Be sure your HME claims will stand up under the microscope.
Providers of home medical supplies are likely to face even greater claims scrutiny in the coming months.
A report from the Government Accountability Office released March 6 highlights a slew of abuses.
Among the stories in the report: Medicare paid for leg braces for patients with amputated limbs even after paying for prosthetics for the same individuals.
The GAO concludes that the Centers for Medicare & Medicaid Services needs to do more to reduce the $700 million a year the agency spends improperly for durable medical equipment.
The report also notes that Medicare has bought multiple home hospital beds for the same beneficiary in a single month.
The report was requested by former Senate Finance Committee Chair Charles Grassley (R-IA).
To read "Medicare: Improvements Needed to Address Improper Payments for Medical Equipment and Supplies," go to
www.gao.gov/cgi-bin/getrpt?GAO-07-59. • The 110th Congress hasn't forgotten about therapists' and their patients' cries for help. Last month lawmakers re-introduced legislation S. 450/H.R. 748, the Medicare Access to Rehabilitation Services Act of 2007, according to the American Physical Therapy Association.
This bill would completely repeal the therapy cap on outpatient physical therapy benefits, as opposed to the current system where therapists may file for exceptions--which expires at the end of the year.
"Passing this important legislation to completely repeal the therapy caps is the best long-term policy solution--rather than passing '1-year fixes,'" commented APTA President R. Scott Ward.
"We should not limit the therapy and recovery options available to our nation's seniors, especially the oldest and sickest on Medicare," said Sen. John Ensign (R-NV), one of four senators and five House members who re-proposed the bill.
Current law limits Medicare coverage of Part B outpatient therapy services, including those furnished in the home, in 2007 to $1,780 for physical therapy and speech language pathology together and $1,780 for occupational therapy. The caps don't apply to therapy furnished under a Part A home health plan of care. • A California state lawmaker has proposed legislation that would require private duty home care agencies to obtain state licensure. Assembly member Dave Jones (D-Sacramento) wants California's Department of Consumer Affairs to license agencies and distribute a list of those who are licensed, Jones says in a release.
Licensure would require background checks on all home care aides, investigation of complaints made by clients, annual assessments of employee performance and annual aide job training. The bill "ensures that consumers will know what services are to be delivered and what protections and coverage they should have when they receive home care services from an organization," California Association for Health Care Services at Home President Joe Hafkenschiel says in the release. • Medicaid funding for certain [...]
