar, and a respiratory pharmacy in Bolivar. Later this summer or fall, Citizens Memorial plans to open another HME location in Stockton, 30 miles west of...
Doctors: Prepare to go face-to-face with patients
July 31, 2004HME News Staff
WASHINGTON - Â Details for a new Medicare regulation that requires doctors to perform a face-to-face evaluation of a patient before prescribing a power wheelchair should be released any day now, say industry watchers.
The Medicare Prescription Drug Act, which President Bush signed into law in December, mandated the face-to-face evaluation as a way to reduce fraud and unnecessary utilization. The law didn't, however, spell out particulars about the face-to-face meeting. For example: what documentation...
Paperwork burden beating providers to a pulp
July 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,...
‘In the home’ takes center stage
July 31, 2004HME News Staff
WASHINGTON - Clinicians, the industry and many in disability groups urged CMS in June to consider revising wheelchair coverage requirements they say “tie their hands” when trying to treat beneficiaries.
The contentious “in the home” and “bed or chair confined” requirements for power wheelchair coverage took center stage during a four-hour special open door forum on CMS's effort to revise the clinical coverage criteria for power wheelchairs and scooters.
“The...
Power Ox gets thumbs up, yet skeptics linger
July 31, 2004HME News Staff
BIRMINGHAM, Mich. - Like ducks in a shooting gallery, questions about the viability of the Power Ox oximetry testing system keep coming, and Power Ox keeps knocking them down, usually with a letter from John Warren, a health insurance specialist at CMS.
The most recent query, voiced by Region A Medical Director Dr. Paul Hughes at a New England Medical Equipment Dealers meeting in June, was this: “When I realize that the [Power Ox] lab only receives the information, I have to wonder if they...
More than CMN
July 31, 2004HME News Staff
Editor, HME News
Applaud U.S. District Court Judge Lawrence Karlton for thrusting the CMN problem to center-stage. But don't get too giddy about a world in which medical necessity is entirely contained within the existing CMN, or even a revision of the current CMN.
Karlton ruled that CMS can't require anything other than the CMN to justify medical necessity. In other words, don't ask for chart notes or progress notes written by a physician.
Worth repeating here is this caveat from one government...