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Home Health & Hospice Week

Regulations:

Other Open Door Forum News

Published on Thu Feb 26, 2004

  • Supplier numbers. There are about 3,500 applications for supplier numbers in the que, down from a high of 4,200, the Centers for Medicare & Medicaid Services said in the Feb. 18 Open Door Forum for home care providers. The National Supplier Clearinghouse is processing between 200 and 250 applications per week under the new scrutiny required by Operation Wheeler Dealer.

  • Fraud. CMS and its contractors are actively investigating wheelchair fraud cases as they find them and turning them over to law enforcement when appropriate, the agency said.

  • ABNs and dual eligibles. Suppliers should be able to use advance beneficiary notices for durable medical equipment upgrades for customers dually eligible for both Medicare and Medicaid. With an ABN, the supplier can charge the state for the expense of upgraded features. However, what Medicaid will pay for the upgrade "is up to the state," CMS noted.

  • Inherent reasonableness. CMS will move forward on IR as soon as it "reasonably" can, a staffer said in the forum. However, the protocol for DMERCs to implement IR cuts is still in development and won't be finalized until this summer.

  • Competitive bidding. Suppliers eager to give their input on the competitive bidding program slated for near nationwide implementation by 2009 will have to wait. CMS hasn't organized its internal work groups on the issue yet, due to the large volume of work required for Medicare law provisions with closer implementation dates.

    Putting together the oversight committee that will include industry members and will advise on the bidding program is a "top priority," a CMS official promised.

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