CMS will accept comments on the standards through Nov. 28. Comments may be submitted by e-mail to DMEPOS_Quality_Standards_Public_Comments@cms.hhs.gov.

PAOC to Discuss Impact of Competitive Bidding, Quality Standards
BALTIMORE--After more than six months since its last meeting, the Program Advisory and Oversight Committee is expected to continue discussion of the possible effects of DME competitive bidding when it meets again today and Tuesday.

The 22-member panel--charged with advising CMS on the implementation of the government-mandated bidding program--has quite a bit of ground to cover according to an agenda for the two-day meeting, including the newly released supplier quality standards (see story above), discussion of the impact competitive bidding will have on consumers and rural areas, and results from small-supplier focus groups held earlier this year.

The panel also will hear from stakeholders how the bidding program might impact specific segments of the HME industry. Presentations from beneficiary organizations and blood glucose systems will be heard today, and presentations focusing on HME, respiratory equipment including oxygen, rehabilitation equipment and assistive technology, orthotics and prosthetics and enteral nutrition are scheduled for Tuesday.

Competitive bidding for DME is mandated by the Medicare Modernization Act to begin in 10 of the country's largest metropolitan areas in 2007 and expand to 80 cities in 2009. HHS has the authority to expand the program elsewhere after that.

CMS is expected to publish a proposed rule shortly detailing exactly how DME competitive bidding will be implemented.

For more information on the PAOC and to view the meeting agenda, visit www.cms.hhs.gov/suppliers/dmepos/compbid/paoc.asp.

Government Reassigns Suspended CMS Medical Director
BALTIMORE--Sean Tunis, the CMS chief medical officer who was suspended earlier this year for falsifying documents, has been reassigned to the Agency for Healthcare Research and Quality as a biomedical research scientist.

Last week, the HHS Office of Inspector General put Tunis on a list of individuals and businesses excluded from participating in Medicare, Medicaid and all federal health care programs. In April, he was placed on administrative leave after the Maryland Board of Physicians charged him with altering documents to show he had completed continuing medical education credits, which are required to maintain a medical license in the state.

Tunis, who also was director of the Office of Clinical Standards and Quality, admitted he had attempted to reproduce lost records of credits he legitimately earned, and agreed to a one-year suspension of his medical license and a $20,000 fine. He also resigned from Mercy Medical Center in Baltimore, where he worked part-time as an emergency physician.

In his new position with AHRQ, Tunis will work on projects related to the education of health care researchers, and will no longer be involved in federal medical decisions, according to an AHRQ spokesperson. Under a consent order, he also must complete an ethics course and 35 hours of CME.

"I regret having made mistakes in handling my [continuing education] records, but I am now pleased to be moving forward into a new phase of my career," Tunis told the Associated Press.

Barry Straub of CMS' Region IX in San Francisco has been serving as acting CMS chief medical officer since Tunis' departure and has also taken his place as acting director of clinical standards and quality.

Houston Woman Charged in $10 Million Power Wheelchair Scheme
HOUSTON--An unlicensed Texas doctor has been indicted for her involvement in a power wheelchair scheme, U.S. Attorney for the Southern District of Texas Chuck Rosenberg announced last week.

According to a release from the U.S. Attorney's office:

Linda Morgan, 52, of Houston was responsible for approximately $10 million in Medicare and Medicaid billings for DME from 2002 through 2004 for writing false prescriptions and CMNs. Morgan is licensed to practice medicine in Oklahoma, but is unlicensed in Texas because she has not passed the state medical boards. She was charged with conspiracy and 12 counts of health care fraud.

The indictment alleges marketers and recruiters brought Medicare and Medicaid patient information--but not the patients--to Morgan, who received approximately $250 in exchange for a power wheelchair prescription and CMN. The marketers would then sell the prescriptions to DME companies, which billed Medicare and Medicaid for power wheelchairs and related accessories at approximately $5,000; the patients, however, received scooters costing between $800 and $1,200.

If convicted of health care fraud, Morgan faces up to 10 years in prison and a maximum fine of $250,000. If convicted of conspiracy, she faces up to five years and a maximum fine of $250,000.

The charges are the result of a joint investigation by the FBI and the Medicaid Fraud Control Unit of the Office of the Texas Attorney General.

U.S. District Judge Dean Whipple denied the group's request for a preliminary injunction Sept. 13, stating that the decision is left up to the state because the federal government doesn't require Medicaid programs to cover DME. It is estimated that the cuts affect 340,000 of the state's one million residents on Medicaid. Gov. Matt Blunt said Missouri's Medicaid overhaul, which also includes cutting more than 90,000 beneficiaries from the rolls, will save the state $146 million.

Mississippi, Texas Receive Medicaid Waivers
BALTIMORE--Texas and Mississippi are the first states to receive Medicaid waivers that will reimburse the states for the full cost of delivering health care services to Hurricane Katrina evacuees.

The waivers provide five months of temporary eligibility for Medicaid or the State Children's Health Insurance Program to evacuees who are parents, pregnant women, children under age 19, individuals with disabilities, low-income Medicare recipients or low-income individuals in need of long-term care. According to CMS Administrator Mark McClellan, similar waivers will be offered to other states affected by the storm and to states hosting evacuees.

In addition, under the waiver, Texas will establish an HHS-funded pool to reimburse providers that have uncompensated costs resulting from providing services and supplies to hurricane evacuees. The pool also can be used to help those not eligible for Medicaid or SCHIP to access private coverage.

A proposed bill in Congress also could offer affected states some Medicaid relief. The legislation, co-sponsored by Sens. Charles Grassley, R-Iowa, and Max Baucus, D-Mont., calls for the federal government to pay 100 percent of Medicaid and SCHIP costs through 2006. Thus far, however, the bill has received opposition from the White House, which said it prefers to issue waivers on a state-by-state basis.

In Brief
Consumer, clinician, provider and manufacturer stakeholders are planning an Oct. 6 fly-in to Washington, D.C., to tell Congress their concerns with CMS' recent mobility policy announcements.Stakeholders from event sponsors--American Association for Homecare, the National Coalition for Assistive and Rehab Technology (NCART), the ITEM Coalition, the Restore Access to Mobility Partnership (RAMP) and United Spinal Association--will fan out across Capitol Hill to share concerns on coding and documentation changes and to ask for a delay in implementation until April 1, 2006. For more information and special room rates, contact AAHomecare at (703) 535-1887.

HHS has announced the appointment of 16 commissioners to a federal panel that will make recommendations to speed the adoption of information technology throughout the nation's health care system. To be chaired by HHS Secretary Michael Leavitt, the panel will hold as many as 12 public meetings a year and will have an annual budget of $3 million. The commission will make recommendations on issues such as privacy and security practices for electronic health care information, "harmonization" of industry-wide standards and the creation of an Internet-based nationwide health information network. For more information, visit www.hhs.gov/healthit.

In January, CMS will start surveying provider satisfaction with Medicare fee-for-service contractors. CMS said it will use the results from a Medicare Contractor Provider Satisfaction Survey when it launches nationally to create custom reports that could help contractors--including the agency's DMERCs--to identify improvements they could make. The agency said it has requested clearance for the survey from the Office of Management and Budget, available at www.cms.hhs.gov/regulations/pra. Both agencies will accept comments until Oct. 4. For more information, visit www.cms.hhs.gov/providers/mcpss.

HHS has extended to March 16, 2006, an interim final rule setting HIPPA penalty procedures for violators of federal health care information standards. The procedural rule, originally set to expire on Sept. 16, applies to covered entities--providers, payers and clearinghouses--that violate HIPPA privacy, security and transaction and codes sets regulations. According to the department, the extension was made to avoid disrupting ongoing enforcement while HHS develops a more comprehensive enforcement rule.