Author

Brook Raflo

  • Legislation & Regulation

    Unannounced JCAHO Surveys on the Horizon

    Oakbrook Terrace, Ill. As part of its shift to a “substantially new” accreditation process, the Joint Commission on Accreditation of Healthcare Organizations is testing an unannounced survey process. Beginning in January 2004, health care providers can volunteer to participate in a pilot program to test the new process, which will take effect for all JCAHO-accredited entities by 2006. “The new accreditation process — dubbed Shared Visions-New Pathways — creates the expectation that each accredited organization be in compliance with 100 percent of the Joint Commission’s standards 100 percent of the time,” said Dennis O’Leary, JCAHO’s president. Already, four hospital systems have volunteered to participate in the pilot program, giving JCAHO permission to conduct three unannounced surveys per year. The incentive for volunteering is good publicity,...

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  • Legislation & Regulation

    Federal Government Ramps Up for HIPAA

    Washington As of April 14, the federal government expected all of the nation’s health care providers to comply with a massive privacy rule — the first in a series of compliance deadlines associated with the Health Insurance Portability and Accountability Act. Preparing to enforce this deadline, the U.S. Office of Civil Rights is adding eight new employees to its HIPAA staff, bringing the total number of HIPAA enforcers to 31, the OCR announced last month. Despite these additions, “the Office of Civil Rights is not a large office,” said Corrine Parver, a health care attorney and partner in the health law services practice of Dickstein Shapiro Morin & Oshinsky. “The HIPAA police are not going to start trooping around the country enforcing compliance.” Nonetheless, complying...

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  • Legislation & Regulation

    Beware of Marketing Ploys that Misuse Medicare, OIG Warns

    Washington Posing as a government-sanctioned program, without federal permission, is against the law, the U.S. Office of Inspector General warned health care consultants and providers April 8. To emphasize this message, the OIG fined the officers of U.S. Seminar $1.1 million for using the term “Medicare” misleadingly in marketing materials the company mailed to more than 300,000 health care providers. “In many instances, you sent a series of three solicitations to providers,” the OIG told the company’s president, vice president and sales manager. “The first of these mailings was a blue brochure describing that the solicitation was ‘formal notice of a workshop detailing local [state] Medicare changes.’ The solicitation refers to ‘Medicare Special Bulletin B-89-23’ and states that ‘compliance is required.’” Follow-up solicitations from U.S....

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  • Providers

    Bond-Holders Buy Graham-Field

    Atlanta At an April 9 auction, The American Stock Transfer and Trust Co. placed the winning bid for the assets of Graham-Field, according to Mark Stead, Graham-Field’s chief restructuring officer. Acting as the trustee for Graham-Field’s bond-holders, American Stock purchased the company “free and clear of liens, claims and encumberances,” Stead said. “Graham-Field’s board of directors unanimously approved the sale, which is subject to formal court approval April 14. The company expects the sale to close by April 30.” After four years in bankruptcy, Graham-Field is emerging under new ownership, and “the company now is working with the bond-holders to ensure a smooth, seamless transition for customers,” Stead continued. “[Graham-Field] expects the bond-holders to maintain a commitment to high-quality products and excellent customer service.” Meanwhile,...

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  • CMS/Medicare

    Gallup Sues CMS Administrator

    Washington Gallup Organization, a nationally known polling company, April 8 filed suit against Tom Scully, administrator of the Centers for Medicare and Medicaid Services, for allegedly interfering in the government’s contracting process. Filed in the U.S. District Court for the District of Columbia, the lawsuit alleges that Scully “engaged in a willful and malicious campaign to violate [Gallup’s] constitutional rights of free speech, free association and due process; federal law; and the rules and regulations of the Department of Health and Human Services, of which CMS is a part.” The lawsuit stems from a survey of hospital performance data — a survey that CMS and the U.S. Agency for Healthcare Research and Quality are overseeing. When Gallup’s managing partner for health care programs, Robert Nielsen,...

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  • Legislation & Regulation

    AAHomecare Meets with Key Policy Advisors

    Washington One way to influence Congress’ decisions is to convince the policy advisors who provide data to lawmakers. Following this model, the American Association for Homecare last month intensified its lobbying efforts, meeting with representatives from both the Medicare Payment Advisory Commission and the U.S. General Accounting Office, to discuss drug pricing and national competitive bidding for durable medical equipment. AAHomecare first met with representatives from the GAO, the government office in charge of evaluating the success of Medicare’s two DME competitive bidding demonstrations. Representing the Coalition for Access to Medical Services, Equipment and Technology, AAHomecare and several consumer advocates told the GAO that competitive bidding is not good for providers, manufacturers or consumers. “I think we demonstrated to the GAO how complex this issue...

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  • CMS/Medicare

    AAHomecare Task Force Submits Code Applications to CMS

    Alexandria, Va. In its ongoing effort to clarify and expand Medicare’s and Medicaid’s coding system for rehab and assistive technology products, AAHomecare’s Re/hab and Assistive Technology Council Coding Task Force last month submitted more than 20 code applications to the Centers for Medicare and Medicaid Services. The task force, which consists of rehab suppliers and manufacturers, has worked for more than two years to develop consensus proposals for codes in the categories of alternative positioning, ambulatory products, bath safety, configured seating, manual wheelchairs and wheelchair accessories. Its mission —” to identify coding deficiencies in the current Medicare [HCFA Common Procedure Coding System] with respect to rehab products” — is critical in light of upcoming regulatory deadlines, AAHomecare said. “All private and public payers must use...

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  • HME Products

    Sweet Success

    The good news for America’s 17 million diabetes sufferers is that the disease is no longer an early death sentence. Careful monitoring of blood glucose — and careful attention to the early warning signs of complications — can ensure a long, healthy life for people with diabetes. The bad news for diabetes-management advocates is that nearly 6 million Americans with diabetes do not even know they have the disease, according to the American Diabetes Association. Fortunately, clinicians and the federal government are beginning to understand the benefits of early diagnosis and disease management, and this growing awareness means huge opportunities for the manufacturers and providers of diabetes-management products. “Ten or 15 years ago, doctors were much more likely to tell someone, ‘You have only a...

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  • CMS/Medicare

    Medicare Funds Are Shrinking Quickly

    Washington By 2026, Medicare Part A will be insolvent, and the government’s expenditures for Medicare Part B will outweigh premiums by a ratio of four to one, according to a sobering report from Medicare’s Boards of Trustees. Each year, the trustees for Medicare’s Hospital Insurance and Supplementary Medical Insurance Trust Funds report to the U.S. Congress on the financial status of the funds. The HI fund lost ground this year, as hospital admissions increased and the Bureau of Economic Analysis predicted lower taxable wages, the trustees said. Similarly, the outlook for the SMI fund worsened, due to the rapid growth of Medicare Part B spending and the passage of reimbursement increases for physicians. “Over the next 10 years, the average annual increase in [SMI] benefit...

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  • Providers

    The MED Group Parts Ways With Invacare

    Lubbock, Texas After more than two decades of business dealings, The MED Group and Invacare have parted ways, for now, according to David Miller, MED’s chief executive officer. Miller insisted the decision not to sign a contract with Invacare “had nothing to do with a failure or breakdown,” despite unsubstantiated reports to the contrary that appeared last week in the trade press. Instead, MED based the decision solely on the results of a new “request for proposals” process, Miller explained. For the first time in MED’s history, the organization late last year asked vendors to submit contract proposals in 15 product categories. During the months of January and February, MED evaluated the proposals and negotiated with each of the potential vendors, attempting to find the...

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