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| April 2, 2007 | Volume 13, Issue 12 |
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ADVERTISEMENT Don't Get Left Behind Just months remain until implementation of the first round of competitive bidding. With it comes mandatory accreditation and a new set of quality standards. Navigating the new landscape requires a solid business foundation that includes tight cost controls, efficient business software and the ability to get paid timely. Help navigating these changes is just a click away. Find out how AnCor has helped their hospital/home health affiliated HME and Home IV clients flourish during times of change. www.ancorconsulting.com  In This Issue: Phantom Posting Shows 10 Competitive Bidding MSAs HME Gets Another Chance with 'Tanner-Hobson' Bill OIG Recommends Strengthening Supplier Enrollment Process eBay to Cease Oxygen Device Sales Popovich Relinquishes Joint Commission Reins Coming Up For more industry news, features and highlights from our latest issue, please visit our Web site at www.homecaremag.com. Headline News Phantom Posting Shows 10 Competitive Bidding MSAs ATLANTA--An apparent list of the 10 metropolitan statistical areas where DMEPOS competitive bidding will begin was posted on CMS' new Competitive Bidding Implementation Contractor Web site Friday morning. The posting was brief, however, and the list of bidding areas remains unconfirmed at this time. The 10 MSAs as they appeared on the site include: --Charlotte-Gastonia-Concord, N.C.-S.C.
In the weeks leading up to the posting, rumors were rampant that the agency would issue its final rule on competitive bidding Friday, and, at the same time, confirm the cities where the bid program will be phased in. A CMS spokesperson, however, said the only official information that had been released was a notice "on the Federal Register Inspection Desk" (located in the physical Federal Register office) that the agency's target date for issuing the final rule had been extended for 30 days. "The initial target for this final rule had been March 31, 2007. CMS is extending the date for an additional 30 days to allow additional time to complete final clearance of the rule," the spokesperson said. Section 902 of the Medicare Modernization Act requires CMS to inform the public of targeted publication dates for regulations and provide a further notification should that publication target change. "Any other information that any group or individual is purporting to be an official CMS announcement on competitive bidding is false," the agency spokesperson said. "CMS has stated from the beginning of the regulatory process that it does not expect to make any announcements on the program until the final rule is published." Washington insiders speculated, however, that technical difficulties with the Web site may have prevented the agency from releasing the final rule, and that the cities on the list are in fact those where CMS will roll out its Medicare bid program. Some said they believe the agency could still issue the rule at any time--perhaps as soon as today--if difficulties with the site can be corrected. Friday morning, many of the CBIC Web pages, including those dealing with supplier information and bid application, showed they were still under construction. Later in the day, CMS restricted access to the site--www.dmecompetitivebid.com--requiring a user log-in and password, and subsequently put up a notice announcing that information on the bidding program "is coming soon." The MMA mandates DME competitive bidding to begin in 10 of the nation's largest MSAs in 2007 and expand to 80 MSAs in 2009, after which the government has the authority to take the program nationwide. Medtrade goes "On the Road." To keep providers updated on the industry's fast-changing landscape, Medtrade has developed a series of specialty mini-conferences to address HME's hottest topics, including competitive bidding, reimbursement changes and more. These new On the Road educational conferences are coming to a city near you, so pick your topic and pick your date. Coming up next: Medtrade's Conference on Accreditation and Competitive Bidding April 16-17, and Medtrade's Billing Bootcamp with Jane Bunch on April 30. For more information, visit Medtrade Conferences On the Road. HME Gets Another Chance with 'Tanner-Hobson' Bill WASHINGTON--In a move championed by industry advocates, on Thursday, U.S. Rep. John Tanner, D-Tenn., introduced a bill designed to "assure access to durable medical equipment under the Medicare program." H.R. 1845, the "Medicare Durable Medical Equipment Access Act of 2007," is co-sponsored by Reps. David Hobson, R-Ohio, and Mike Ross, D-Ark. The proposed legislation is a new version of the Hobson-Tanner bill introduced last year, which failed to make it through congressional channels before the end of the term. "We made a few minor changes, but the bill is essentially the same as the one submitted last year," said Randy Ford, Tanner's communications director. "Hopefully, this is the year we'll have some legislative success with it." The Tanner-Hobson bill is aimed at ensuring accessibility for Medicare beneficiaries and fairness to HME providers under the impending competitive bidding project. The Medicare Modernization Act of 2003 mandates competitive bidding, and CMS is scheduled to implement the program this year. According to its language, H.R. 1845 would amend the current mandate so that any HME provider could participate in Medicare "at the selected award price so long as they submit bids at less than the fee schedule amount otherwise applicable to the items and they otherwise comply with applicable program requirements." In other words, the bill would allow any qualified provider who has submitted a bid below the current allowable to continue doing Medicare business. The bill also calls for a complete analysis of the impact of competitive bidding once it has been fully implemented in the first 10 cities. That analysis would include impact on beneficiary access to quality products and impact on providers of items and services covered under the project. In addition, the bill would prohibit expansion of the competitive bidding program or the application of the bid rates to non-bid areas unless specifically authorized by Congress after the date of H.R. 1845's enactment. The American Association for Homecare praised the re-introduction of the bill and pledged to "vigorously seek" more cosponsors. "The home care community applauds the leadership of these congressmen," said Tyler Wilson, AAHomecare president. "The current law for competitive bidding threatens to reduce access to care for home care patients served by the Medicare program. The new bill would help to ensure that home care providers can continue to compete in a fair program." The text of the bill should be available shortly at http://thomas.loc.gov. With the advent of competitive bidding and a new era for the HME industry, what is the biggest challenge now facing your company? To vote in HomeCare's monthly Web poll, visit www.homecaremag.com. OIG Recommends Strengthening Supplier Enrollment Process WASHINGTON--The HHS Office of Inspector General issued a report Friday on south Florida HME providers based on results of unannounced visits to home care companies in Miami-Dade, Broward, and Palm Beach counties. The counties were targeted for review based on previous allegations of supplier noncompliance with Medicare standards. Working in collaboration with CMS and the National Supplier Clearinghouse, the OIG inspected 1,581 businesses to assess their compliance with five specific requirements, which state that suppliers must: 1) maintain a physical facility; 2) be open and staffed during business hours; 3) have a visible sign; 4) post hours of operation; and 5) maintain listed telephone numbers. During the site visits, OIG found that 45 percent of DMEPOS suppliers in the three south Florida counties did not comply with at least one of the five standards reviewed. Thirty-one percent of suppliers did not comply with the first two requirements of maintaining a facility at the business addresses that they provided to Medicare and being open for business during posted hours. Another 14 percent were open but failed to meet at least one of the three remaining requirements that OIG reviewed. "It is clear that Medicare continues to be highly vulnerable to DMEPOS fraud and abuse," said Inspector General Daniel Levinson. "It is vital that we protect Medicare beneficiaries from unscrupulous suppliers who are gaming the system at the expense of our nation's seniors and taxpayers. Our colleagues at CMS share our goal of ensuring program integrity, and I am pleased that they have agreed with many of our recommendations." Based on the report findings, the OIG recommended that CMS strengthen the supplier enrollment process to ensure that suppliers meet the Medicare standards through several actions, including: --conducting more unannounced site visits and out-of-cycle
inspections;
In a separate report released at the same time, the OIG documented the results of out-of-cycle visits to 169 DMEPOS suppliers not located in Florida. "Through our out-of-cycle site visits, we found that 10 of the 169 DMEPOS suppliers did not physically exist," according to the report, which noted that an additional six existed at their stated business addresses but were closed during posted hours of operation. "The 10 absent DMEPOS suppliers billed Medicare almost $393,000 in the two months after we had determined that they were absent," the report said. "Of the nearly $393,000 in submitted claims, the suppliers received almost $197,000 in reimbursements as of Dec. 31, 2005." The six suppliers that were closed during business hours collectively billed Medicare almost $102,000 in the two months after OIG discovered that they were closed, and received almost $52,000 in reimbursements as of Dec. 31, 2005. According to the OIG, its findings suggest that out-of-cycle visits targeting DMEPOS suppliers "may be warranted in other areas of the country." To view the report on south Florida suppliers, click here. To view the report on suppliers in other areas, click here. eBay to Cease Oxygen Device Sales BUFFALO, N.Y.--In what stakeholders call a victory for the entire respiratory industry and the patients it serves, AirSep Corp. executives said that giant Internet marketer eBay will cease selling prescription oxygen devices. The issue of what happens to concentrators and other oxygen delivery devices after an oxygen patient dies has long been a concern to industry stakeholders, according to AirSep and others, with many risks for consumers who assume ownership of used equipment via garage and Internet sales. There is, for example, no assurance that the level of oxygen is appropriate for the user, and the absence of clinical oversight can lead to dangerous outcomes. In the fight to eliminate sales of prescription respiratory equipment on eBay, the industry has finally won, said AirSep's Joe Priest, president and CEO. "Kathy Sanchez and our staff did yeomen's work to change eBay's policy regarding the sale of prescription oxygen devices on the site," Priest said. "Every time we saw one up, they sent an e-mail and told them it was a medical device, [that oxygen is] an FDA-controlled drug, and it's just not a device that should be on eBay." The effort took two years and involved weekly--or even more--phone calls and e-mails to eBay officials, said Sanchez, AirSep's marketing and public relations manager. In February, she received an e-mail from Jack Christin Jr., eBay's senior regulatory counsel, stating that the sale of oxygen concentrators, oxygen compressors, oxygen conservers and their accessories that require a prescription would not be allowed. The policy is applicable to the U.S. and Canadian eBay sites. Nichola Sharpe, senior public relations manager, eBay corporate communications, said the decision came following contact between eBay and the FDA, as well as AirSep and other respiratory product manufacturers including Inogen, Hill-Rom and Invacare. "[We] worked both with the FDA and with manufacturers of prescription oxygen devices and decided that these devices should not be sold on eBay," she said. Since the policy change, Sanchez said she has noticed a remarkable decline in the number of oxygen products listed on the site. "We were thrilled that we received the notice that eBay was changing its policy," she added, noting that suppliers and patients alike have applauded the effort. Popovich Relinquishes Joint Commission Reins CHICAGO--Maryanne Popovich, long-time executive director of home care accreditation for The Joint Commission, retired Friday, ironically just as the HME industry is on the cusp of mandatory accreditation. On Friday, in fact, some industry stakeholders caught a glimpse of what might well be the first 10 cities in CMS' competitive bidding project (see top story), where providers will be required to be accredited by a CMS-approved accrediting body in order to bid. Mandatory accreditation of all providers will follow at some point, although CMS has not yet set the effective date for that. Popovich, who has held her position for 14 years, said she is looking forward to moving back to her home state of Pennsylvania, spending time with her family and nurturing her penchant for traveling and museums. "Who knows, I may even take an art class," she said. The former nurse, who has been with The Joint Commission since its inception in 1988 when she started out as a surveyor in the home health division, said she will stay on in a part-time capacity during the transition as a new executive director is named. Gina Zimmermann, senior executive director of business development for the agency, said the organization hopes to have a replacement for Popovich within two to three months. The new executive director will immediately need to grapple with the mandatory accreditation issue for HME providers. Already, Zimmermann said, "we are seeing a steep increase in interest; that's actually across all segments in the areas that we accredit--even in home health without [durable medical equipment] and hospice, too." Looking back on her years with The Joint Commission, Popovich said, one of her proudest moments was "that we were the first to accredit HME." Popovich, who is a member of the Program Advisory and Oversight Committee, formed to advise CMS on competitive bidding, said she had no idea when she made the decision to retire that The Joint Commission, like other industry stakeholders, would still be waiting for the final rule on competitive bidding. "We thought it was going to come out last fall," she said. Still, she feels the time is right to retire. The Joint Commission, which recently shortened its name (from JCAHO), is well-positioned to deal with the changes coming down in the industries it covers, she said. But Popovich believes the HME industry will experience some tough times, and said she harbors some concerns about competitive bidding. "I am speechless as to whether it is going to be good or it is going to be bad," she said. "It has the potential to be of benefit. But I have no idea, even as a member of the Program advisory board, how they are going to roll out the products, the rules, how they are going to administer the bids coming in. "I want the organizations to bid realistically and read the rules," she continued. "They are not going to benefit anyone by going low. But I am more concerned ... about who is going to be allowed to service [the equipment]. I am very concerned that we are not going to have enough providers for people to access this service ... I'm worried about the whole process." Still, she thinks the industry could be on the brink of some of its best times, largely because of the mandatory accreditation provision. "Despite the uncertainties, I think if the industry can just hold tight and look beyond to two or three years, it is going to be in much better shape," Popovich said. "I absolutely am aware of the reimbursement issues ... but I think the industry has the best opportunity I've seen in all my years to [establish itself] as a credible service segment. "Once the credibility has been established, the value of the service and the reimbursement will flow from there." Coming Up The Tennessee Association for Home Care (TAHC) is holding its annual spring conference today through Thursday in Franklin, Tenn. For more information, call (615) 885-3399 or visit www.tahc-net.org. The Pacific Association for Medical Equipment Services (PAMES) will hold its annual convention April 10-11 in Portland, Ore. For more information, call (503) 253-9691 or visit www.pames.org. HMEducation.com will offer the following online seminars this month: "Mandatory Accreditation for Medicare Part B Suppliers" on Apr. 11; "Retail HME Cash Sales" on April 12; "How to Succeed With Competitive Bidding" on April 18; and "Profitable Reimbursement Strategies" on April 19. The series is sponsored by the University of Southern California School of Pharmacy. For more information, visit www.hmeducation.com. Dynamic Seminars & Consulting will hold a teleconference called "Sales Strategies with Louis Feuer" April 13. For more invormation, call (954) 435-8182 or visit www.dynamicseminars.com. The Illinois Association for Medical Equipment Services (IAMES) will hold its annual conference April 19-20 in Lisles, Ill. For more information, call (630) 369-7782 or visit www.iames.org. The American Occupational Therapy Association (AOTA) will hold its annual conference and expo April 20-23 in St. Louis. For more information, call (301) 652-2682 or visit www.aota.org. Medtrade Spring will be held April 24-27 in Las Vegas. For more information, call (800) 241-9034 or visit www.medtradespring.com. The Visiting Nurse Associations of America (VNAA) will hold its annual meeting April 25-27 in Palm Desert, Calif. For more information, call (617) 737-3200 or visit www.vnaa.org. The Pennsylvania Association of Medical Suppliers (PAMS) will hold its annual convention in State College, Pa., April 29-May 1. For more information, call (717) 795-9684 or visit www.pamsonline.org. The South Carolina Medical Equipment Services Association (SCMESA) will hold its annual meeting and trade show in Myrtle Beach, S.C., May 3-4. For more information, call (803) 926-1772. THERE'S STILL TIME TO REGISTER! Join HomeCare tomorrow (Tuesday, April 3), for an interactive teleconference "Accreditation: What You Need to Know and When You Need to Act." It's time to move on accreditation--even if you're not involved in Medicare competitive bidding this year. How long does it take? How much does it cost? Find out what you should think about in addition to fees, and get help in choosing the accrediting body that's right for your company. Get your questions answered and get the information you need to get going! Presented by Mary Ellen Conway, president, Capital Healthcare Group, and sponsored by HomeCare. Click here to download a fax registration form, or call (770) 618-0200 for more information. To revisit this news any time during the week, go to www.homecaremonday.com. ADVERTISEMENT |
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