HME News

NOV 2018

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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News 6 WWW.HMENEWS.COM / NOVEMBER 2018 / HME NEWS Wednesday, November 28, 2pm ET M&A: The market outlook The keepers of "The Braff Group M&A Insider" in HME News will provide a detailed view of the market, not only for HME but also for ancillary markets and health care at large. TBG has no shortage of data points: It tracks trends in everything from transactions to debt capacity to private equity investment. They'll discuss those trends, as well as which sectors are hot, which sectors are not, and most importantly, why M&A in HME may be making a comeback. Due to the cancellation of this year's HME News Business Summit, we are bringing some of the sessions to you in our new Summit Talks Webcast Series! Dexter Braff President, The Braff Group Presenters: Pat Clifford Managing Director, The Braff Group Liz Beaulieu Editor, HME News Register online and view the other webcasts in the series at: Can't make a live event? Everyone who registers gets a link to view the recording after the webcast! All webcasts are $99 each. Moderator: BY LIZ BEAULIEU, Editor WASHINGTON – Much has been made of CMS's plans to reduce the paper- work burden on healthcare provid- ers, but what about on HME pro- viders, specifically? The agency's most recent attempt was in September, when it released a proposed rule aimed at removing unnecessary, obsolete or excessive- ly burdensome Medicare compli- ance requirements. The rule, how- ever, focused on Part A. "There was nothing in the rule for us," said Kim Brummett, vice president of regulatory affairs for AAHomecare. "We have been working with the Provider Com- pliance Focus Group and have made many suggestions to them for reducing the paperwork burden." CMS has made some conces- sions, including loosening the PATIENTS OVER PAPERWORK Room for improvement for HME proof of delivery requirement and removing the date stamp from the written order prior to delivery, but there's plenty more that could be done, stakeholders say. So what are the top areas where CMS could reduce the paperwork burden for HME providers? KIM BRUMMETT, AAHOMECARE "More flexibility on physician orders. As an example: allow mul- tiple PAP accessories to be on the same order when a patient uses different supplies over the course of a year. "A fairly new requirement: that the liter flow of an oxygen patient needs to be documented in the medical record. Most times, this is documented on the order, not nec- essarily the medical record." KELLY GRAHOVAC, THE VAN HALEM GROUP "The diabetic shoe policy requires documentation showing that sev- eral criterion have been met, in addition to a comprehensive plan of diabetic care being doc- umented by the physician treat- ing the patient f o r d i a b e t e s . (That) is a lot. "A walker is such an inexpen- sive piece of DME; however, if not documented properly, it will deny. Specifically, the physician must document a mobility limitation that impairs the beneficiary from partic- ipating in one or more MRADLs in the home; and document the ben- eficiary can safely use the walker and the walker will improve the mobility deficit. (All) for a piece of equipment that is often purchased as a cash item." HME AAH finds large decreases in 2017 fee schedule WASHINGTON – There will be an average decrease in reimburse- ment of 36.8% in 2017 for the top 25 HCPCS codes for HME, according to a new analysis by AAHomecare of the new reim- bursement compared to 2016 and 2015 reimbursement. Low-air loss mattresses (E0277) will see the biggest hit: about a 58% decrease in reimbursement, on average, in 2017 vs. 2016. To perform the analysis of the recently released 2017 fee schedule, AAH segment- ed eight geographical regions and averaged the reimbursement for all the states within each region. At the high end, the "regional rate" in New England, will decrease 60.2% in 2017 vs. 2016. CMS reports reduction in identified overpayments WASHINGTON – Recovery audit con- tractors identified and corrected nearly $441 million in improper payments in fiscal year 2015—a decrease of 82.8% compared to 2014. In a new report to Congress, "Recovery Auditing in Medicare Fee-For-Service for Fiscal Year 2015," CMS attributes the de- crease to the prohibition on the RACs performing patient sta- tus reviews on inpatient hospital claims. Kelly Grahovac

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