Callers Receive Few Answers at Open Door Forum
BALTIMORE--With only a year left before competitive bidding is scheduled to begin, the subject seemed to be top-of-mind for participants at CMS' DME, Home Health and Hospice Open Door Forum on Thursday. But the agency offered few answers for those who posed questions about the impending DME bid program and related topics.

The proposed regulation on competitive bidding--originally expected to be released last spring--is currently in final clearance and should be published "very soon," a CMS project officer announced. When a caller asked if "very soon" meant by the end of the year, the official responded, "That's all I can give to you right now--very soon."

For months, the industry has been anxiously awaiting release of the proposed rule, which should detail how DME competitive bidding will be implemented when it begins in 10 of the country's largest metropolitan statistical areas--also not yet identified--in 2007. CMS personnel advised stakeholders to keep checking the DMEPOS competitive bidding Web site, available by clicking here, for updates on the coming rule.

The agency did reiterate that the final supplier quality standards--which HME providers must meet in order to participate in the bid--will be published in the spring of 2006.

The next DME, Home Health and Hospice Open Door Forum is scheduled for Jan. 18.

Invacare Lowers Fourth-Quarter Earnings Guidance
ELYRIA, Ohio--Invacare Corp. announced its fourth-quarter sales and earnings will be below expectations, citing problems with the implementation of a new $20-million enterprise resource planning system.

The company said last week that it expects a revenue shortfall of $30 million for the quarter due to lost revenue from difficulties in processing orders using the new accounting system and an inability to ship products on time. The disruption also has resulted in additional overtime in manufacturing, distribution centers and customer service and added costs in expediting products to customers, the manufacturing giant said.

Net sales for the quarter will likely range from $370 million to $380 million, 3 to 6 percent lower than sales for the fourth quarter last year. For the full year, the company expects a net sales increase between 9 and 10 percent, compared to a prior guidance of between 11 and 12 percent.

Commenting on the results, Invacare Chairman and CEO Mal Mixon said, "Although we are disappointed with the likely fourth-quarter results and the adjustment to previous guidance, the company continues to execute on its previously announced plans to reduce costs and reconfirms that these cost-reduction initiatives should result in annualized pre-tax savings of at least $25 million as Invacare enters 2006. The fourth-quarter impacts of the ERP are disappointing, but this is a one-time event and does not change our outlook for 2006 and beyond of significantly improved profitability arising from our cost-reduction actions."

The company expects major issues with the new system to be resolved by the end of the year. "Our order intake capability has substantially recovered and, with the addition of added processing capacity and a few remaining application refinements, we are confident we will be in a position to offer our customers significantly enhanced service and support early next year," Mixon said.

According to Reuters, the computer system is the second stage of a three-part Oracle Corp. software implementation to automate Invacare's North American home care business.

Conference on Aging Offers Recommendations to Support Baby Boomers
WASHINGTON--The 2005 White House Conference on Aging convened last week to address long-term planning needs for the next decade as the first wave of baby boomers approach retirement age.

The White House-sponsored conference, which meets once every 10 years, is charged with making recommendations to the president and Congress on aging policies. Approximately 78 million baby boomers will begin to turn 60 in January, a major concern to policy planners.

Strengthening and improving both the Medicare and Medicaid programs, along with promoting innovative models of noninstitutional long-term care, are among the resolutions presented at the conference. In remarks at the conference, CMS Administrator Mark McClellan cited long-term care as a "critical part of healthy long-term living."

According to McClellan, "We are now in an era when it is possible and often desirable for millions of seniors with long-term care needs to age in place" in their homes. He added that Medicare benefits emphasizing prevention, including the coverage of prescription drugs, are expected to improve seniors' lives.

Other resolutions presented at the conference include:

--reauthorizing the Older Americans Act within the first six months following the 2005 conference;
--developing a coordinated, comprehensive long-term care strategy by supporting public- and private-sector initiatives that address financing, choice, quality, service delivery and the paid and unpaid work force;
--ensuring that older Americans have transportation options to retain their mobility and independence;
--supporting geriatric education and training for all health care professionals, paraprofessionals, health profession students and direct-care workers;
--improving recognition, assessment and treatment of mental illness and depression among older Americans;
--attaining adequate numbers of health care personnel in all professions who are skilled, culturally competent and specialized in geriatrics; and
--improving state- and local-based integrated delivery systems to meet 21st-century needs of seniors.

The final conference report will be given to the president and Congress by June 2006. For more information, including a list of the conference's 50 resolutions, visit www.whcoa.gov.

U.S. Life Expectancy Continues to Rise
WASHINGTON--As life expectancy continues to rise in the United States, driving growth for HME, so does the number of Americans who are overweight or obese, according to a recent study.

The study, released this month by the National Center for Health Statistics, found that life expectancy has risen to 77.6 years for those born in 2003, compared to 77.3 years the year before. In 1990, life expectancy was 75.4 years.

But although Americans' overall health has improved, an increase in the overweight and obese is a growing concern as these conditions are risk factors in heart disease, hypertension and back pain.

Forty percent of adults ages 55 to 64 are obese, the report found, up from 31 percent in the 2003 report. The study featured a special section on this demographic, noting it is "projected to be the fastest-growing segment of the adult population over the next decade" with an increase from 29 million in 2004 to 40 million by 2014.

More than half of those in this same age group have high blood pressure as well, up from previous years. Deaths resulting from heart disease, cancer and stroke, however, decreased in 2003.

Substantial allocations to public health programs, research, health care and health education have contributed to the improvement of the overall health of the nation, the report said. Also, public health education campaigns have contributed to a decline in deaths from cardiovascular disease.

To view the report, click here.

State News
California to Implement Medicaid Provider Rate Cut in 2006
SACRAMENTO, Calif.--The California Department of Health Services confirmed last week that providers will take a 5 percent Medicaid rate cut in 2006.

Although DME is exempt from the cut to Medi-Cal, the state's Medicaid program, it will affect most services, medical supplies and incontinence supplies, according to the California Association of Medical Product Suppliers.

The 5 percent cut originally was scheduled to run Jan. 1, 2004, through Dec. 31, 2006, but the measure was temporarily put on hold by a federal court following a lawsuit filed by the California Medical Association in 2003. In August, a federal court of appeals reversed the order, clearing the way for the cuts to begin.

CMA has launched what it calls "an aggressive campaign to change the administration's mind" and said it will be sponsoring urgent legislation in an effort to block the cuts before next year. "California's neediest patients and their physicians will get a lump of coal for the holidays if the [Gov. Arnold] Schwarzenegger administration follows through with its plan to cut Medi-Cal payments by 5 percent on Jan. 1," the organization stated last week.

The cut will not be retroactively implemented for claims before 2006, however, and is scheduled to last only through the end of 2006.

New York City to Collect Diabetics' Personal Patient Data
NEW YORK--In what observers are calling a landmark decision, New York City will start gathering personal medical information in an effort to curb dramatic increases in diabetes cases.

The New York City Board of Health ruled Wednesday that clinical laboratories must report comprehensive information about diabetic patients' blood sugar tests to the city health department. The ruling, the first of its kind in the country, will allow the city's diabetes prevention and control program to "improve surveillance and target interventions to improve outcomes," according to department documents.

The information will be used to remind diabetics to take better care of themselves and promote lifestyle changes to control their disease.

Between 1992 and 2004, diabetes cases doubled among adults in New York City according to a health department survey. There are some 530,000 diagnosed cases of diabetes in the city, with another 265,000 estimated as undiagnosed.

The city has tracked some other diseases, beginning with tuberculosis in the late 1800s. But collecting data about people who have a non-contagious illness like diabetes has raised the objections of some privacy advocates.

"This isn't smallpox," attorney James Pyles, who represents health care groups with medical privacy concerns, told the Associated Press in July. "The state, or city in this case, does not have a compelling interest in the health of an individual that overrides that individual's right to privacy."

City officials disagree.

New York City Health Commissioner Dr. Thomas R. Frieden told the AP that the treatment of diabetes costs $5 billion per year to treat in New York, and in 2003 was the fourth leading cause of death in the city, killing 1,891. "I don't think we can afford not to do anything," he said.

The city's health department has estimated the cost of implementing the diabetes tracking program at $1 million to $2 million a year.

In Brief
The National Supplier Clearinghouse Advisory Committee is accepting questions from providers to be presented at its quarterly meeting Jan. 18. E-mail questions to schafhause@aol.com by Dec. 23.

The staff of HomeCare wishes you a joyous holiday season and a prosperous New Year. HomeCare Monday will resume publication Jan. 9, 2006.

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