industry

HME

  • 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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  • DME Competitive Bidding Back on the Table in Florida

    Tallahasee, Fla. For the third time in three years, competitive bidding for Florida Medicaid DME business is back in play. The current proposal, stated as proviso language in state appropriation bills, asks for a contract on Medicaid DME — excluding customized wheelchairs, colostomy and ostomy supplies, orthotics and prosthetics — with payments no more than 80 percent of current Medicaid rates. “The bid [would] begin at a 20 percent reduction and go from there,” said Javier Talamo, director of political services at PediStat, a Miami provider of pediatric DME and services. The proposal says DME providers should “bid on services like ventilator care and high-tech pediatric care, which by their complexity should be [acquired] on a capitative basis,” he said. “[The proposal] deprives the [beneficiary]…
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  • Latest HME News

  • New Products

    Turbo Wheelchair/Manual Wheelchair Merlexi Craft Call 800/959-4765. Web site: www.merlexi.com Circle 493 or visit www.homecaremag.com for company information Evolution Technologies/Walker Horizon DX Call 800/556-2558. Web site: www.evolution.ca Circle 488 or visit www.homecaremag.com for company information Consumer Care Products/Positioning Aid Functional Form 107 Side Layers Call 920/893-4614. Web site: www.consumercareinc.com Circle 439 or visit www.homecaremag.com for company information. Bed-Check Corp./Bed Monitor Basic-Check and Classic-Check Call 800/523-7956. Web site: www.bedcheck.com Circle 441 or visit www.homecaremag.com for company information. Quantum Rehab/Wheelchair Power Positioning System Tru Balance Call 800/800-8586. Web site: www.quantumrehab.com Circle 483 or visit www.homecaremag.com for company information. A&D Medical/Blood Pressure Monitor LifeSource UA-767PC Call 888/726-9966. Web site: www.lifesourceonline.com Circle 498 or visit www.homecaremag.com for company information Amoena/Post-Surgery Camisol Style 2105 Call 800/726-6362. Web site: www.us.amoena.com Circle…
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  • Earning Your Credentials

    I hope that you have read the February and March 2004 issues of HomeCare magazine very carefully. Among a series of articles advising providers on doing business in these changing times, the importance of accreditation is clearly described. Now, I want to play the Devil’s Advocate. Do we need accreditation? The meaning of accreditation is that someone (of authority) has sanctioned or provided credentials or certification that the recipient has met or complied with specific standards. At a Medtrade Spring panel discussion in Las Vegas, several of the industry’s accrediting organizations made presentations re-viewing their individual programs and respective benefits. What is interesting is that all of these programs have one common thread: They show DME/HME dealers ways to run their businesses more efficiently, and…
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  • Wheel-Chariots of Fire

    Top-tier wheelchair athletes are shattering records and racking up big titles this season — both on the court and on the street. Longmont, Colo.-based Sunrise Medical’s Team Quickie is heralding the performance of star basketball player Jeff Glasbrenner, who set a National Wheelchair Basketball Association (NWBA) record at the 56th NWBA Tournament April 4 in Phoenix. Glasbrenner scored 63 points and grabbed 26 rebounds for his team, the Denver Rolling Nuggets. In the process, he smashed the previous NWBA scoring record of 39 points set in 1968. Enmeshed in his performance, however, Glasbrenner was impervious to his record-breaking game. “I was in a zone,” he says. “I couldn’t hear the crowd. I had no idea.” Glasbrenner was named the tournament’s MVP and will go on…
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  • 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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  • Many Rivers to Cross

    The Centers for Medicare and Medicaid Services’ retraction of the DMERCs’ December Web bulletins on restrictive Medicare coverage for motorized wheelchairs and power-operated vehicles (POVs) was a great victory for the entire power wheelchair community, consumers and the HME industry. It is, however, only the first milestone that the industry, in partnership with consumers, needs to attain. Our overall objective related to powered and manual mobility is to ensure that consumers with real medical need continue to have access to mobility devices, enabling them to engage in activities of daily life within their homes. Achieving the following five goals, in conjunction with the consumers we serve, should be an industry priority at the national level. A specialist in health care legislation, regulations and government relations,…
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  • HME Providers Move into Wal-Mart

    On March 17, Lake Forest, Calif.-based Apria Healthcare opened a pilot store inside a Duncanville (Dallas), Texas, Wal-Mart. The Scooter Store, New Braunfels, Texas, is running branches in Wal-Marts in Montgomery, Ala.; Daytona Beach and Pensacola, Fla.; Hendersonville, N.C.; and Fort Worth, Texas. Salem, Mass., provider Hutchinson Medical has opened two branches inside Wal-Marts in Epping, N.H., and Waterford, Conn. And Lawrenceville, Ga.-headquartered National Vision Inc., which operates 400 eye care centers in Wal-Mart stores in the United States and Mexico, will open one or more HME test stores inside the world’s largest retailer in the second quarter. All of these companies hope to capitalize on Wal-Mart’s astronomical foot traffic. Worldwide, more than 138 million customers walk into the mass merchandiser every week. Its U.S….
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  • 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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  • View from the Top

    2003’s Top Providers Gather Strength to Keep Climbing   As HME ascends the face of a politically insecure future, revenues and new market potentials remain strong. In 2003, most companies, large and small, reported peak sales, but as Washington winds up to cut reimbursements more deeply, the positive outlook is not universal. HME businesses will have to retrain themselves, like finely tuned athletes, to beat credibility issues on Capitol Hill and deal with new requirements mandated by the Medicare Modernization Act. But the numbers in HomeCare‘s Top Companies listings speak for themselves. The market is out there. The climb may be harrowing — but that much more worthwhile — in the years ahead.   Winning in the Field, Losing on the Hill   By Tom…
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  • Wake Up to Billing for Sleep Apnea

    In 2002, the DMERCs changed coverage policies for CPAPs and supplies to treat those diagnosed with obstructive sleep apnea (OSA). These changes opened the doors to many who could not receive treatment under the old policy. Now, continuous positive airway pressure devices (CPAPs) — HCPCS code E0601 — are covered for patients diagnosed with OSA documented by a facility-based, attended polysomnogram (sleep study) and who meet either of the following criteria: (1) The apnea hypopnea index (AHI) is greater than or equal to 15 events per hour, or (2) The AHI is from five to 14 events per hour with documented symptoms of (a) hypertension, history of stroke or ischemia heart disease; or (b) excessive daytime sleepiness, impaired cognition, mood disorders or insomnia. Correct Documentation…
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  • Image Is Everything

    Despite a massive government crackdown on fraud in the power mobility sector, demand for scooters still grows, offering a viable option for an aging, mobile population. And such unequivocal demand remains the market’s primary driver. “As Medicare continues to review the K0011 claims and requests for power chairs are being denied, dealers and individuals are looking to the scooter market to provide an alternative,” says Al Thieme, president of Amigo Mobility. Even though the Centers for Medicare and Medicaid Services has retracted the DMERCs’ power wheelchair policy clarification issued in December, many in the industry predict a certain level of scrutiny to continue. “I think the scooter market is going to start expanding more because of [Medicare’s scrutiny of] power wheelchairs,” says DuWayne Kramer, president…
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