industry

HME

  • Senate Omnibus Bill Does Not Mention HME

    Washington Home medical equipment providers breathed a sigh of relief Jan. 24, after the U.S. Senate passed a $390 billion omnibus budget package that did not include HME competitive bidding. The omnibus package consists of 11 appropriations bills that address almost every government function for the 2003 fiscal year. Responding to Senate Finance Committee Chairman Chuck Grassley’s request, the package delayed a 4.4 percent Medicare physician reimbursement cut, slated to take effect this year, and brought reimbursements for rural and small urban hospitals in line with reimbursements for large urban hospitals. The Senate’s package also included a 5 percent rural home health add-on for a six-month period, ending Sept. 30, 2003. “The current 10 percent rural add-on is scheduled to expire April 1, 2003, if…
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  • IR 101

    The Centers for Medicare and Medicaid Services Dec. 13, 2002, issued a long-awaited interim final rule concerning the application of “inherent reasonableness” to certain Medicare Part B items and services. This expedited IR authority could have an immediate and potentially devastating impact on home medical equipment providers, because the durable medical equipment regional carriers now have the ability to reduce payments for durable medical equipment, prosthetics and orthotics at a faster pace. Effective Feb. 11, 2003, the regulations explain the process whereby CMS and Medicare carriers — including the DMERCs — will reduce or increase payment amounts when the federal government believes the existing payment amounts are either grossly excessive or grossly deficient. CMS issued the rule as an “interim final rule,” because the agency…
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  • Latest HME News

  • Why Bother?

    Welcome back to Compliance University! Today we apply fresh, new perspectives to The Question They Dare Not Ask: “Why should I bother?” In December, I established the premise that any home medical equipment provider without a working regulatory compliance program is, in effect, deciding that there is no need to bother with compliance. This phenomenon certainly is not limited to HME providers. Medical groups, ancillary service providers, long-term-care organizations and even hospitals continue to operate without compliance programs in place. Last time, I presented six reasons to bother with a compliance plan, focusing on staying out of trouble with the government. While these reasons certainly are important, too often they are the only issues that providers consider. In fact, there are at least 12 additional…
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  • Congressional Outlook

    With the prospect of war on the horizon, it is hard to be excited about watching what will unfold domestically in 2003. Nonetheless, a major part of our population will be focusing intently on Washington as President Bush attempts to address both domestic issues and international crises while initiating his own re-election campaign. The President’s Jan. 28 State of the Union address was one of the more interesting that I have witnessed. It was full of surprises — initiatives for developing a hydrogen-powered car, assisting those suffering from addiction and providing medicines to AIDS victims in Africa — balanced with strong and determined words about the situation in Iraq. The President seemed to say that the United States would provide compassionate assistance to those in…
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  • Medicare’s Saviors?

    Like eager boy scouts who offer to usher an elderly woman across the street, federal lawmakers are lining up to guide Medicare into the 21st Century. The Democrats are reporting that, while the elderly woman would like to have help with her grocery bag, she otherwise is “just fine, thank you.” Republicans are insisting that, without substantial help, the elderly woman might never make it across the street. Both parties are promising to add a prescription drug benefit to Medicare, but Republicans say that radical reform must accompany any such benefit. Away from the glare of television-camera lights, lawmakers on both sides of the aisle admit that budget cuts are inevitable. If history has taught the home medical equipment industry anything, it is that Congress…
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  • Don’t Worry, It’s Cool

    When I broke my neck in an automobile accident, I quickly realized that being separated from the physical world changed the way many people communicated with me. Most people are apprehensive at the thought of offending disabled people by acting inappropriately. What do I do? What do I say? Maybe I should just ignore them… Take my advice: Treat people, with or without a disability, with a little courtesy, respect and some common sense. To follow are a few examples: I am not a “shut-in.” Nor am I wheelchair-bound or confined to a wheelchair. I simply am a wheelchair user, and I do get out. The word “handicap” derives from an old English term meaning “cap in hand,” which signifies a beggar. No one wants…
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  • The Future Looks Bright

    Today’s home medical equipment providers are a hardy bunch, to say the least. Despite facing in 2002 an economy that was leveled alongside the Twin Towers and the Pentagon, and in 2003 the looming threat of national competitive bidding for durable medical equipment and an inherent-reasonableness regulation, HME providers remain optimistic about the industry. According to HomeCare‘s annual Forecast Survey, HME providers continue to predict increased revenue for 2003. Of the 374 providers who responded to this year’s survey, only 3 percent expect their companies’ revenue to decrease, while 10 percent expect revenue to remain static, and a whopping 84 percent forecast increased revenue. Of those who predicted a revenue increase, more than one-third foresee an increase of between 6 percent and 10 percent, and…
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  • A Rose Among Thorns

    During the five years since the Balanced Budget Act of 1997 took effect, the risk profile for home medical equipment and respiratory companies — a critical factor in merger and acquisition strategy and valuation — has remained constant. Market dynamics have been stable, and reimbursement threats from competitive bidding, inherent reasonableness and average wholesale pricing for nebulizer medications never gained enough traction to become more than a steady, annoying drone. However, the threats increased in 2002. If not for the lack of a Medicare-reform package to attach it to in the Senate, some form of national competitive bidding legislation very well could have become law last year. Still, even if the industry manages to hold the line on NCB, the Centers for Medicare and Medicaid…
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  • Pick Your Prophet

    Ask a question of three home care providers and you will receive three different responses. At a least, that was the case when HomeCare queried Jim Binson, chief executive officer of Binson’s Home Health Care in Center Line Mich.; Todd Christopher, chairman and chief executive officer of Home Care Supply in Beaumont, Texas; and Joel Mills, president of Advanced Home Care in High Point, N.C., about their 2003 forecasts for the industry. HomeCare: How would you characterize the upcoming year for the HME industry? Jim Binson: Challenging and rough. A shaky economy, reduced reimbursement from state and federal programs, HIPAA, compliance [issues], lack of manufacturer support, competitive bidding, specialty providers, Wal-Mart and Walgreens entering our industry — all of these are equally challenging. Todd Christopher:…
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  • The Road Ahead

    The only thing permanent about life is change. Most would agree that this proverb applies to the home medical equipment industry, too. Granted, the industry has experienced many challenges during the past 10 to 12 years: acquisition mania, “superstore threats,” and concerns revolving around mass retailers, “direct” manufacturers, managed care, accreditation, oxygen reimbursement cuts and more. Nevertheless, one constant remains: the importance of the local, full-service HME provider. Whether the provider operates independently, as part of a buying group, or as a national account location, an autonomous, local, full-service, experienced and caring HME, mobility or rehab provider still is what best serves people in need of our products, and I fully expect this will continue to be true. There is a saying, “All politics is…
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  • No Pain, No Gain

    This year will be a challenging, but opportunity-filled year for the home medical equipment industry — let’s call it a “no-pain, no-gain” environment. The Internet will continue to affect the evolution of HME software into an essential component of the HME business profitability and productivity equation. Speed, security, affordability, redundancy, improved work flow and real-time access to information — all of these are the benefits of Internet-based HME software products and services. The biggest HME software innovations in 2003 will revolve around continued early adoption of Internet-based applications by forward-thinking HME organizations. As more businesses adopt HME software packages, they will become as de rigueur as computers, cell phones and DVD players are to the general population. Of course, there will be challenges to overcome…
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  • Sounding the Charge

    It’s a busy time for Sunrise Medical Products chairman and chief executive officer Mike Hammes. The company has been busy rolling out new products in its mobility, respiratory and standard products divisions, as well as sponsoring a grassroots campaign about the dangers of drowsy driving (for more about this campaign, see HomeCare‘s annual Sleep Supplement in the March 2003 issue). But Hammes was eager to share his predictions for the upcoming year, which he says will be one of continued growth for the durable medical equipment industry. Hammes on the economy: “The direct effect of the weak economy has not affected [the industry] significantly. However, if the economic stagnation continues for an extended period of time, it will clearly affect our industry, especially the Medicaid…
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