Archive: February 2013

MINNEAPOLIS - A federal judge may have granted the government's request to dismiss a competitive bidding-related lawsuit filed against CMS by a specialty HME provider, but that doesn't mean he thinks justice was served. “This is a sad day for those who believe that when a judge adheres, even-handedly, to his or her oath of office, justice will prevail and the public interest will be served,” U.S. District Judge Donovan Frank wrote in a memorandum. Shoreview, Minn.-based...

WASHINGTON - A prepayment review of power wheelchair claims processed in Jurisdiction B resulted in an 80% error rate, according to National Government Services (NSG), the DME MAC there. Of 1,022 claims processed from Oct. 1 2012�-Dec. 31, 2012, 122 were paid in full, while the remaining claims were completely or partially denied, according to the review. The most common reasons for denials were: Local Coverage Determination (LCD) criteria not met; face-to-face examination with a physician not...

WASHINGTON - A prepayment review of intermittent catheterization kits processed in Jurisdiction B resulted in an 85.6% error rate, according to National Government Services (NGS), the DME MAC there. Of 257 claims processed from Sept. 1-Dec. 31, 2012, 220 were denied, according to the review. The most frequent denial—“failure to meet one or more of the required coverage criteria”—accounted for 37% of denied claims. Sixty-one of the claims were denied because the requested documentation...

NEW BRAUNFELS, Texas - A week after federal and state agencies raided its headquarters, The Scooter Store released a statement saying it is complying with the investigation.“We respect the government's investigation and will continue to work with investigators to make sure they have access to the information they need to conclude their activities,” stated Marty Landon, CEO of The Scooter Store.Neither The Scooter Store nor the FBI has stated the reason for the investigation. When asked...

WASHINGTON - A pair of lawmakers have asked the Government Accountability Office (GAO) to study the impact of a 72% cut, on average, to reimbursement set to go into effect July 1 as part of a national mail order program for diabetes supplies. In a letter, Reps. Diana DeGette, D-Colo., and Ed Whitfield, R-Ky., co-chairs of the Congressional Diabetes Caucus, stated they are “concerned about what it will mean for beneficiaries' access to diabetes testing supplies (DTS) and their ability to...

FORT MYERS, Fla. - Signature Sleep Services (d/b/a Sleep 960) and C-PAP Horizon Project have agreed to integrate their sleep products and services, and combine their marketing efforts, according to a press release. Sleep960 provides diagnostic and therapy products, consultation and management services, and PSG educational courses. C-PAP Horizon provides technology and business services for HME providers who specialize in sleep therapy. Previously, some products did not share data and were not designed...

YARMOUTH, Maine - Providers barely had time to absorb the news that Medicare will pay for all diabetes supplies at the mail-order rate, when those rates were announced, far below the industry's low expectations.The double whammy left many wondering whether or not any small providers would be able to stay in the Medicare game. Provider Mark Gielniak submitted a bid knowing it was a long shot (he didn't get a contract offer), but he banked on offsetting any losses by beefing up other aspects of his...

In too many HME businesses, there's a lack of leadership that's leaving them ill-prepared for the minefield of audits and competitive bidding. That's the central challenge Miriam Lieber sees in her consulting work with HME providers, and she'll share her lessons learned with Medtrade Spring attendees. HME News: How do you recommend HME providers improve their culture of leadership? Miriam Lieber: Find ways to create an environment of leadership and accountability and measure...

Louis Feuer has been presenting at Medtrade since 1987, one of the longest tenured speakers in the industry. He's seen it all over the years, and thinks HME providers can learn a lot by the example of Walt Disney and the Disney business model. Feuer will bring his Mickey Mouse ears and gloves to Medtrade Spring, along with his Disney-inspired lessons. HME News: Why Disney? Louis Feuer: There are very few organizations worldwide that focus on customer service like Disney. Disney created...

Dennis Clark got his start in prosthetics working as a janitor and technician at his father's O&P business in 1968 and obtained his own credentials in 1980. These days, he's a partner in Clark & Associates Prosthetics and Orthotics in Cedar Rapids, Iowa. Clark spoke with HME News recently about how the nature of the O&P industry has changed, and why he's never wanted to do anything else.HME News: How has providing O&P changed in recent years?Dennis Clark: We've been protected to a certain extent...