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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.

  • 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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  • CMS/Medicare

    CMS Should Watch Medicaid Accounting, GAO Says

    In a March 16 report, the government’s General Accounting Office said the Centers for Medicare and Medicaid Services should closely monitor how states use the upper payment limit, a maximum price that the federal government pays as its share of Medicaid costs. The report, titled Medicaid: Improved Federal Oversight of State Financing Schemes Is Needed, says that some states use accounting techniques that inflate program costs — closer to the upper payment limit — to acquire higher program payments from the federal government. For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.

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  • CMS/Medicare

    CMS Issues Physican Self-Referral Regs

    The Centers for Medicare and Medicaid Services has issued the second phase of its final regulations prohibiting physicians from making referrals to entities with whom they have a financial relationship. A study by HHS’ Office of Inspector General revealed that excessive use of some services is encouraged when physicians have a financial relationship with the organizations to which they refer patients. CMS defines a financial relationship as either a compensation arrangement, an ownership or a direct or indirect investment interest. Organizations are also prohibited from billing for services provided as a result of a prohibited referral. The prohibition applies to durable medical equipment and supplies, physical therapy service and home health services, among others. For breaking news, go to www.homecaremonday.com, the electronic news service of...

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  • Legislation & Regulation

    Heard at the Show

    As usual, providers attending Medtrade Spring expressed their opinions about a number of the industry’s most pressing issues. Following are some of their comments on a range of topics they say are chief concerns. On certification “When you get into custom rehab equipment, you better know what the heck you’re doing or you should not be in it. We’re out there for the end user. There are lots of unqualified people in this business [who] should not be, no doubt about it. When you start getting more certification, it’s going to help clean up the industry a lot.” — Gary Salazar, rehab technology specialist, Mobility Giver Inc., Huntington Beach, Calif. On reimbursement cuts “Reimbursement and access to care is the chief concern. Third-party [payers are]...

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  • CMS/Medicare

    CMS Retracts Controversial Power Wheelchair Clarification

    Baltimore Last month, the Centers for Medicare and Medicaid Services told legislators that it is retracting the power wheelchair coverage clarification issued by the four DMERCs in Dec. (see HomeCare, January 2004). “CMS has decided to retract the Dec. 9, 2003, Durable Medical Equipment Regional Carrier (DMERC) article which was intended to reiterate our coverage policy on power wheelchairs,” wrote Carleen Talley, director of CMS’ Congressional Affairs Group, in a notification that was circulated to Capitol Hill offices. “The coverage policy remains unchanged from when it was originally put into place in 1985. CMS will continue to pay claims as it has prior to and following the issuance of the December 9, 2003, DMERC article.” The notice said the agency is taking the action “in...

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  • Legislation & Regulation

    OIG Investigates MMA Cost Estimate

    In mid-March, Health and Human Services Secretary Tommy Thompson asked the HHS Inspector General to investigate allegations by Richard Foster, CMS’ chief actuary, that he was told to withhold higher cost estimates of the Medicare Modernization Act (MMA) when it was under consideration by Congress last year. Shortly before the House of Representatives passed the measure in late November, lawmakers received a Congressional Budget Office cost estimate on the legislation of $395 billion over 10 years, an estimate the CBO continues to stand behind. But in its 2005 budget, the Bush administration pegged MMA’s cost at $534 billion over 10 years. House lawmakers called for an investigation of the matter following a published report that Foster had been told by then-CMS Administrator Tom Scully to...

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  • CMS/Medicare

    CMS Matches Disease Management Costs

    In a recent announcement, CMS said that it will match states’ costs for operating disease management programs and has sent a letter to state Medicaid directors informing them of the program.The agency said it hopes the federal match will encourage states to adopt more disease management programs to improve health outcomes and lower the costs of managing care for patients with chronic diseases. States can pursue disease management programs under a Medicaid waiver or a state plan amendment, according to the agency. CMS is also undertaking a disease management program for Medicare. For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.

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  • CMS/Medicare

    CMS to Slow Non-TCS-Compliant Claims

    The Centers for Medicare and Medicaid Services recently announced that beginning July 1 it will slow processing of non-compliant claims — paying them no earlier than 27 days after receipt — to encourage use of the standardized transactions and code sets (TCS) format. Compliant claims could be paid as early as 14 days after receipt. Shortly before the original TCS-compliance deadline, which was scheduled Oct. 16 last year, CMS enacted a contingency plan allowing providers to submit non-compliant claims as long as they demonstrated a “good faith effort” toward compliance. Last month, CMS announced that 69 percent of electronic Medicare claims from all health care providers are now in the TCS format. In February, however, 82 percent of HME providers who responded to a HomeCare...

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  • CMS/Medicare

    Greenspan: Trim Medicare

    In late February, Federal Reserve Chairman Alan Greenspan told members of the Committee on the Budget that Congress should trim Social Security and Medicare benefits instead of raising taxes to help control the nation’s budget deficit, which is expected to exceed $500 billion this year. Greenspan has said that the real strain on the economy is expected to hit when baby boomers reach retirement age and entitlement costs begin to rise. For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.

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