Medical Practice Compliance Alert - Nov 2013
Can providers keep their businesses and industry on the rails?
- By David Kopf
- Oct 01, 2013
Ever since the Centers for Medicare and Medicaid Services began testing its competitive bidding program, providers have been on a roller coaster trying to stop the program. They’ve seen some bright points, such as the delay through the Medicare Improvements for Patients and Providers Act, but they’ve seen even more terrifying plummets, such as the Round One implementation, and now the even more precipitous Round Two implementation.
WASHINGTON – In a June 21 letter to the Office of the Inspector General (OIG), Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, call on the agency to investigate the possibility that CMS deliberately overlooked its own rules when awarding contracts for competitive bidding, according to a press release.
The OIG is charged with identifying and combating waste, fraud and abuse in more than 300 programs, including Medicare.
“We have asked the Inspector General to look into the shortfalls, but also to investigate the possibility that officials at Medicare intentionally ignored their own rules when problems began to arise,” Thompson stated.
The Centers for Medicare & Medicaid Services (CMS) reportedly is developing a new integrity contractor called a Unified Program Integrity Contractor (UPIC).
These contractors will focus on both Medicare and Medicaid integrity issues, and the Zone Program Integrity Contractors (ZPICs) and the Medicare Administrative Contractors (MACs) will be folded into the UPICs, according to an email sent last Friday by Dianne De La Mare, vice president of legal affairs for the American Health Care Association (AHCA).
De La Mar was reporting on what she described in her email as a conference call held last Friday by CMS Program Integrity. She added that MACs would not be going away; however, their integrity responsibilities will be folded into those of the UPICs.
Writing that the Medicaid Integrity Contractors (MICs), will be phased out, De La Mar also indicated that the recovery auditors will remain in place. Moreover, she concluded, CMS will be consolidating all of its Medicare and Medicaid data into one unified database.
Medicare and the FDA (Food and Drug Administration) are choosing to lower costs at the expense of your health. They are allowing cheap and faulty blood sugar test strips into the marketplace. Test strips that have been proven — the FDA admits — to give inaccurate glucose readings.
This is dangerous for anyone who has diabetes, no matter what your age. We cannot allow this to continue and, together, we can stop it — and we must.
I want you to write a letter to the FDA to keep bad strips out of the market. That’s it, that’s all, that simple. Go, as soon as you read this, and use one of the sample letters that has already been created for you at StripSafely.com.
All-States to hire 50 new workers
Medical supply company wins big Medicare contract
FLETCHER — All-States Medical Supply plans to double its staff in the next two months, hiring 50 people to field calls under a new Medicare contract.
All-States is one of only 18 suppliers recently awarded contracts to take orders and ship glucose monitors to the nation’s estimated 6 million diabetic patients covered by Medicare.
The company also plans a $1 million investment in its 26,000-square-foot call center and warehouse, upgrading servers and installing a new phone system to handle the increase in calls, said Jason De Los Santos, the company’s vice president of operations.
Medicaid doesn’t always follow Medicare, and therein lies the rub for HME providers doing battle in this latest frontier on audits, industry consultants say.
Case in point: For diabetes supplies, Medicare requires a new order when there is a change in the order, but Medicaid requires a new order every year, says Wayne van Halem, president of The van Halem Group in Atlanta.