Author

HomeCare Staff

HomeCare staff Meg Herndon and Hannah Wolfson were joined by writers Kristin Easterling and Gail Short to tell these stories. Tamara Davie’s photo on page 32 was taken by Ursula Hope Photography.

  • Providers

    Editor’s Inbox

    Room with a View [Regarding the Dallas power wheelchair scheme (“Texas Déjà Vu,” March 2004)], it turns out I actually sold a case of bedpans to one of the defendants. When I visited him, I couldn’t figure out why he was doing so much mobility business out of a lousy, windowless office in a cheap, shared office suite in an awful location. At least in prison, he’ll get a window! — Janet White, Rehab Exchange/DME Depot LLC, Richardson, Texas Not a Dirty Word As an industry, we need to start standing tough when it comes to reimbursement issues. We are quick to say how much our services are worth when we are talking to payers and legislators, then we accept contracts that don’t even cover...

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  • Legislation & Regulation

    Hobson Drafts Legislation To Repeal 2005 Reimbursement Cuts

    Washington A U.S. Representative plans to introduce legislation that would repeal 2005 reimbursement cuts for some DME products and oxygen. The Medicare Modernization Act (MMA) implements the cuts next year for manual and power wheelchairs, nebulizers, diabetic supplies, air mattresses and oxygen. Cuts will be based on an Office of Inspector General (OIG) report on Federal Employees Health Benefits Plan (FEHBP) median pricing and a forthcoming OIG report on home oxygen and oxygen equipment. But Rep. David Hobson, R-Ohio, said he wants to stop the cuts from happening. In a letter to House Speaker Dennis Hastert, R-Ill., and Rep. Bill Thomas, R-Calif., former chairman of the Medicare Conference, Hobson said he planned to draft legislation to rescind the reimbursement-cut provision in MMA. “I continue to...

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  • Operations

    2004 Reimbursement Survey

    To remain profitable in the new Medicare era — with closer scrutiny of K0011 claims, slowed payment of non-HIPAA-compliant claims (which CMS says soon it won’t accept at all) and coming cuts across a string of bread-and-butter products in 2005 — it’s more important than ever that claims are clean and that reimbursement practices are efficient. To find out where home medical equipment providers stand in denials and appeals, days sales outstanding (DSO), staffing and more, HomeCare fielded the magazine’s annual reimbursement survey — our fifth — to a randomly selected group of domestic subscribers asking about their reimbursement procedures. Providers of all types and sizes responded, and the results of this year’s survey are based on answers from 281 of your peers throughout the...

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  • CMS/Medicare

    CMS Considers Changes To Wheelchair Coverage Policy

    Washington This year, HME industry advocates and the Centers for Medicare and Medicaid Services (CMS) have volleyed back and forth in a K0011 coverage debate that may end with vigilant payment oversight, pricing changes or even changes to national coverage policy for wheelchairs. Since a DMERC clarification of power wheelchair policy was issued in December, industry stakeholders have spoken out against CMS’ strict interpretation of policy language, voicing concerns regarding beneficiary access to medically necessary power equipment and provider payments. Although CMS retracted the clarification in mid-March, some advocates say access questions remain. At a March 31 Open Door session on the issue, CMS officials said the agency cannot give a more specific definition of its policy language. “Being more specific than the national policy,...

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  • CMS/Medicare

    Trustees Say Medicare Could Go Broke Sooner Than They Thought

    Washington By 2019, the Medicare trust fund could go broke. According to the annual report released in late March by the Social Security and Medicare Boards of Trustees, Medicare’s insolvency date is now seven years sooner than the trustees projected last year. The bleak financial situation stems from medical advances that allow people to live longer, more productive lives. “But the result of these very happy trends, unfortunately, is a rate of growth of medical costs that will continue to far outstrip that of the economy,” the trustees said, adding that “legislative action to remedy this situation will be required shortly.” According to the report, the new Medicare prescription drug law also raises “serious doubt about the sustainability of Medicare under current financing arrangements.” The...

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  • CMS/Medicare

    CMS Prepares to Form DME Advisory Committee

    Baltimore The wheels may be starting to turn toward competitive bidding. At a Home Health, Hospice and DME Open Door Forum in late March, CMS announced it is preparing for the formation of a DME advisory committee to advise the agency on quality standards, financial standards, data collection strategies and, ultimately, the logistics behind implementation of competitive bidding as required under the Medicare Modernization Act (MMA). “We’re just getting started now,” a CMS official told HomeCare. “The committee … has to be there at the start of the process. I would hope we would have internal decision-making done … by late summer. [But that is] pure speculation.” MMA creates an Advisory and Oversight Committee to advise the Secretary of Health and Human Services on development...

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  • HME Products

    NCART Wants HHS To Carve Out Rehab Products from NCB

    Washington The National Coalition for Assistive and Rehab Technology (NCART), a coalition formed in February to address issues specific to the rehab industry, says it will push for rehab products to be exempted from national competitive bidding. In a position paper released in April, the organization said high-tech rehab products qualify under a provision of the Medicare Modernization Act allowing the Health and Human Services Secretary to exempt certain products when competitive acquisition “is not likely to result in significant savings.” In addition, the paper points out the provision specifies that in implementing HHS’ competitive acquisition authority, “the secretary may consider the clinical efficiency and value of specific items within codes, including whether some items have a greater therapeutic advantage to individuals.” According to the...

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  • Legislation & Regulation

    Houston Psychiatrist Convicted In PWC Fraud Scheme

    Houston On April 1, Houston psychiatrist Lewis Gottlieb was convicted for his involvement in a multi-million-dollar power wheelchair billing scheme uncovered last year. The psychiatrist defrauded Medicare and Medicaid of $16 million by approving hundreds of motorized wheelchairs for beneficiaries in return for kickbacks from wheelchair suppliers. Indicted last September, Gottlieb pleaded guilty to executing a health care fraud scheme and receiving kickback payments between October 2001 and May 2003. He now faces a maximum penalty of 10 years in federal prison for the health care fraud conviction, five years for the illegal kickback conviction and another five years for the conspiracy conviction. Sentencing is set for June 24. During last month’s hearing, Gottlieb admitted to signing hundreds of CMNs in exchange for $200 per...

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  • Providers

    CHAD Names New CEO

    Chatsworth, Calif. Respiratory manufacturer CHAD Therapeutics has named Earl L. Yager president and CEO. Previously president, CFO and secretary, Yager succeeds Thomas E. Jones, who had been CEO since 1998 and who will remain as chairman of the board. “CHAD’s board is pleased to name Earl Yager as chief executive officer, a position he is well-equipped to fill with distinction,” Jones said. “[Yager] has repeatedly demonstrated his leadership and effectiveness in managing the business. He has made critical contributions to our strategy to enhance CHAD’s leadership in the conserver segment of the oxygen therapy market and to enter new growth markets in oxygen therapy and related fields. His efforts to increase manufacturing efficiency, improve margins and reduce costs also have met with success.” Yager, a...

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  • Providers

    Provider NewsWire

    Apria Acquires Housecall Business Apria Healthcare, Lake Forest, Calif., has acquired Knoxville, Tenn.-based Housecall Medical Resources’ respiratory therapy, HME and infusion locations in Tennessee and Florida. Housecall CEO John Heller said the transaction will help fund growth of Housecall’s core businesses, home health nursing and hospice. Eckerd Goes to Jean Coutu, CVS JCPenney will sell its Eckerd drugstore operations for $4.5 billion. The Jean Coutu Group, based in Quebec, will acquire 1,539 Eckerd drugstores and facilities in 13 states in the Northeast and Middle Atlantic, as well as the Eckerd home office in Florida, for $2.375 billion. CVS, Woonsocket, R.I., will acquire 1,260 Eckerd stores in the remaining southern states, principally Florida and Texas, along with Eckerd Health Services, the drug chain’s $1 billion pharmacy...

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