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by: Mike Moran - Friday, March 7, 2008

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The National Association of Independent Medical Equipment Suppliers (NAIMES) has launched an online petition to stop CMS from competitively bidding home medical equipment. By Friday, about 2,500 people had signed the petition. A good chunk of the signees have also left comments explaining how competitive bidding will decrease the quality of patient care and force some businesses to close their doors.

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“Because they can sign the petition and submit comments online, just sitting in their offices, they’re not intimidated by the marble columns of Washington, D.C., and they’re able to talk from their hearts,” said Wayne Sale, chairman of the association. “I hope some of these words will be part of the bricks that build a fortress around our industry.”

NAIMES hopes 30,000 people will sign the petition, which it plans to deliver to each member of Congress. The association has already sent the petition to hundreds of members and others. Friday, it also planned to send the link to attendees of AAHomecare’s Legislative Conference. Providers like Bruce Bayes have forwarded the petition to hundreds of contacts.

“We have a list of 550 clients, therapists, doctors and other providers that we sent this to,” said Bayes, president of Custom Mobility in Largo, Fla. “I think it’ll get 30,000 or more names.”

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by: Mike Moran - Wednesday, March 5, 2008

You should be in Washington, D.C., at AAHomecare's Legislative Conference, listening to presentations by the likes of U.S. Sen. Pat Roberts, R-Kan., and Rep. Jason Altmire, D-Pa. HME News Editor Mike Moran's there, and he'll have a reporter's roundup on the conference in Monday's NewsWire.

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For those of you surfing the Net in between presentations or not in D.C. (gasp!), I came across this release today. It's about a new "online superstore" that features only over-the-counter drugs and home medical equipment eligible for coverage through Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs).

This is interesting. If HSAs are the wave of the healthcare future, as many would have us believe, why aren't more HME providers trying to come up with ways to harness this part of a customer's spending power? Think of the marketing potential: Spend your HSA money here on home medical equipment that your insurer won't cover! It seems to be a logical next step in the quest to increase cash sales.

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by: Mike Moran - Tuesday, March 4, 2008

On Friday afternoon, we were still awaiting official word, but it appears that CMS will require that HME providers who plan to submit bids for round 2 of national competitive bidding be accredited or apply to become accredited by May 14, 2008. To win a contract, providers must complete accreditation by Oct. 31, 2008. Both The VGM Group

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(to the first round's 10). With two months until May 14 and seven months until Oct. 31, I hope providers in Detroit, Tampa and other round 2 CBAs already have this ball rolling.

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by: Mike Moran - Monday, March 3, 2008

A few interesting news items popped up today:

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under the headline "RACs rack up refunds," you won't be surprised that CMS plans to extend its use of private contractors to examine medical records and collect overpayments beyond California, Florida and New York.

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According to Newsday: "The contractors have shown they're pretty good at their work. In just three years, they've returned more than $300 million to the federal government—and that's just from three states. That experiment is winding down. But a larger, national program will soon take its place. The rollout of 'recovery audit contractors' will be gradual. They'll monitor health care providers in 10 states beginning this spring. In October, an additional five states will join."

Providers have criticized the RAC system. Because contractors keep a percentage of the overpayments they find, they have an incentive to be "overzealous."

* The Office of Inspector General (OIG) released a report today that states providers are still having problems complying with certain Medicare standards. The OIG inspected 905 providers to see how they complied with four "easily observed rules": maintain a physical facility; be accessible during reasonable business hours; have a visible sign; and post hours of operation.

The OIG found that 115 of the 905 providers did not maintain a physical facility or were not open during unannounced site visits. Another 79 providers were open but did not meet at least one of the two additional requirements. Additionally, 124 providers met the four requirements, but "their claims had in common an atypical characteristic."

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The OIG recommends that CMS strengthen the supplier enrollment process.

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by: Mike Moran - Friday, February 29, 2008

The NASDAQ hasn’t given up on Orlando-based Rotech Healthcare—yet.

On Feb. 21, the NASDAQ approved Rotech's application to transfer from the stock market’s Global Market to Capital Market listing, according to a Feb. 25 Securities and Exchange Commission (SEC) filing. The provider began listing on the Capital Market, under the same symbol (ROHI), Feb. 27. The Capital Market has less restrictive continued listing requirements, including a $1 minimum bid price requirement.

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The NASDAQ notified Rotech on Nov. 16 that it was in danger of being delisted from the stock market for not meeting a minimum market value of $15 million. The provider, which today is valued at $12.21 million, had until Feb. 18 to regain compliance. Rotech filed an application to transfer to the Capital Market listing on Feb. 8.

According to the SEC filing: “As previously reported, the company is currently not in compliance with the $1 minimum bid price requirement under NASDAQ Marketplace rules. The delisting of the company’s common stock would likely have a material adverse effect on the trading price, liquidity, volume and marketability of the company’s common stock.”

Rotech’s stock is currently trading at 48 cents per share.

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by: Mike Moran - Wednesday, February 27, 2008

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Here's a story The Long Riders ipod you don't come across too often, courtesy of the Register-Herald in Beckley, West Va. Billie Lewis takes her 20-year-old Chihuahua named Taco with her on home medical equipment deliveries. Taco becomes sick with congestive heart failure. Lewis' employer, Patient's Choice, provides Taco with an oxygen concentrator to help him breathe easier. Lewis tapes the oxygen tube to a box and places the box over Taco's bed. Lewis told the newspaper: "He sleeps with his head right against that box. We know he can't last forever. His little heart is finally going to give out."

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by: Mike Moran - Friday, February 22, 2008

AAHomecare, in a letter dated Feb. 22, asked the Department of Health and Human Services and CMS to "suspend" the first round of national competitive bidding based on a new study conducted by two economists from Robert Morris University.

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The associations states: "This study calls into question the fundamental underpinnings of this program. On the basis of this study and for the same reasons that we have questioned since its roll-out (impact on quality of care and access to care), the association urges the Centers for Medicare and Medicaid Services (CMS) to suspend the implementation of round one of the Medicare competitive bidding program. We think the agency should be required to evaluate the principles and conclusions of this report and again consider whether competitive bidding is in the long-term interest of Medicare, its beneficiaries and taxpayers."

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The Long Riders buy For details on the study, scroll down to the blog titled, "Pennsylvania HME association unveils competitive bidding study."

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by: Mike Moran - Wednesday, February 20, 2008

Tune in tonight to see Amanda Overmyer, a 23-year-old respiratory therapy nurse, compete on American Idol. The show's judges named Overmyer as one of their final 24 contestants last week. Overmyer, 23, worked days at Lincare’s Kokomo, Ind., branch before wowing Randy Jackson, Paula Abdul and Simon Cowell with her grounded personality and Janis Joplin-esque voice, first in Atlanta, where she auditioned, then in Hollywood. Jackson dubbed Overmyer, who rides a Harley-Davidson motorcycle, the “Rock and Roll nurse.” In a video clip on the American Idol Web site, Overmyer said she wants to become the next American Idol because “I suppose that’s the American Dream—to take something that you love doing and make money at it.” Her musical influences: Joplin, Bob Seger, Creedence Clearwater Revival and Guns n’ Roses.

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by: Mike Moran - Monday, February 18, 2008

Here's the text of a press release issued today by the Pennsylvania HME association. We'll release some hard facts from the study on national competitive bidding later, but in a nutshell, this report demonstrates once again that NCB "is really just an anti-competitive scheme that is being unleashed on America’s elderly, infirmed and disabled,” says PAMs Executive Director John Shirvinsky.

PITTSBURGH, Pa – A new study was released today by the Pennsylvania Association of Medical Suppliers (PAMS). The study, conducted by Brian O’Roark, PhD and Stephen Foreman, PhD, JD, MPA, showed that the Centers for Medicare and Medicaid Services’ (CMS) so-called “competitive bidding” program threatens Pittsburgh Medicare patients and businesses. This program will begin the process of taking effect in Pittsburgh in March. Speaking at the United Cerebral Palsy of Pittsburgh, the study authors and PAMS Executive Director John Shirvinsky highlighted the program’s potential risks.

Shirvinsky said, “Some of the most seriously ill and disabled Medicare patients in the greater Pittsburgh area are currently targeted as guinea pigs for an ill-considered program that will profoundly affect the manner in which they receive in-home medical equipment, supplies and related services.” The program will impact items such as power wheelchairs, oxygen equipment and supplies, CPAP and BiPAP’s, hospital beds, walkers, mail order diabetes supplies and much more.

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In attendance were some of the 200-plus patients served daily at UCP. Their disabilities include acquired brain injury, mental retardation, spina bifida, spinal cord injury and cerebral palsy. These are exactly the type of people PAMS, the study authors, and people like Congressman Jason Altmire believe will be threatened by CMS’ competitive bidding program.

One Pittsburgh home medical equipment provider who shares these concerns about the program is Georgie Blackburn, Vice President of Blackburn’s Physicians Pharmacy, Inc. in Tarentum. Blackburn is a past PAMS president and Executive Board Member of the American Association for Homecare.

“We’ve built our businesses upon uncompromised service and dedication to our patients,” Blackburn said. “‘Competitive bidding’ reduces this to a commodity and will award those companies able to bid the lowest price with a three-year contract. That is not the small provider. Throngs of small providers will no longer be able to serve Pittsburgh’s Medicare patients who depend upon us. We are deeply concerned about quality, continuity, and timeliness of care for our patients. We are concerned that we may not survive ‘competitive bidding.’”

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O’Roark and Foreman, both economics professors at Robert Morris University, conducted an independent evaluation of the likely economic consequences of Medicare’s proposed “competitive bidding” program for durable medical equipment and supplies (DME). The study labeled CMS’s competitive bidding program as “uncompetitive” and “poor public policy.”

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“The limits on competition that CMS is proposing to implement will have great potential to produce higher prices and lower service quality,” Foreman said. “The franchise bidding process that CMS is implementing is at odds with everything that we know about markets, efficiency and incentives. We should be encouraging added competition in the market, not limiting it. Limits on competition like those proposed by CMS rarely, if ever, make consumers better off.”

“This so-called ‘competitive bidding’ program is really just an anti-competitive scheme that is being unleashed on America’s elderly, infirmed and disabled,” Shirvinsky said.

Shirvinsky outlined the risks to patients and the economy as the loss of patient choice, confusion and inconvenience for patients, dramatic cutbacks in patient service and responsiveness, higher long-term Medicare costs, and the potential for hundreds of small business failures and thousands of job losses. He called upon “CMS to immediately postpone the signing of Round 1 ‘competitive bidding’ contracts that are planned for March of 2008. In light of this new information, Congress deserves the opportunity to review and evaluate the potential negative impacts of “competitive bidding” before the program does harm to individuals, the economy and the Medicare system.”

Congressman Jason Altmire, Chairman of the Small Business Subcommittee on Investigations and Oversight, is opposed to any Medicare reform threatening to unfairly penalize small businesses.

New Jersey Drive movie download In a prepared statement, Altmire said, ““The report released by Robert Morris University today adds to a mounting body of evidence that indicates CMS’ Competitive Bidding Program is a bad deal for small medical equipment suppliers and the patients they serve. I am deeply concerned that CMS is moving ahead with implementing its new competitive bidding program without truly accounting for the toll it could take on our local economy. If hundreds of western Pennsylvania’s small medical equipment suppliers are forced to close, thousands of hard-working people will loose their jobs and countless patients will no longer be able to receive quality, personalized service close to home.”

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PAMS President Robert Brown noted, “this study confirms that ’competitive bidding’ delivers a devastating blow to patient care and choice, as well as costing a lot of hard-working small business owners and employees their livelihood. Congress must repeal the midnight mandate that durable medical equipment and supplies must be purchased by Medicare through the flawed, so-called ‘competitive bidding’ process.” Brown is Vice President of Andrew Brown’s Home Healthcare in Scranton, PA. Scranton has been identified by CMS as one of 70 metropolitan areas to participate in Round 2 of the competitive bidding program later this year.

by: Mike Moran - Tuesday, February 12, 2008

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Here's what AAHomecare reported this morning about the proposal:

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ALEXANDRIA, Va. — A Senate bill introduced last week would impose a $500,000 surety bond requirement on providers of durable medical equipment (DME) under Medicare and would put thousands of small homecare companies out of business, says the American Association for Homecare.

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A law passed in 1997 requires a $50,000 surety bond for DME providers as a deterrent to fraud and abuse. However, the federal government has never actually implemented the surety bond requirement for the DME sector. The Centers for Medicare and Medicaid Services has proposed that the amount increase to $65,000.

The bill introduced last week, S. 2603, called the “Medicare Fraud Prevention Act of 2008,” would increase the $50,000 surety bond requirement by a factor of 10. The bill would also increase civil and criminal fines for Medicare fraud and abuse. The bill is sponsored by Senators Mel Martinez (R-Fla.), John Cornyn (R-Texas), Norm Coleman (R-Minn.), Lamar Alexander (R-Tenn.), David Vitter (R-La.) and Jim DeMint (R-S.C.).

“The impact of a half-million dollar surety bond requirement would be devastating on law-abiding small providers,” said Tyler J. Wilson, president of the American Association for Homecare. “This provision would put a lot of home medical equipment providers out of business without fixing the fraud and abuse problem. No one is more concerned about getting criminals out of Medicare than the homecare sector, but this is clearly a case of throwing the baby out with the bathwater. Why would the government increase the surety bond by 1000 percent before it has even implemented the original amount?”

Insurance experts say a $500,000 surety bond would require that DME providers put up collateral to back the half-million-dollar bond, on top of the $10,000 to $20,000 cost of the bond.