Hospital audit legislation a model for HME?

From:  HomeCare Magazine

In AAHomecare’s concentrated efforts to reduce the audit burden on homecare providers, the association is carefully examining newly introduced legislation introduced on behalf of hospitals. The legislation contains a number of provisions that would help HME providers keep Medicare payments that they are entitled to for equipment and services furnished to Medicare beneficiaries.

Rep. Sam Graves (R-Mo.) recently introduced H.R. 6575, the Medicare Audit Improvement Act, a bill designed to ease the audit burden for Part A hospital claims. While the bill specifically applies to hospital claims, many of the provisions could be adapted and modified into proposals to address the audit issues plaguing DME providers. For hospital claims subject to audit, the bill would:

Do you hear what I hear?

From: HME News

by: Elizabeth Deprey

In the beginning of the Sept. 19 PMD demo congressional hearing, the two senators there thought that mobility companies that advertise on TV were pulling something over on American taxpayers. (Just watch the opening remarks and you’ll see what I mean.)

They even played commercials from both Hoveround and The Scooter Store (no idea how old or new these were, since I don’t watch a lot of TV and hadn’t seen either one before.)

Bidding is Now Open for the Round 1 Recompete of the DMEPOS Competitive Bidding Program

From: CMS

The Centers for Medicare & Medicaid Services (CMS) is now soliciting bids for the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.

All bids must be submitted in DBidS, the online bidding system, before 9:00 p.m. prevailing Eastern Time on December 14, 2012. All required hardcopy documents that must be included as part of the bid package must be RECEIVED by the Competitive Bidding Implementation Contractor (CBIC) on or before December 14, 2012. The contract period for the Round 1 Recompete is January 1, 2014 – December 31, 2016.

Enact H.R.6490 “Medicare DMEPOS Market Pricing Program Act” – OMB Refuses to Enforce the Paperwork Reduction Act

The Center for Regulatory Effectiveness (CRE) has provided OMB’s Office of Information and Regulatory Affairs (OIRA) with massive and uncontradicted evidence demonstrating that the CMS competitive bidding program violated the Paperwork Reduction Act (PRA), see our comments to OMB here, our comments to CMS here, a peer reviewed analysis of the CMS program by CalTech researchers here, and a letter from over 240 economists to White House condemning the program here.

Speculation rife on Round 2 announcement

From: HME News

If the HME industry had a collective water cooler to gather around, it’s likely the main topic of conversation would be Round 2 payment amounts.

“This is too tight a secret with CMS,” said Walt Gorski, vice president of government affairs for AAHomecare.

CMS has said only that it will announce the payment amounts sometime this fall and speculation is rampant about when that might be. The agency is obviously working on it. CMS recently sent bona fide letters to bidders in the mail order diabetes category, and providers had until Oct. 9 to respond.

OIG work plan includes several new reviews for DME

Editor’s Note:  The OIG FY 2013 Work Plan is attached here.

From: HME News

WASHINGTON – What durable medical equipment will bear the brunt of the Office of Inspector General’s (OIG’s) scrutiny next year? Diabetes supplies.

The OIG, which released its work plan for 2013 on Oct. 3, has four reviews planned for this product category, including one new review related to competitive bidding:

1.  A review that will focus on supplier compliance with payment requirements for blood glucose test strips and lancets (The LCDs require that the physician’s order for each item billed include certain elements and be retained by the supplier);

Industry leaders urge swift action

From: HME News

by: Liz Beaulieu

WASHINGTON – It’s do or die; it’s make or break; it’s now or never. Any of these sayings aptly describe the recently introduced bill to replace competitive bidding with a market-pricing program (MPP), industry stakeholders say.

“This is by far the best opportunity we’ve had and, in many ways, the last opportunity we’ll have,” said Wayne Stanfield, president and CEO of NAIMES. “If we don’t succeed, Round 2 will go forward and it will be too late for many, many providers.”