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by: Mike Moran - Thursday, March 12, 2009

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The 007 Man with the Golden Gun hd On the heels of a White House healthcare summit on March 6, the administration announced plans to hold similar regional summits across the country. The summits will take place in California, Iowa, Michigan, North Carolina and Vermont.

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HME associations in those states have submitted verbal and written requests to attend the summits to make sure the industry is part of discussions. In her request to Vermont Gov. Jim Douglas, Karyn Estrella, executive director of the New England Medical Equipment Dealers, stated: “We believe that this important discussion on healthcare reform must include the value of home care.”

Last week, the Michigan Home Health Association secured a seat at the summit in Dearborn, Mich., on March 12.

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Zombieland film Of the 150-plus lawmakers, health industry executives and “average Americans” who participated in the White House summit on March 6, only one represented home care: Val Halamandaris, president of the National Association for Home Care & Hospice.

by: Mike Moran - Friday, March 6, 2009

It doesn't look like any homecare organizations were invited to participate in President Barack Obama's healthcare summit today. More than 150 lawmakers, health industry executives and "average Americans" were invited, but not AAHomecare, not the National Association for Home Care and Hospice. That doesn't make much sense when one of the goals of the summit was to determine how to lower costs. It's some consolation, though not much, that homecare advocates, such as Rep. Mike Ross, D-Ark., were present. Click here Leprechaun 4: In Space movies The Hills Have Eyes dvdrip

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for a list of the invited.

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–Liz Beaulieu

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by: Mike Moran - Wednesday, March 4, 2009

Here's the thing about healthcare reform: It can help and hurt the HME industry.

It can help by increasing the pool of insured—the more people who have insurance, the more people who have access to healthcare services and products, including HME. It can also help by increasing the focus on prevention. HME is a major league player in that ballpark. If a patient with diabetes, for example, takes care of himself by regularly checking his blood sugar levels using a glucose monitor—a piece of HME—he’ll be less likely to end up in the hospital needing an expensive amputation.

It can hurt by making HME a target for cuts. Healthcare reform won’t come cheap, and the government needs to pay for it somehow.

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This isn’t news to most of you, but yesterday, we learned that healthcare reform has the potential to hurt more than we thought. In the past, lawmakers have said healthcare reform would be exempt, at least partially, from pay-go rules. Now they’re doing an about-face.

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CongressDaily reports that Sen. Max Baucus, D-Mont., chairman of the Finance Committee, has decided healthcare reform needs to be fully offset. According to CongressDaily:

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Being There download As for offsets, Baucus said staff is just beginning to figure out what pay-fors might be palatable. "I'll be taking the temperature of senators to see which measures are either the path of least resistance or which measures are more popular," he said.

For the Boys movie full Do you think lawmakers consider HME a “path of least resistance”?

If you have a senator that sits on the Finance Committee, contact him or her sooner rather than later. Resist!

— Liz Beaulieu

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by: Mike Moran - Wednesday, February 25, 2009

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Despite reports to the contrary, the DME MACs for jurisdictions A and B have not issued a new certificate of medical necessity (CMN) for oxygen.

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“The purpose of the article was not to talk about a new CMN document, but to talk about some of the scenarios that have come up due to the 36-month cap and how they apply in the CMN world,” said Dr. Robert Hughes, the medical director for the two jurisdictions.

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The Feb. 18 article details the four situations in which a new 36-month rental period can begin and for which a new initial CMN is required: initiating use of home oxygen; resuming use after a break in medical necessity of at least 60 days; replacing equipment after a patient reaches the five year reasonable useful lifetime; and replacing equipment due to damage, theft or loss.

For the first and second situations, the requirements for the initial, recertification and revised CMNs remain the same. For the third and fourth situations, however, there are some changes.

AAHomecare has posted the article on its Web site.

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by: Mike Moran - Thursday, February 19, 2009

Last night, after a long (but informative) day discussing everything from ABNs to oxygen modalities, attendees at National Respiratory Network's respiratory conference decided to let their hair down, for better or worse.

Enter Rock Band in which several teams made up of some of the best and brightest in the respiratory industry decided to play Rock Band. Wigs, feather boas, air guitars and a lot of guts took to the stage in a battle of the bands. Judges included Jeff "Paula Abdul" Baird and Andrea Stark.

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The Tommyknockers video The competition kicked off with KR and the Sunshine Band led by Kelly Riley.  One can only hope the feedback she gets from this year's conference attendees is as strong as she got from her mike last night. Just kidding Kel! She got the crowd on their feet.

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Who knew WestMed Rehab's Tim Pederson could sing?  And congrats Tim. I think I overheard that you just got engaged.

 Also appearing last night: SeQual's very own Ron Richard. For those of  you who don't already know, Ron is an actual musician. I don't think that helped him last night, but for those of you in SoCal, Ron is going on tour in real life in that area very soon.

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Rumor has it last night's performances could wind up on YouTube. Keep your eyes peeled.

I'd also like to give a shout out to my tablemate Penny Girard, from Allstar Oxygen Services in California. She was one of several providers to be honored at last night's award ceremony as an outstanding respiratory provider.

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by: Mike Moran - Wednesday, February 18, 2009

Some are opening branches, others are laying off employees. Some drove from nearby Lubbock, others flew from Alaska and Hawaii.  But the attendees to The MED Group's National Respiratory Network's 2009 Respiratory Seminar are all here in San Antonio this week because they want to do business better and stay on top of the many changes thrown at them. As director Kelly Riley said in her opening remarks:  Last year and heading into 2009 has been some of the craziest times we've ever seen. We decided if we can't control the craziness, we might as well participate.

Craziness must be why Kelly is hosting a battle of the bands tonight.

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As the week goes on, we'll hear from Don Clayback abut recent industry changes (rumor has it, he'll touch on surety bonds), get a Medicare update from Dr. Robert Hoover, and discuss home sleep testing (so far, not the boon early supporters had predicted, say attendees).

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by: Mike Moran - Friday, February 13, 2009

Paranormal Activity release You know what really irked me about AAHomecare’s initial plan to reform the Medicare oxygen benefit? Leslie Norwalk. When AAHomecare and the Council for Quality Respiratory Care (CQRC) unveiled their plan to revamp the oxygen benefit in January, the former CMS administrator was front and center, explaining the ins and outs. This was not the first time a Washington mercenary has gone to work for HME. A few years ago, AAHomecare hired former CMS Administrator Tom Scully as a consultant. Did Scully or Norwalk while at CMS ever do anything to benefit the HME industry? Did they ever say anything supportive? Maybe, but you’ll have to dig deep to find it. Yet one day they’re working against the industry, and the next day they’re working for it. Call me old fashion, but that doesn't seem right.

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Phoebe in Wonderland Mail Order Bride dvd The Last House on the Left movie buy American Splendor You really can’t blame providers for not embracing this first pass at overhauling oxygen. The CQRC is a powerhouse of industry expertise and leadership, but it’s also an alliance of manufacturers and national and regional HMEs like Pacific Pulmonary and Apria. Most independent HMEs don’t want this group of providers crafting policy for the entire industry. You can’t blame them for feeling that their best interests and Lincare’s might not be the same. Secondly, despite a lot of hard work crafting this plan, it lacked a key component: The fee schedule. That is sort of like building a car and forgetting to install an engine. It’s a tough sell.

— Mike Moran, Executive Editor

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by: Mike Moran - Wednesday, February 4, 2009

Powder video AAHomecare announced this week that it has formed the New Oxygen Coalition (NOC) to "resolve issues" related to reforming the Medicare oxygen benefit.

Bugsy Malone movie download As you know, AAHomecare and the CQRC shared their plans for reform with state associations and other industry stakeholders in January. The response wasn't exactly rousing. While nearly all stakeholders agree that the oxygen benefit needs to be reformed, they disagree on how it should be done.

Hence, the NOC and the need to "resolve issues."

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As I've been told, here are the main differences between the reform plans floating out there:

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AAHomecare and the CQRC are touting a case mixed adjusted payment system used by home health agencies and other providers. Under the system, providers would get reimbursed on a sliding scale based on patient ambulation. Reimbursement would then be further adjusted based on needs, such as high liter flow.

The other plans on the table also reimburse providers based on ambulation. But they don't further adjust reimbursement based on needs specific.

Proponents of the second plan believe the more simple a payment methodology, the better the chances of winning widespread support. And with widespread support, the better chances of implementation sooner rather than later, providing relief to providers who are now suffering in a post-cap environment.

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Do you think these groups will get on the same page?

One provider told me: "I’m rooting for it. I don’t want to see a riff. Our industry looks terrible right now.

Liz Beaulieu

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by: Mike Moran - Tuesday, February 3, 2009

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Tom Daschle, the much-lauded and applauded nominee for Secretary of Health and Human Services, has apologized to the Senate Finance Committee for failing to pay a few taxes. In a letter, Daschle tried to explain "overlooked" taxes on consulting work and failure to pay taxes on use of a car service. "My mistakes were unintentional," he wrote in the letter. He recently paid $128,203 in back taxes and $11,964 in interest and was expected to meet with the committee today.

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Powder hd I am not sure what constitutes "unintentional" when we are talking about more taxes than many of us make in a year (or several years). I'll give him the benefit of the doubt. Is he a good health policy person? Signs point to yes. Still, I'd like the man in charge to be a little more detail oriented. After all, severe lack of attention to detail with regard competitive bidding and the 36-month cap on oxygen is still giving the HME industry a collective headache.

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by: Mike Moran - Wednesday, January 28, 2009

Cigna Government Services, the DME MAC for Jurisdiction C, released a bulletin this afternoon that appears to contain additional details on the 36-month oxygen cap.

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The bulletin addresses how to replace oxygen equipment after the five-year reasonable useful lifetime and how to bill for contents

At the end of the bulletin, Cigna states: "A Change Request (CR) and a MLN Matters Article will be forthcoming."

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