Providers Face Issues about Prior Treatments for Oxygen
According to HME industry stakeholders, an increasing number of providers have learned that Medicare may deny provider claims if records don’t show that an oxygen patient has “tried and failed” on other treatments that include respiratory medications and pulmonary rehab. This is because oxygen is not added to a patient’s treatment plan until they reach the most severe levels of a COPD disease, according to the prevailing standard of treatment for COPD.
This puts HME providers under a tough situation because it does not seem appropriate to tell a doctor what kind of treatment plan to use, said Clark Robichaux of Oxy Care Equipment Company. Furthermore, some patients need oxygen regardless of what is specifically noted on the medical record. Stakeholders believe that CMS needs to work more in educating physicians about what is needed to ensure access to oxygen therapy, rather than leaving it to providers.
Relationship Between Treatment of Sleep Disorders and Psychiatric Outcomes
Improvement over baseline in symptoms of comorbid psychiatric disorders was suggested to be associated with treatment of sleep disorders, and sleep apnea in particular, according to a new study. Doctor Umesh Vyas, chair of the Department of Psychiatry and medical director of the Sleep Disorders Center in the Mayo Clinic Health System in Mankato, Minnesota, presented the results of his study at the 2012 Annual Meeting of the American Psychiatric Association. He pointed out that sleep is a vital physiological need, important for physical, mental, and emotional well-being. Most of the time, sleep disorders are comorbid with psychiatric conditions such as depression, but the directionality of the relationship is still unclear. However, Dr. Vyas feels that the relationship is probably bidirectional, in such a way that sleep disorders can worsen psychiatric issues and vice versa.
In a press conference, Dr. Vyas said that prospective studies are still needed to further define this relationship. The current study was a retrospective, observational chart review done to examine the impact of the treatment of sleep disorders on psychiatric disorder outcomes.
HME News Brief Highlights from HMEnews.com
AAHomecare President Tyler Wilson has made a recommendation to the Internal Revenue Service to exempt all HME items and supplies from a 2.3% medical device excise tax. During a public hearing by the agency, Tyler said the IRS should expand the exemption to include a “bright-line test” that clearly lists all such items and supplies within the safe harbor.
New Events Added to VGM’s Heartland Conference
Two new events were added by the VGM Group to the schedule for The Heartland Conference in June. The first will be vice president for development Mark Higley’sdiscussion of the Round 1 recompete of national competitive bidding. The second will be a discussion of the CERT program and how providers can reduce billing errors, presented by two DME MAC medical directors.
Providers Signs Pledge to Continue Fighting
The campaign “I’m Still Fighting Pledge,” sponsored by People for Quality Care (PFQC) has been signed by More than 300 HME providers. According to a PFQC press release, providers have committed to tasks ranging from giving out education materials about competitive bidding to reaching out to the media.
HMEB Survey Shows Respondents Expecting Revenue Growth in the Sleep Market
According to the latest sleep market survey conducted by HME Business and Mizuho Securities USA Inc., there is an improvement in the sleep market growth possibly because of the economy and home testing, with providers’ sleep revenue growth seen at 8.9 percent in the last 12 months.
The survey results for 2Q 2012 show a 5.7 percent growth from the 4Q 2011 survey. In the next 12 months, respondents anticipate their sleep revenue to grow by 7.5 percent, an increase of 7 percent compared to the 4Q 2011 survey. Also expected is home testing to increase growth by 1.3 percent.
HMEs continue to see the economy as a factor affecting their sleep revenue growth, though the expected impact has declined compared to prior survey. On average, 20 percent respondents see a reduction in their sleep revenue by 0.4 percent over the next 12 months due to the slow economy.
More than 300 Providers Closed due to Medicare Funding Requirements
The VGM Group, together with the National Association of Independent Medical Equipment Suppliers (NAIMES), have made a list of more than 300 businesses that have closed or sold out due to either the competitive bidding or other Medicare funding requirements. This is in response to a request made by Rep. Pat Tiberi (R-Ohio) during a hearing on competitive bidding conducted by the House Ways and Means Health Subcommittee.
John Gallagher, vice president of Government Relations for VGM in a message to VGM members, said that it is important for providers and beneficiaries to ask questions about competitive bidding and beneficiary access to quality care by communicating with representatives on the House Ways and Means Health Subcommittee. Gallagher also emphasized the need for providers to let government officials know that competitive bidding has put over 300 companies out of business, and to continue pushing for a score of the Market Pricing Program (MPP).
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