Issue link: https://read.dmtmag.com/i/50323
■ Provider Lisa Feierstein says people need to get serious about the deadly risks of sleep apnea. See story this page. Sleep program drives Re-peat biz . . . . . . . . . . . . . . . . . . . . 1 OIG report gets it wrong, says AOPA ................ 25 Diabetes awareness event draws crowd ............. 25 RN Plus shuns Medicare. . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Rx and Specialty Providers WWW.HMENEWS.COM / JANUARY 2012 / HME NEWS 25 BRIEFS Catheters, test strips face more reviews WASHINGTON – National Government Ser- vices, the Jurisdiction B DME MAC, will continue to conduct prepay reviews for intermittent sterile catheter kits (A4353), it announced in November. As of Sept. 30, 166 claims have been reviewed, with an 89.8% error rate. The top two reasons for denial: no documentation received (48%) and denied as non covered (40%). Also in Jurisdiction B, prepay reviews will continue for glucose test strips for three to eight units of service. As of Sept. 30, 3,685 claims have been reviewed, with a 90.4% error rate. The top two reasons for denial: medical necessity not established (63%) and documentation submitted did not establish medical necessity for over- utilization. Support surfaces fail test WASHINGTON – Add Group 2 support surfac- es to the list of DME that has a high error rate. National Government Services, the Jurisdiction B DME MAC, stated in a mes- sage in November that the product cat- egory has a 93% error rate. Of 285 claims reviewed, 108 were denied because no additional documentation was received in response to a request letter. Other reasons for denial: Invalid physician orders; invalid proof of delivery; lack of documentation for a comprehensive treatment program; and the beneficiary's medical condition did not meet coverage criteria. Program helps pharmacies build new revenue streams ALEXANDRIA, Va. – The National Commu- nity Pharmacists Association (NCPA) has launched "Front-End Overhaul…More Traffic, More Profits!" a program aimed at helping community pharmacies maximize their front-end retail space and diversify their product mix. The program is headed by Gabe Trahan, an expert in layout modi- fication, merchandising and advertising. Among other aspects of the program, NCPA members will have access to on- site and virtual consultations to help them identify merchandising opportunities. Watermark lands contract for home sleep tests BOCA RATON, Fla. – Watermark Medical has inked a deal with UnitedHealthcare to provide home sleep testing services, the company announced in November. Under the multiyear contract, Watermark will ship home sleep diagnostics equipment directly to the patient. It's the first national contract for Watermark Medical. Short take Scarborough, Maine-based National Sleep Therapy has named June Sorensen its Kentucky territory manager, point of care specialist. Sorensen is based in the provid- er's Lexington office. AOPA: Report downplays role of prosthetist BY THERESA FLAHERTY, Managing Editor WASHINGTON – The American Orthotic & Prosthetic Associa- tion (AOPA) wants prosthetists recognized as the allied health- care professionals they are, rather than as "device dealers." In November, AOPA offi- cials met with Peter Budetti, CMS administrator for program integrity, to discuss a number of concerns triggered by an August report from the Office of Inspector General (OIG). The meeting was a good first step, said Joe McTernan, direc- tor of coding and reimburse- ment, education and program- ming for AOPA, who attended the meeting. "We'll continue to try to fol- low up with him and his staff," he said. "We would love to see some recognition that we are not device dealers, and go back to how it has been traditional- ly—to allow the prosthetist to document the need for clinical care of patients." DIABETES Event draws crowd BY THERESA FLAHERTY, Managing Editor WHEATFIELD, N.Y. – With its refer- ral sources seeing more diabetes patients then ever, Health Sys- tem Services (HSS) saw a chance to raise awareness—and its pro- file in the community. In November, the provider hosted its first Diabetes Aware- ness Day, an event that drew about 75 patients to its retail showroom here. "The projections for the num- ber of people who are going to develop diabetes are staggering, so we thought it made sense to do this," said Doug Mooradian, director of marketing and pub- lic relationships for HSS. "This way, people could learn about resources that are available to them locally." The American Diabetes Association says as many as one in three Americans could develop diabetes by 2050. The associa- tion has designated November as Ameri- can Diabetes Month to raise awareness. HSS brought in HEALTH SYSTEM SERVICES hosted a dia- betes awareness event in November. On the day's agenda: tips on healthy eating. several of its refer- ral sources, which include two hospi- tal systems and a DIABETES SEE PAGE 26 "Prosthetists aren't standing behind a counter handing over legs to patients." Joe McTernan, AOPA The report from the OIG said that Medicare in 2009 made $43 million in improper payments for lower limb pros- theses that didn't meet certain requirements, and another $61 million for prostheses with no documentation from referring physicians. The report doesn't accurately reflect how prosthet- ic care is provided, McTernan says. Typi- cally, if a patient has something wrong with his prosthe- sis, he calls the pros- thetist, not the physician. "The prosthetist can do the evaluation, and if there is some- thing that requires referral back to the physician, then the pros- thetist is going to suggest the AOPA SEE PAGE 26 PROVIDER AND AUTHOR Lisa Feierstein admits the title of her book is dramatic, but wanted to make sure it stands out. New book won't 'pussyfoot' around sleep apnea risks BY T. FLAHERTY, Managing Editor P ROVIDER LISA Feier- stein wants people to know that the dangers of untreated sleep apnea go beyond feeling irritable or depressed. So in November, she pub- lished "Defy Death: 9 Steps to Better Health for Sleep Apnea Sufferers," a free e-book with tips on managing sleep apnea and using CPAP machines. "I truly believe that people need to be educated about the dangers of untreated sleep apnea," said Feierstein, presi- dent and co-founder of Active Healthcare. "I wanted to put together a product that could help people recognize them- selves, and hopefully, motivate them to take action." The e-book is available by contacting Active Healthcare. While general awareness BOOK SEE PAGE 27 Weekly newsletter a real Snewzzz BY THERESA FLAHERTY, Managing Editor DETROIT – While she can't deny the importance of a good night's sleep, it's not unusual to find provider Robyn Parrott burning the midnight oil most Thursdays. That's when the president of Sleep Solutions scrambles to put the finishing touches on her weekly e-newsletter. "We are active on education here in the local community and it's tough to get all of it out," said Parrott. "I thought, 'Why can't we do a Friday newsletter?' and the idea was born." The Friday Snewzzz features news related to the sleep indus- try or research; something educational; local events; informa- tion about upcoming webinars; and a fun fact, be it on sports, Michigan or something else that's interesting. The newsletter goes out to about 460 area sleep techs and physicians, as well as a few HME industry professionals from Respironics and The VGM Group. The newsletter has helped cement Sleep Solutions' reputation as an information resource, said Parrott. "We always post any type of Medicare or insurance changes," she said. "We try to be the first in the area to get that out, and they call us if they have questions." Sleep Solutions was founded in 1997, and has grown to 30 employees and two locations in Detroit and Saginaw. The com- pany specializes in CPAP, but offers a full line of home medical equipment. HME