HomeCare’s columns are our way of providing our readers with short bits of expert advice. The top columns from 2015 reflect the entrepreneurial spirit of our readers. HME/DME providers searching for new ways to compete in the market latched on to our “7 New Opportunities for Today’s DME Entrepreneur” and our “5 Reasons to Invest in the DME Market Now” columns. Other top columns reflect the desire of our readers to stay on top of 2015’s regulatory changes such as ICD-10 and competitive bidding’s threats to complex rehab providers.
1. 7 New Opportunities for Today's DME Entrepreneur
With the multitude of changes and challenges in today's durable medical equipment (DME) marketplace, successful entrepreneurs are seeking new opportunities where they can employ their skill and experience. Ask yourself: What opportunities and markets are right for my company, my customers, and myself? How do I successfully enter new, parallel markets without jeopardizing my current DME operation?
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2. What the Round 2 Recompete Means for Oxygen
Competitive bidding is back, and its presence means more potential problems for respiratory service providers. The DMEPOS Competitive Bidding Round 2 Recompete will go into effect July 1, 2016, with the winners being announced several months earlier. Although the bid start dates may seem far off, CMS's proposed timeline will leave unprepared providers scrambling to catch up.
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3. DME by the Numbers
Re-enrollment in Medicare is often one of those activities conducted during the fall. The industry has been told that CMS is revising the 855-S form that suppliers use for Medicare program enrollment and re-enrollment in order to better align the accreditation product categories that list the DME items pharmacies and suppliers provide. We have not seen the revised form yet, but we are expecting it to be released at any time.
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4. Congressional Legislation Introduced to Help Complex Rehab and Rural Providers
Congress introduced two bills to address concerns with CMS's plans to apply competitive bid (CB) rates to statutorily exempt complex rehab technology (CRT) wheelchair accessories and to apply bid rates in non-bid areas. Absent passage of the legislation, Medicare payments to providers will be cut significantly for CRT wheelchair accessories and the DME items included in competitive bidding. Outreach and advocacy efforts with your federal legislators are needed to help strengthen support for passage of the bills.
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5. The European Wet Room Solves Bath Problems
Because most accidents happen in and around the tub, tub-to-shower conversions are the most popular trend in remodeling. The European Wet Room is a curbless shower for tile and commercial-grade vinyl that removes the biggest physical barrier in the bath. The curbless shower opens up the room and eliminates obstacles. This new product solution is reinventing the bath.
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6. The Moment of Truth on Audits
AAHomecare has been to the Hill, CMS, GAO, OIG and everywhere in between, speaking passionately about the problems with Medicare audits and how they are crushing an industry already under pressure. Out there on the front lines of this battle, the most frequent response from policymakers comes in the form of a question:
"Do you have any data to back up your statements?"
"Can you show me with numbers how this is affecting your industry?"
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7. Congress Focused on Home Health Care
While Congress permanently fixed the perennial Medicare physician payment reform issue earlier this year, Congress has been consumed with a new and wide array of health and Medicare issues, including home health care, which will continue through the end of this year.
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8. It's Now or Never
Unless you have been living under a rock for the last five to 10 years, there is a pretty good chance you have heard all the buzz about retail and cash sales. Well, guess what? The time to act is now, and there are two major reasons why.
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9. Understand Oxygen Rental Periods
The 36-month oxygen rental period can restart in a number of circumstances. While some relate to a supplier’s business activities, there are important patient-related situations as well.
Read more.
10. Are You Prepared for ICD-10?
On October 1, the nation adopted the new ICD-10 diagnosis code set. ICD-10 is the 10th edition of The International Statistical Classification of Diseases and Related Health Problems, published by the World Health Organization (WHO). ICD-10 codes are “a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.”
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11. Billing Part B Patients in Skilled Nursing Facilities
The government has taken the position that if a facility originally received Medicare certification for participation as a skilled nursing facility (SNF), then that prohibits a DME supplier from billing Part B for products delivered to custodial patients residing in the facility. On Feb. 24, a Louisiana federal court ruled against the government.
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12. Rethinking Senior Advertising
Seniors have spoken, and they're tired of being portrayed as frail and helpless. In a recent study of adults ages 70 and older, only one in five is satisfied with how the age group is depicted in the ads that are supposed to be forging a connection between seniors and the products they purchase. It's no wonder. Most of these ads lack creativity, some are downright patronizing and they're often so formulaic you could easily swap out logos and no one would notice. In the end, there is little connection to the brand, and even less with the audience. As an industry, we must change our entire approach if we want to connect with the millions of baby boomers who are redefining societal views on aging.
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13. In the Pressure Cooker
You may be working in the toughest and most challenging home care environment ever. Most managers are placed in front of staff and are expected to have the answers, all the while needing guidance, direction and support, and answers of their own. Just a few recommendations may be able to help you manage the pressure.
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14. 5 Reasons to Invest in the DME Market Now
While the world of durable medical equipment (DME) has experienced more than one random acorn via competitive bidding, RAC audits, Medicare cuts and related market turbulence, there remains tremendous opportunity for those who can see beyond self-imposed despair and stop jumping to false conclusions. Below are five points to consider as you look for potential DME investments.
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15. The Affordable Care Act and the 60-Day Rule
There is an inherent adversarial relationship between the DME supplier and CMS. On the one hand, the DME supplier markets products and services, receives the physician's order, obtains the necessary supporting documentation, delivers the product and educates the patient, and bills and collects from Medicare. On the other hand, the Medicare contractor audits the supplier's documentation. If the contractor concludes that the documentation is deficient, then the contractor will assert that Medicare should not have paid the claim and the supplier is required to repay Medicare.
Read more.
To see the other Top 15 of 2015 articles, click here. Do you have ideas for topics we should cover in 2016? Email Stephanie Lepore at slepore@cahabamedia.com.
