Industry Steps Up Push for Hobson-Tanner Bill Support
WASHINGTON--Nearly four months after its introduction, a proposed bill that would make changes to the competitive bidding provision in the Medicare Modernization Act has picked up 49 co-sponsors. But according to Washington insiders, the Hobson-Tanner bill (H.R. 3559) needs 150 additional names to catch Congress' attention.

Supporters say the legislation, introduced this summer by Reps. David Hobson, R-Ohio, and John Tanner, D-Tenn., would help to protect small providers and ensure beneficiaries' access to equipment when DME competitive bidding takes effect in 2007 (see HomeCare Monday, Aug. 1).

"If we can get 200 co-signers, I think there's a very good chance we can get this bill passed," said Wayne Grau, New England senior area manager for Exeter, Pa.-based Pride Mobility Products, who is leading a nationwide educational effort to drum up support for the legislation.

One of the reasons the bill has not gathered more co-signers, he said, is that the industry has been distracted by other recent issues such as changes to mobility policies and reimbursement cuts. "Look at all of the things that have come up in the past few months. A lot of people in the industry have put the bill on the back burner," said Grau, who is also government relations chair for the New England Medical Equipment Dealers Association (NEMED). "I think people have lost a little focus."

Grau has been traveling the country speaking to providers, state associations and representatives in an effort to bring the industry's attention back to the bill. The goal is to gather 100 signatures by mid-January and 200 by mid-February, he said. Capitol Hill experts say at least 100 co-sponsors will be needed in order to get a companion bill introduced in the Senate.

One of the most important things providers can do, supporters say, is to educate their members of Congress.

"Right now this bill is the one tangible thing the industry can point to that rectifies some of our concerns with the [competitive bidding] regulation," said Don Clayback, senior vice president of networks for Lubbock, Texas-based The Med Group.

"I think people need to keep contacting representatives and continue to push forward and tell the story. What we need to do is re-energize people to see if we can get over that 100-mark."

While most representatives aren't aware the Hobson-Tanner bill exists--about 1,000 bills are introduced every session--Grau points out, many have been receptive, especially when they learn the bill doesn't ask for more money.

"I honestly don't think they're sitting in Washington saying, 'We need to stick it to the medical equipment guys.' They just don't know how [competitive bidding is] going to affect providers and the beneficiaries," he said. To date, he has held more than 18 meetings and gained support from nine legislators for the bill.

The text of the Hobson-Tanner Bill, called the Medicare Durable Medical Equipment Access Act of 2005, or H.R. 3559, is available at http://thomas.loc.gov.

For a list of current co-sponsors, click here.

Find your members of Congress at www.us.gov/Contact/Elected.shtml.

PAOC Adds New Member
BALTIMORE--Michael Tootell, director of health policy for the Ross Products Division of Abbott Laboratories, is the newest member of the government committee charged with advising CMS on implementing Medicare's DME competitive bidding program.

The Program Advisory and Oversight Committee recently lost two of its members. Dr. Ken Viste, who was medical director at the Physical Rehabilitation Unit at Baltimore's Mercy Medical Center and staff physician at St. Agnes Hospital, passed away in August. Dan Waldmann, former director of federal affairs at Johnson & Johnson, recently accepted a new position at another company.

After a two-day meeting in September during which supplier quality standards were discussed, the committee is scheduled to meet again after the proposed rule on national competitive bidding is published. For more information on the PAOC, click here.

CMS Reduces Improper Payments by Half
BALTIMORE--Aggressive oversight and new improvement efforts have cut the number of improper fee-for-service Medicare claims payments by half in one year, from 10.1 percent in 2004 to 5.2 percent in 2005, a $9.5 billion reduction in improper payments, CMS Administrator Mark McClellan announced Thursday.

Citing a drastic reduction in errors related to insufficient and missing documentation for claims as the chief reason for improvement, McClellan said "the unprecedented, $9.5 billion reduction in improper Medicare payments reflects our commitment to careful measurement and targeted oversight, and we intend to keep building on these efforts. We are measuring the accuracy of payments more closely, and that enables us to target our efforts more effectively with Medicare contractors and providers."

According to a CMS report, error rates for the fiscal intermediaries category dropped from 16.4 percent to 3.4 percent, and carriers' error rates dropped from 11.4 percent to 6.4 percent. The error rate for the DME and regional carriers category dropped from 11.1 percent to 8.6 percent, making it the category with the highest percentage of errors.

The error rate reduction has occurred despite a growing volume of claims and complexity of payment processing, CMS said. The agency pays more than 1 billion fee-for-service claims each year, and provides oversight to state payments for services provided under Medicaid and the State Children's Health Insurance Program.

In 2005, Medicare also made monthly payments to more than 450 Medicare health plans across the U.S.

CMS reviewed approximately 160,000 fee-for-service Medicare claims in 2005 as part of its Medicare error rate testing program. By providing accurate statistical information at the level of particular contractors and types of medical services, the agency said it can now identify where problems exist and target improvement efforts to address the problems.

In 2006, CMS will review Medicaid fee-for-service medical claims, and in 2007, will measure improper payments in the fee-for-service, managed care and eligibility aspects of Medicaid. CMS will then calculate state-specific error rates upon which a national Medicaid error rate can be estimated.

Also in 2007, CMS will begin to measure improper payments in SCHIP programs and will begin to select states for measurement once every three years, similar to the selection in the Medicaid improper payment effort.

"Program and fiscal integrity oversight is an integral part of CMS' financial management strategy, and we place a high priority on detecting and preventing improper or fraudulent payments," said McClellan, who noted he has asked Congress to include $720 million for Medicare program integrity in its budget and $80 million for oversight in other programs, including Medicaid.

Provider News
Apria to Consolidate Billing, Distribution Centers
LAKE FOREST, Calif.--In January, Apria Healthcare Group plans to close its Sacramento billing office and lay off 75 people. At the same time, the giant national provider also will open a 100,000-sq. ft. distribution center in Woodland, Calif., that will employ 75, according to the Sacramento Business Journal.

Both moves are part of a strategy to consolidate the number of billing and distribution facilities nationwide and cut costs in the face of dwindling reimbursements, and neither has anything to do with the company's slowed earnings, Lisa Getson, executive vice president, business development/clinical services, told the Journal.

This year alone, she said, the company has taken a $20 million hit in reduced reimbursements for HME, oxygen and inhalation drugs. Apria's third-quarter revenues increased just 1 percent over revenues for the same quarter last year, and the company has lowered its earnings estimate for 2005 to 2 to 3 percent.

In June, the company announced it was looking for a buyer, but in late October, said it had decided against a sale and instead would "focus 100 percent on revenue growth and operating improvements."

Last week, the company said it repurchased approximately 7.3 million shares of its outstanding common stock at a price per share of $23.83, for a total purchase of $175 million, as part of a $250 million share repurchase program.

While the provider plans to keep services like in-home visits, deliveries and repair as close to patients as possible, Getson said, back-office operations like billing and warehousing will be consolidated to improve efficiency and save money. With 38 billing centers in 2003, the company is looking to shrink that number to fewer than 20 by the end of 2006.

Apria has more than 11,000 employees and 500 branches serving all 50 states.

Air Products Adds Nightingale Medical
CONSOHOCKEN, Pa.--Air Products Healthcare recently purchased Indianapolis-based Nightingale Medical to expand its coverage in the Great Lakes region. According to Air Products, Nightingale, which has additional locations in Anderson and Carmel, is the largest independent home care company in central Indiana.

Last year, Air Products Healthcare acquired Melrose Park, Ill.-based Ultra Care, one of the largest privately held home respiratory and infusion companies in the country, to strengthen its presence in the greater Chicago area. The company acquired six home care companies during fiscal 2004.

Arcadia Buys Madrid Medical
SOUTHFIELD, Mich.--Arcadia Resources subsidiary American Oxygen and Medical Equipment acquired Indiana respiratory and DME supplier Madrid Medical, Arcadia officials announced last week.

The move marks the continued expansion of Arcadia, a home care mail-order pharmacy, DME supplier and staffing service provider. In June, the company acquired Health-Link, a DME supplier with operations in Northwestern Indiana and metropolitan Chicago.

The same month, Arcadia also acquired Illinois catalog outsourcing and product fulfillment company Rite at Home Healthcare Products, gaining licensing rights to distribute Sears' Shop at Home catalog of home health and wellness products via direct mail and the Internet. Arcadia opened six Sears Home Health Care centers in the Detroit area in October.

In Brief
Today is World Diabetes Day, and the disease is on the rise, according to the Centers for Disease Control and Prevention. The number of people with diabetes in 2005 jumped by 14 percent from 2002, according to the CDC's 2005 National Diabetes Fact Sheet. In the United States, 20.8 million people currently have diabetes (7 percent of the population), up from 18.2 million people in 2002. In addition, it is estimated that 6.2 million of those with diabetes remain undiagnosed. As of this year, another 41 million people have pre-diabetes, CDC said, a condition that increases the risk of developing type 2 diabetes--the most common form of the disease--as well as heart disease and stroke. To view the report, click here.

Wednesday is World COPD Day, an annual event organized by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to improve awareness and care of chronic obstructive pulmonary disease (COPD). COPD is the fourth-leading killer of Americans after heart disease, cancer and stroke, according to the American Thoracic Society, which focuses on respiratory and critical care medicine. Public health experts project that COPD will become the third-leading cause of death in the United States and the world by 2020, ATS said. For more information on World COPD Day, visit www.goldcopd.org.

Thursday will mark the 29th annual Great American Smokeout, sponsored by the American Cancer Society to help smokers quit cigarettes for at least one day in hopes they will quit forever. Smoking causes almost 90 percent of lung cancers, and also causes several lung diseases that can be just as dangerous, including chronic bronchitis and emphysema. More than 7 million current and former smokers suffer from COPD, the name used to describe both chronic bronchitis and emphysema. The late stage of chronic lung disease is one of the most miserable of all medical conditions, according to experts. It creates a feeling of gasping for breath all the time, similar to the feeling of drowning. For more information visit www.cancer.org, or to find a free Quitline, call (800) ACS-2345.

National Family Caregivers Month calls attention to the one in five adults who care for a chronically ill, disabled or elderly loved one. According to the National Family Caregivers Association, an estimated 50 million Americans belong to this invisible workforce. Observed in November, the month seeks to draw attention to the challenges facing family caregivers, advocate for public policy to address family caregiving issues and raise awareness about community programs that support family caregivers. Visit the organization at www.thefamilycaregiver.org for resources and help that you can recommend to caregivers.

To revisit this news any time during the week, go to http://www.homecaremonday.com.

Visit this week's sponsor at www.medforcetech.com.