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Comments on the home medical equipment (HME) business. Tips on starting an HME company; Reasons for the decision of some HME providers to sell their businesses; Advantages of having an HME business.

The author reflects on Medicare audits as the third constants of life. She states that there are two types of audits, the Comprehensive Error Rate Testing (CERT) and the Recovery Audit Contractor (RAC). For her, the most serious type of audit is the RAC audit because one cannot be familiar with it unless he service beneficiaries in New York, California or Florida, the only states involved in the RAC demonstration project.

The article offers guidelines on how to deal damaged medical equipment or when they becomes unusable. According to the author, once the equipment has become inoperable, the owner should determine whether they should repair the item or replace it. Meanwhile, she also mentions about the first question to ask if the owner has decided to replace it, which is he is still receiving rental payments from Medicare on the item.

Discusses the important elements of a corporate compliance plan. Standards of conduct; Roles of the corporate compliance officers; Importance of forms of communication from which to receive complaints; Areas of exposure for home medical equipment companies that must be included in the compliance plan; Aspects that must be examined pertaining to the kickback statutes that can result in violations to the False Claims Act in the U.S.

The article provides information on the new oxygen regulations which focus on the 36-month rental cap and the post-cap payment rules. The said oxygen coverage guidelines are discussed vividly for people to be informed regarding the implementation of the changes that are happening within the corporate environment. It also notes that it is important to be updated to all policy changes as there will be more to come in the future.

The author reflects on the change of the continuous positive airway pressure (CPAP) policy into PAP policy for medical companies in the U.S. He notes that CPAP and respiratory assist devices (RADs) are necessary for federal and state insurance patients. He found out that this policy has become a diagnosis-driven policy. He mentions that no aspect Health Systems Trust (HST) may be performed by a durable medical equipment (DME) supplier.

The article reports on compliance issues of diabetic supplies for Medicare reimbursements. Medicare reimburses diabetic patients if they meet the medical coverage criteria. Inform patients up front to require a copy for the test logs monthly in order for Medicare to reimburse for the over-utilization. Monitors that provides computerized downloads that will suffice as appropriate documentation and Medicare should be paying for the amount of supplies needed.

The article discusses the importance of prepayment and postpayment audit letters to home medical equipment (HME) providers in the U.S. The author inferred that ignoring an audit letter or missing out an information requested in the letter would yield consequences on the part of the HME provider. She believed that failing a prepayment audit would mean not being reimbursed for an item and could trigger more prepayment audits in the future.

The author shares the impact of the employees' lack of knowledge on the importance of various modifiers used to bill home medicare equipment in the U.S. She said that the lack of knowledge for modifiers will cause the employer to experience a large overpayment. She added that enough knowledge on modifiers will also cause the employer to contradict on Medicare policy which led to fraudulent billing.

The author reflects on the implication of the Deficit Reduction Act of 2005's 36-month cap on oxygen and the impending competitive bid for home medical equipment (HME) providers in the U.S. She relates that the 36-month cap is retroactive until January 1, 2006, which means that all concentrators that are out on beneficiaries will remain to be in rental for 36 months. Moreover, she suggests that HMEs should start looking into the needed adjustments to comply with the 36-month oxygen cap.

The article offers tips on using activity-based costing in managing a company. According to the author, activity-based costing allows one to simplify business and improve its processes by modifying anything that is not necessary. The steps include defining the activities of the company, and assigning resources to the activities in order to see the actual amount associated with the activities.