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Beneficiaries Say Medicare Bidding Program is Failing Them

From: RT Magazine

Many Medicare beneficiaries face obstacles that either delay or prevent them from obtaining critical durable medical equipment (DME) and services in nine regions of the country where a controversial procurement system was implemented a year ago, according to data collected by the American Association for Homecare (AAHomecare), an association representing DME providers nationwide.

Despite assurances from the Centers for Medicare and Medicaid Services (CMS) that the well-being of Medicare patients wasn’t compromised by the competitive bidding system, Medicare beneficiaries taking part in AAHomecare’s survey sharply contradicted those assurances.

CMS reins in CPAP reviews

From: HME News

By Theresa Flaherty, Managing Editor

YARMOUTH, Maine – Providers should be able to catch their breaths now that CMS has told a recovery audit contractor (RAC) to ease up on semi-automated CPAP reviews.

“The audit hasn’t been rescinded, but it’s still a huge win,” said Andrea Stark, a reimbursement consultant with MiraVista in Columbia, S.C., and a member of the AAHomecare HME/RT Council, which worked with CMS on this issue. “They will not send out any new request letters, but providers must still respond to any letters they’ve already received.”

From CRE’s DME Hotline: 1-800-613-7678 (Beaumont, TX)

“My name is Alice…. I get a neutralizer from Walson in Beaumont, Texas. I would like to continue with this service because I’m very satisfied with it. If you have any questions….”

Listen to complete call

Why ‘Round Zero’ Was Zapped

From: Home Care Magazine

Many factors led to Medicare’s delay of PMD project
by Dave Parks

The HME industry achieved a rare victory on Dec. 29 with Medicare’s last-minute delay of a demonstration project requiring prepayment reviews of power mobility devices in seven states. Experts say the delay was the product of many factors, and predicted that the the reprieve would be temporary.

“It’s coming,’’ said James Herren, a consultant and executive director of the Association for Tennessee Home Oxygen & Medical Equipment Services. “Be prepared.”

In fact, at press time, officials announced a new timetable and restructuring for the … Continue Reading

Medicare beneficiaries express alarm over competitive bidding

From: HomeCare Magazine

Twenty-one Philadelphia-area Medicare beneficiaries sent a letter to Pennsylvania’s two senators last week expressing fear of competitive bidding arriving in Round 2 of the Medicare program.

Sent to Sens. Bob Casey, D-Pa., and Pat Toomey, R-Pa., the letter was the product of a recent Town Hall Teleconference call hosted by VGM Group’s Last Chance for Patient Choice, People for Quality Care and the Pennsylvania Association of Medical Suppliers. The 21 beneficiaries learned about competitive bidding during the teleconference.

The letter lists three areas of concern: the importance of receiving timely service, preserving access to local providers and protecting the … Continue Reading