MEDICARE UPDATE
Young Medical/Toledo I.V. Care offers you the latest updates on Medicare. Our President, Tim Pontius, has served in one of the top leadership roles as a Medicare liaison for many years.
He has served as Chairman or Vice Chairman of the Region B Council working with the Carrier for Ohio, Michigan, Indiana, and other states plus the District of Columbia. He also serves on multiple committees for the American Association for Homecare. Kathy
Mikolajczak, Vice President of Operations, is also a Board member for the Ohio Association of Medical Equipment
Services (OAMES) ,and Chairs the Federal Legislative Committee for the National Home Infusion Association (NHIA). Jim Frederick, Director of Compliance , currently serves as the President for OAMES .
As you see, our companies represent some of the top leadership in the entire industry. That allows us to bring this expertise and experience back here to provide you the best informed support service available anywhere!
The most talked-about subject involving Medicare in the past year was undoubtedly the Medicare Prescription Drug Bill. To read more about this Bill, please go to our link for
Legislative updates.
Good News ! The power wheelchair policy ( described below) has been rescinded by
CMS. We are currently working with CMS to arrive at a policy clarification or update that is agreeable with both
Payor and Suppliers. Updates will be posted as soon as we have them)
The following is a brief description of what CMS had implemented last Fall, and was recently rescinded as noted
above. (As far as Medicare, the most recent change involved an interpretive change by our Medicare Carrier in Indianapolis. In fact, all four DMERC’s adopted this change. The new interpretation makes it much more difficult for an individual to qualify as “bed-confined” or “chair-confined.”
While this “tightening” is meant to eliminate fraud and abuse, the fact of the matter is that it will now become much more difficult to qualify for power wheelchairs in general, and perhaps all wheelchairs.
As one of the leaders of the American Association for Homecare, we are actively working with the Center for Medicare Services (CMS) and other industry Coalitions to get this terrible change overturned. Please watch this site for updates.)
Another change you will see is that, as part of the Medicare Bill, payment has been reduced for respiratory medications. While the reduction for 2004 is about 15% off of 2003 prices, the law mandates a change in 2005 to a level so low that this benefit may disappear altogether. I also address this in the Government Relations section of this website. I will post updates toward June when we get any new information.
I continue to remind you that there are extensive rules that we must follow in order to qualify a beneficiary for each product that Medicare covers. We will make every effort to make your experience with us a positive one, and I look forward to hearing from you personally to let me know how we did.
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