industry

HME

  • Are You Prepared for a Motorized Mobility Audit?

    If the DMERCs were to audit your K0011s (motorized wheelchair with programmable controls) and/or your E1230s (power operated vehicles/scooters), would you survive the audit? As part of the government’s 10-point plan to curb fraud and abuse in this market, the local medical review policy (LMRP) was reviewed carefully, giving consistency on how the DMERCs will audit and reimburse for these items. Not only will there be pre-payment reviews, there will be numerous post-payment reviews to verify that the provider should have been paid based on the documentation obtained. For K0011s and E1230s, Medicare will apply the national policy on old as well as current dates of service. The policy states that a “patient must be bed- or chair-confined without the use of a wheelchair, and…
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  • Industry Standards

    One of the platforms I have preached for many years is that there are far too few standards for products offered to Medicare beneficiaries. The price CMS pays to DME dealers usually is the same for a quality walker as it is for a cheap knockoff. Invariably, the knockoff may look the same as the quality unit, but that is normally as far as it goes. The knockoffs often break down, and many do not have the same life expectancy as the quality items. Can you compare a walker that may cost the dealer $50 (or more) with one that is sold to him for $15 or less? We need standards, and they should be strict and enforceable. To push for standards, I recommend that…
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  • Latest HME News

  • They May Not Need You Yet

    This is no Medtrade. That’s something Reece Franklin hears over and over from the home medical equipment businesses that exhibit at his Southern California Senior Expo. The first clue might be the large dance floor, last year placed in the back corner of the Ontario, Calif., Convention Center. Others might be the cruise ship exhibitors and the Lion’s Club booth. At this show, instead of manufacturers marketing to providers, providers market to consumers. At its inaugural event last October, roughly 6,000 people walked through the turnstiles onto the show floor. The expo sold 249 out of 250 booths and had 187 vendors. Among them, 11 were DME dealers, each marketing directly to potential customers, social workers and other referral sources. “There’s been an explosion of…
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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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  • 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,…
    Read More →: The Scooter Store Lays Off 200

  • 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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  • Medtrade Spring Preview

    Medtrade Spring is set to open next month in Las Vegas, and show producers say this edition of the buying and networking expo — a more intimate version of its fall trade show — will focus on building business and improving quality of life. To be held at the Las Vegas Convention Center, March 16-18, the show will offer more than 75 educational sessions and exhibits from 450 HME manufacturers. Attendees can see the newest products, get an update on grassroots legislative efforts and learn the ins-and-outs of accreditation, soon to be required under the recent Medicare reform law. The spring event comes on the heels of Medicare legislation, just as the home medical equipment industry is looking at the playing board to plan its…
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  • Redefining Rehab: Making a Name for Itself

    Over the last few years, the only thing more elusive than adequate funding for rehabilitation products and services has been an objective and comprehensive definition of rehab. Many profess to know what it is — and what it isn’t. One person’s rehab is another’s consumer power. There seems to be a pervasive attitude that “high-end” rehab is intrinsically better than all the rest. Many people dislike the service delivery model used by providers of non-rehab mobility services and mistakenly denigrate the value of these products and services to clients. Given the funding environment on both the federal and state levels, these issues have polarized the industry and profession, and rightly so. To be sure that we are all speaking the same language, here are two…
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  • Redefining Rehab: From State House to Capitol Hill

    In 2003, Tennessee became the first state to mandate certification for HME dealers when fitting individuals in wheelchairs for long-term use. Now known as “consumer protection” legislation, the law is a good beginning, according to Darren Jernigan, director of government affairs for Lebanon, Tenn.-based Permobil, which was instrumental in drafting the legislation and hopes to encourage other states to follow Tennessee’s lead. While provisions in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 make accreditation mandatory for providers reimbursed by Medicare, state laws would require certification for individuals and would apply to all providers, whether they do business with the government or not. “Requiring that a consumer who needs a wheelchair for long-term use be seen by a person with credentials in seating…
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  • Redefining Rehab: Serving Bob

    Many in the home medical equipment services industry wonder why the rehab community is constantly trying to differentiate itself from the rest of HME.
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