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Headline News
Newest Competitive Bidding Debacle: Providers Might Have Misstated Bids
ATLANTA--An unknown number of home medical equipment providers got an unwelcome New Year surprise: letters from Competitive Bidding Implementation Contractor Palmetto GBA questioning their bids and seeking further documentation.

Providers were given until today to respond to the inquiries or face disqualification of their bids.

"We got a registered letter [on Dec. 28], and basically it says that they are contacting us about an urgent bid evaluation that could affect our bid and requires an immediate response," said Jerry Jeanes of Choice Medical in Denton, Texas. "The letter I have has five HCPCS codes on it and says that they want a dealer price list and invoice or something that details the actual cost for these five items."

Jeanes was one of at least 15 providers who reported receiving the letters to Waterloo, Iowa-based buying group VGM last week, according to Mark Higley, vice president-development. While it is unclear how many providers received such letters or whether CMS was sampling the bids or evaluating every single bid, the issue noted in each of the letters VGM heard about was the same: the bids themselves, Higley said.

"It is obvious that these letters are for bids approximately one-tenth of the purchase price," he said. "I don't think these were low-ball bids; the providers intended to submit an appropriate bid, but now they could be disqualified."

Higley said he believes some providers became confused by the bid form, which called for them to calculate their capacity in months but to enter the actual bid amount as a single purchase price.

"My concern is that some providers bid a monthly rental amount rather than the purchase price," he said.

Jeanes is sure he did just that. "What I think happened in my case is that when I looked at the instruction sheet I got from CBIC, when you get to some of these HCPCS codes, [it] says that one unit equals one monthly rental. So when I calculated my bid, I deducted whatever the [discount] was I was going to reduce my amount by and I divided the base by 10, and that was the amount I provided."

For example, he said, the allowable was $210.70 for a pair of elevating leg rests. "I took my discount off of that, and divided the balance by 10, and that's what I submitted to them.

"This is my fault, obviously, based on what I interpret now to be confusing instructions," Jeanes said sadly. "We jumped through all these hoops and spent all this money, and to be disqualified because of this just makes me sick."

The threat of disqualification is very real for Jeanes and the other providers who received such letters, Higley said, because their bids cannot be changed. The letters themselves reiterate that: "It is important to note that bid amounts may not now be revised. As stated in the [Request for Bids], once the bidding window closes, all bids are considered final and no further amendments to the bids are permitted."

So what hope do recipients of the letters have?

"While the CBIC will not automatically accept bids approximating one-tenth (the monthly rental amount) in a purchased item category, there may exist a chance of bid acceptance if the provider documents the acquisition cost and includes an explanatory letter with the submission," Higley said.

Government officials would not say exactly how many letters went out, according to Walt Gorski, vice president of government relations for the American Association for Homecare, who was enlisted by Higley to pursue the matter with CMS.

As of Friday, Gorski said, CMS had not made a determination as to what it will do. But providers who respond to the letters with strong documentation could help their own cases.

"They want to see what we are telling them. A supplier has to be very up front and say, 'A mistake was made; I bid one-tenth of what I wanted to bid,'" Gorski said.

"From AAHomecare's perspective, in those cases when a supplier bid one-tenth of what they wanted to bid, it would seem there would be an easy patch," he added. "Whether CMS will do that I guess depends on how much it affects capacity. We are very concerned that small suppliers who found this system very confusing to begin with will be left out of the program because of a simple error. Even the IRS lets you correct mistakes."

For his part, Jeanes is hopeful that CMS will allow a fix to an honest mistake. He was faxing all the requested documentation on Thursday.

"I am going to send several pages from the instruction sheet and show them I didn't make this up and that there was a reason for what I did and hope they will be forgiving and understanding," he said. "All I can do at this time is keep my fingers crossed."

A list of the 10 CMS-approved accreditation organizations can be viewed online at http://www.cms.hhs.gov/medicareProviderSupEnroll/03_DeemedAccreditationOrganizations.asp.

Maximum Comfort Loses CMN Decision on Government's Appeal
REDDING, Calif.--A federal appeals court has overturned a lower court's ruling that held a certificate of medical necessity was sufficient for Medicare to pay a claim for a power wheelchair, but the plaintiff in the case says he'll appeal the new ruling all the way to the U.S. Supreme Court.

Tom Lambert, owner of Maximum Comfort in Redding, Calif., said Friday he would exhaust every legal option open to him. "I'm not going to throw in the towel now," he said, adding that he and his attorney, Bart Fleharty of Wells Small and Selke in Redding are trying to figure out "whom to complain to now."

The ruling, issued Dec. 21 by the U.S. Court of Appeals for the Ninth Circuit, maintains that other documentation may be required by Medicare in order for a provider to be reimbursed. That ruling negates a June 2004 opinion by the U.S. District Court for the Eastern District of California that Medicare could not require Maximum Comfort to submit more documentation beyond a CMN for reimbursement of a power wheelchair. The court in that decision said Medicare could not require suppliers to obtain beneficiaries' medical records or to make judgments about whether equipment was medically necessary.

The Ninth Circuit court, however, said the CMN was not required and its information was limited. Referring to a Medicare Act subsection about CMNs, it states: "The subsection does not state that the certificate of medical necessity is the sole vehicle for claims reimbursement, nor does it state that a completed certificate, establishes, by itself, a right to reimbursement.

"We conclude," the new opinion reads, "that the applicable provisions of the Medicare Act do not make the certificate conclusive and that the [Secretary of the Department of Health and Human Services] may require additional documentation to establish medical necessity. We accordingly reverse the decision of the district court."

The ruling was a disappointing one for Lambert, who started his fight in 1999. At that time, a claims audit by the then-Region D DMERC determined that Maximum Comfort had failed to submit documentation in addition to the CMN to prove medical necessity for K0011 chairs. Post-payment auditors concluded that the provider owed Medicare $785,000. (See HomeCare, August 2004.)

After the company appealed, two administrative law judges ruled in Lambert's favor, saying that, for the supplier, the CMN was indeed the only medical record necessary, but the Medicare Appeals Council subsequently reversed those decisions. Lambert then filed suit against the Department of Health and Human Services, and the case ended up in U.S. District Court for the Eastern District of California, where he won the decision that was just overturned.

Ironically, the issue itself is moot because CMS has since revised its requirements for PWC reimbursement, and a CMN is no longer necessary.

Indeed, said Lambert, that is likely to be a basis for an appeal, since attorneys for HHS argued that the CMN was an optional document, not a mandatory one.

"That was true as of June 1999," Lambert said. But the claims in question ran from 1998 to June 1999 and thus did not fall under the new rules. "They are taking the new rules and trying to apply it to old business," he said.

The new opinion also says that Maximum Comfort is not "excused from liability." That means Lambert might ultimately have to repay Medicare, but how much is a big question mark. "I don't have a clue," he said.

In the past nine years, he has already lost his home, reduced his business and filed for bankruptcy while contesting the original post-payment audit. But Lambert says things are better these days because he chose to fight Medicare.

"You know what the rules are now. I think the dealers are safer today than when we thought the CMN was it," he said.

Stakeholders Push Ahead with Second Lawsuit to Stop NCB
CLEVELAND--As the clock ticks steadily toward the July 1 implementation date for national competitive bidding, industry stakeholders are making yet another bid to stop the project by filing a lawsuit on behalf of a small Ohio home medical equipment provider.

The suit was filed in December in U.S. District Court for the Northern District of Ohio (Cleveland Eastern Division) on behalf of Premier Medical by Cleveland-based law firm Walter & Haverfield LLP. It alleges that competitive bidding violates what is known as the Regulatory Flexibility Act, which "requires all agencies to carefully scrutinize ways to minimize the economic impact on small entities."

"The Final Competitive Bidding Rule violates the Regulatory Flexibility Act because [the Department of Health and Human Services] failed to adequately address the specific considerations for small businesses," the suit argues.

The recent lawsuit is the second backed by Waterloo, Iowa-based buying group VGM and its Last Chance for Patient Choice, a non-profit formed to fight competitive bidding. This suit, however, takes a different tack than its predecessor, filed in June in Dallas, which challenges the constitutionality of competitive bidding. (See HomeCare Monday, June 18, 2007.)

"The Ohio lawsuit is based on CMS' failure to follow federal law in enacting the rules related to the so-called competitive acquisition program," said Jim Walsh, VGM Group president and legal counsel. "This is a different theory than was urged in the Texas suit."

"[Competitive bidding] doesn't adequately address the effect on small providers," Walter & Haverfield attorney Michael Jordan told HomeCare. "I think we have beneficiaries who will be able to show the direct adverse impact that will occur."

The Ohio suit, which names as defendants Department of Health and Human Services Secretary Michael O. Leavitt and CMS Acting Administrator Kerry Weems, alleges that CMS did not "pursue alternatives to the competitive bidding scheme that would have minimized the significant economic impact on small entities."

"CMS could have (and in fact, was required to by the new law) set up the regulations to help protect the current dominance in the home care equipment markets of small businesses," Walsh said. "For example, a 'carve out' for Small Business Administration-level businesses could have been mandated in the regulations allowing small businesses to continue to serve patients who were Medicare beneficiaries if they accepted the bid prices of the non-small business bidders."

Instead, he noted, "the rules that CMS did adopt absolutely assure that small business participation in this segment of the health care industry will be cut in half or worse."

Under the competitive bidding project, the lawsuit notes, only 30 percent of small providers at most would be protected, and those shut out of the program have "no avenue for administrative redress."

The 14-page document requests that competitive bidding be halted now and in the future.

Attorneys had hoped to file the new lawsuit in October, but waited in hopes of gaining more plaintiffs. There is still the possibility of adding small providers to the suit, both Jordan and Walsh said.

"We will be adding more plaintiffs if they step up," said Walsh, lauding Premier for making that choice. "The number of companies willing to do that is surprisingly small. They're worried that they are going to get put on a list of troublemakers somewhere and be in trouble. But we don't need a lot of plaintiffs. What's good for one is good for all."

The government has 60 days to respond to the suit.

Meanwhile, the first lawsuit filed in Texas by Amarillo-based Brown & Fortunato is in a holding pattern. In that suit, the government's response was to file a motion to dismiss the suit primarily on the grounds that the case was not "ripe"--that is, that bids have not yet been awarded or denied so there is nothing to adjudicate.

"After giving it serious thought, we have made the decision not to file a motion for reconsideration," said attorney Jeffrey S. Baird, chairman of Brown & Fortunato's Health Care Group. "Rather, we are waiting for the CMS announcement of winning bidders. When that happens, then the government's 'ripeness' argument either goes away or is substantially weakened. At that time, we will seriously consider refiling the lawsuit."

CMS is scheduled to announce winners from the first round of DMEPOS bidding in March.

Respironics Board Endorses $5.1 Billion Bid from Philips
MURRYSVILLE, Pa.--Respironics' board of directors has endorsed a $5.1-billion bid by Royal Philips Electronics to acquire the sleep and respiratory equipment maker.

Netherlands-based Philips has offered $66 per share for Respironics, a more-than 20 percent increase above the company's recent closing prices. The deal is expected to close some time in the first quarter of 2008, pending approval from shareholders and regulators.

Philips said the acquisition would make it a leader in the global home health care space and in the fast-growing field of obstructive sleep apnea management and home respiratory care. The deal will also strengthen its in-hospital position given Respironics' non-invasive ventilation and respiratory monitoring products for hospitals and clinics, the company said.

"A core part of Philips' health care strategy is to take a leading position in the high-growth sector of home health care," Steve Rusckowski, CEO of Philips Healthcare and a member of the board of management of Royal Philips, said in a statement. "This acquisition, with its significant strategic and financial benefits to Philips Healthcare, is another important step in carrying out this strategy."

For the 12-month period ended Sept. 30, Respironics reported sales of approximately $1.2 billion. In its last five fiscal years, the company has seen revenues grow at a rate of 19 percent. Almost three-quarters of its sales come from the company's sleep and home respiratory business, which includes diagnostic and therapeutic devices for sleep disordered breathing and chronic respiratory diseases.

According to Philips, growth in the global respiratory market is expected to be at least 10 percent a year going forward, and the market for global sleep apnea management in particular is expected to show a mid-teen percentage growth rate annually as rising awareness of the condition leads to increasing diagnosis and treatment of OSA.

Respironics' respiratory management portfolio is also synergistic with Philips' current offerings in patient monitoring, from pre-hospital admission to long-term disease management in the home. The combined businesses will profit from cross-selling opportunities, according to Philips.

Upon completion of the acquisition, Respironics will become the centerpiece of Home Healthcare Solutions, which will form part of Philips Healthcare.

The Respironics deal is one of a steady stream of U.S. acquisitions by Philips' medical arm, according to press reports. Last month, the company bid $619 million for Maryland-based Visicu, which makes patient monitoring equipment. In 2006, Philips announced the acquisition of Lifeline Systems, and Health Watch and Raytel Cardiac Services, a Connecticut-based home heart-monitoring service, were added last year. The company said its Home Healthcare Solutions currently supports almost one million at-risk seniors, either in their own homes or in senior living facilities throughout the U.S. and Canada.

"The combination of Respironics and Philips will allow us to continue to provide exceptional products and services to our customers and allow Respironics to expand its leadership in the global sleep and respiratory markets" said Respironics President and CEO John L. Miclot. "Philips is the right partner to create additional growth opportunities for our company, and we believe that our company will benefit significantly by being part of a larger, growing and dynamic organization."

Respironics has approximately 5,300 employees worldwide.

Hoover Returns to Role as Medical Director for Cigna
ATLANTA--After more than two years in HME's private sector, Dr. Robert Hoover will reassume his role as a Cigna Government Services medical director when he takes over those duties for Jurisdiction C on Jan. 14.

Hoover left his position as medical director for the Cigna-administered Region D DMERC in 2005 to join Sunrise Medical as senior vice president of global clinical services, subsequently becoming chief medical officer for Somerset, Pa.-based DeVilbiss Healthcare when Sunrise split its mobility and respiratory operations last year.

Hoover said he had enjoyed his time with Sunrise and DeVilbiss, but called it "a fantastic opportunity when Cigna approached me about returning as the Jurisdiction C medical director." Following a year-long tug of war with Palmetto GBA to become the government's new Jurisdiction C DME MAC, Cigna was awarded the contract and took over full operations for the region in June 2007. (See HomeCare Monday, Jan. 29, 2007.)

In a HomeCare Q&A with Hoover conducted last week, he outlined the work that lies ahead of him and gave his thoughts on some of the industry's most pressing issues.

HomeCare: Why are you leaving DeVilbiss for Cigna?
Hoover: Although I've enjoyed my time with Sunrise and DeVilbiss, there was a significant amount of travel associated with the global responsibilities. Family considerations came into play along with the desire to return to my duties as a medical director. And yes, I did miss working with my colleagues both at Cigna and the other contractors.

When I was at Cigna and responsible for Region D, I felt that our team did a good job of building relationships with providers, physicians and beneficiaries. Personally, I tried to be open-minded and listen to providers and their issues. While I couldn't always accommodate their requests, I believe the provider community believed that I was accessible and was willing to work collaboratively with them. I'd like to continue that same policy for providers in Region C.

I feel confident that DeVilbiss will continue to grow in my absence ... They've got a fantastic product portfolio including iFill, Pulmo-Aide and IntelliPAP that will support their continued success in the marketplace. It has truly been a pleasure to be part of their growth and I wish them the best in the future.

HomeCare: Has your time "on the other side" of HME given you a new perspective of this industry and its needs?
Hoover: I think I have a better appreciation for the day-to-day "struggles" of the typical HME provider. I've always felt that the majority of providers were hard-working, honest and dedicated to rendering the best care possible for their patients. My time at Sunrise and the interactions I've had with our customers and others in the industry have simply confirmed by beliefs.

One of the main things that I've experienced is the age-old issue of physician education about HME and Medicare's policies. I've traveled around the country over the past two years and spoken to physicians and HME providers and it's clear that many of Medicare's policies are poorly understood by physicians. I think the root cause can be traced, in part, to the contractors and the Centers for Medicare & Medicaid Services who don't have a sustained educational effort directed specifically towards physicians and DMEPOS.

For example, the DME MAC contractors aren't funded to do physician education, only HME provider education. However, I think much of the "blame" falls on physicians who simply aren't interested or more likely, don't have the time, to learn the HME policies. Unfortunately, the fallout for the failure of physicians to document properly lands on the HME provider who's held responsible for the claim and supporting documentation.

HomeCare: What are the most pressing problems that you see for the HME industry coming up this year? What are the most pressing issues you will have to deal with as medical director?
Hoover: 2008 will continue to be a challenging year for the HME industry. While respiratory providers dodged a cut in oxygen equipment reimbursement at the end of 2007, Congress only provided a temporary patch for the Medicare program and will have to revisit funding issues in early 2008. That reimbursement uncertainty is hanging over the industry creating a lot of nervousness which translates into decreased sales. Competitive bidding will also be a significant force in 2008 with the announcement of Round 1 contracted suppliers (and fee schedule) and the beginning of Round 2.

As the medical director for Region C, one of the main issues will be improving the Comprehensive Error Rate Testing (CERT) program scores. Cigna was quite successful in Region D in bringing down the CERT error rate through intensive education and targeted claim reviews. Region C has consistently ranked high in the CERT program among the four DME MAC contractors so making improvements in that metric will be a top goal.

In addition to provider and physician education, I will also be looking at any new policies that might need to be developed to help providers improve their claim submission accuracy. I view policies as an educational tool since they tell the provider community exactly how to submit claims properly and with the appropriate documentation. Policy revisions and/or new policy development will be a focus upon my return to Region C.

HomeCare: Is there anything in particular you hope to focus on/change/improve as medical director for Cigna?
Hoover: I'm a big proponent of education, as you can guess from my previous responses. Unfortunately, education takes a while to have an impact versus targeted claim review. I feel we were very balanced in our approach in Region D with a good mix of education and claim review. My preference is education since claim review, whether pre- or post-payment, is labor intensive. It involves a lot of resources in terms of claim processing, nurse review time and in some cases, appeals workload. I'd like to get to know my provider community in Region C by working with the Region C provider council and encourage their collaboration in any educational efforts we initiate. Again, I prefer an open-door policy and look forward to working with this new region.

HomeCare: Regarding competitive bidding, do you feel that complex rehab should be included?
Hoover: True complex rehabilitation equipment should not be included in competitive bidding; however, part of the issue is how "complex rehab" is defined.

There are clearly patients who require very customized equipment and accessories, and it's inappropriate to "commoditize" that equipment. Moreover, patients requiring complex rehab equipment are by definition, complex patients. They require more time and effort on the part of the rehab professional to fit the patient with the proper equipment and accessories. Couple that with a Medicare fee schedule that is already "lean" on the complex rehab end of the spectrum and I don't think Medicare will see the savings envisioned for this group of products.

HomeCare: Regarding the recent preliminary decision on home sleep testing, and assuming the final will be essentially the same, what kinds of opportunities do you see for HME providers?
Hoover: Home sleep testing will raise awareness of OSA, both in the physician and beneficiary community. Managed care will piggyback on the Medicare policy and we'll ultimately see more patients with access to diagnosis and treatment. As we learn more about the impact of OSA on other diseases like heart disease, stroke and diabetes, having greater access to diagnostic tools and treatment options will benefit both patients and the health care system.

HomeCare: Do you see a better way that the industry and government can work together to better serve Medicare beneficiaries?
Hoover: The HME industry gets a black eye every time a report of fraud gets published in the trade or lay press. For the past two years I've heard stories from providers about "this guy" or "that guy" who are defrauding the Medicare system. It's clear to me that providers know who the "bad guys" are in their communities.

Unfortunately, I can count (without taking my shoes off) the number of providers that contacted me in the seven years I spent as Region D's medical director with credible leads on fraudulent providers. This industry must adopt a "Community Watch" mentality and actively report providers that are stealing money from Medicare and its beneficiaries. At the same time, CMS, its contractors and law enforcement must also respond promptly and with follow-up when providers generate fraud leads. There's nothing more disheartening that doing your job as a provider and reporting a fraudulent dealer only to have no action taken by enforcement authorities.

Finally, and this may be the most important aspect of this point, the trade and lay press must give recognition to the providers that initiated the reporting. I'm not suggesting specific names of the people reporting but it should be made clear that when an investigation is concluded and reported in the press, the HME industry get a share of the credit for being the "good guys."

In Brief
Noridian Administrative Services (NAS), the Jurisdiction D DME MAC, has warned HME providers not to be fooled by organizations that have adopted Web addresses similar to its own (www.noridianmedicare.com). "Some companies have launched Web sites with a modified spelling of our Web site address in the hopes people will misspell our Web site address and be redirected to their 'mock' Web site for non-Medicare related purposes," according to NAS. To avoid confusion, NAS advised providers "to look for the NAS and CMS logos on the Web site address they enter and/or visit to assure the legitimacy of the Web site and related content."

The industry dodged a bullet shortly before Christmas when Congress passed a new Medicare bill with no reimbursement cuts for HME. Even so, advocates are going to have to fight the good fight again this year, according to Cara Bachenheimer, senior vice president of government relations for Invacare, Elyria, Ohio. "The Medicare proposals contained in earlier House and Senate Medicare packages in 2007, specifically oxygen payment cuts and elimination of the first-month purchase option for power wheelchairs ... will undoubtedly be on Congress' Medicare agenda this spring as Congress develops a new Medicare package," Bachenheimer said. In the final version of the bill that was passed, the nation's lawmakers delayed a 10.1 percent physician pay cut, which would have taken effect Jan. 1, by six months. But with the limited "doc fix," which the HME cuts would have helped to pay for, "physicians will be in the same bind again come July 1, 2008," Bachenheimer said, and legislators will once again be hunting for funds to eliminate it. "Given the 2008 landscape, we need to gear up our grassroots efforts since Medicare discussion will begin much earlier than usual in the year," she said.

In a recent report, the HHS Office of Inspector General was not exactly complimentary toward South Carolina's Medicaid agency, which it said let HME companies remain in the program even though their Medicare supplier numbers had been revoked. "The State agency took no action against eight suppliers who violated Federal standards and had their Medicare numbers revoked. Of the eight suppliers that we identified, the State agency paid $2,084,390 (Federal share $1,459,073) to four suppliers after their Medicare supplier numbers were revoked. The other four suppliers had not billed for any DME, even though they maintained active Medicaid supplier numbers. We recommended the State agency revise the DME enrollment and renewal process to include verifying the validity of an applicant's Medicare DME supplier number and consider suspending or terminating Medicaid DME suppliers who have had their Medicare supplier numbers revoked," the OIG said. The state said it would take the findings under advisement. Click here to view the full report.

Beginning this month for the next 18 years, one of the 78 million baby boomers born between 1946 and 1964 will turn 62 every 8 seconds and become eligible for Social Security. In three years, these same Americans will begin to become Medicare-eligible as they reach age 65.

Hospital bills have increased nearly 90 percent, from $462 billion in 1997 to $873 billion in 2005, according to a study by the Agency for Healthcare Research and Quality. The study, which analyzed data based on total charges for 39 million hospital stays, said the national hospital bill increased by an annual average of 4.5 percent in recent years. Medicare and Medicaid accounted for nearly two-thirds of all hospital charges.

Coming Up
The Ohio Association of Medical Equipment Services (OAMES) is urging industry stakeholders to attend a public hearing on the state's proposed restrictive contracting rule Jan. 9 at 10 a.m. at the Rhodes State Office Tower in Columbus. For more information, click here to view the public hearing notice or contact the OAMES office at (614) 876-2424.

CMS will hold its regularly scheduled Home Health, Hospice & DME Open Door Forum Wednesday, Jan. 9, at 2 p.m. EST. To participate by phone, call (800) 837-1935 and reference Conference ID 18789483.

The Georgia Association of Medical Equipment Services (GAMES) will hold its Conference on Accreditation and National Competitive Bidding Jan. 10-11 in Atlanta. For more information, call (770) 395-7700 or visit www.gameshme.org.

The Big Sky Association of Medical Equipment Suppliers will hold its quarterly meeting Jan. 11 in Butte, Mont. For more information, call (406) 777-7301.

Bargmann Management/Homecare Collection Service has scheduled "Get Paid Faster and Accurately ... the Billing Process from Intake through Collections" Jan. 17 in Akron, Ohio with speaker Lisa Bargmann. For more information, call (866) 633-9291 or visit www.homecarecollection.com.

The Assistive Technology Industry Association will hold its annual meeting Jan. 30-Feb. 2 in Orlando, Fla. For more information, call (877) 687-2842 or visit www.atia.org.

VGM Group has revised the dates of its National Competitive Bidding Seminar Series. New dates and locations are as follows: Jan. 31 in Chicago; Feb.12 in Phoenix; Feb. 14 in St. Louis; Feb. 26 in Baltimore; Feb. 28 in Charlotte, N.C.; March 4 in San Jose, Calif.; March 6 in Tacoma, Wash.; March 18 in Newark, N.J.; March 20 in Providence, R.I.; April 1 in Columbus, Ohio; April 3 in Detroit; April 15 in Denver; April 17 in Atlanta; April 22 in Tampa, Fla.; April 24 in Houston; April 29 in Nashville, Tenn.; and May 5 in Long Beach, Calif. For more information, call (800) 642-6065 or visit www.vgm.com.

The North Carolina Association for Medical Equipment Services (NCAMES) will hold its Winter Meeting Feb. 5-6 in Greensboro, N.C. For more information, call (919) 387-1221 or visit www.ncames.org.

Send calendar submissions for 2008 to HomeCare Associate Editor Erin Greer at egreer@homecaremag.com.

Visit this week's sponsor at www.arsmeds.com.