Industry Notes:
Medicare Cuts Power Wheelchair Spending By 33%
Published on Thu Aug 26, 2004
Are you one of the many suppliers caught in the crossfire? The Medicare cuts to power wheelchair spending are going deeper than ever intended, and beneficiaries and suppliers will pay the price.
So argues the Power Mobility Coalition, which says Medicare spending on power mobility products in 2004 will drop "a drastic 33 percent ... compared to 2003 levels." And 2004 spending, which PMC estimates will be $740 million, will be $100 million less than even 2002 levels. Expenditures for 2003 were $1.13 billion.
PMC generated its estimate using data pulled from the Statistical Analysis Durable Medical Equip-ment Regional Carriers (SADMERC), it says.
The Centers for Medicare & Medicaid Services "and its regional contractors are using the context of fraud and abuse to harm a great many needy beneficiaries and legitimate suppliers instead of enforcing laws that aim directly at those who are committing fraud," PMC executive director Erik Sokol charges in a release. For-profit hospice chain VistaCare Inc. is facing numerous shareholder lawsuits after announcing it would take a $6.2 million reserve for Medicare cap overages and a $1.8 million overall loss for the quarter ended June 30 (see Eli's HCW, Vol. XIII, No. 29, p. 231). The suits charge the Scottsdale, AZ-based company with securities fraud.
The company and its top execs "caused VistaCare's shares to trade at artificially inflated levels through the issuance of false and misleading financial statements," says San Diego law firm Lerach Cough-lin Stoia Geller Rudman & Robbins, one of the firms filing suits on behalf of shareholders. An 18 percent drop in VistaCare's stock price after the reserve announcement sparked the suits, which were filed in Arizona federal court.
VistaCare did not respond to a request for comment. Sen. John Ensign (R-NV) is going to bat for DME and respiratory companies. In a recent letter to CMS, Ensign called for a "meaningful" dispensing fee for inhalation therapy to cover costs to providers, reports the American Association for Homecare. CMS recently announced a 90 percent cut to respiratory drug payment rates, but said it would consider increasing the dispensing fee for the drugs (see Eli's HCW, Vol. XIII, No. 28, p. 218).
Ensign also called for CMS to carefully study the impending price reductions for DME items based on the Federal Employees Health Benefits Program (FEHBP), AAH says. Home health agencies reporting disputes with other HHAs over beneficiary transfers have a bit more red tape to deal with at regional home health intermediary Cahaba GBA. Agencies Cahaba serves used to be able to simply report problems to customer service representatives over the phone, but now HHAs must fill out a required form to get help, the RHHI explains in its August newsletter to providers.
And if you fail [...]
