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May 23, 2011 Volume 17, Number 20

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Table of Contents
- Bid Briefing Redux—Not: Opponents to Tell Their Side
- Tornado Recovery Continues in Hard-Hit Alabama
- ACOs Spell 'Opportunity' for HMEs
- Docs Still Looking for Their Own Medicare Fix
- New Oxygen Policy Synchronizes RULs
- Don’t Let Debt Debate Distract Lawmakers from Bidding Repeal Effort
- Open Door on Wednesday; CareCentrix Moves into Florida; More News in Brief

For more industry news, features and highlights from our latest issue, please visit our Web site at www.homecaremag.com.

- Headline News
Bid Briefing Redux—Not: Opponents to Tell Their Side
WASHINGTON—Former North Carolina Rep. Nancy Johnson and Professor Peter Cramton will present a congressional staff briefing on competitive bidding tomorrow, and industry stakeholders hope it will reveal the picture they see of the program’s devastating effects.

At a May 10 briefing on Round 1, CMS officials told congressional staffers the program was going fine and that the agency had received “virtually no complaints”—only 43 out of 54,000 calls.

But “unlike last week's briefing to members of Congress by Medicare, this meeting will be from the point of view of a noted economist/bidding design expert, HME providers and an oxygen patient,” according to a message from the Accredited Medical Equipment Providers of America.

Called “Competitive Bidding Congressional Update—What You Need to Know,” the briefing will be introduced by Rep. Sue Myrick, R-N.C. In addition to Johnson and Cramton, the University of Maryland economist who has repeatedly warned that CMS’ bidding design is “fatally flawed,” panelists invited to speak include:

• Tom Milam, a member of the Program Advisory and Oversight Committee and former COO of AmMed Direct;
• Barbara Rogers, PAOC member, president/CEO of the National Emphysema and COPD Association and an oxygen user;
• Paul Gabos, CFO of Lincare and Round 1 rebid winner; and
• Rob Brant, owner of City Medical Services, North Miami Beach, Fla., also a Round 1 rebid winner.

Brant, president of AMEPA, said he is looking forward to relating his experiences; he closed his company at the end of April even though he won a contract for oxygen in the Miami competitive bidding area.

“This is an opportunity as a bid winner and somebody who closed their business [to tell legislators] that Medicare is not being truthful with Congress,” Brant said Friday. “They are getting information from CMS and, in their minds, it is accurate and truthful and the program is working well and saving money, so let’s move forward.

“The truth of the matter is, I had to close my business because I only won one contract. I couldn’t do hospital beds, CPAP, enteral supplies, diabetic supplies—that’s why I had to close my business.”

Speaking in April at Cramton’s mock auction—intended, the economist said, to show how a “well run” auction would work—Lincare's Gabos questioned the Round 1 process and prices. Of the 73 bids it entered, he noted, Lincare won only two.

“Needless to say, we were shocked when we saw the results … prices down 25 to 40 percent in some of these categories,” Gabos said. “You know, when we see prices down 25 to 40 percent and then understanding that those prices are based on median prices so that half of the winning bidders actually bid less than that, you really start to question the integrity of the bid process.”

A number of bid winners were looking to get out, he added.

“We have been inundated with requests by winning contract providers to purchase their companies,” Gabos said. “It’s very well known that Lincare, a very well-capitalized company, did not win a significant number of contracts. I can tell you that we have confidential information from over 30 companies that have won bids, and we've been contacted by at least twice as many as that.

“I can tell you that these companies are broke … they were broke before Jan. 1, and they're even more broke now,” he continued. “Some of these companies are not able to take new patients until an existing patient comes off service because they can't buy a new piece of equipment.”

Brant said he is well aware of the difficulty some beneficiaries have had in finding new providers.

“CMS says it has had 54,000 inquiries and only 43 complaints,” he said. “Well, I have several hundred patients who are still looking for new providers since we closed our doors in April and they can’t find one. I am sure they are part of the 54,000 patients making ‘inquiries.’ When this program expands in Round 2, proportionally they are going to have over a million ‘inquiries’ and they won’t be able to handle it.”

Brant said he is hopeful that his comments and those of the other panelists will move legislators to back H.R. 1041. Introduced in March, the competitive bidding repeal bill currently has 98 cosponsors in the House but no companion bill in the Senate.

Commented Seth Johnson, vice president of government affairs for Pride Mobility Corp., “I hope the … briefing will continue to raise awareness of the fundamental flaws with the Medicare bidding program and compel Congress to act in a more direct manner.”


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Tornado Recovery Continues in Hard-Hit Alabama
CORDOVA, Ala.—Almost a month after a string of storms devastated wide swaths of the southern United States, Ken Glover, RPH, quietly opened the doors of a large trailer and filled prescriptions for grateful patients. The sturdy 100-year-old building that once housed Glover Drug in Cordova, Ala., was no more, heavily damaged by two tornadoes on April 27.

In addition to the operation in Cordova (population 2,400), Glover has two other pharmacy/home care locations in Jasper, Ala., and one in Dora. All four sites had power knocked out after the first storm hit at the crack of dawn, essentially rendering backup protocols useless.

“We have a plan in place for disasters such as fires, tornadoes and floods,” lamented Glover. “But this plan did not encompass total destruction within a 30- to 40-mile radius, with all of our locations knocked out at one time.”

After learning of the first tornado, Glover sent a crew to Cordova to check the damage. When he heard about the destruction, he went to the store to retrieve what he could.

“There were leaks, roof damage and the window was blown out,” said Glover. “All the buildings around us were crumbled. I was able to get our computer system, prescription records and the controlled drugs because we did not know what kind of security would be available.”

After securing the window with plywood, Glover initially thought he had a “fixable situation.” Little did he know another tornado would strike the same location later that day. After returning to his Dora store, Glover sent his crew home as the weather deteriorated. He visited a nursing home under heavy rains to deliver medicine to a patient, then wound his way back to Cordova to retrieve a printer.

On the way back to his car at about 4:40 p.m., the alarm warning went off. “Another tornado had been spotted and was on a direct path to where I was,” reported Glover. “I jumped in my car and drove about eight miles home. I walked out on my back porch with my daughter, and we watched the tornado as it came over the city of Cordova.”

Upon returning to the site after the second tornado, Glover realized that the “fixable situation” wasn’t one.

“Total destruction,” said Glover. “I have never seen anything like it in my whole life. Ten buildings sitting right where I had parked my car at 4:40 were gone. At that point, probably three-quarters of Alabama was without power.”

Running off a generator at the Dora location, Glover Drug was the only drug store for miles, and people were coming from everywhere for help, Glover said. Despite the lack of regular phones and spotty cell coverage, Jennifer Weathers, RN, the provider’s DMEPOS coordinator, said the company was able to get the word out.

“Cell service was terrible, but we were able to use Facebook, Twitter and text messaging,” said Weathers. “We could get online on our phones with Facebook apps. We have a Facebook fan page, so we were able to communicate with customers using that. That was exciting, because we were able to ease their minds that we had all their supplies here at the Dora store. We opened the Dora store two days after the storm.”

As for the Cordova operation, Glover found a temporary trailer in Memphis, got it back to Alabama and re-opened his doors just last week.

“There was no building for rent, because every one had been destroyed,” Glover said. “We were one of the first downtown businesses to open, and it was nice to see familiar faces. I now have a plan on my desk of what the new permanent fixture will look like, and we are looking in that direction.”

Mike Hamilton, executive director of the Alabama Durable Medical Equipment Association, continues to work with affected providers, and the stories of hardship are piling up. “I know of a provider who had all four of his locations hit in one day,” said Hamilton. “We had one member with a 45,000-sq.-ft. warehouse with roll-up garage doors on both ends. The front door got splintered, and pieces of the door took all of the equipment in the building and shoved it out the back door.”


Atlanta-based Friends of Disabled Adults and Children is providing wheelchairs and other medical equipment to tornado victims in Tuscaloosa, Ala. The equipment will be distributed by ReMedy, a Birmingham-based recycler of medical items. FODAC is also continuing to collect and distribute equipment to other affected states. In Georgia, the company has set up several drop-off sites in the Atlanta area. For more information, see the FODAC website or contact chrisbrand@fodac.org.

You can also donate to any disaster relief efforts, such as the floods, wildfires and storms experienced throughout the country this year, through the American Red Cross Disaster Relief fund or the Salvation Army's disaster response
.


ACOs Spell 'Opportunity' for HMEs
WATERLOO, Iowa—Savvy home medical equipment providers can be the “go to” companies in the emerging world of 21st century health care, but they need to be quick to align themselves with newly forming Accountable Care Organizations, an industry analyst said last week.

“You want to establish that relationship with the ACO before someone else does,” advised Alan Morris, director of alternate care programs for Waterloo, Iowa-based VGM.

The reason? ACOs will soon be the new referral sources in town and if you aren’t aligned with one or more, you could find yourself shut out of the Medicare business.

Under the Affordable Care Act, physicians, hospitals and other providers can form ACOs that work together to coordinate care for Medicare beneficiaries. Such networks will be expected to improve the health and experience of beneficiaries and reduce the growth rate of health care spending. In return, the networks will share in any savings to the Medicare program, which are anticipated to tally upwards of $430 million over three years.

On May 17, CMS unveiled two concepts related to ACOs. Its Pioneer model will be available this summer and is aimed at ACOs that have already begun coordinating care for patients and can utilize alternative payment mechanisms, such as private payers.

In addition, the Advance Payment ACO model will allow certain ACOs participating in the Medicare shared savings program to access their savings up front as a way of covering the costs of infrastructure and staffing. CMS is asking for comments on that idea, and the agency’s Innovation Center is offering learning sessions to teach providers about ACOs, as well as ideas for improving care delivery.

At this point, CMS doesn’t recognize DME companies as network partners, Morris said, adding that VGM plans to address that in its comments to CMS. Still, there is an opportunity for industry providers to partner with networks and beef up their businesses, he said.

“There are new incentives to keep patients out of the hospital,” Morris said of the program. “[ACOs] are going to count on DMEs. DME [companies] are going to have to look at making their businesses more attractive to ACOs. There are new initiatives that we can take to prepare ourselves to be the ‘go-to’ people.”

Morris suggested the following:

• Form your own loose network, aligning yourself, say, with an infusion company and a home health agency for an “all-encompassing” home health care network. This is especially advisable for smaller HME businesses, Morris said, because it allows them more leverage. He noted that VGM is working on creating a network for its members that would establish connections with various ACOs.

• Invest in telehealth, that is, remotely monitoring patients in their homes. “That’s going to be a booming market at a whole new level we haven’t seen before,” Morris said. “It’s going to be a huge market. Somebody is going to have to deploy the device, and it might as well be us.”

• Offer a health-coaching program. In addition to providing the equipment to help keep patients out of the hospital, offering a health-coaching program that enhances a patient’s health and lifestyle is a value-added service, Morris said. While such a service is not reimbursable, it does give HME companies an advantage over their competitors. As the industry has seen in Round 1 of competitive bidding, referral sources—in this case, the ACOs—tend to call on the HME companies able to provide the most services.

HME companies swift enough to position their companies to align with an ACO have much to gain, according to Morris.

“The thing about ACOs is that they are extremely expensive to implement,” he said, noting that while CMS has pegged the price of implementation at $1.8 million, physicians and hospitals say it is far beyond that, more ranging from $11 million to $26 million.

“If ACOs are going to spend the money, it has got to reach beyond their Medicare population,” he said. “They are going to go to the DMEs with all of their patients, not just some of their patients, and that will be beyond the Medicare market.” So an HME company’s reach could be expanded greatly—and that could be a benefit when competitive bidding comes to communities nationwide.

Morris said HME providers should consider the establishment of ACOs as an opportunity.

“As long as providers are proactive and put themselves in the position of offering more than just equipment, it is an opportunity,” he said. “If they are just going to stay on the sidelines and see what is going to happen, they may be stuck there.”

For a fact sheet on CMS’ ACO initiatives, go to www.healthcare.gov/news/factsheets/accountablecare05172011a.html.


Docs Still Looking for Their Own Medicare Fix
CHICAGO—The American Medical Association recently gave Congress its recommendations about how Medicare’s looming physician payment issue should be fixed.

The association has for years called for a redo of the sustainable growth rate (SGR) formula by which physician payments are calculated, and which, for years, has resulted in annual pay decreases that have subsequently been prevented by Congress. Under the current formula, if Congress doesn't again act to stop reimbursement cuts scheduled for Jan. 1, 2012, the docs are looking at a 29.5 percent pay reduction.

The annual Medicare Trustees’ report, issued May 13, highlighted the problem, noting that the cut is a big part of keeping program finances in line.

But AMA immediate past president J. James Rohack said in a statement that "the Medicare Trustees report leaves no doubt that the time to repeal the Medicare physician payment formula is now—to keep from digging a deeper financial hole and to preserve access to care for patients … This cut is the highest ever scheduled under the broken Medicare physician payment system, and it threatens access to care for our nation's seniors, military families, people with disabilities and the baby boomers now entering Medicare. The longer it takes to reform this system, the greater the cost.”

In a proposal presented to Congress earlier this month, the AMA called for total repeal of the SGR, to be replaced stable payments for a five-year period during which testing of pilot projects would take place to form the basis for a new physician payment system.

"We will continue to work with policy-makers on both sides of the aisle to replace the broken Medicare physician payment system with one that better reflects the costs and practice of 21st century medical care, and provides stability for physicians and their Medicare patients," Rohack said.

Read the AMA statement in full.

For the AMA’s testimony to Congress, see www.ama-assn.org/ama/pub/news/news/ama-president-testifies-medicare-payment.page?.


New Oxygen Policy Synchronizes RULs
The following release from MiraVista LLC includes a clear explanation from industry consultant Andrea Stark on how CMS' new reasonable useful lifetime (RUL) policy for stationary and portable oxygen equipment affects HME suppliers. Announced in CR 7213, the new policy took effect May 8, 2011. For additional information, contact Stark at customerservice@miravistallc.com.

COLUMBIA, S.C.—On May 8, 2011, a new oxygen policy went into effect that synchronizes the reasonable useful lifetimes (RUL) of stationary and portable oxygen equipment. In cases where a patient has both stationary and portable equipment, the RUL of the stationary unit will now serve as the RUL for both pieces of equipment, regardless of when the portable was prescribed.

The most common reason for asynchronous RULs between stationary and portables is that a patient initially qualified nocturnally. Patients who initially qualify for oxygen therapy during sleep only qualify for stationary equipment and must secure a separate test, while they are awake, to qualify for portability.

DME consultant and reimbursement expert Andrea Stark expects the change will be positive for most suppliers.

“It’s important to note that the new policy is just synchronizing the reasonable useful lifetime at the 60-month mark. It is not directly affecting the capped rental mark of 36 rental payments,” Stark said. “The majority of suppliers will still receive their full 36-months of rental for both pieces of equipment, with the added bonus of starting new capped rentals for their portable units earlier.”

According to Stark, portable equipment is generally prescribed along with, or shortly after, a stationary concentrator. So for the majority of suppliers, the new rule means less time servicing portable equipment and less time providing contents they can’t bill for separately.

For example, if a patient is prescribed a portable system six months after a concentrator, the supplier may bill for the following once the concentrator caps at 36 months:

• Six additional months of simultaneous billing for the remaining portable rentals and portable contents to reach the portable’s 36-month cap (billing for portable contents may begin only after the stationary unit caps).

• An additional 18 months of billing for portable contents only (once the portable unit caps, the stationary unit will be 42 months into its service period and will have 18 months remaining to reach its 60-month RUL).

Under previous policy guidelines, if the patient above elects to start a new capped rental period for their stationary equipment, the supplier must discontinue billing for portable contents (as this is considered included in the stationary rental) and must wait an extra six months to restart the portable rental. Since the portable unit has capped, this leaves the supplier servicing the equipment for the remainder of its RUL without separate payment. However, this wait is eliminated under the new RUL policy.

Effective May 8, 2011, suppliers may chop off those additional non-paid months of portable service and simultaneously begin a new rental period for portables with stationary equipment.

According to Stark, even if a portable unit is added after a stationary unit caps, suppliers still receive up to two full years of both rental and content payments for the portable, plus have the added benefit of completely eliminating the additional two-year service period for the portable equipment.

“Not only will suppliers be able to start new rentals sooner,” said Stark, “but the new policy alleviates the administrative burden of going back multiple times to get revised documentation and CMNs. Now they can do it all in one swoop.”

While Stark sees this policy change as positive for suppliers, she understands why some may be tempted to view the change as negative.

“In the past, changes to the oxygen policy haven’t necessarily been in the best interests of suppliers,” said Stark. “So it’s only natural that the first instinct may be to see history as repeating itself. However, I see suppliers as ultimately coming out on top with this one.”

Stark did provide one situation where suppliers may initially take issue with the policy change.

”If a supplier doesn’t provide gas or liquid portables and chooses to provide a home fill or portable concentrator more than two years after stationary therapy was initiated, the potential exists to lose out on a few premium rentals over the course of 10 years,” said Stark. “But this scenario is such a far stretch, that you really have to be reaching for sour milk.”

One thing that hasn’t changed is the inability to bill for separate contents when a concentrator is under rental.

“Under both the former and current policy, whenever the stationary is not renting, suppliers can simultaneously bill for the portable rental and contents, said Stark, “but once the stationary restarts, contents are cut out.”

The new change in policy also proves positive for suppliers affected by competitive bidding.

Under current bidding guidelines, if a grandfathered supplier provides oxygen equipment to a patient and the patient starts a new capped rental, the patient must use a contracted supplier for the new rental. At the same time, the grandfathered supplier must continue to provide any oxygen equipment (i.e. the old portables) for which a new capped rental period has not yet started.

“If a stationary unit reaches its RUL and the patient resides in a bid area, then the patient must get their replacement equipment from a contracted supplier,” said Stark. “Under the old policy, if the therapy is staggered and a new concentrator rental begins, the grandfathered supplier is strapped with continuing to provide the portable until its RUL is reached, and they are unable to bill for contents.”

The new RUL policy alleviates grandfathered suppliers from the burden of continuing to service unpaid portable units by requiring contracted suppliers to take over both pieces of equipment simultaneously.

Read CR7213 in full.


Industry Commentary
Don’t Let Debt Debate Distract Lawmakers from Bidding Repeal Effort
The following from the American Association for Homecare appeared in the organization's May 18 newsletter.

WASHINGTON—The debate about raising the debt ceiling will suck up a lot of oxygen in Congress over the months ahead. This means we will have to fight to maintain a focus on the need to repeal bidding in Washington—a city that suffers from attention as well as budget deficits.

[Last] Monday, the United States reached its debt ceiling of $14.3 trillion. The Secretary of the Treasury told Congress that he will use accounting maneuvers to extend the debt ceiling to early August. If the debt ceiling is not raised then, the federal government could default on its loans and trigger alarm in the world’s financial markets. Both the White House and the House Republican leadership have plans to address the debt ceiling and make significant cuts in federal spending, but the plans differ dramatically. The White House plan cuts $4 trillion in spending over 12 years through discretionary spending reductions and repeal of some Bush-era tax cuts. The House Republican plan cuts $6.2 trillion of federal spending mainly through reduced spending and entitlement reform, which includes fundamental changes to the Medicare program.

While legislation to increase the debt ceiling will likely pass, the debate will consume time and attention of House and Senate members. To keep Congress on track to repeal suicide bidding, the HME sector will keep the issue front and center.

If you have not contacted your senators and/or representative about the fatally flawed bid program, you should do so immediately. You can reach your senators and representative by phone by calling the Capitol Hill switchboard at 202/224-3121. To email your federal legislators, go to www.capwiz.com/aahomecare.

If your representative has cosponsored H.R. 1041, take time to thank the legislator for supporting HME providers and patients. This provides the opportunity to ask the member of Congress to raise support to the next level by contacting Senate colleagues about repeal.

If you have any feedback from your senators or your representative, please provide the information to AAHomecare so our staff can follow up with the congressional offices. Please contact Jay Witter at jayw@aahomecare.org with specific feedback.


In Brief
Open Door on Wednesday; CareCentrix Moves into Florida; More News in Brief
BALTIMORE—CMS has scheduled its next Home Health, Hospice and DME Open Door for Wednesday, May 25, from 2 p.m. to 3 p.m. ET. To register for the audio-only streaming web forum, go to www.cms.hhs.gov/apps/events/event.asp?id=642.

CareCentrix Moves into Florida
HARTFORD, Conn.—Home health benefits manager CareCentrix has inked a deal with BlueCross BlueShield of Florida to become the exclusive provider of home health services for the insurer’s nearly 4 million members in the state, including coordination of home infusion therapies and DME. CareCentrix has also signed a two-year contract with BCBS of Tennessee as the exclusive manager of DME for the plan’s 32,000 Medicare Advantage members across that state. In an effort to staunch a hemorrhage of red ink last year, Tennessee contracted with CareCentrix to handle DME benefits for its TennCare (Medicaid) beneficiaries. According to providers, the cuts that followed averaged 15 to 25 percent. For more, see TennCare Changes Could Cut Ranks of Medicaid Providers, HomeCare Monday, Sept. 3, 2010.

Bush to Keynote AdvaMed 2011
WASHINGTON—President George W. Bush will address attendees at the fifth annual medtech conference hosted by the Advanced Medical Technology Association. AdvaMed 2011 will be held in Washington, D.C., at the Walter E. Washington Convention Center Sept. 26-28. President Bush will give an afternoon address on Sept. 27 as well as participate in a moderated Q&A forum. For more about the conference, see www.advamed2011.com.

Graham-Field Cuts the Ribbon
ATLANTA—GF Health Products made it official May 12 with a ribbon-cutting ceremony at its new Atlanta facility, which relocates the company’s Lumex recliner production from Taiwan. With help from a local economic development program, the company renovated a 96,000-sq. ft. facility in the city's Doraville suburb and added another 7,200 square feet. The move represents a $1.75 million investment and 17 new jobs as the third phase in the manufacturer’s Back in the USA! initiative. The company kicked off the effort in July 2009 with production of the Patriot Homecare Bed at its Fond-du-Lac, Wis., facility.

Active American Opens New Branch
LAKE JACKSON, Texas—Active American Mobility & Medical Supply is planning an open house Wednesday (May 26) to celebrate its new facility, which includes an accessible bathroom display with a roll-in shower. The company will have a home modification specialist on hand during the all-day event. The provider is based in Stafford, Texas.

Paragon Adds Dulany
PHILADELPHIA—Merger-and-acquisition firm Paragon Ventures has announced the addition of Patrick Dulany, Esq. With more than 30 years of experience in the health care industry, Dulany was most recently COO and general counsel of Bedford, N.H.-based Infusion Solutions, which was recently sold.

Essentially Women Stays Focused on the Future
OXFORD, Mich.—Essentially Women held its 11th annual conference and trade show last month in Glendale, Ariz. Called Focus on the Future, the show’s courses offered information on business development, management, successful sales, merchandising, marketing techniques and accreditation. Exhibits showcased products including post-breast surgery, compression, lingerie, orthopedics, wigs, lymphedema, breast cancer awareness and other medical equipment and supplies. “Even in the midst of economic challenges and industry upheaval, this event was well attended,” according to a release. Founded in 1996, the group purchasing organization for women’s products has grown to over 800 members with more than 1,000 locations.

Jurisdiction A Reminder on Glucose Monitor Supplies
HINGHAM, Mass.—According to a May 20 notice from NHIC, the Jurisdiction A DME MAC, on glucose monitor supplies, recent data analysis for Jurisdiction A shows instances where beneficiaries have received supplies that exceed the policy's usual utilization amounts. While there may be occasions when a beneficiary may require greater than expected amounts, the notice said, “There are specific requirements associated with the provision of higher than usual utilization amounts.” For a reminder on some of those “commonly overlooked requirements,” see the full message on the Jurisdiction A website. Scroll down to “Glucose Monitor Supplies - Utilization Reminder.”

Oxygen Webinar in Jurisdiction B
INDIANAPOLIS—National Government Services, the Jurisdiction B DME MAC, will hold a webinar for small suppliers who bill oxygen and oxygen equipment on Tuesday, May 31, at 10 a.m. ET. Specific topics include certification and recertification requirements and issues, duplicate claim issues and documentation requirements. Registration is available online only and must be completed no later than Friday, May 27. Register for the webinar.

Version 5010 Call on Wednesday
BALTIMORE—CMS will hold its 16th education call on implementation of HIPAA Version 5010 and D.0 transaction standards on Wednesday, May 25. The session will focus on a HIPAA 5010 status update for Medicare Fee-For-Service, HETS Eligibility Transaction, Coordination of Benefits Contractor and Medicaid. In addition, resources and guidance will be provided for 5010 testing and to help the audience through the transition to implementation. The presentation will be followed by a Q&A session. Registration for the call will close at 2 p.m. ET on May 24. To register, go to www.eventsvc.com/palmettogba/052511.

Allstate Files $2.1 Million Suit against DMEs
HAUPPAUGE, N.Y.—Allstate Insurance is looking to recover $2.1 million against 37 New York area defendants in a lawsuit alleging DME companies and wholesalers submitted fraudulent and misleading bills. The complaint specifically cites 11 DME companies owned by nine individuals, and 11 DME wholesale companies owned by six individuals. The suit is the second brought by the company in as many weeks; Allstate filed a $4.7 million insurance fraud suit in New York about two weeks ago.

ERs Closing while Visits on the Rise
CHICAGO—From 1990 to 2009, the number of hospital emergency departments in urban areas dropped by 27 percent—from 2,446 to 1,779—while the number of ED visits increased, according to a new study published in the Journal of the American Medical Association. Read the study abstract.


To revisit this news anytime during the week, check www.HomeCareMag.com. We welcome your comments. Drop a line to HomeCare Editor-in-Chief Gail Walker at gwalker@homecaremag.com.
In observation of Memorial Day, HomeCare Monday will resume publication June 6. As we remember those who have died in military service to our country and those who serve the United States today, the staff of HomeCare wishes you and yours a safe and pleasant holiday.



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