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Headline News
Switchboard Shutdown Nets New H.R. 1845 Cosponsors, but VGM Says Work Is Not Done
WATERLOO, Iowa--HME stakeholders took to the phones by the thousands last Wednesday to urge support on Capitol Hill for industry bills that would staunch the reimbursement and accessibility blood-letting.

Some 8,167 phone calls to legislators were recorded on the VGM Group's special "Shut Down the Switchboard" Web site; the site itself garnered 33,000 hits, said John Gallagher, vice president, government relations, for the buying group. Gallagher came up with the idea for the Washington call-in to raise lawmakers' awareness of the industry.

"We're pleased--very pleased," he said, noting that the phone calls resulted in two additional cosponsors for H.R. 1845--the Medicare Durable Medical Equipment Access Act--which would amend competitive bidding to protect patient access to quality care and protect small providers. Reps. Hank Johnson, D-Ga., and Lee Terry, R-Neb., signed on as cosponsors on Nov. 14, bringing the total to 147.

But as happy as VGM officials were at the event's outcome, they cautioned that the work is not done.

"You've got to do follow-up," Gallagher said, noting that providers need to send emails or faxes to legislators within the next week or two. As Congress wrestles with ways to fund the so-called Medicare "doc fix" to reverse a scheduled 10 percent physician fee cut, oxygen and power mobility cuts are once again on the table. Providers must request that legislators support the industry bills and make the case for no additional cuts to HME, Gallagher said. "The follow-up is going to be so key."

Providers should "request that response," he said. "[Say] 'I really want to know where my congressman stands.'"

VGM initiated the project in honor of World COPD Day as a way to drum up support for H.R.1845/S. 1428 and H.R. 621/S. 1484, the Home Oxygen Patient Protection Act. The Web site featured the Capitol Hill switchboard number, a press release for providers to send out and talking points about the bills. Gallagher said the total call tally could be three or four times greater since not everyone who made calls logged them on the site.

"We received many calls from state association officials who said they knew more people had called than our site reported," he said. "Carol Napierski, executive director of NYMEP, reported that one of their providers on Long Island had at least 75 of their patients call. Michael Hamilton, executive director of ADMEA, said that many providers asked their customers to call. Others called talk radio and sent the press release to every newspaper and TV station in the state."

That a unified movement was underway--and having an effect--was evident to those who viewed the all-day Webathon or listened via phone as Gallagher and other VGM executives, including Founder Van G. Miller and Jim Walsh, president and general counsel, urged providers to make the calls.

Providers also called in to VGM to report from the grassroots side.

Steve Slater of Airway Oxygen in Wyoming, Mich., said he involved all of his employees and oxygen patients in an email drive. "I hope to have 100 emails for each congressman," he said. "It's been a good day, but after today, the important thing will be to keep the pressure on."

Another provider from Ohio reported making 64 calls and said that after 4:30 p.m. Eastern time, most of the legislators' voicemail boxes were full.

Cara Bachenheimer, vice president of government relations for manufacturing giant Invacare, Elyria, Ohio, dialed in with a view from the Hill.

"They are literally putting together the Medicare package as we speak," she said, noting that oxygen was "a very big target" and the first-month purchase option for power wheelchairs was also under scrutiny. "These are definitely sensitive issues," she said, adding that consensus among the legislators could come behind closed doors where public comment is not invited.

"It is critical that these legislators hear from their constituents," Bachenheimer said.

As the day wore on, more and more legislators did hear. Gallagher fostered a friendly competition among the states. "Texas, you've got 286, Florida has 327. Get it on, Texas!" he exhorted.

In the end, it was Ohio that landed the greatest number of calls--1,086. Iowa was second with 779, followed by Virginia, 559; California, 544; Massachusetts, 516; Florida, 477; and Texas, 475.

Gallagher credited state associations with helping to spur support. "They really put forth the effort in getting the word out and rallying their troops to call D.C.," he said.

Gallagher pointed to the effort from the fledgling year-old Utah Medical Equipment Dealers association. "In calls per capita, UTMED was tops," he said.

The 22-member group helped generate 393 calls.

"We made some good progress," said a modest Tom Bradley, president of UTMED and owner of Petersen Medical in Orem, Utah. He applauded VGM for sparking the movement.

Brant Curtis, coordinator of UTMED and inventory controller at Petersen, said the company's employees had made about 100 calls. "We're hoping it will make a difference," he said.

"Medtrade continues to be the best place to learn how to survive in today's climate," said Bird. "Medtrade is still the meeting place for the HME community. It is a gathering of people trying to learn how to move their businesses forward."

Opposition Builds to OIG Pricing Report on PWCs
WASHINGTON--Opposition to a recent Office of Inspector General report comparing Internet prices for power wheelchairs with Medicare reimbursements of the equipment continues to grow.

On Wednesday, Reps. Tom Allen, D-Maine, and Ron Lewis, R-Ky., sent a "Dear Colleague" letter to fellow House members blasting the report. "We find it inappropriate and misleading to compare those prices to the service delivery model for power wheelchairs under the Medicare program," the congressmen wrote.

Released Oct. 30, the OIG report found that Medicare's fees for PWCs were 45 percent higher than prices available on the Internet. For the first three months of 2007, the report said, the government could have saved nearly $40 million if its payments had been the same as those Internet prices. (See HomeCare Monday, Nov. 5.)

Subsequently, House Ways and Means Health Subcommittee Chairman Pete Stark, D-Calif., lauded the report in a letter sent to other representatives.

But the response from Allen and Lewis disputes the OIG's findings.

"There are extensive service-related costs associated with Medicare compliance that need to be considered in any comparison," the congressmen pointed out. "In particular, the Group 3 power wheelchairs available over the Internet cannot be customized to fit the individual needs of a person who is severely disabled ...

"Complex power wheelchairs (Group 3) need to be fitted, programmed and configured to fit the individual through extensive assessment and exact patient measurements. This can require multiple home visits as well as coordinating with a beneficiary's physical and/or occupational therapist. In addition, suppliers of Group 3 power wheelchairs employ specially trained staff knowledgeable in assessing and fitting these power wheelchairs to the unique needs of the beneficiary," the congressmen continued, noting that Internet providers are not required to provide any of these services.

Allen and Lewis are co-authors of H.R. 2231, which seeks to exclude complex rehab from competitive bidding. Bidding Group 3 chairs "can result in ill-fitting power wheelchairs and a decline in clinical outcomes and reduced function, independence and increases costs for the Medicare program and its beneficiaries who rely on these devices," their letter noted.

The American Association for Homecare sent its own letters to both Stark and Inspector General Daniel Levinson disputing the report.

"We firmly maintain that the cost of acquiring power wheelchairs used by Medicare beneficiaries through the Internet does not in any way compare to the cost of providing these devices to Medicare beneficiaries adhering to the appropriate standards of care," the Nov. 12 letters stated.

"Internet purchasing and the Medicare provider model are completely different ... Under Medicare, durable medical equipment providers must shoulder the expense of evaluating the beneficiary's specific needs, assessing the home, assembling the wheelchair, delivering the equipment to the home, conducting customized on-site fitting to accommodate the individual's seating needs, performing on-site training, processing claims for payments to insurers and maintaining facilities to provide service and repair.

"Any accurate analysis of costs required to provide the expected Medicare standard of care must take into account these services and administrative costs, which are distinct from the costs of acquiring the equipment," AAHomecare said.

To read the OIG report in full, click here.

To read AAHomecare's full response, click here.

Respiratory Expert Charts the Changes, Predicts Solid Year Ahead
ATLANTA--Though beset with challenges like the 36-month rental cap for home oxygen, respiratory providers should see a solid 2008 with significant opportunities, according to one industry expert.

"Providers can expect less-expensive concentrators, in-home qualifications for CPAP patients and transitions to nebulizer medications that only have to be taken twice each day as opposed to the four times each day of the normal medications prescribed today," said Mickey Letson, president, The Letco Companies, Decatur, Ala.

If CMS approves the in-home CPAP qualification next month, Letson said, providers can look forward to "huge successes" as more CPAP patients are qualified in 2008 than ever before.

"The importance of this is that now HME providers will be bringing in patients who are significantly younger and have the potential to extend profitability on a per-patient basis by more than double that which is enjoyed today," he said. "This should provide more stable, long-term growth over the next several years for a market that is facing capped rental for oxygen in 2009."

Letson noted that, because it is becoming "much more difficult" to make it as a specialty provider of respiratory medications in home health, those providers are now focused on providing oxygen, CPAP therapy, nebulizer medications and related supplies. While a small provider used to be able to open shop and do only neb med business, he said, such specialization can now only be successful for established companies with significant volumes in a specific market.

In addition, respiratory medication providers have had to change the way they forecast, Letson said.

When reimbursements were posted in December and remained in effect for the entire following year, providers could plan a strategy and then spend the year executing it. But with reimbursements now based on an Average Sales Price formula--a four-quarter average of previous pricing reported by manufacturers, plus 6 percent--"it is extremely difficult in today's environment to plan and strategize when pricing can change dramatically each quarter," he said.

The intent of the moving averages was to limit price fluctuations, Letson explained, but "this obviously did not work, as albuterol reimbursement dropped 25 percent in a single quarter." Moreover, he said, in today's marketplace, physicians are resisting allowing providers to change prescriptions for patients several times each year.

"Providers still must plan for the year and execute that plan," Letson said. "Focus has now shifted ... to providing medications that offer a more stable, consistent reimbursement as well as a much broader drug mix for the provider's patients."

Having all patients on just one or two primary medications is no longer a smart strategy, he continued. "This could prove devastating should the reimbursements move significantly on those products."

Pre-Payment Reviews Continue, Point Up Huge Denial Rates
COLUMBIA, S.C.--HME providers in Jurisdictions A and B have been slammed with claim denials in a number of areas this year, according to the results of several pre-payment reviews released by TriCenturion, the regions' DME PSC.

Most of the denials, according to the results, were due to inadequate, incomplete or improper documentation.

"Providers really need to pay attention to the guidelines that Medicare sets forth and abide by them," said Lisa Bargmann of Bargmann Management and Homecare Collection Service in Akron, Ohio. "Many providers are looking for easy answers to avoid the Medicare requirements; however, there are not any."

The reviews are part of a stepped-up effort by CMS to curtail reimbursement for unnecessary items and to combat fraud and abuse. Through its contractors, CMS has been scrutinizing claims for various products, a practice that is expected to continue and perhaps even escalate.

As a result of the intensified scrutiny, claim denials have soared, to as much as 93.6 percent for some power wheelchairs in Jurisdiction B and 99.25 percent for surgical dressings in Jurisdiction A.

"Denial rates have increased because there is a more concentrated effort on saving costs, especially when Medicare views that services are being provided that are not warranted under their guidelines," Bargmann said. "I expect those denials and audits to continue at a high amount."

Bargmann said providers can help guard against denials by making sure the patient qualifies for the equipment and having proof on file.

"Just because Medicare doesn't require you to send in the proof up front does not make it OK not to have the information," she said. "Each time a provider bills for a service that has not been qualified, that creates an opportunity for a take-back on not only that patient but an extrapolation across all patients. It also puts the provider number in jeopardy, along with additional fines and punishments."

Following are the results of TriCenturion's recent reviews:

--Power Wheelchairs HCPCS K0823.The Charge Denial Rate was 87.5 percent for Jurisdiction A and 93.6 percent for Jurisdiction B. This pre-payment review will continue.

--Negative Pressure Wound Therapy HCPCS E2402. This review was continued in Jurisdiction B as the result of an overall 83.72 percent CDR in a 2006 probe of new products added in the policy group. While results for the third quarter showed 25 percent of the claims were paid, 63 percent were denied because policy criteria were not met, and another 12 percent were denied for non-response. This pre-payment review will continue.

--Surgical Dressings HCPCS A6209-A6214. The CDR was 99.25 percent for Jurisdiction A and 98.77 percent for Jurisdiction B. This pre-payment review, which has been completed, showed that 71 percent of the claims were denied because medical necessity was not supported.

--Heat/Cold Application HCPCS E0215 (electric heat pad, moist) and E0217 (water-circulating heat pad with pump). The CDR was 84.38 percent for Jurisdiction A and 92.43 percent for Jurisdiction B. The review, which is complete, showed that in Jurisdiction A, 30 percent of the claims were denied as not medically necessary because the information submitted did not demonstrate that policy criteria were met. In Jurisdiction B, 59 percent of the claims were denied for the same reason.

--Rollabout Chair HCPCS E1035. This review, which has been completed, was conducted in Jurisdiction B. The CDR was 29.2 percent, with most claims being denied because they were deemed not medically necessary.

Family Crime Ring Sentenced in S. Fla. Kickback Scheme
TAMPA, Fla.--Four family members who owned a series of Miami DME companies and outpatient rehab facilities have each been sentenced to 57 months in prison for Medicare fraud, Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced Nov. 9.

Carlos Berenguer, 61, Ivan Aguera, 34, Aristides Berenguer, 64, and Robert Berenguer, 58, were sentenced for their roles in a $20 million Medicare kickback and medication billing scheme, according to the U.S. Attorney's office. In addition to their prison terms, each was ordered to pay over $1.4 million in restitution.

The four defendants pleaded guilty to 14 criminal counts in March.

Brothers Carlos and Aristides Berenguer owned Select Medical Equipment, while another brother, Robert Berenguer, owned Professional Medical Equipment. Carlos Berenguer's stepson, Ivan Aguera, owned Palm Medical Equipment. Through these companies, the four recruited and paid Medicare patients to participate in schemes involving false claims for unnecessary oxygen concentrators and compounded aerosol medications.

Prosecutors said none of the four defendants owned a pharmacy capable of billing Medicare for drugs, so they conspired with the owners of Miami pharmacies to refer patients in exchange for half of what Medicare paid for aerosol drugs. From 2001 to 2003, the Berenguers and Aguera were responsible for Medicare's payment of over $1.4 million based on false claims.

Another family member, Ricardo Aguera, who owned three Miami health care companies, was sentenced to 121 months in prison following a week-long jury trial in March.

According to the U.S. Attorney's office, the aerosol medication scheme was one of the most common health care frauds in south Florida. In 2006, Medicare paid over $155 million for aerosol meds in Miami-Dade County, making it the single most common item billed to Part B. From 2005 to 2006, claims for aerosol medications increased over 100 percent. In addition, according to Medicare data, Miami-Dade County alone accounted for more paid DME claims than every state in the country except California, Texas, New York, Michigan and Ohio.

Kirk Ogrosky, deputy chief of the fraud section of the U.S. Attorney's criminal division, Miami, and Jeffrey Neiman, trial attorney with the fraud section of the Department of Justice, Washington, prosecuted the case with assistance from the HHS Office of Inspector General, the FBI and the Medicaid Fraud Control Unit of the Florida Attorney General's Office.

In related news, another south Florida DME provider was sentenced to more than five years in prison for her role in a compounded aerosol medications scheme.

Marianela Smith was sentenced to a 66-month prison term and ordered to pay $363,000 in restitution by the U.S District Court for the Southern District of Florida Nov. 9. Smith, who was tried in August, was found guilty of five criminal counts involving physician kickbacks for phony prescriptions for the compounded meds. According to a statement from the U.S. Attorney's office, she obtained the aerosol medications from previously convicted pharmacy owners in Miami. Between 2000 and 2003, those pharmacies billed Medicare more than $17 million.

Since beginning operations in March, Medicare Fraud Strike Force teams in South Florida have indicted 120 defendants in Miami-Dade County alone. To read more about the Strike Force, click here.

To read more about the case against Marianela Smith, see HomeCare Monday, Sept. 10.

30,000 Medicaid Providers Cheat on Their Taxes, GAO Finds
WASHINGTON--According to a Government Accountability Office report released Wednesday, more than 30,000 Medicaid providers over seven states owe the federal government more than $1 billion in taxes for 2006.

Medicaid providers from California, Colorado, Florida, Maryland, New York, Pennsylvania and Texas--in all, representing about 5 percent of the program's providers--were found to be cheating on their taxes, thus defrauding the government out of billions. The report comes on the heels of a study earlier this year that showed Medicare providers owe some $1.3 billion in taxes for 2005.

Most of the unpaid taxes were payroll taxes withheld from employees' wages but never paid to the government, the report found, and some providers diverted the money for their own benefit. "Many of these individuals accumulated substantial assets including million-dollar houses and luxury vehicles," the GAO said.

Of 25 cases selected for in-depth studies, the GAO found "abusive and related criminal activity" in all of them. Some providers were also cited for substandard patient care.

"These doctors are supposed to be serving the most needy. Instead, they are cheating taxpayers in order to line their pockets," Sen. Norm Coleman, R-Minn., told USA Today.

Coleman requested the study with Sen. Carl Levin, D-Mich., who called for the adoption of a tax levy to address the problem. The GAO said if such a levy had been in place in the seven states, the federal government could have collected between $70 million and $160 million toward the tax debts.

Others have suggested preventing those providers with federal tax debts from enrolling in Medicaid. But officials with CMS have said that could adversely impact states' ability to provide health care to low-income people.

Annual Rankings Show Decline in Nation's Health
WASHINGTON--Despite progress in several key indicators, the overall health of the nation declined over the past year, according to a report from the United Health Foundation, the American Public Health Association and Partnership for Prevention.

The report--the 18th annual edition of "America's Health Rankings: A Call to Action for People & Their Communities"--measured the overall healthiness of states and the nation based on a comprehensive set of health determinants and outcomes. The study factored 20 related health measures, including smoking, binge drinking, violent crime, infectious disease, high school graduation, health status and several measures of mortality.

While there have been modest gains in reducing cancer and cardiovascular mortality rates, the improvements are dwarfed by increases in obesity, the number of uninsured, children in poverty and risky health behaviors such as tobacco use, the report said.

"Even though specific mortality rates have improved, this report shows there are still many people who, through unhealthy personal behaviors, adverse community environments and difficult access to care, are vulnerable to a future life of poor health--which is essentially preventable," said Reed Tuckson, M.D., who serves on the UHF Board. "The consequence of this reality manifests itself in a poor quality of life, people living with chronic disease, compromised productivity and significant escalation in the costs associated with managing chronic illness."

Over the last six years, the report said, the nation's health "has virtually stagnated" due to obesity, a growing number of uninsured and persistent lack of progress in key health measures such as tobacco use, violent crime and children in poverty.

Obesity has increased from 11.6 percent of the population in 1990 to more than 25 percent today, the report said. More than 55 million Americans are obese and, as a result, are at significant risk for other diseases, such as heart disease, diabetes, stroke and cancer.

In addition, the report noted, the number of Americans who are uninsured has increased from 13.4 percent in 1990 to 15.8 percent today. According to the Institute of Medicine, people without health insurance are sicker and die sooner.

The report identified Vermont as the healthiest state in the country, followed by Minnesota, Hawaii, New Hampshire and Connecticut. Mississippi ranks as the least healthy state, with Louisiana, Arkansas, Oklahoma and Tennessee completing the bottom five.

Although the U.S. can now celebrate its highest life expectancy in history (77.9 years), the report said 43 other countries still have life expectancies that are higher, including Japan, Sweden, France, Canada, Italy and Austraila.

For the entire report, visit www.americashealthrankings.org.

Clayback Appointed MED Group VP of Government Relations
LUBBOCK, TX--On Friday, The MED Group announced that Don Clayback, who had been serving as senior vice president of networks, including direct management of MED's National Rehab Network, has been appointed vice president of government relations to focus full-time on lobbying and industry support initiatives.

Clayback, who has worked in the HME industry for over 22 years as a provider and consultant, will also assist the group's members as they navigate the competitive bidding process, according to a press release. He also serves on the executive committee and board of directors of the National Coalition for Assistive and Rehab Technology, AAHomecare's Regulatory Committee and its Rehab and Assistive Technology Council.

David Jones, residing in Fort Collins, Colo., who had been serving as regional manager for the West, has been promoted to director of MED's National Rehab Network. Jones has over 20 years in the industry and is a RESNA Certified Assistive Technology Supplier.

The MED Group has over 300 members in more than 924 locations throughout the United States and Puerto Rico.

Provider News
Equity Firm Buys Arizona HME Company
CHICAGO--A Chicago-based private equity firm has snapped up a majority interest in Maverick Healthcare Group, dba as Preferred Homecare, a Mesa, Ariz., HME provider.

Details of the transaction were not disclosed.

"We have followed the growth of Maverick since 2002 and watched it develop into the leading provider of home health care services in the Southwest," said Gregory Moerschel, partner, Beecken Petty O'Keefe & Company, which made the acquisition from The Halifax Group of Washington, D.C. "BPOC looks forward to supporting the company's continued growth."

Maverick offers a full range of HME, including respiratory therapy, infusion therapy and custom rehab equipment, and serves nearly 35,000 patients through 27 locations in Arizona, California, Colorado, New Mexico and Nevada. It also has eight independent sleep diagnostic testing facilities in Arizona and New Mexico.

Since March 2005, when Halifax acquired the majority interest, the company's profitability has nearly doubled, 10 locations have been opened and two acquisitions made, officials said.

Earlier this month, Maverick announced it had purchased Park InfusionCare, a Phoenix-based HME provider, from Ascendant Solutions of Dallas for $4 million. Park generated revenues of $7.3 million, with an operating loss of $250,000, in 2006.

State News
MESA Elects Officers for 2008
CASSELBERRY, Fla.--Covering Arkansas, Louisiana, Oklahoma and Texas, the Medical Equipment Suppliers Association has announced its newly elected slate of officers for 2008.

Cindy Bishop of Diamond Medical Equipment & Supply Co. in Little Rock, Ark., will serve as president, with other MESA officers including Sandra Hoskin of American Medical Equipment, Houston, vice president; Michele Garthright of Mike's Medical, Clinton, Okla., secretary/treasurer; and Dede Shinabery, American HomePatient, Little Rock, Ark., immediate past president.

The new board will take office Jan. 1.

Manufacturer News
Applied Home Healthcare in New Quarters
WESTLAKE, Ohio--Applied Home Healthcare Equipment moved its headquarters and North American plant to Westlake, Ohio, in September. In an unusual "ribbon cutting" ceremony for the new plant, owner and CEO David Marquard II and Westlake Mayor Dennis Clough cut through a chain with an oxy-acetylene torch.

Complete with employee training facilities, the newly renovated 27,000-sq. ft. building has double the manufacturing capacity of the company's previous facility in North Olmsted, Ohio. The new headquarters also includes a temperature- and humidity-controlled LAN computer room that ties together voice and email communications. The 4.5-acre site has wireless telephone and computer access through a Cisco system, and a new direct video link with the company's plant in Germany facilitates production planning and control.

Serving customers in 85 countries, Applied manufactures a range of respiratory and oxygen-related products, and offers accreditation and compliance training materials.

"We outgrew our previous buildings," Marquard said. "The new facility will give us room to grow and continue servicing our customers at the high level of performance we always have demanded of ourselves. Our goal is to grow the business in double digit figures each year and so far we have always been able to achieve that."

Applied Home Healthcare Equipment and Superflash Compressed Gas Equipment are divisions of Applied Companies, founded by Marquard in 1993.

Gendron Expands Midwest Manufacturing
ARCHBOLD, Ohio--Bariatric product maker Gendron announced Tuesday it will move its headquarters and expand its overall manufacturing operation across five locations to accommodate growing business.

On Nov. 30, Gendron's corporate offices, including customer service, sales and accounting, will move to Bryan, Ohio. The company will also expand a facility in Pioneer, Ohio, to house product engineering, design, prototyping and testing. The Pioneer operation will also handle final assembly and will be the company's primary hub for shipping and receiving.

Three plants in South Central Ohio, Northeast Indiana and Southern Michigan will share additional component manufacturing. The company has been based in the Midwest since 1872.

"In the past 10 years, we have nearly tripled our sales," said Gendron president and CEO Steve Cotter. "Expanding and modernizing our facilities, as this move allows us to do, enables us to continue to develop innovative bariatric care products and meet demand for those products." The company manufactures a range of bariatric products including wheelchairs, beds and bath safety products.

In addition to its facilities expansion, Gendron recently hired Dr. Kevin Huffman to serve as medical director. A board-certified bariatric physician, Huffman has more than 17 years of clinical experience in obesity management. In his new position, he will help determine product development priorities and will serve as a treatment consultant for Gendron's customers.

Somnotech Signs on with Evo
MONROEVILLE, Pa.--Somnotech, the U.S. partner of German medical technology company Weinmann, announced it has entered an exclusive distribution agreement with Evo Medical Solutions for distribution of its Soyala CPAP masks and accessories in the United States.

"This year we've already expanded our CPAP lines and also invested heavily in home sleep testing equipment. We actually weren't looking for another mask to distribute, we have several good quality selections; but when Somnotech demonstrated their mask to us in a presentation at the recent Medtrade event in Orlando, we all knew right away we wanted this mask in our lineup."

Somnotech CEO Patrick Karem said the mask features an ultra-silent exhaust coupled with a durable frame. "These masks have thrived in Western Europe for the past several years. The replacement period for masks over there is much longer compared to what you see in the U.S., and Somnotech has been building masks to meet the needs of the European market's more exacting standards for quote some time now," he said.

In Brief
Saying the proposed bill exceeded his request by nearly $10 billion in discretionary spending, President Bush vetoed Congress' $606 billion FY 2008 Labor-HHS-Education appropriations bill Nov. 13, thus sending members of the House and Senate back to the drawing board. Congressional Democrats failed to override the veto on Thursday. Now, according to press reports, Senate Majority Leader Harry Reid, D-Nev., has put forth a plan to roll the bill into a $484.2 billion omnibus package including all the other unapproved 2008 appropriations bills that would split the difference between the amount of spending Democrats want and that requested by the president.

In its newsletter last week, the American Association for Homecare reported that some providers are complaining about problems related to CMS' recently launched fraud demonstration project in South Florida and Southern California. "Some providers were confused by a CMS letter outlining implementation steps by CMS and the National Supplier Clearinghouse, and specifically the accreditation deadline," AAHomecare said. "In at least one case, a provider noticed that information completed online for the form 855S changed after it was completed and printed out. The concern is that if providers assume that the information is correct and do not check completed sections, the NSC will store incorrect information." For more on the fraud demo, see HomeCare Monday, July 9.

The country's aging baby boomers will have "minimal effect" on overall health care spending growth, according to a study published in Health Affairs this month. Despite growth in the population age 65 and over, health care spending is expected to increase by only .4 percent per year through 2050, according to "U.S. Health Spending By Age, Selected Years Through 2004." The study authors added that "most would find it surprising that for Medicare, aging is expected to have an even smaller effect (.1 percent per year) per enrollee for the same period." Health spending will increase, however, as the baby boomers move into their mid-80s, the study said.

Coming Up
The American Association for Respiratory Care (AARC) heads to Orlando, Fla., Dec. 1-4 for the 53rd International Respiratory Congress. For information, call (972) 243-2272 or visit www.aarc.org.

The American Association for Homecare and the California Association of Medical Product Suppliers (CAMPS) will hold a Road Scholars Tour Medicare Survival Toolkit seminar Dec. 3-4. For more information, call (703) 836-6263 or visit www.aahomecare.org.

The VGM Group has scheduled a series of seminars on competitive bidding in 2008. The full-day seminars, called "Competitive Bidding: Preparing for Round Two," have been set for: Chicago, Jan. 31; Phoenix, Feb. 12; St. Louis, Feb. 14; Baltimore, Feb. 26; Charlotte, N.C., Feb. 28; San Jose, Calif., March 4; Tacoma, Wash., March 6; Newark, N.J., March 18; Providence, R.I., March 20. Additional dates include: Columbus, Ohio, April 1; Detroit, April 3; Denver, April 15; Atlanta, April 17; Tampa, Fla., April 22; Houston, April 24; Nashville, Tenn., April 29; and Long Beach, Calif., May 5. For information, call (800) 642-6065 or visit www.vgm.com.