Archive: August 2012
In brief: Re-supply guidance released, NRRTS pushes bill
August 31, 2012HME News Staff
BALTIMORE - As promised, the four CMS medical directors have released an FAQ on re-supplies. CMS announced in a June bulletin that items that need periodic replacement, like CPAP supplies, must be non-functioning. That led to numerous questions from providers about the policy and how to comply with it. The 15-question document attempts to explain the policy and answer questions like, why the documentation guidelines are so vague (to give suppliers discretion) and what "non-functional" means (the...
'Pieces coming together' for HST
August 31, 2012Liz Beaulieu, Editor
YARMOUTH, Maine - 2012 could end up being a watershed year for home sleep testing (HST), say vendors that have large stakes in the market.In the past year, several private payers like Humana and Wellpoint/Anthem have begun requiring preauthorizations for in-lab sleep tests, also know as polysomnography (PSG)—a move that has made home sleep tests more attractive to physicians, vendors say.“We estimate that, this fall, 65% to 70% of all covered lives under commercial plans will be under...
MPP: HME industry ready to 'rock and roll'
August 31, 2012Theresa Flaherty, Managing Editor
WASHINGTON - Expect to see Rep. Tom Price, R-Ga., introduce a bill for the market-pricing program (MPP) soon after Congress reconvenes Sept. 10, industry stakeholders say."He's indicated that he wants to move forward with the legislation since the congressional calendar is running short," said Jay Witter, senior director of government affairs for AAHomecare.Price indicated in late August that he was willing to take the lead on MPP, an alternative to the competitive bidding program. The bill is currently...
Full steam ahead for PMD demo
August 31, 2012Elizabeth Deprey
WASHINGTON - Despite protest from HME stakeholders, CMS officials stated during an Open Door Forum Aug. 29 that a new power mobility demonstration project would kick off as scheduled Sept. 1.
AAHomecare on Aug. 27 called for CMS to start the demo 30 days after it released a final version of instructions. CMS released those instructions during the forum.
“We're very excited (to get) started,” said Melanie Combs-Dyer, deputy director of the Provider Compliance Group at CMS.
The...
What happens to retail diabetes supplies under 15% cut?
August 31, 2012Theresa Flaherty, Managing Editor
YARMOUTH, Maine - There's no official timetable, but it's unlikely CMS will drag its feet on pushing forward with its plan to use inherent reasonableness (IR) to reduce reimbursement for retail diabetes supplies, industry stakeholders say.
"I would expect a proposed rule sooner rather than later because they can implement this more quickly than competitive bidding," said Cara Bachenheimer, senior vice president of government relations for Invacare. "Once you have the proposed rule, then...
The stories you've loved lately
August 31, 2012Elizabeth Deprey
Theresa sized up the hmenews.com views for stories this month and came up with this list of Top 5 Mobility stories:
1. Scooter Store: 'Whatever is going on is not good for our industry'
2. Provide K0005? You'll need an ATP
3. Five-year rule haunts mobility providers
4. PMD demo: CMS may change stance on accessories
5. PMD demo details still up in the air
Four of these stories revolve around CMS and its mobility policies, whether it's shifting K0005 into complex rehab, requiring providers to replace...
National complex rehab conference announced
August 30, 2012HME News Staff
ARLINGTON, Va. - NCART and NRRTS will combine CELA, the National Medicaid Summit and a new CRT Leadership Day into a three-day conference April 30-May 2, 2013, in Arlington, Va.
The National CRT Leadership and Advocacy Conference will allow attendees to save time and resources while participating in complex rehab education, networking and advocacy, organizers say.
The first day will include business presentations and breakout sessions for provider and manufacturer management teams.
The second...
RIP Big Ed
August 30, 2012Theresa Flaherty, Managing Editor
Big Ed died this week.
I just saw him a few weeks ago, well, the back of his head anyway, when I dropped in for a movie date with his granddaughter (Sal, again, my apologies for renting "21 Jump Street").
"THAT YOU THERESA?"
I may have mentioned in a previous blog that Big Ed was a bit hard of hearing.
For the last year his health has declined: heart, kidneys, mobility. Last week, his family and doctors decided it was time to make him comfortable and let nature take its course. Thanks to a dedicated...
Sleep apnea patients don't have to cost more
August 29, 2012Theresa Flaherty, Managing Editor
BALTIMORE - It's time to think about the bigger picture when it comes to treating obstructive sleep apnea, says Ed Grandi, executive director of the American Sleep Apnea Association (ASAA).That's why, this year, the ASAA has named its annual conference "The Economic & Clinical Impact of Sleep Apnea.""There are a lot of conferences out there that just talk theory," said Grandi. "There are solutions out there that work and technologies to address the condition effectively."The event, to be held Oct....
A competitive bidding story in numbers
August 29, 2012HME News Staff
Medicare has finally released utilization records for Round 1 of its bidding program in home medical equipment and it did not take a Freedom of Information Act request or act of Congress to attain the records. Ironically, Medicare has included the 2011 allowable units, with a corresponding list of HCPCS codes, as part of the Round 1 recompete worksheets.
AMEPA has compared some of the most common codes to the 2008 utilization records published in the Round 1 rebid worksheets and it is easy to understand...