AAH: Delay PMD demo
From: HME News
WASHINGTON – AAHomcare on Monday called for CMS to delay a PMD demo scheduled to start Sept. 1 because the agency still hasn’t released a final version of instructions.
“AAHomecare is eager to work with CMS, but is calling for an implementation delay until 30 days after a final version of the operational guide is published on the CMS website to ensure that providers, physicians and beneficiaries have been educated on all aspects of the program,” it stated in a press release.
“We’d have to go to downtown Seattle or somewhere far away because now all of a sudden the government has put all these people out of business”
From: CRE’s DME Hotline: 1-800-613-7678 (Kent, WA)
“Hi, this is Molly…and my husband Floyd…just got a walker, but we’re locked into one place to get it. We’d have to go to downtown Seattle or somewhere far away because now all of a sudden the government has put all these people out of business. But we’ve handled these things before and this is wrong, definitely wrong because how do you get there to get them? It just really puts a real burden on the individual and I think this needs to be addressed, stopped. This competitive bidding is wrong. … Thank you, bye.”
Medical equipment providers decry Medicare effort
By Bob Glissmann
An effort to crack down on price gouging on home medical equipment has, according to a government report, saved millions of dollars.
But the providers of such equipment as wheelchairs, walkers and oxygen concentrators say that Medicare’s competitive bidding program will create problems for U.S. businesses and consumers.
The program started in nine metropolitan areas in 2011. Next July, it’s set to go into effect in 91 other metro areas, including Omaha-Council Bluffs. It’s supposed to go nationwide in 2016.
Providers and others gathered Wednesday at Kohll’s Pharmacy and Homecare in southwest Omaha to express their concerns about the program.
Pharmacists Eye Counseling Pay To Keep Diabetic Test Strip On Shelves
From: Inside Health Policy
As retail pharmacists brace for significant Medicare pay cuts for diabetic testing supplies, some in industry are looking to getting reimbursed for counseling diabetics as a way to keep test strips and other diabetic supplies on their shelves. Retail pharmacists say they will stop selling the supplies if CMS cuts payment anywhere close to the competitive bid price for mail-order supplies, but if Medicare were to pay pharmacists for counseling diabetics, that would both save Medicare money and provide pharmacists a way to continue selling supplies, industry sources say.
CMS stands ground on Round 1 re-compete
From: HME News
by: Theresa Flaherty
BALTIMORE – With CMS’s announcement last week of the timeline for the Round 1 re-compete, it’s likely that recent unpopular changes to the program are here to stay.
Of particular concern: The re-compete, first announced in April, features about 100 new product codes and nine product categories, including an HME category comprising everything from urinals to patient lifts.
“It’s unfortunate that they lumped it into such large categories, but it doesn’t seem like CMS is going to budge,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Once they start announcing detailed timelines, they really don’t have an opportunity to make changes.”
“Although an industry which provides life-sustaining equipment and services to Medicare beneficiaries cannot be considered as akin to a mutinous legion, CMS’ punishment of them is far harsher…”
Editor’s Note: The Center for Regulatory Effectiveness’ comments to the White House Office of Management and Budget on CMS’ Information Collection Request for the home medical equipment bidding program is attached here.
CRE’s comments document that the initial round of their program has “reduced the small business share of the Medicare home medical equipment market by almost half from CMS projections for 2012 and radically reduces the number of Medicare supplies by 85-95%.”
Moreover, “the overwhelming consensus by academic and federal experts” is that CMS program faces the “high probability of failure in the near future” and a “near certainty of failure sometime down the road.”
Bidding Timeline for the Round 1 Recompete
8/16/2012 The Centers for Medicare & Medicaid Services (CMS) announces bidding timeline, begins bidder education program
8/20/2012* Registration for user IDs and passwords begins
9/7/2012* Authorized Officials are strongly encouraged to register no later than this date
9/28/2012* Backup Authorized Officials are strongly encouraged to register no later than this date
10/15/2012* CMS opens 60-day bid window for Round 1 Recompete
10/19/2012* Registration closes
11/14/2012* Covered document review date for bidders to submit financial documents
12/14/2012* 60-day bid window closes
Spring 2013* CMS announces single payment amounts, begins contracting process
Study: CMS doesn’t answer the phone
WATERLOO, Iowa – A study released Monday reveals that calling the Centers for Medicare & Medicaid Services results in at least a five-minute wait before a human voice is heard.
An independent accounting firm, Hogan-Hansen PC of Waterloo, Iowa, conducted the study for Last Chance for Patient Choice, a non-profit organization dedicated to ending competitive bidding for home medical equipment, and the American Association for Homecare.
Lack of clarity pervades re-supply rule, according to NewsPoll
From: HME News
by: Elizabeth Deprey
YARMOUTH, Maine – Most providers say CMS’s new re-supply rule is “about as clear as mud.”
Sixty-three percent of the respondents to the latest HME NewsPoll say they don’t have a good understanding of the rule, which requires providers to prove that re-supply items like CPAP masks are non-functioning before they replace them. The biggest unknown: a clear definition of non-functioning.
“Although I hope we do have a good understanding, it is not completely clear what CMS wants us to document,” said Sally Johnson, manager at Cuyahoga Falls, Ohio-based Klein’s Orthopedic & Medical Equipment.
CMS Seeks Comments: Attending Physician’s Certification of Medical Necessity for Home Oxygen (Reinstatement of a previously approved ICR)
Tomorrow’s Federal Register will contain a notice from CMS attached here on reinstatement of a previously approved Information Collection Request (ICR). Under the Paperwork Reduction Act, CMS is not allowed to collect information from ten or more people/organizations without OMB’s approval.
The text of the CMS notice — which includes contact information at CMS for more information — is reprinted below:
Type of Information Collection Request: Reinstatement of a previously approved collection;
Title: Attending Physician’s Certification of Medical Necessity for Home Oxygen Therapy and Supporting Documentation Requirements;