Archive: 2011
OIG: CMS takes too long to identify problems
December 29, 2011HME News Staff
WASHINGTON - CMS revoked the billing privileges of 21% of high- and medium-risk newly enrolled HME providers, but not before the agency reimbursed them $2.8 million and $70,582, respectively, according to a new report from the Office of Inspector General (OIG).
"Some suppliers in our sample received significant Medicare reimbursement before CMS's contractor conducted its first post-enrollment site visits to the suppliers' business locations and CMS took enforcement action," the report states.
The...
2012, here we come
December 29, 2011Liz Beaulieu, Editor
YARMOUTH, Maine - HME providers have set business goals to do everything from increasing cash sales to reducing expenses to fighting audits in 2012.
Provider Johnny Carroll says he plans to increase cash sales to 65% of his overall business in 2012. Cash sales topped out at 26% in 2009 and 51% in 2010.
"We plan to open a new branch with a retail concept and a large display room with good, better, best selection," said Carroll, director of operations and marketing for the Vidalia, Ga.-based Alliance...
In brief: CMS modifies audit process, associations get connected
December 29, 2011HME News Staff
BALTIMORE - CMS will focus its audits for home oxygen therapy on more recent claims, AAHomecare reported last week. The agency has decided to make the change after meetings with the association and other stakeholder organizations. CMS's DME MACs will now focus on auditing claims with initial dates of service within the last few months, rather than the last few years. Additionally, when the DME MACs do audit older claims, they will give providers 45 days instead of 30 days to respond. CMS told AAHomecare...
CMS dumps cushions from Round 2
December 29, 2011Elizabeth Deprey
WASHINGTON - The complex rehab industry had another reason to celebrate last week when efforts to remove skin protection wheelchair cushions from Round 2 of competitive bidding finally paid off.
Industry efforts to exclude the four codes (E2622, E2623, E2624 and E2625) began even before Round 1 was implemented Jan. 1, 2011, and CMS agreed to make the change Dec. 28.
"The position that we've taken all along is that you shouldn't bid an under-defined code," said Dave McCausland, senior vice president...
New ways to make money and new ways to do business
December 29, 2011Liz Beaulieu, Editor
When you're back at work after the New Year, and you're looking for something to take your mind off things for a few minutes while you eat lunch, check out HME News TV.
I just put together the schedule for January and February, and it's a good one. There are ideas for new ways to make money (get into home sleep testing for non-Medicare payers) and new ways to do business (eliminate non-value-added activities and use patients as couriers for documentation).
Of course, it wouldn't be HME News TV without...
Industry gets temporary reprieve from PMD demo
December 29, 2011Elizabeth Deprey
WASHINGTON - Just days before it was set to start, CMS hit the brakes on its power mobility device demonstration project.
CMS on Dec. 29 stated that it will delay the demo, which was set to start Jan. 1, "until further notice" and that it will give the industry at least a 30-day notice before the next start date.
"We worked closely (with CMS) to have them understand the impact that this proposal would have on power mobility providers and patients," said Walt Gorski, vice president of government...
PAOC fades to black
December 29, 2011Theresa Flaherty, Managing Editor
BALTIMORE - The Program Advisory and Oversight Committee (PAOC), quietly disbanded Dec. 31, and committee members had mixed feelings about its legacy.
"I think there could have been much better opportunity between the (home medical equipment) industry and regulators on a program of this magnitude and importance," said Walt Gorski, vice president of government affairs for AAHomecare and PAOC member. "I think many PAOC members felt their hands were tied in making rational recommendations."
The 17-member...
CMS delays PMD, RAC demos
December 28, 2011HME News Staff
BALTIMORE - CMS announced today that it has “delayed until further notice” a new power mobility device (PMD) demonstration that was scheduled to kick off in seven states on Jan. 1.
As part of the first phase of the demo, all PMD claims submitted by providers will be subject to a prepayment review process. In the second phase, scheduled to begin three to nine months later, physicians and practitioners will be subject to a prior authorization process.
“CMS received many comments/suggestions...
FDA negotiations and law firm investigations
December 28, 2011Liz Beaulieu, Editor
Did anyone else notice the flurry of law firms that announced they're investigating Invacare's board of directors following the company's Dec. 8 announcement that it would work with the FDA to negotiate an agreement to address concerns with two facilities?
Said agreement, called a consent decree, could possibly cease certain operations at Invacare's corporate headquarters and wheelchair manufacturing facility in Elyria, Ohio.
At last count, there were at least half a dozen law firms that made such...