Archive: November 2006
Home IV director reflects on tenure
November 30, 2006HME News Staff
In her 15 years at the National Home Infusion Association--nearly 10 as its executive director--Lorrie Kaplan has embraced what she calls "the big tent" approach. She has brought players from all corners of the industry together to push for greater awareness and better coverage of infusion services. In March 2007, Kaplan will resign from NHIA. HME News spoke with her recently about NHIA's achievements during her tenure, as well as what the future holds for the infusion industry.
HME News: What are...
Advertising assistance poses risks, OIG warns
November 30, 2006HME News Staff
WASHINGTON - The OIG sent a shiver through the industry in October when it issued an advisory opinion that questioned the legality of the advertising assistance that some manufacturers offer providers. The opinion also irked a number of industry watchers who criticized the OIG for sticking its nose where it doesn't belong--in the free market.
"The purpose of sales is to get sales, to induce people to buy your stuff," said healthcare attorney Ann Berriman. "They are saying that any activity in health...
Florida limits O2 licenses
November 30, 2006HME News Staff
TALLAHASSEE, Fla. - Licenses to provide home oxygen therapy in Florida have become harder and harder to come by, a healthcare attorney said recently.
The state's board of pharmacy has denied dozens of applications in recent months, says Javier Talamo of the Law Offices of Kravitz & Talamo in Miami. The reason, according to the board: The applicants lack the experience needed to provide oxygen, and therefore, pose a danger to the public.
"How are they supposed to get experience if they need licenses...
HMEs embrace home health
November 30, 2006HME News Staff
Rumor has it that several well-known players in the HME industry are "feverishly" looking to buy their way into the HHA industry. The main reason: While many HME companies have lost ground due to respiratory and rehab reimbursement cuts, HHA companies, overall, have gained momentum.
The rumor doesn't surprise M&A firms like The Braff Group. While the Pittsburgh, Pa.-based firm has always covered both industries, it recently decided to "throw more resources at the HHA industry," said Bob Leonard,...
Provider celebrates decade of service
November 30, 2006HME News Staff
NIAGARA FALLS, N.Y. - In upstate New York, where economic development is big news, Health System Services is making headlines.
The company celebrated its 10-year anniversary Oct. 18 at its new headquarters.
The family-owned company began as a supplier of HME and billing services to long-term care facilities and hospitals before branching into the retail market in 2001.
Expanding its presence made sense because HHS was already handling a lot of product, said Doug Mooradian, account executive.
"It's...
O2 provider takes to the open road
November 30, 2006HME News Staff
Monty Lankford worried he was sticking his neck out when he spoke up at Medtrade West last March about the importance of HMEs banding together. What he found was a group of "sheep without a shepherd," so to speak. Lankford, president/CEO of Franklin, Tenn.-based TLC Medical, says his first love is politics. He planned to hit the road after the November elections on his own personal campaign to rally the troops. Lankford spoke with HME News recently about his goal to visit every provider in Tennessee--for...
Medicaid fraud program takes shape
November 30, 2006HME News Staff
WASHINGTON - The director of the Medicaid Integrity Program, which has been charged with Medicaid reform, said the program must operate in a flexible manner in order to fulfill its mission.
"I learned early on that criminals are much more nimble than the government," said Robb Miller, active director of the Medicaid Integrity Group in an Oct. 26 conference call. "We need to remain as flexible as possible to address emerging issues and be prepared to take on new threats as they develop to the Medicaid...
Think pink
November 30, 2006HME News Staff
During October, women's health providers pulled out all the stops to raise breast cancer awareness--and their business profile.
"A lot of the retailers themselves are survivors and they have a passion for what they do," said Carla Fox, general manager at Marietta, Ga.-based Amoena. "They really get behind National Breast Cancer Awareness Month and do a lot of promotions in their store."
Amoena creates a new pin every year that providers can sell or use as giveaways. A percentage of sales goes to...
Legal
November 30, 2006HME News Staff
Q. Medicare recently refused to pay a claim we filed, saying the equipment was not medically necessary. Why are we held liable when we relied on the opinion of the treating physician?
A. Section 1879 of the Social Security Act includes a limitation of liability provision to protect providers who "did not know, and could not reasonably have been expected to know, that payment would not be made" for items or services that have been furnished to a beneficiary. While this law appears to support the notion...
CMS makes concessions
November 30, 2006HME News Staff
WASHINGTON - Providers breathed a small sigh of relief last month, when CMS further revised its coverage criteria for power mobility devices to address what the industry believed were two big flaws.
After discussions with stakeholders, CMS dropped the "stand-and-pivot transfer" requirement for complex PMDs. The agency also expanded the number of PMDs that are eligible for advance determination for Medicare coverage (ADMC).
"(The revised coverage criteria) isn't perfect, but, by and large, it's a...