topic

Legislation & Regulation

Coverage of federal and state legislation and regulation affecting HME providers, home health agencies and patients.

  • Vladeck Predicts HME Market Will Double by 2020

    The chief concern among many attendees at Medtrade Spring in Las Vegas comes as no surprise. “Getting paid and reimbursement cuts,” said Scot Silber, CEO of Green Valley Drugs Home Health and Physician Sales, Henderson, Nev. “Reimbursement cuts,” said Gary Salazar, rehab technology specialist at Mobility Giver Inc., Huntington Beach, Calif. But the coming 2005 cuts didn’t dampen buying activity at the industry trade show and conference, where approximately 7,000 HME providers, manufacturers and others associated with the home health care industry gathered March 16-18 at the Las Vegas Convention Center. Exhibitors and attendees alike said the aisles were busier this year, and Medtrade producers reported a 13 percent increase in attendance from 2003 — a sign, according to some, of continued strong business in…
    Read More →: Vladeck Predicts HME Market Will Double by 2020

  • Task Force to Address NSC Activity

    The Health Law Center announced at Medtrade Spring in Las Vegas that it will form a task force to address the problems facing HME providers because of “expanded activity” by the National Supplier Clearinghouse in assigning and managing provider supplier numbers. “The NSC has commenced an unprecedented level of provider scrutiny,” according to Neil B. Caesar, president of the Greenville, S.C., law practice. “Unfortunately, the NSC’s internal operating systems do not appear ready to handle this volume of new activity. The NSC is ignoring its own regulations, denying suppliers their legal rights and holding suppliers accountable for a set of rules that are not well-communicated and are applied inconsistently among the NSC’s own site inspectors.” Caesar said task force members will review the NSC’s failure…
    Read More →: Task Force to Address NSC Activity

  • Latest Legislation & Regulation News

  • The Value of Home Care

    It should come as no surprise that one of the most pressing problems facing lawmakers and policymakers today is finding solutions to the many challenges facing America’s health care system. With the explosion of Medicaid costs, the expansion of Medicare and the high costs of prescription drugs, there are no easy answers and no quick fixes. No group is faced with these challenges more than the nation’s governors and state legislatures. AAHomecare is working with the National Governors Association (NGA), state legislative groups and individual states as coalition partners to help them address these challenges, and help them understand that home care is part of the solution for the future of health care in America. Obviously, now is the time to turn the debate around…
    Read More →: The Value of Home Care

  • 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]…
    Read More →: Heard at the Show

  • 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…
    Read More →: OIG Investigates MMA Cost Estimate

  • Texas Dj Vu: Another Big Power Wheelchair Scam

    Dallas News of power wheelchair fraud returned to the Lone Star State in February when 11 Dallas-area residents, including DME dealers and a physician, were arrested in a multi-million-dollar Medicare billing scheme. Unsealed Feb. 5 by the U.S. Attorney in the Northern District of Texas, indictments allege that the defendants submitted fraudulent claims for reimbursement of power wheelchairs and diverted the funds they received from Medicare for personal use. The U.S. Department of Health and Human Services said billings in the schemes were in excess of $36 million, with more than $15 million paid out by Medicare to the defendants. According to the indictments, older individuals were often approached by recruiters who offered them free scooters in exchange for their Medicare information, which was then…
    Read More →: Texas Dj Vu: Another Big Power Wheelchair Scam

  • Administration Pegs Medicare Reform at $534 Billion

    Washington In its $2.4 trillion budget for 2005, the Bush administration pegs the cost of the new Medicare reform law over the next decade at $534 billion. That’s about a third more than the Congressional Budget Office estimate of $395 billion lawmakers used when the controversial legislation passed after a months-long debate. The new Medicare law makes prescription drug benefits available to the more than 40 million Americans covered under the massive government program, and also gives insurance companies and private health plans a role. Administration officials added that predicting a price for Medicare includes a range of unknowns, such as how much drug prices will rise, how many seniors will buy drug coverage and how many of those enrolled in the program will switch…
    Read More →: Administration Pegs Medicare Reform at $534 Billion

  • GAO Investigates Medicare Ad Campaign

    Washington The General Accounting Office, at the request of several congressional Democrats, has decided to investigate whether the Bush administration is using a Medicare ad campaign for political purposes. In February, Department of Health and Human Services Secretary Tommy Thompson unveiled a nationwide education campaign to inform Medicare’s 40 million participants about the program’s new benefits. Under provisions of the Medicare reform law, seniors will be offered a prescription drug discount card in June of this year, and a prescription drug benefit starting in 2006. Pegged at $12.6 million, the campaign includes network and cable television advertising to run through March, and a print, radio and Internet Spanish-language campaign. HHS has also produced a flyer about the new Medicare law to be mailed to 36…
    Read More →: GAO Investigates Medicare Ad Campaign

  • Ready for the Challenge

    The home care industry is facing many challenges in 2004 due to enactment of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The American Association for Homecare is well prepared. We have developed an action plan to ensure that policy-makers hear our message to preserve access to high-quality home care equipment and services. And we are putting our strategy in place, a multi-pronged approach that entails concerted efforts on Capitol Hill, in the administration and federal agencies, at the state level and in the public arena. Relationship Building Since passage of the new law, Capitol Hill and the administration have been in an “Okay, how do we move forward now?” mode. There have been lots of personnel changes in Washington, as is always the…
    Read More →: Ready for the Challenge

  • Debate on DMERC Power Wheelchair Clarification Heats Up

    Washington Debate surrounding the DMERC clarification on Medicare coverage for power wheelchairs heated up last month as industry stakeholders expressed their frustrations about the policy during a CMS Home Health, Hospice and DME Open Door Forum on Feb. 18. The controversial clarification followed CMS’ September 10-point plan, called “Operation Wheeler Dealer,” aimed at curbing fraud and abuse of the Medicare power wheelchair benefit. One of the plan’s points required the four durable medical equipment regional carriers to adopt a consistent approach to medical review of motorized equipment. According to the ensuing clarification, which was posted on the DMERCs’ Web sites in December, power wheelchairs are covered for “patients who are non-ambulatory,” that is, those who “can only bear weight to transfer from a bed to…
    Read More →: Debate on DMERC Power Wheelchair Clarification Heats Up

  • Grassroots Lobbying It’s Our Business

    With the many Medicare changes (and when do we not have to deal with various legislative, regulatory and other policy changes?), every provider in our industry must first take the time to understand how important it is to get to know his or her legislators, and second, to spend time educating these legislators about our businesses, the products and services we provide and the consumers we serve. For those of you who have resisted over the years, now is the time to act. No one can do a better job than you. The following step-by-step primer focuses on how to lobby federal legislators, but the same rules apply to state representatives and senators. A specialist in health care legislation, regulations and government relations, Cara C….
    Read More →: Grassroots Lobbying It’s Our Business

  • Getting Accredited and Doing It Now

    While the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) dictates that the Secretary of Health and Human Services develop quality standards for the durable medical equipment industry, the language of the law leaves interpretation wide open. Given the large number of DME providers and related organizations that must comply, it is expected that all accrediting organizations currently serving this industry will be needed to meet the requirement. It will be up to the provider to choose an accrediting organization and to develop a strategy for becoming accredited within a relatively short period of time. Fundamentally, accreditation is designed to establish a culture within a company that promotes sound business policies, best service and care practices, commitment to ethical conduct and methodologies that validate continual…
    Read More →: Getting Accredited and Doing It Now

OUR DIGITAL PARTNERS

trending

From Our Partners