Archive: June 2010
PECOS update: This could be big
June 30, 2010Mike Moran
John Shirvinsky, the executive director of the Pennsylvania Association of Medical Suppliers (PAMS) sent me this email a few minutes ago. This is such important information that I asked John if I could share his email and he said yes. So here it is:
I just received a call from the PA Medical Society telling me that they are receiving calls from physicians who are being advised by long term care facilities, pharmacies and HME providers that effective July 6, 2010, they will no longer accept prescriptions...
CMS announces winning bid amounts
June 30, 2010HME News Staff
BALTIMORE - CMS announced today that a competitive bidding program scheduled to kick off Jan. 1, 2011, in nine cities will slash reimbursement for certain durable medical equipment by, on average, 32%.
The agency touted significant average savings for frequently used DME like oxygen concentrators ($173.17 to $116.16 per month, on average), semi-electric hospital beds ($127.12 to $80.35) and diabetic supplies ($75.32 to $33.44).
CMS stated that small suppliers, those with gross revenues of $3.5...
Providers on ZPIC audits: 'We will stand with Richard'
June 30, 2010Liz Beaulieu, Editor
After we ran this story about Richard Lamb in our HME NewsWire this week, I got a handful of e-mails from anxious and angry providers who say they're going through the same thing. They're not quite closing their doors due to ZPIC audits, but they're wounded and limping in that direction.
Here's what Jeff Brast from Special Care Home Oxygen had to say:
We went through one of these audits at the beginning of the year and did not get paid for about eight weeks. We are still trying...
Mississippi, Alabama, Tennessee, W. Virginia, Louisiana, Oklahoma, Kentucky, Arkansas and S. Carolina
June 30, 2010Theresa Flaherty, Managing Editor
What do all these states have in common (besides being Southern)? They are the current fattest states in the nation, with more than 30% of adults weighing in as obese. Mississippi, a frequent flyer on this list, tops it off at 33.8%. Are y'all trying for 40%?
Maine, where we live, isn't too much better, tied with Arizona at number 29 with a rate of 25.8% (ayuh). Sadly, only one state has less than 1/5 of its citizens classified as obese. Colorado, at 19.1%.
All this is included in the report, “F...
Breaking news
June 29, 2010HME News Staff
BALTIMORE - CMS officials told members of its Program Advisory and Oversight Committee (PAOC) this morning that it plans to announce winning bid amounts for Round 1.2 of competitive bidding Thursday afternoon.
A PAOC member told HME News: "Tomorrow afternoon announcement of single payment amounts (SPAs) will happen via typical outreach materials: CBIC and CMS Web sites and list servs."
The member also wrote: "Tomorrow afternoon winning bidders will get an e-mail telling them to expect a Federal...
With diabetes, it's all in the delivery
June 29, 2010Theresa Flaherty, Managing Editor
This headline was in my inbox this morning: "Got diabetes? Do these things or you may go blind." Well, thanks, that's helpful. I hadn't heard a million times already that I need to control my blood sugar and eat well.
I had planned to blog about the above-mentioned when actual diabetes DME industry news started rolling in today. CMS has been a busy little agency, if you read the Federal Register last Friday (you know you didn't).
CMS published a proposed reg, open for public comment, that would exempt...
Are you one of the 21?
June 28, 2010HME News Staff
BALTIMORE - CMS late last week released a 2011 Proposed Medicare Physician Payment Rule that lists the 21 additional areas to be included in Round 2 of national competitive bidding.
They are, courtesy of Cara Bachenheimer, senior vice president of government relations at Invacare:
Philadelphia-Camden-Wilmington, PA, NJ, DE, MD
Washington-Arlington-Alexandria, DC, VA, MD, WV
Boston-Cambridge-Quincy, MA-NH
Phoenix-Mesa-Scottsdale, AZ
Seattle-Tacoma-Bellevue, WA
St. Louis, MO-IL
Baltimore-Towson,...
'I am so happy I could cry'
June 28, 2010Liz Beaulieu, Editor
In the July issue, I wrote a story about how the New Hampshire Medicaid program had moved to a cost-plus 10% instead of a cost plus 30% method of paying for certain home medical equipment. The changes was particularly difficult for complex rehab providers. Jan Soderquist, CEO of Rehab Equipment Associates in Manchester, said of providing gait trainers under the payment rules, which the state put in place April 1:
"You'd have to be a mail order provider to be able to do these products at...
Wall Street loves Lincare's chances under competitive bidding
June 25, 2010Mike Moran
A lot of big time Wall Street investors and hedge fund managers think that competitive bidding is going to be very, very good to Lincare. That's because, they say, Lincare has the economies of scale that will help it operate profitably once competitive bidding slashes Medicare reimbursement to the bone.
Sounds a lot like what the industry has been saying all along: Competitive bidding will benefit Lincare and other national companies that have the scale and resources to weather the reimbursement...
PECOS: What a long and strange trip it's been
June 25, 2010Liz Beaulieu, Editor
When we reported in late May that, per an interim final rule published that month, physicians must enroll in the Provider Enrollment, Chair and Ownership System (PECOS) by July 6, not Jan. 3, we were inundated with e-mails and phone calls.
This can't be, providers said!
Because we based our initial story on an Open Door Forum, providers, justifiably, wanted to read the news somewhere other than HME News. Here's the interim final rule published in the Federal Register, and note this paragraph (bold...