Bid News Blog

From: HME News

WASHINGTON – AAHomecare has delivered a letter signed by five industry associations to Sens. Max Baucus, D-Mont., and Orrin Hatch, R-Utah, urging them to support a market-based pricing system for HME.

In the Oct. 14 letter, AAHomecare outlined industry concerns about the current competitive bidding program.

The letter states: “The competitive bidding program is a deeply flawed pricing mechanism that has and will continue to create significant obstacles to quality patient care and needed services while threatening the homecare infrastructure for our nation’s seniors and persons with disabilities.”

From: HME Business

NCPA survey confirms that cuts from bid program will cause a mass exodus by community pharmacies.

By David Kopf

Eighty-four percent of community pharmacists surveyed in a report commissioned by the National Community Pharmacists Association (NCPA) said they would likely drop out of the Medicare diabetes program if forced to take reduced payments or competitively bid.

The survey of 800-plus community pharmacists, conducted over September and October 2011, was commissioned by the NCPA after CMS indicated that by 2016 providers of diabetic supplies (including testing strips, monitors, lancets, glucose control solutions) will either have to accept prices established under the mail order competitive bidding process or competitively bid in order to continue participating in the Durable Medical Equipment, Orthotics, Prosthetics and Supplies (DMEPOS) program.

From: HME News

PERRYVILLE, Mo. – Provider Patrick Naeger said he has proof that there’s a better way to save money than a 36-month cap for home oxygen therapy.

When Missouri needed to cut its Medicaid budget last year, the state proposed paying for oxygen the same way Medicare does. Instead, Naeger and the other members of the Missouri Medicaid DME Advisory Committee convinced the state to adopt what they call the “Missouri Oxygen Flip”—paying less for stationary concentrators but more for portable concentrators. The move saved the state $2.1 million in its first year.

From: HME News

By Theresa Flaherty, Managing Editor

BALTIMORE – Suction pumps and negative pressure wound therapy devices (NPWT) need consistent coverage criteria to ensure patient care, AAHomecare told the four medical directors in a Sept. 23 letter.

In August, the DME MACs released draft local coverage determinations (LCDs) that would create separate coverage criteria for pumps. They would add a not reasonable and necessary statement for wound suction pumps (K0473) and related supplies (K0744—K0746); and add new coverage criteria for gastric suction pumps.