industry

HME

  • Just More to Overcome, Not a Call to Exit

    OK. Among the many things home medical equipment providers were grateful for on Thanksgiving, Congress probably did not make the list. But come Monday morning, after a couple of “why me’s?,” and perhaps a dose of Prozac with a Starbucks chaser, HME owners across the country got around to what they do best — adapting and thriving. Here are a few reasons why the new Medicare Prescription Drug, Improvement, and Modernization Act (MMA) won’t send providers screaming into the night. As Bad as the Bill Is — and It’s Bad — It’s Not That Bad Other than the dramatic change in nebulizer reimbursement from discounts off Average Wholesale Price to a new model of Average Sale Price plus a paltry 6 percent (which clearly took…
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  • Beyond the Test Strip

    In the movie The Graduate, main character Benjamin gets a bit of advice on the industry of the future — “Plastics.” If Benjamin were a home medical equipment provider in early 2004, the response would be completely different: “Blood glucose meters,” HME experts would say. “Lancets and test strips. Footwear, skincare and sugar-free medicines.” In short, diabetes is big business, and, sadly for the American population, the market is expected to grow. Big Numbers As of 2002, more than 17 million Americans had been diagnosed with diabetes — an increase of 61 percent since 1991 — and that number is expected to double by 2050, according to the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention. Another 5.9 million Americans…
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  • Latest HME News

  • An Overnight Success

    The number of people diagnosed with obstructive sleep apnea continues to rise, making this a lucrative, yet challenging, opportunity for the home medical equipment industry. Patients with OSA, however, are not most providers’ classic customers. Namely, they are not typically Medicare beneficiaries, which means providers must rethink how they market to this population. Likewise, payer sources expect positive outcomes, which means patient compliance is integral to the success of an OSA program. There are certain characteristics that describe the typical OSA patient, such as middle-aged, male and overweight, but research is demonstrating that additional factors also come into play. “Generally, the most affected population is middle-aged males, though postmenopausal women face similar increased incidence,” says Nicholas J. Macmillan, global sleep products manager for Sunrise Medical’s…
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  • Building on Success

    When Sandra and James Hoskin were leasing a small retail space in front of a Houston hotel in 1987, their landlord evicted them. He was selling the property to a buyer who needed the space. Vowing never to lease again, the co-owners of American Medical Equipment soon began property-hunting. This was the late ’80s, when “real estate wasn’t moving at all,” Sandra recalls. But the stale market ultimately worked to the couple’s advantage when they found a rundown piece of real estate — with enormous potential. “The owner really wanted to get rid of it,” Sandra says, adding that he actually dropped the price $100,000 and was willing to finance the purchase himself. The area had trash on the streets and relatively light traffic, “but…
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  • Professionalism Is Part of Solution

    Just as with regulatory compliance, one of the keys to addressing the new Medicare Prescription Drug, Improvement, and Modernization Act (MMA) successfully is to address your own internal management systems. Ironically, this is both a key part of the solution and a key part of why we’re in this mess in the first place. Why? The greatest insight I draw from the Medicare reform law is sobering: Congress does not believe that the HME industry has its act together. We cannot discount the fine lobbying work done by the American Association for Homecare and state associations. But Congress appears convinced that those organizations present the voice of only the very best suppliers. Our lawmakers evidently believe that most HME providers do not have their acts…
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  • A Ton of Prevention

    The Medicare Reform Act, otherwise known as the Medicare Prescription Drug Improvement, and Modernization Act (MMA), became effective Jan. 1, 2004. Although the reimbursement reductions that affect the home medical equipment industry will become more severe over time, you should not sit idly and wait for the larger cuts to become effective. Rather, it is imperative to begin evaluating your company’s practices to prepare for the bigger changes that are forthcoming. Knowing what to expect will help you make an educated decision about your company’s future direction. Refine Operations Know the facts. Before planning for change, explain Medicare reform to your staff. Identify those changes that are effective immediately and those whose implementation is scheduled for later. For example, we know that fees are frozen…
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  • Look Upon the Doughnut

    The last few months have been trying times, filled with much confusion, with information changing daily, with regulations that we all have difficulty understanding. It seems that the bureaucrats in Washington, D.C., are having difficulty in finding a common approach to Medicare, to Medicaid, to Social Security, to a rapidly rising national debt and to resolving our difficulties with terrorists. While the government’s recent actions have had a detrimental effect on the average DME/HME dealer, HHAs and most other health practitioners, this is not the time for sackcloth and ashes. On the contrary, now is when you have to restructure your plans for the future. Throughout this issue of HomeCare, you’ll find lots of suggestions from the experts on how to prepare your business for…
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  • Picking Up the Pace

    It’s no secret that participating in sports and recreation offers a wealth of benefits in terms of physical and emotional health. For people with disabilities,
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  • The Scooter Store Lays Off 200

    New Braunfels, Texas In January, The Scooter Store announced the layoff of 200 employees, a move the company attributes to the clarification of Medicare’s power wheelchair coverage policy, issued in December by the durable medical equipment regional carriers. “We deeply regret the necessity of reducing our work force,” Margaret McGuckin, the company’s executive vice president of marketing, stated in a press release. “Unfortunately, we have no choice since the unreasonable new ‘clarification,’ when its full impact is felt, may prevent us from serving thousands of disabled elderly people who, with power mobility, would have been able to continue to live independently.” Under the DMERCs’ clarification, issued as part of the Centers for Medicare and Medicaid Services’ 10-point plan to curb power wheelchair fraud and abuse,…
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  • Industry Stakeholders Fight DMERC Power Wheelchair Clarification

    Washington In response to the policy clarification on power wheelchairs issued in December by the four DMERCs, industry stakeholders continue their opposition and have requested an open dialog with the Baltimore-based Centers for Medicare and Medicaid Services on the issue. According to the DMERCs’ new clarification, power wheelchairs will be covered only for “patients who are non-ambulatory.” (See “The Scooter Store Lays Off 200,” page 8.) Industry advocates have also said that the clarification’s medical review guidelines may be applied retroactively. “The application of these new policies to beneficiaries who have already received power wheelchairs that met the previously accepted coverage criterion will cause irreparable harm to both beneficiaries and suppliers,” said American Association for Homecare President and CEO Kay Cox. In a December letter…
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  • Apria Signs OSA Suppliers, Does Not Renew Gentiva Contract

    Lake Forest, Calif. To accommodate the growing sleep apnea market, Apria Healthcare has extended its purchasing relationship with Murrysville, Pa.-based Respironics and has also signed shared primary supplier agreements with New Zealand-based Fisher & Paykel and Longmont, Colo.-based Sunrise Medical. Respironics will remain a shared primary supplier for all CPAP sleep therapy units and accessories. The company will be the primary supplier for all bi-level and smart CPAP devices for the sleep apnea market and the single-source supplier for all infant apnea and sleep diagnostic equipment. Respironics will also continue as a shared primary supplier for volume ventilators. Lisa Getson, Apria’s executive vice president, business development/clinical services, said the provider also named Fisher & Paykel as a shared primary supplier. Under terms of the agreement,…
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  • Court Blocks California Medicaid Reimbursement Reductions

    Sacramento, Calif. Citing potential beneficiary access problems, a federal judge granted a preliminary injunction in December blocking provider cuts to Medi-Cal, the California Medicaid program, that were slated to go into effect Jan. 1. The cuts were part of a compromise budget proposal passed last summer by the state legislature and signed by then-governor Gray Davis. For California HME providers, the ruling affects those who sell disposable medical supplies such as incontinence supplies, said Bob Achermann, executive director of the California Association of Medical Product Suppliers (CAMPS). A 5 percent reduction of DME was “discretionary for the [California Department of Health],” he said. The department has not said it would enact the reductions yet, and they probably will not do so, he explained, “because of…
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