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OIG Calls Most Ambulance Restocking Programs OK

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Date: Thu, 6 Dec 2001 06:47:50 -0600
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<http://www.medicalnewswire.com/06.asp> 	Wednesday, December 05,
Wednesday, December 05, 2001	
Headlines	Subscribe <http://www.medicalnewswire.com/subscribe/> 	
OIG Calls Most Ambulance Restocking Programs OK
Congress Considers New Repayment Tactics … You Should Too
Superstar Coding Tips Help You Master IRF-PAI Tool 
Patent Awarded To Penjet For Needleless, Lyophilized Drug Injector 
Indictments Handed Down In Hospital Fraud Case
Feds Revisit Outpatient Cost Reports

OIG Calls Most Ambulance Restocking Programs OK	
WASHINGTON, DC (Medical Newswire) After a slew of advisory opinions
addressing ambulance restocking programs, the HHS Office of Inspector
General has finalized a safe harbor rule that protects covered deals
from anti-kickback prosecution.

And the watchdog agency's final version of the safe harbor, published in
the Dec. 4 Federal Register, is even more lenient than its May 22, 2000
proposal. Among the significant changes: the OIG has eliminated
requirements involving monitoring by an oversight entity and has eased
certain restrictions involving billing. 

"The OIG believes that the vast majority of ambulance restocking
arrangements are lawful under the anti-kickback statute," the agency
says in the preamble to the rule. 

To be covered by the safe harbor, a restocking arrangement must meet
four "general" conditions relating to the appropriate billing of federal
health care programs, documentation requirements, safeguards relating to
referrals and compliance with other applicable laws. In addition, each
of the three safe harbor categories involves a set of more specific
conditions providers must meet.

To see the rule, go to

*	http://www.access.gpo.gov/su_docs/fedreg/a011204c.html


Congress Considers New Repayment Tactics … You Should Too	
RESEARCH TRIANGLE PARK, NC (Medical Newswire) The debate on overpayments
is roiling on Capitol Hill, as Congress debates new policies that could
keep CMS from demanding repayment while a provider appeal is in the
works. Some proposals would allow repayment over extended periods of
time in cases of severe financial hardship. And other changes may be on
the way…

That's why you need our experts to guide you through the minefield of
handling overpayments. Assuming that inconsistencies will always “come
clean in the wash” can be a grave mistake, says Ankur Goel, a partner
with Washington-based McDermott, Will & Emery. “At the same time, the
government is considering provisions that will spell relief for some
providers,” adds attorney Heidi Kocher with Brown & Fortunato in
Amarillo, TX.

Goel and Kocher will help you find the strongest financial ground -
while remaining compliant - at Eli Research’s audio seminar, “Medicare
Repayments: Whether, When and How to Make Them.” The conference will
take place on Tuesday, Dec. 11, 2001 from 1 to 2:30 p.m. “This realistic
approach will get all your decision-makers on the same, correct page,”
comments Goel.

Program highlights include seven tough questions you must answer before
making the decision to repay; how to distinguish between situations
calling for repayments and those requiring disclosures; an in-depth
exploration of the mechanics of repayments; and practical tips for
integrating repayment and disclosure decisions into your compliance
plan. “We’ll show you how to make good decisions during the repayment
process,” promises Kocher.

Nursing home administrators will earn CEU’s at this seminar.

For more information about registration and pricing, call 1-800-874-9180
or visit: 

*	http://www.eliresearch.com/repayments.html


Superstar Coding Tips Help You Master IRF-PAI Tool 	
RESEARCH TRIANGLE PARK, NC (Medical Newswire) The Inpatient
Rehabilitation Facility Patient Assessment Instrument (IRF PAI) hits the
streets January 1, 2002. That’s just around the corner. The best way to
avoid a New Year’s headache - in advance - is to know that your facility
will be reimbursed for the true cost of caring for your patients. 

If you didn’t make it to one of the Atlanta or San Francisco-based
training sessions sponsored by the Center for Medicare & Medicaid
Services, it’s not too late to prepare your IRF staff with the skills
needed to score the new PAI. From now on, your entire staff will have an
impact on the amount of reimbursement your facility receives, says Ann
Lambert, with Portland, ME-based Baker Newman & Noyes. “That’s why a
well-trained, knowledgeable staff is more vital than ever before,” adds

Ms. Lambert will draw on real-life case studies from her national base
of clients to illuminate the IRF-PAI at Eli Research’s audio seminar,
“Hot IRF-PPS Issues: Improving Coding Accuracy and Compliance.” The
conference will take place on Thursday, Dec. 13, 2001 from 1 to 2:30
p.m. “Accuracy and compliance are your keys to unlocking the best
possible reimbursement results,” comments Lambert.

Program highlights include scoring impairment groups, how to manage case
mix groups effectively, co-morbidity codes, quality indicators and staff
training tips. Ms. Lambert will also reveal to approach the ethical and
financial dilemmas of patients who exceed predicted reimbursement.
Course materials include tools designed just for this event. “Your
facility will be able to use these worksheets throughout the next year,”
promises Lambert.

Coders, nurses, physical and occupational therapists will earn CEU’s at
this seminar.

For more information about registration and pricing, call 1-800-874-9180
or visit: 

*	http://www.eliresearch.com/IRFPAI2002.html


Patent Awarded To Penjet For Needleless, Lyophilized Drug Injector 	
LOS ANGELES, CA (Medical Newswire) A US Patent for mixing a lyophilized
(freeze-dried) drug with a diluent in a needleless jet injector prior to
administration has been granted to PenJet® Corporation, a Los Angeles,
CA medical device company, it was announced today. Foreign patents are

“Pharmaceutical manufacturers will now be able to package their
innovative lyophilized drugs in a needleless, single use, inexpensive
jet injector,” said Thomas P. Castellano, PenJet® Corporation’s CEO.
“Although it has wide applicability for the needleless delivery of a
great many drugs, it is particularly relevant to the increasing number
of highly potent, biotechnologically derived proteins that require
lyophilization to maintain their required shelf life.”

The PenJet® needleless injector is packaged with a lyophilized drug in
its integral ampoule along with a reagent (diluent) in a separate
carrier. Prior to administering an injection, the user docks the diluent
housing to the front of the PenJet® ampoule. The reagent is pushed into
the ampoule containing the lyophilized product, liquefying it so it can
be injected.

The PenJet® patented shuttle system allows the two components to be
thoroughly mixed by transferring it back and forth a few times. After
mixing, the user removes the reagent housing from the end of the PenJet®
and administers a needleless injection.

To give a needleless injection with a PenJet®, a protective cap and
safety ring that avoids accidental triggering is removed, the nozzle is
placed against a suitable injection site, such as the upper arm, thigh
or stomach, and the PenJet® administers the injection when gently
pressed. After use, the PenJet® can be safely discarded in any trash
receptacle, or recycled into non-medical devices, since it has no needle
and has injected all the medication or vaccine it contained.

Half the size of a conventional fountain pen, the PenJet®, uses a
patented self-contained, compressed inert gas system to inject drugs
into the skin surface without a needle. The patient experiences minimal
sensation and no noise when the injection is given. 

PenJets can administer a wide range of subcutaneous, intradermal and
some intermuscular injections® and will be shipped from a pharmaceutical
company, pre-filled with a drug dose ready to inject. 

Unlike a disposable syringe with a needle that is filled from a
medication bottle, PenJets® both store and administer a needleless
injection. This eliminates the pain and fear associated with needles, as
well as the risk of accidental needle sticks and improper dosages.
Compared to prior jet injectors, which are expensive, noisy, awkward to
fill and inject with, the small PenJet® is easy to store, carry and use.

PenJets® are safe and simple enough for most people to instantly
administer an injection to themselves or others without any prior
experience. Coupled with its low cost, PenJets® are applicable for uses
ranging from mass inoculations of entire populations for diseases such
as influenza and smallpox, to home administration of pharmaceuticals by
patients or their caregivers. It should prove useful in underdeveloped
nations where vaccines can be distributed and safely administered to
people who have little or no access to health care professionals.

PenJet® Corporation has begun to license pharmaceutical companies to use
its innovative needleless drug delivery systems, which are covered by
nine U.S. patents with many more pending in the U.S. and around the

PenJet® Corporation is a private company specializing in proprietary
drug delivery systems that encompass drug delivery devices, and fully
automated aseptic assembly and filling equipment. Its principals have
licensed many medical device patents, awarded to some of the world's
largest pharmaceutical companies and medical device manufacturers. 

*	http://www.penjet.com
*	Click here to email for more information
<mailto:bob@penjet.com?subject=Medical Newswire Inquiry> 


Indictments Handed Down In Hospital Fraud Case	
GRAND RAPIDS, MI (Medical Newswire) A federal grand jury issued two
indictments after a health care fraud investigation United Memorial
Hospital in Greenville, MI.

The first indictment charges the hospital and two physicians, Daniel
Seward, former chief of staff, and Matthew DeWys, former chief of
emergency medicine, with conspiracy to commit wire and mail fraud. The
indictment also charges the hospital with 30 counts of wire and mail
fraud. The second indictment charges Michael Mihora, former chief
executive officer, with false testimony. Each count in both indictments
calls for a penalty of up to five years imprisonment and $250,000 in

These indictments relate to an earlier case that resulted in physician
Jeffrey Askanazi’s conviction on 33 counts of mail fraud, which included
billing Medicare, Medicaid and private insurers for unnecessary
procedures he performed at United Memorial. The hospital allegedly
billed facility fees to Medicare and Medicaid for the unnecessary

The Michigan Attorney General’s office and United Memorial dispute
whether the hospital took corrective action in the Askanazi case. 


Feds Revisit Outpatient Cost Reports	
WASHINGTON, DC (Medical Newswire) In a recent audit report, the HHS
Office of Inspector General weighed in on a North Miami Beach, FL
hospital's cost reporting practices for one of its outpatient specialty
clinics. According to "Audit of the Outpatient Oncology Clinic Costs at
Parkway Regional Medical Center" (A-04-00-01223), Parkway deviated from
Medicare cost guidelines in two respects. First, the OIG says, the
medical center didn't adequately document the reasonable cost of the
management fees associated with the oncology clinic, making it
impossible for the watchdog agency to assess the validity of $8.9
million in Medicare reimbursement.

Second, the hospital - inadvertently, according to Parkway - included on
its cost report lease expenses for the clinic that were incurred after
the clinic stopped providing services, the OIG says.

To see the report, go to

*	http://oig.hhs.gov/oas/reports/region4/40001223.pdf


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Received on Wednesday, 5 December 2001 18:44:36 UTC

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