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Expect new faces, same goal at AAHomecare

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03/29/2013
Liz Beaulieu

ALEXANDRIA, Va. – There’s a changing of the guards in the works at AAHomecare, but it won’t slow down the association’s efforts, leaders say.

AAHomecare and President/CEO Tyler Wilson have mutually agreed that he will leave the association in September, when his contract expires. Other recent departures: Walt Gorski, vice president of government affairs; Michael Reinemer, vice president of communications and policy; and Stacey Harms, manager of government affairs. The departures come at a time when AAHomecare is on the front lines fighting competitive bidding and audits.

“We’re going to keep focused on getting the job done,” said John Shirvinsky, an immediate past chairman. “You can’t be distracted by things like this.”

AAHomecare has already started the process to find Wilson’s replacement. Leaders expect him or her to be in place and up to speed long before September. The association is also working to replace Gorski, now a consultant. In the meantime, his counterpart, Jay Witter, who leads the association’s lobbying activities, will keep the association active in regulatory matters.

The timing of the departures, especially of Wilson and Gorski, AAHomecare’s most public faces, is coincidental, leaders say.

“The two are completely unrelated,” said Joel Marx, chairman. “Walt leaving was unexpected and he will be missed. But we have a lot of support behind us. Attorney Asela Cuervo has indicated that she can spend more time with the association, and she’s one of the most talented people in regulatory matters.”

While AAHomecare, under Wilson’s leadership, has been unable to slay the industry’s biggest foe—competitive bidding—leaders say the association is far better off than it was six years ago.

“When Tyler came in, we had no financial strength, no ability to spend money,” Marx said. “The investments that we made last year alone to fight competitive bidding were in the seven figures.”

AAHomecare may have a new leader soon, but the association will remain laser focused on replacing competitive bidding with a market-pricing program (MPP), leaders say.

“Any time there is a change in senior management, work and communication styles will be unique to each leader, but the priorities are likely to change very little,” said Robert Steedley, incoming chairman. “We have a strong commitment to continue efforts with MPP, as well as addressing other problems.”


In brief: ResMed lawsuit, surety bond update

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03/29/2013
HME News Staff

SAN DIEGO – ResMed has sued Taiwanese manufacturer Apex Medical and its U.S. distributor, Medical Depot, doing business as Drive Medical, to stop alleged patent infringement. ResMed has filed parallel legal actions in the International Trade Commission (ITC) and U.S. federal court, alleging its patents are being infringed by several Apex products, including the Wizard 210 and 220 masks; the Freedom 210 and 220 masks made by Apex and sold by Medical Depot; and the iCH and XT Fit flow generators. “We invest over a hundred million dollars in research and development each year to fuel these advances and other companies should not be allowed to infringe ResMed’s intellectual property by using our technology,” stated David Pendarvis, global general counsel and chief administrative officer for ResMed. ResMed is asking the ITC to stop the import and sales of these products in the United States, and it’s asking the U.S. federal court to stop the alleged patent infringement and award damages against the defendants.

OIG to CMS: Increase surety bond amounts

WASHINGTON – The Office of Inspector General (OIG) has made another push for CMS to use surety bonds to recover overpayments from HME providers. In a report this month that updates a similar report from 2011, the OIG stated that, as of July 2012, CMS has collected only $263,000 out of the millions it could have collected using the surety bond requirement. In this month’s report, the OIG also raises the stakes by recommending, among other things, that CMS use its legislative authority under the Affordable Care Act to require increased surety bond amounts for suppliers that receive high overall Medicare payments. “Most overpayments will likely remain uncollected because a number of suppliers had overpayments of more than $50,000 and CMS can recover only up to the amount of the surety bond,” the OIG stated. The OIG also recommended that CMS improve oversight of supplier data to ensure accurate and consistent information, and review guidelines to state that collection of debts through surety bonds is based on dates of service. CMS concurred with the OIG’s recommendations. CMS began requiring providers to obtain surety bonds of at least $50,000 in October 2009. One of the goals of the requirement: Ensure that the agency recovers erroneous payments resulting from fraudulent or abusive billing practices. Industry stakeholders reported last year an uptick in the number of claims filed against surety bonds by Medicare.

ASP figures: Budesonide back down

BALTIMORE – Pricing for budesonide took a plunge in the latest average sales price (ASP) figures for respiratory medications. Budesonide (J7626) decreased 49 cents to $4.76 per dose. In the previous quarter, the drug saw an increase of 38 cents, to $5.26 per dose. The two brand-name long-acting beta agonist (LABA) drugs continue to get favorable pricing. Brovana (J7605) increased 4 cents to $5.37 cents per dose; Perforomist (J7606) increased nearly 27 cents to $5.29 cents per dose. Other pricing stayed flat: albuterol (J7613) and ipratropium (J7644) were both up less than 1 cent to 13 cents and 12 cents, respectively, per dose.

Stand Up for Homecare raises $50K

LAS VEGAS –AAHomecare’s fundraising reception, Stand Up for Homecare, raised more than $50,000 toward awareness and advocacy efforts, according to an association bulletin. The reception, held during Medtrade Spring 2013, drew more than 200 guests. “These activities provide critical support to our efforts to deliver positive public policy outcomes for the homecare sector, including the campaign to replace the current version of the Medicare bidding program with a more sustainable alternative,” said Tyler Wilson, president of AAHomecare, during the reception.

Provider short takes

Apria Healthcarehopes to secure a $750 million loan to refinance debt as borrowing costs remain at historic lows, according to an article from Bloomberg…Joy Comfort, a medical supply company based here, has launched a new e-commerce website, according to a press release…Global Medical Direct (GMD), a medical equipment provider with HME and diabetes supplies branches, signed a consulting contract with Connectyx Technologies.

Vendor short takes

Any provider can now take advantage of HQAA’s Accreditation Maintenance Program Toolkit (AMPT). The online program, which helps providers stay up-to-date with accreditation standards, was previously available only to HQAA customers…CareTouch Communications has launched Adhere, a sleep therapy compliance management service for HME providers, according to a press release. The service communicates with patients and gives HME providers patient status information during the first three months of sleep therapy…ResMed will keep its headquarters in southern California, after its board decided the benefits of staying were greater than that of relocating, according to an article from the San Diego Union-Tribune…Two sleep therapy products from Somnetics International—the Transcend APAP device, and the Transcend EZEX CPAP device—have received the CE Mark, certifying that they meet European health and safety standards, according to a press release…The Board of Certification/Accreditation (BOC) has launched an online web portal called MyBOC to provide round-the-clock customer service to accredited facilities…Bruno Independent Living Aids has agreed to sponsor the Paralyzed Veterans of American 2013 Bass Tour competition for the fifth year in a row.

People news

Invacare Chairman Mal Mixon has published a book that details his rise from humble beginnings to successful entrepreneur. In “An American Journey,” available on Amazon, Mixon shares not only how he grew Invacare’s sales from $19 million to almost $2 billion but also how he became a dedicated philanthropist and overcame cancer and a stroke…AAHomecare has welcomed two new members to its leadership team for the HME/Respiratory Therapy Council. The association has named Tim Hatt, director of home medical equipment and legislative affairs for Wright & Filippis in Rochester Hills, Mich., and Andrea Stark, owner of Mira Vista in Columbia, S.C., chairman and vice chairwoman, respectively…OxySure, a developer of oxygen solutions, has announced that Jeremy Jones, former chairman and CEO of Apria Healthcare, will join the company as an independent director on April 1…Edward Vishnevetsky has been named a “Legal Leader on the Rise” by Texas Lawyer Magazine. Vishnevetsky is an associate with Munsch Hardt Kopf & Harr in Dallas.

CMS reverses position on Medicare Advantage

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04/02/2013
HME News Staff

BALTIMORE – No April Fools’ Day joke here: CMS announced on Monday a 3.3% increase in reimbursement rates for Medicare Advantage in 2014.

This, after originally proposing a 2.3% reduction in February.

“The policies announced today further the agency’s goal of improving payment accuracy in all our programs, while at the same time ensuring program stability and preserving beneficiary choice,” stated Jonathan Blum, acting principal deputy administrator for CMS, in a press release.

The government pays private insurance companies, which lobbied hard against the reduction, to run Medicare Advantage. About 25% of the 47 million Americans on Medicare pay more to be part of the program, according to news reports.

Shares of Humana, a major provider of Medicare Advantage plans, rose 8% in after-hours trading from a close Monday of $75.02, according to reports.

Stakeholders to lawmakers: Talk bidding during meetings

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04/05/2013
Leif Kothe

WASHINGTON – Industry stakeholders are angling to use the upcoming confirmation hearing of CMS Acting Administrator Marilyn Tavenner as a platform to voice their concerns about competitive bidding.

A portion of Tavenner’s confirmation hearing, set for Tuesday, April 9, involves face-to-face meetings with members of the Senate Finance Committee, who scheduled the hearing.

“Each senator has a chance, in a closed-door way, to sit down with the nominee and go through the issues that are priorities,” says Cara Bachenheimer, senior vice president of government relations at Invacare.

Unlike her predecessor, Don Berwick, Tavenner has broad bipartisan support in Congress, including from House Majority Leader Eric Cantor, R-Va., according to news reports.

Stakeholders hope that, through committee members, they can pressure CMS to be more transparent about competitive bidding, including how the agency calculated the Round 1 and 2 payment amounts.

“The process is so secretive, and it shouldn’t be this way,” says Jay Witter, vice president of government affairs at AAHomecare. “It should be more open—we’re looking for definite answers.”

It won’t be the first time Tavenner hears concerns about competitive bidding. Witter met with Tavenner in December and he said the meeting was positive.

“The senators are going to indicate concerns with the competitive bidding process, and also talk about the benefits of the market-pricing program,” Witter said. 

Have ABNs become 'gray area'?

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04/05/2013
Elizabeth Deprey

WASHINGTON – The proper use of advance beneficiary notices (ABNs) has shifted—and not in the HME provider’s favor, industry stakeholders say.

CMS has evolved its policy to the point where providers can no longer use ABNs to “upgrade” within the same code, says Andrea Stark, a reimbursement consultant with MiraVista.

“We are operating in gray areas,” she said. “It has definitely been an erosion of how we utilize this.”

Case in point: In January, the PDAC expanded the definition of mastectomy bras to include the words “any size, any type.” That makes it very difficult to justify an upgrade, Stark said.

Other products will soon feel the effects of CMS’s new position on ABNs, stakeholders say.

“The ripple effect is going to be widely felt,” Stark said. “I haven’t seen mass education in other policies, but I don’t think we’re far from seeing that emerge throughout.”

What are providers to do? They can bill claims non-assigned, says Bruce Brothis, president of Allegient Billing & Consulting. This requires a provider to be categorized as non-participating with Medicare, he said.

“Outside the competitive bidding areas, the patient can pay you full retail upfront, then you submit a claim to Medicare to get the patient reimbursed 80% of the Medicare allowable,” Brothis said.

The competitive bidding wrinkle

Contract suppliers in competitive bidding areas also have to deal with the non-discrimination clause when using ABNs.

“Items furnished by contract suppliers must be the same as those offered to other customers,” said Marshall Meringola, an attorney with Amarillo, Texas-based Brown and Fortunato. “They want to make sure beneficiaries under competitive bidding have access to the same products all other Medicare beneficiaries and private pay customers have access to.”

What that means: Even if contract suppliers offer good, better, best options, they’re going to get paid the same, stakeholders say.

Contract suppliers can set up separate retail companies to offer upgraded products—but they must dot their i’s and cross their t’s, says consultant Jack Evans.

“Medicare requires that the retail store must have a different name so as not to confuse Medicare patients that the retail store still bills Medicare,” said Evans, president of Malibu, Calif.-based Global Media Marketing. “(The retail locations also need) a separate physical address and a separate tax ID/corporate entity.” 

In brief: Investor buys Permobil, Drive responds to lawsuit

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04/05/2013
HME News Staff

STOCKHOLM, Sweden – Permobil, a manufacturer of high-end power wheelchairs, has been acquired by Investor AB, a Swedish investment firm. Private equity firm Nordic Capital agreed to sell Permobil for $842.3 million. Under Nordic’s wing, the company’s sales have nearly doubled, according to reports. Last year, Permobil, which operates in 30 countries, generated revenue of about $246.3 million. The company’s annual sales growth over the past decade has averaged 8%, according to reports. Investor AB President and CEO Borje Ekholm says Permobil offers “an attractive platform for future profitable growth.” “As a long-term owner, we look forward to, together with the dedicated management and employees, contributing to Permobil’s further development,” he stated. “Investor has a long track record of building companies within the healthcare arena. We believe we can help create an even stronger company by, for example, sharing knowledge within manufacturing, health economics and expansion into new geographies.” The acquisition, which is subject to approval from competition authorities, is expected to close during the second quarter of 2013.

Drive Medical suspends sale of certain CPAP masks

PORT WASHINGTON, N.Y. – In light of a lawsuit filed by ResMed, Drive Medical has suspended the sale and marketing of several of its CPAP masks, the company has announced. In March, ResMed filed parallel legal actions in the International Trade Commission (ITC) and U.S. federal court, alleging that its patents are being infringed by Apex Medical and its U.S. distributor, Medical Depot, doing business as Drive Medical. Drive Medical will offer substitute products to its customer base while it investigates the allegations made by ResMed, the company stated.

CMS reverses position on Medicare Advantage

BALTIMORE – No April Fools’ Day joke here: CMS announced on Monday a 3.3% increase in reimbursement rates for Medicare Advantage in 2014. This, after originally proposing a 2.3% reduction in February. “The policies announced today further the agency’s goal of improving payment accuracy in all our programs, while at the same time ensuring program stability and preserving beneficiary choice,” stated Jonathan Blum, acting principal deputy administrator for CMS, in a press release. The government pays private insurance companies, which lobbied hard against the reduction, to run Medicare Advantage. About 25% of the 47 million Americans on Medicare pay more to be part of the program, according to news reports.

Numotion: New name, new acquisition

ROCKY HILL, Conn. – Effective June 1, Numotion will become the official name of the company formed by the January merger between ATG Rehab and United Seating & Mobility. The company has also made its first acquisition since the merger, buying Ultimate Mobility, a provider of power wheelchairs based in Worcester, Mass., according to a press release. Frank Biondello, regional executive vice president of Numotion, stated in the release that the purchase “expands our presence in central and western Massachusetts, and helps strengthen our services throughout the state.”

Stakeholders ramp up complex rehab efforts

WALSENBURG, Colo. – NRRTS last week urged complex rehab stakeholders to call their members of Congress on April 10 and ask them to support a separate benefit category for complex rehab, according to a press release. The call-in runs concurrently with the National CRT Leadership and Advocacy Conference on April 9-11, and is designed for providers, manufacturers, clinicians and patients who cannot attend the event. Stakeholders have also launched a petition to urge members of Congress to support H.R. 942, a bill introduced by Reps. Joe Crowley, D-N.Y., and Jim Sensenbrenner, R-Wis., that would create a separate benefit category for complex rehab.

Provider short takes

IntegraSleep, a sister company to Active Healthcare, has opened a fourth location. The Durham-Chapel Hill, N.C., location will allow IntegraSleep to keep up with “overwhelming demand” for its services, according to a press release.IntegraSleep already has locations in Raleigh, Clayton and Smithfield, N.C. It offers a full range of sleep services, including polysomnography, CPAP titration and home sleep studies. Active Healthcare then follows up with equipment, therapy and compliance monitoring…Dynamic Healthcare Services (DHS) has appointed David Erb its new director of sales, according to a press release. “David will immediately begin recruiting and developing our sales staff, while simultaneously building our sales pipeline and lead development channels in strategic, targeted markets,” stated Terry Luft, CEO of DHS, in the release…SleepMed, a sleep testing and therapy company, has completed a merger with Watermark Medical, a Boca Raton, Fla.-based sleep testing and therapy company, according to a message from Watermark executives. The company will operate as SleepMed, but the Watermark Medical name will be maintained for use with physician customers, the message noted.

Vendor short takes

ZirMedhas launched a web-based service that helps providers determine a patient’s financial responsibility prior to providing service or care, according to a press release. The solution, called ZirMed Patient Estimation, enables providers to get paid faster and more accurately, thereby improving cash flow, the company states in the release...Fastrack Healthcare Systems has become the exclusive billing software provider for members of Independent Medical Co-Op (IMCO), according to a press release. IMCO recently launched a membership group serving independent HME providers…DeVilbiss Healthcareis offering free sleep workshops in four cities throughout April and June, according to a press release. The workshops, set for April 16 in Denver, April 30 in Toronto, May 15 in Pittsburgh (full), and June 18 in Detroit, include two modules: “Keys to Sleep: Diagnosis to Treatment” and “Success in Sleep: Connecting the Dots.” The workshops are worth six continuing education credits (CEUs).

Rotech files bankruptcy, secures financing

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04/08/2013
HME News Staff

ORLANDO, Fla. – Rotech Healthcare announced today that it has filed voluntary petitions for reorganization under Chapter 11 of the U.S. Bankruptcy Code.

As part of its reorganization plan, Rotech will eliminate about half of its secured debt, the company stated in a press release.

“Today’s actions will enable us to create a capital structure that will provide a foundation for sustained profitability and future growth,” stated Steven Alsene, president and CEO of Rotech, in the release. “This effort is being undertaken to fix our balance sheet and will not affect our operations. Given the support of our secured stakeholders, we expect the reorganization process to conclude quickly.”

With widespread consensus among key stakeholders, Rotech plans to receive confirmation and successfully complete the reorganization within 90 to 150 days.

Additionally, in what Rotech says is a vote of confidence, Silver Point Finance, the holder of an existing $23.5 million term loan, has agreed to provide debtor-in-possession financing of up to $30 million. Rotech will use this financing for ordinary working capital purposes and to ensure normal operations during the Chapter 11 process, according to the release.

CMS names contract suppliers for Round 2

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04/09/2013
HME News Staff

BALTIMORE – CMS proceeded with its competitive bidding program today by releasing the names of 799 contract suppliers for Round 2.

CMS awarded 13,126 contracts to 799 suppliers in 91 competitive bidding areas for certain HME. Additionally, it awarded contracts to 18 suppliers as part of its national mail-order program for diabetes supplies.

On July 1, these contract suppliers will begin providing DME at new payment amounts that are, on average, 45% below the current fee schedule for certain HME and, on average, 72% below the current fee schedule for diabetes supplies.

The contract suppliers for HME have 2,988 locations to serve Medicare beneficiaries in the competitive bidding areas. The suppliers for diabetes supplies have 52.

CMS awarded 90% of contracts to suppliers that are already established in the competitive bidding area, the product category or both. Small suppliers, those with gross revenues of $3.5 million or less as defined by the program, make up 63% of the contract suppliers.

In all, CMS received 48,424 bids from 2,641 suppliers during a 60-day bidding period from Jan. 30 to March 30 last year.

CMS expects competitive bidding to save an estimated $25.7 billion between 2013 and 2022.

Now that the names of the contract suppliers are public, CMS will begin educating suppliers, beneficiaries and referral sources about competitive bidding.

For a list of contract suppliers:

http://www.dmecompetitivebid.com/palmetto/cbicrd2.nsf/docsCat/Round%202~Contract%20Suppliers~Contract%20Supplier%20Lists?open&expand=1&navmenu=Contract^Suppliers||

For a fact sheet:

http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4573&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

For CMS’s press release:

http://www.cms.gov/apps/media/press/release.asp?Counter=4578&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date


Industry gathers 'ammunition'

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04/12/2013
Liz Beaulieu

BALTIMORE – Industry stakeholders believe CMS may have shot itself in the other foot when it released the names of the 799 suppliers who won 13,126 contracts as part of Round 2 of competitive bidding.

“There are glaring problems with this list,” said Wayne Stanfield, president and CEO of NAIMES. “CMS has failed on every level: They have selected unqualified companies; they have given hundreds of contracts to suppliers that have no ability to fulfill them. It goes on and on.”

The list of contract suppliers follows the release on Jan. 30 of the single payment amounts—an almost unbelievable 45% and 72% below the fee schedule, on average, for HME and diabetes supplies, respectively.

Stakeholders say the “glaring problems” in the 307-page list include the small number of contract suppliers (799 for 91 areas in Round 2 vs. 356 for nine areas in Round 1) and the small number of local contract suppliers in any given bid area (some estimate a one-to-four ratio of local to non-local suppliers).

“If you take Apria (in Pearl City, Hawaii) out of the CPAP category in Honolulu, the next company that comes up is 3,000 miles away in California,” said Rob Brant, CEO of AMEPA. “One is 6,000 miles away in Florida.”

CMS says it awarded 90% of contracts to suppliers that are “already established in the bid area, the product category or both.” Stakeholders say it was a calculated move to report the information this way. By contrast, in Round 1, the agency broke it down: 76% of contracts to suppliers already furnishing the items in the bid areas, and 97% of contracts to those with experience with the items.

“They’re lying through their teeth,” Stanfield said.

Stakeholders are also taking CMS to task for awarding 63% of the contracts to small suppliers, those with $3.5 million or less in gross revenues. While this may seem like a positive, when you consider how few contract suppliers there are and how few of them are local, it becomes alarming.

“I don’t know how they’ll serve the sheer volume of beneficiaries,” said Cara Bachenheimer, senior vice president of government relations for Invacare. 

Stakeholders plan to weave all of this into a powerful case for delaying the start of Round 2 on July 1 and, ultimately, replacing competitive bidding with a market-pricing program (MPP).

“It’s going to provide us with some good ammunition,” Bachenheimer said.

In brief: Senator calls hearing, Apria borrows $900M

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04/12/2013
HME News Staff

WASHINGTON – Sen. Claire McCaskill, D-Mo., has scheduled a hearing to address HME marketing tactics, according to a press release. In advance of the hearing, entitled “Oversight and Business Practices of Durable Medical Equipment Companies,” McCaskill is encouraging those who have experienced aggressive sales tactics from HME companies, such as “repeated telephone calls and aggressive sales pitches,” to call her office and share their stories. “It’s clear talking to folks in and out of Missouri that what’s going on in this industry deserves scrutiny,” she stated in the release. “These sales tactics are costing taxpayers money.” The hearing, slated for April 24, is the first for McCaskill’s new panel: the Subcommittee on Financial & Contracting Oversight. Witnesses testifying before the panel will include representatives from CMS, along with individuals representing companies in the HME industry, according to the release.

Apria completes debt refi

LAKE FOREST, Calif.—Apria Healthcare has secured a term loan credit facility of $900 million, according to a press release. Additionally, the company has issued notices of redemption for $700 million of its outstanding 11.25% senior secured notes (series A-1) due 2014 and $160 million of its outstanding 12.375% senior secured notes (series A-2) due 2014.

N.Y. members of Congress to CMS: Delay Round 2

WASHINGTON – A bipartisan group of New York lawmakers has asked CMS to delay the expansion of competitive bidding. A letter signed by 19 New York members of Congress expresses “concern” with Round 2 of the program, set to kick off July 1, particularly with respect to the recently announced single payment amounts. CMS has designed a program, the letter states, “that does not hold bidders accountable for their bids, does not ensure that bidders are qualified to provide the products in the bid areas, and produces bid rates that are financially unsustainable over the long term.” The letter also blasts a lack of transparency from CMS. “Congress has repeatedly asked CMS for detailed information regarding the competitive bidding system and CMS has failed to provide even basic information about the program,” the letter states.

CPAP treatment improves productivity, study finds

BERLIN, Germany – CPAP treatment bolsters productivity at work for those suffering from sleep apnea, according to a study conducted by the European Respiratory Society and the European Sleep Research Society. Using the Endicott Work Productivity Scale, a questionnaire designed to assess workplace productivity, and the Epworth Sleepiness Scale, a questionnaire that measures daytime sleepiness, researchers found that 35 of 45 sleep apnea patients who adhered to CPAP treatment for three months showed significant improvement at work. The 10 patients who did not comply with the treatment showed no significant improvement, the study found. “Previous research has shown the potential benefits of CPAP to patients’ health and quality of life and our findings add to this body of evidence,” stated lead author Evangelia Nena, MD, PhD. The study will be presented April 11 at the Sleep and Breathing Conference in Berlin. 

M&A: Home Care Medical, Valley Respiratory

New Berlin, Wis.-based Home Care Medical, a provider of HME, respiratory care and home infusion products, has acquired HomeCare Resources, based in Sheboygan, Wis. The acquisition gives the company a third retail store in southeastern Wisconsin. Home Care Medical will expand the offerings at HomeCare Resources, which specializes in CPAP therapy, mobility aids, bathroom therapy and other HME, to include oxygen therapy, ventilator management, rehab technology, and bracing and compression garments…Phoenix-based Valley Respiratory Services, a provider of HME, power mobility devices and respiratory services, has acquired RTA Homecare, adding three new locations in Mesa and Casa Grande, Ariz., according to a press release. With the new acquisition, the company now owns seven locations throughout Arizona.

Vendor short takes

Invacarewill release its financial results for the first quarter of 2013 before the market opens on Thursday, April 25. In a conference call scheduled that same day at 8:30 a.m. EST, the company plans to discuss its earnings and give an update on certification audits relating to its consent decree* with the Food and Drug Administration (FDA) at its Taylor Street wheelchair manufacturing facility…For the first time in its 37-year history, Convaid has a new look. The company has launched a new logo and tag line. Coming this summer: a new website. “Convaid has also redefined its mission to help create a better life for special needs youth and their families by exemplifying compassion, customization and being the best in class,” according to a press release…QS/1 has released a tool to help pharmacies better serve Medicare Part B customers, and comply with regulations and audits. QS/1’s Medicare Part B Compliance Documentation allows pharmacies that use NRx or PrimeCare Pharmacy Management Systems to retain the documents required for audits.

Sanomedics buys Prime Time Medical

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04/18/2013
HME News Staff

MIAMI – Sanomedics International, a medical technology holding company, has acquired Prime Time Medical, a Largo, Fla.-based HME provider, for $3 million, according to a press release.

The acquisition is Sanomedics’ third in the HME industry.

“Prime Time Medical is another step in our continual process of expanding our portfolio while we implement our growth strategy,” stated Keith Houlihan, co-founder and president of Sanomedics.

Sanomedics seeks to acquire sleep therapy operating businesses to develop a portfolio of products and services in this growing market. Its goal: to provide sleep apnea patients with an “end-to-end” service platform, according to the release.

Prime Time Medical, a provider of mobility devices, portable oxygen concentrators, compressors, diabetic supplies and respiratory products, posted about $5 million in revenue for 2012, according to the release.

The acquisition is tentatively scheduled to close April 24, 2013.

In brief: Sanomedics buys Prime Time, PE firm backs AxelaCare

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04/19/2013
HME News Staff

MIAMI – Sanomedics International, a medical technology holding company, has acquired Prime Time Medical, a Largo, Fla.-based HME provider, for $3 million, according to a press release. The acquisition is Sanomedics’ third in the HME industry. “Prime Time Medical is another step in our continual process of expanding our portfolio while we implement our growth strategy,” stated Keith Houlihan, co-founder and president of Sanomedics. Sanomedics seeks to acquire sleep therapy operating businesses to develop a portfolio of products and services in this growing market. Its goal: to provide sleep apnea patients with an “end-to-end” service platform, according to the release. Prime Time Medical, a provider of mobility devices, portable oxygen concentrators, compressors, diabetic supplies and respiratory products, posted about $5 million in revenue for 2012, according to the release. The acquisition is tentatively scheduled to close April 24, 2013.

New PE firm gets behind AxelaCare

LENEXA, Kan. – AxelaCare Holdings, a home infusion therapy provider owned by Denver-based private equity firm Excellere Partners, was recently acquired by Harvest Partners LP, a private equity firm based in New York, according to multiple reports. “The company’s investment in processes, technology and people has led to an efficient, scalable model with opportunity for continued growth as a larger share of the population seeks access to these vital services,” stated Ira Kleinman, senior managing director at Harvest Partners, in a press release. AxelaCare, founded in 2008, is based in Lenexa, Kan. Terms of the transaction were not disclosed.

Prodigy Diabetes Care, OK Biotech align ownership

CHARLOTTE, N.C. ­– Prodigy Diabetes Care, a distributor of diabetes testing supplies, has acquired substantial ownership of the publicly owned shares of OK Biotech, a manufacturing partner based in Taiwan, according to a press release. For its part, OK Biotech has purchased a minority stake in Prodigy Diabetes. The two companies formed the new relationship to meet the demand of a consolidated customer base for high-volume, lower cost diabetes testing supplies, according to the release. Once the 72% cut to diabetes supplies was announced as part of Round 2 of competitive bidding, Prodigy Diabetes made a concerted effort to “strengthen our affiliation with OK Biotech and meet with many of the bid winners to offer them our best pricing,” stated Rick Admani, COO of Prodigy Diabetes. “We knew we needed to take an aggressive approach to the new Medicare program,” he stated.

Amazon makes foray into HME

SEATTLE – Amazon.com has launched an online store that will sell certain home medical equipment, according to a press release. The store, called “50+ Active and Healthy Living,” will sell incontinence supplies, daily living and mobility aids, blood pressure monitors, and diabetes management items, but HME comprises only a fraction of the hundreds of thousands of products offered. Other products include everything from vitamins and supplements to activity monitors.

Emphasis on revenue, innovation for Heartland 2013

WATERLOO, Iowa – Nearly 80 sessions, featuring 20 new speakers, are slated for The VGM Heartland Conference, June 10-13 in Waterloo, Iowa, according to a press release. “We’re focusing on revenue opportunities, business innovations and networking,” stated Ron Bendell, president of VGM. “We’ve added small group discussions on business topics, and sessions that are designed to help our members succeed with new revenue sources and take proactive approaches to the audits that are plaguing HME.” On June 10, four pre-conference educational sessions will be offered, including “Sales Training Fast and Furious” presented by Louis Feuer, an HME industry veteran. Chad Knaus, crew chief for Jimmie Johnson, a five-time NASCAR champion, will provide the keynote address titled, “Building a Successful Team in a Competitive Environment.” Early bird registration rates apply for those who register by May 17.

Clinton to keynote NCPA convention

ALEXANDRIA, Va. – Former president Bill Clinton will deliver the keynote address at the National Community Pharmacists Association’s annual convention and trade expo, according to a press release. “ The organization’s 115th annual convention is scheduled for Oct. 12-16, 2013, at the Walt Disney World Swan and Dolphin Resort in Orlando, Fla. NCPA is currently running an early bird promotion special until June 30, 2013.

Provider short takes

Watermark Medical, a sleep apnea diagnostics company which recently merged with Columbia, S.C.-based SleepMed, has received $32.2 million from at least 20 investors since the merger, according to an SEC filing. Founded in Boca Raton, Fla., in 2008, the company manufacturers an at-home headset called ARES, which uses sensors to compile data designed to measure a patient’s risk for sleep apnea, the article noted…Hayward Medical Market, an HME and bathroom safety company in the San Francisco area, has founded an online shopping site to supplement its three Bay Area locations, according to a press release. The website—www.medmartusa2.com— offers 4,000 medical products, including incontinence products, walking aids, wheelchairs and nebulizers…National Incontinence, a distributor of incontinence supplies, has implemented a new live chat feature on its website that allows customers to communicate with staff.

Vendor short takes

Pride Mobility Productshas named Andrew Pyrih its new senior vice president of domestic sales. Pyrih will focus chiefly on strategic development of Pride’s retail mobility business, while working closely with Jay Brislin, vice president of Quantum Rehab…Top End, Invacare’s sports and recreation division, is sponsoring the Greenville 2013 Para-Cycling Open, slated for April 19-21 in Greenville, S.C. The competition is for athletes with physical disabilities, including both para-cyclists and handcyclists…Ankota, a cloud-based business portal for healthcare companies, has raised $2 million to expand its sales, marketing and technology staff, according to an article from medcitynews.com. The company, which helps coordinate the transition of care between providers and physicians, will add between 12 and 15 new staff members this year.

New focus on market-pricing program

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04/19/2013
Leif Kothe

WASHINGTON – When the bill to replace competitive bidding with a market-pricing program (MPP) is introduced, it will have lead sponsors on both sides of the aisle, industry stakeholders say.

When a similar bill was introduced in September of 2012 during the previous session of Congress, its lone lead sponsor was Rep. Tom Price, R-Ga. The new bill, now being finalized, will be spearheaded by Price and a Democratic lawmaker, stakeholders say.

“The good news from the industry’s perspective is both Democrats and Republicans seem to agree that this program is fundamentally flawed and an alternative needs to be put in place prior to any start,” says Seth Johnson, vice president of government affairs for Pride Mobility.

At press time, stakeholders declined to name the Democratic lawmaker.

With the introduction of the MPP bill imminent, stakeholders are putting on the backburner another bill that they’re working on to delay implementation of Round 2 on July 1. The reason for prioritizing MPP: eliminating confusion, stakeholders say.

“If the delay bill came out first, everyone may want to jump on that bill,” says Wayne Stanfield, president and CEO of NAIMES. “But if we can get the MPP bill out first, it would be the driving factor.”

Stakeholders say delaying the implementation of Round 2 would be only a stopgap measure, a less direct route to the industry’s ultimate goal: doing away with competitive bidding in its current form.

“Dr. Price wants to make sure that all the focus is on the MPP bill, and nothing else,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “In this case, we really need the whole enchilada.”

 

Subcontracting: 'Everybody's doing it'

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04/19/2013
Liz Beaulieu

YARMOUTH, Maine – Industry attorneys sum up the bulk of the activity in the wake of CMS’s announcement of the contracts suppliers for Round 2 with one word: subcontracting.

“It’s the biggest thing going on,” said Edward Vishnevetsky, an associate with Munsch Hardt in Dallas. “Providers want to know, how do we create proper subcontracting agreements?”

The interest is coming from both contract and non-contract suppliers, attorneys say, but more often than not, the latter is initiating the activity.

That’s because subcontracting is one of the only ways, at this point, for non-contract suppliers to stay in the Medicare game when Round 2 goes into effect in 91 areas on July 1, attorneys say.

“Non-contract suppliers get the benefit of maintaining their relationship with their referral sources and patient base, which can benefit them for other kinds of activities,” said Neil Caesar, president of the Health Law Center in Greenville, S.C. “Everybody’s doing it.”

For contract suppliers, subcontracting is a good way to get their foot in the door in areas and/or for products that are new to them, attorneys say.

“They need the subcontractor’s referrals,” said Jeff Baird, chairman of the Health Care Group at Brown & Fortunato in Amarillo, Texas. “They know that the subcontractor has hospitals that are loyal to it.”

In the nine areas in Round 1, which went into effect Jan. 1, 2011, subcontracting worked well, attorneys say, but it’s more of a tactical move than a profit center.

“Neither party makes much money,” Baird said. “No matter how you slice and dice it, both parties are dividing up a smaller pie.”
In addition to subcontracting, attorneys say they’ve seen an increase in the number of contact suppliers making acquisitions, mostly through asset purchases.

“I’m seeing a realignment in the industry,” Baird said. “In the CBAs, I’m seeing bigger players that are gobbling up smaller players who were awarded contracts.”

Still, the bulk of the activity remains in subcontracting, attorneys say.

“Whereas in Round 1, there was often a decision to be done with it, the majority of what I’m seeing in Round 2 is strategic moves for sustenance,” Caesar said.

Subcontracting 101

According to the competitive bidding implementation contractor (CBIC)*, the supplier standards limit subcontracting agreements to:

1.  Purchase of inventory;

2.  Delivery and instruction on the use of Medicare-covered items; and

3.  Maintenance and repair of rented equipment.

Services like intake and assessments, coordination of care, submission of claims, ownership responsibility and product safety must be provided by the contract supplier.

 

CMS updates on 2% cut

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04/23/2013
HME News Staff

WASHINGTON – CMS contractors this week provided new and revised questions and answers about the 2% cut in Medicare payments that went into effect April 1 as part of automatic spending cuts.

The new and revised Q&As are as follows:

Question: If a durable medical equipment capped rental period started before April 1, 2013, are the rental payments for months after April 1, 2013, subject to the 2% reduction?

Answer: Any claims for rental payments with a "FROM" date of service on or after April 1, 2013, will be subject to the 2% reduction, regardless of when the rental period began. For example, if a capped rental wheelchair was provided in February 2013, the monthly rental payment for May 2013 would be subject to the 2% sequestration reduction. The initial and subsequent monthly rental payments billed with a "FROM" date of service beginning on or prior to March 31, 2013, would not be affected by the 2% reduction.

Question: How long is the 2% reduction to Medicare fee-for-service claim payments in effect?

Answer: The law specifies that the 2% reduction to Medicare fee-for-service payments resulting from the sequestration order that the President was required to issue on March 1, 2013, applies to all payments for services furnished in the one-year period after the reductions begin. For Medicare, the reductions begin on the first day of the first month after the order is issued, meaning they began on April 1, 2013. Accordingly, this sequestration order covers all payments for services with dates of service or dates of discharge (or a start date for rental equipment or multi-day supplies) April 1, 2013, through March 31, 2014.

Question: Are drugs excluded from the 2% reduction?  

Answer: No. All fee-for-service Medicare claim payments are subject to the 2% reduction. There are no exemptions provided in the law for drugs or any other healthcare item or service provided under the fee-for-service program.

For a comprehensive list of Q&As on the cut, go here:

https://www.noridianmedicare.com/partb/mandatory_payment_reductions_in_the_in_the_medicare_fee_for_service_program_sequestration.html


Rep. Price drops MPP bill

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04/25/2013
HME News Staff

WASHINGTON – Rep. Tom Price, R-Ga., on April 24 reintroduced a bill to replace competitive bidding with the HME industry’s market-pricing program (MPP).

Out of the gate, H.R. 1717 has 25 co-sponsors—nearly double the 13 co-cosponsors the previous bill had when it was introduced in September. That bill eventually gained 94 co-sponsors.

The second phase of competitive bidding is set to kick off July 1 in 91 cities. Single payment amounts for Round 2, announced Jan. 30, are, on average, 45% below the current fee schedule.

Stakeholders say the HME industry needs to work quickly to get more members of Congress to co-sponsor the bill. Although it could proceed as a standalone, it’s more likely to get attached to a larger bill, they say.

“Time is of the essence,” stated NAIMES in a bulletin. “We must gain 219 co-sponsors as quickly as possible. This is the path to stop the bidding program that will devastate our industry.”

The current roster of 25 co-sponsors includes 21 Republicans and four Democrats:

Barletta, Lou [R-PA11]

Blackburn, Marsha [R-TN7]

Braley, Bruce [D-IA1]

Capito, Shelley [R-WV2]

Chabot, Steve [R-OH1]

Crenshaw, Ander [R-FL4]

DesJarlais, Scott [R-TN4]

Fortenberry, Jeff [R-NE1]

Grimm, Michael [R-NY11]

Harper, Gregg [R-MS3]

Johnson, Bill [R-OH6]

Joyce, David [R-OH14]

King, Peter “Pete” [R-NY2]

Lankford, James [R-OK5]

Larson, John [D-CT1]

Loebsack, David [D-IA2]

Marino, Tom [R-PA10]

McKinley, David [R-WV1]

Nunnelee, Alan [R-MS1]

Posey, Bill [R-FL8]

Roe, David [R-TN1]

Ryan, Tim [D-OH13]

Scott, Austin [R-GA8]

Thompson, Glenn [R-PA5]

Tiberi, Patrick “Pat” [R-OH12]

 

 

 

 

 

 

New MPP bill starts strong

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04/26/2013
Theresa Flaherty

WASHINGTON – The HME industry needs to hit the ground running now that a new bill to replace competitive bidding with a market-pricing program (MPP) has been dropped, say stakeholders.

“This is not the beginning of the battle, this is the meat of the battle,” said Joel Marx, AAHomecare chairman. “There is no turning back.”

Right out of the gate, H.R. 1717, the “Medicare DMEPOS Market Pricing Program Act of 2013,” had 25 co-sponsors. Reps. Tom Price, R-Ga., and John Larson, D-Conn., introduced the bill April 24.

Price introduced a similar bill in the previous Congress. That bill eventually gained 94 co-sponsors.

“We’re hoping we can rack up a bunch of additional co-sponsors really quickly,” said Cara Bachenheimer, senior vice president of government relations with Invacare. “Those previous co-sponsors should immediately be singing back on.”

The biggest weapon in the industry’s arsenal: The list of Round 2 contract suppliers, released April 11, which reveals a small number of total contract suppliers and a small number of local contract suppliers in bid areas. Industry stakeholders are working with state associations to flesh that out with data.

“We need to package that up, state by state,” said Bachenheimer. “Then they can see their local providers have been passed over in favor of these—in many cases—brand-new, inexperienced companies.”

For H.R. 1717, the “pay for” is split between reduced interim payments for providers in Round 2 areas until MPP is implemented and unspent federal funds, stakeholders say. Price’s previous bill called for interim payments equal to the single payment amounts, but with reduction in reimbursement of, on average, 45%, that wasn’t an option, stakeholders say.

“This doesn’t hold the HME industry responsible for the whole 45%,” said Jay Witter, vice president of government affairs for AAHomecare. “This sends a signal to Congress that we are serious about paying for a better system, but that we are not solely responsible for the terrible Round 2 results.”

In another effort on the competitive bidding front, Rep. Robert Wittman, R-Va., has submitted language to the Appropriations Committee that would stop funding for the competitive bidding program until MPP is passed. With the introduction of H.R. 1717, that may no longer be necessary, say stakeholders.

“It was a positive step that he put that out there,” said Wayne Stanfield, president of NAIMES. “It shows members are concerned and they are reaching out in whatever ways they can think to stop this.”

Catching the industry by surprise last week: the announcement by Sen. Max Baucus, D-Mont., that he would not seek re-election. Baucus chairs the influential Senate Finance Committee, which oversees Medicare and Medicaid.

Still, the announcement shouldn’t have much impact on current efforts to stop competitive bidding, say stakeholders.

“He’s still there for two more years, he’s still the chairman, and he’s still important,” said John Gallagher, vice president of government relations for The VGM Group.

Leading industry associations join forces

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04/26/2013
Theresa Flaherty

ALEXANDRIA, Va. – In the biggest sign of industry unity yet, AAHomecare and NAIMES announced April 26 that they will merge into one organization.

“This is a time when we most need to have the industry all on one page,” said Wayne Stanfield, NAIMES president and CEO. “This will create a better, more focused and reenergized trade association.”

The merger, effective May 22, will bring about 140 new members under the AAHomecare umbrella, increasing its membership to about 600 members.

That’s a boost for the association, which has struggled with declining membership rolls in recent years.

“There’s no question when you add 140 new members who are energetic and passionate that this will bring a new energy to AAH,” said AAHomecare Chairman Joel Marx.

The association has also seen some upheaval in the past few months, with the departures of several high-profile staffers, most recently the March announcement that President/CEO Tyler Wilson would step down when his contract expires in September. Those departures and the merger are not connected, says Marx.

“Every organization needs new blood and new ideas and this is a great opportunity,” he said.

Stanfield, who, along with Wayne Sale, launched NAIMES in 2007 as a grassroots advocacy and support organization for independent providers, will join AAHomecare as vice president of provider relations. His immediate goals in his new role include working with state associations to create a district-level grassroots advocacy program, as well as reaching out to allied professional associations in pharmacy, home infusion and long-term care.

“I think everybody attacked everything from a different direction,” said Stanfield. “If we are able to work with all those groups, I think that will be a very positive step forward.”

AAHomecare last week also announced that it has tapped Kim Brummett as its new senior director of regulatory affairs. Brummett has worked at High Point, N.C.-based Advanced Home Care for 15 years. She is also chairwoman of the Jurisdiction C Advisory Council and sits on several industry committees and boards.

Sen. McCaskill on fraud: Enough blame to go around

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04/26/2013
Leif Kothe

WASHINGTON – Both the HME industry and CMS came under fire April 24 during a congressional hearing to review provider business practices and Medicare audits.

The hearing was the first for the Subcommittee on Financial & Contracting Oversight, which is led by Sen. Claire McCaskill, D-Mo.

“One significant concern is the prevalent practice among some medical equipment companies to aggressively call, email and write Medicare beneficiaries to directly market their products,” McCaskill said, citing a doctor from Chesterfield, Mo., who was recently “besieged by faxes from companies asking her to sign prescriptions from these patients so that the companies can bill Medicare.”

Two HME providers—Jon Letko, president of Milford, N.J.-based U.S. Healthcare Supply; and Dr. Steve Silverman, president of Boca Raton, Fla.-based Med-Care Diabetic and Medical Supplies—were invited to testify but declined. AAHomecare submitted a statement for the record.

“I continue to believe that these companies can provide us useful information that would assist the subcommittee in its oversight,” McCaskill said. “We will continue to discuss the possibility of these witnesses appearing in front of us at a future date.”

In the latter half of the hearing, McCaskill, a former auditor herself, took CMS’s auditors to task for recovering only $34 million of roughly $10 billion in improper payments identified in 2011.

“How much of their contract is based on how well they do and how much of it do they get regardless of whether or not they’re complete failures at it?” she asked.

Testifying at the hearing were two representatives from CMS: Peter Budetti, deputy administrator and director of the Center for Program Integrity; and Laurence Wilson, director of the Chronic Care Policy Group. When McCaskill asked for data separating improper payments due to fraud versus those due to technical errors, Budetti could not supply the information.

“The way that the statistical sample is structured and the way that it measures improper payments is not a very sensitive tool in terms of actually looking at fraud,” he said.

McCaskill was not satisfied with Budetti’s response.

“Well then why do we have it?” she asked. “Why are we auditing anything?”

In brief: CMS delays PECOS edit, TSS employees sue

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04/26/2013
HME News Staff

WASHINGTON – CMS is pushing back the start date for edits to the Provider Enrollment, Chain, and Ownership System (PECOS). In a bulletin, CMS cited “technical issues” for delaying the May 1 start date. The edits, once implemented, will deny claims that contain the names of physicians not enrolled in PECOS. CMS said it would advise on a new implementation date in the “near future.” In the meantime, informational edits will continue to be sent for those claims that would have been denied had the edits been in place.

Former TSS employees sue over stock plan

NEW BRAUNFELS, Texas – The Scooter Store founder Doug Harrison and others who manage the company’s employee stock ownership plan (ESOP) now face a lawsuit by former employees. Three former employees filed a class-action lawsuit on behalf of 2,938 plan members in U.S. District Court for the Western District of Texas on April 23, seeking to recover damages and all other forms of relief as a result of “the defendants’ multiple breaches of fiduciary duty.” According to the lawsuit, those breaches include: 1.) Harrison “usurped opportunities” available to the ESOP when he sold or otherwise transferred or conveyed his shares on or after Feb. 1, 2011, to Sun Capital Partners and these shares were placed under the ownership of Sun Scooter Store; 2.) Harrison, in coordination with TSS Holdings, TSS and Houlihan Lokey Financial Advisors, manipulated the price per share for the common stock so that he and/or his family members could sell their shares at prices above fair market value; and 3.) Harrison, Principal Life Insurance Company and First Banker Trust Services failed to diversify the assets in the ESOP when they knew that the value of the common shares was very likely to diminish in value substantially from 2011 through to the present. The lawsuit also claims that $7.5 million in cash in the ESOP as of Dec. 31, 2011, has not been accounted for. The ESOP has 13.48% equity in The Scooter Store, according to the company’s recent bankruptcy filing. Members who are vested can sell their shares when they retire or leave the company. While The Scooter Store, the company, is not named as a defendant in the lawsuit, it also faces two lawsuits, another from former employees and one from the city of New Braunfels.

The outcome of those lawsuits is up in the air as The Scooter Store proceeds with the bankruptcy process.

TSS, CMS reach agreement

NEW BRAUNFELS, Texas – The Scooter Store has reached an agreement with CMS that lifts apayment freezeon the company, according to an article from mysanantonio.com. Thecompany can nowreceive payments from CMS, allowing it to avoid liquidation, according to the article. After The Scooter Store filed for bankruptcy April 15, CMS said it was entitled to freeze payments to the companyto offset millions in overpayments, the article noted. Under the agreement, The Scooter Store will continue to repay CMS $83,000 a month, a figure that will increase to $125,000 a month starting July 1, according to the article. A judge approved the agreement April 25.

Senate panel backs Tavenner nomination

WASHINGTON – Marilyn Tavenner, Barack Obama’s nominee to oversee CMS, received the unanimous backing of the Senate Finance Committee Tuesday, according an article from Reuters. The panel’s support could pave the way for a vote by the full Senate that could make Tavenner the program’s first official administrator since 2006. A former hospital company executive and nurse, Tavenner has been CMS’s acting administrator since 2011, and has broad bipartisan support. Among Tavenner’s supporters is House Majority leader Eric Cantor, R-Va., who introduced her at an April 9 confirmation hearing.

HHS proposes increased rewards for reporting fraud

WASHINGTON – The Department of Health and Human Services (HHS) has proposed increasing to $9.9 million the rewards paid to Medicare beneficiaries and others whose tips about suspected fraud lead to the recovery of funds, according to a press release. The rewards are part of a proposed expansion for the Senior Medicare Patrol Program, which is designed to educate beneficiaries on how to prevent, detect and report Medicare fraud and abuse. “Today’s announcement is a signal to Medicare beneficiaries and caregivers, who are on the frontlines of this fight, that they are critical partners in helping protect taxpayer dollars,” stated Kathleen Sebelius, secretary of HHS. Under the proposed changes, a person that provides specific information leading to the recovery of funds may be eligible to receive a reward of 15% of the amount recovered, the release noted. The changes are modeled on an IRS program that has returned $2 billion in fraud since 2003.

Washington state passes CRT bill

OLYMPIA, Wash. – The Washington state legislature has approved HB 1445, a bill that creates a separate benefit category for complex rehab technology (CRT) within the Medicaid program, according to a press release from NCART. The bill, similar to a CRT bill currently being pursued at the federal level, passed unanimously in the Senate (46 to 0) and overwhelmingly in the House of Representatives (92 to 3). Helping to pass the bill: a state CRT workgroup comprised of manufacturers, providers, consumers and clinicians, the release noted. The bill has three main objectives: protecting access for complex needs patients to necessary technology and services; improving safeguards for the delivery and provision of CRT; and providing patients the opportunity to avoid institutionalization. The legislation is expected to be signed into law in mid-May and take effect Jan. 1, 2014, according to the release.

AOPA: Victims 'will walk and run again'

ALEXANDRIA, Va. – The American Orthotic and Prosthetic Association (AOPA) is leading a coalition to provide access to care for uninsured/underinsured amputee victims of the Boston Marathon bombings, according to a press release. Members and partners of AOPA have pledged to give these amputees and those with related mobility impairment the necessary access to artificial limbs, customized bracing and mobility assistive devices. They would like to ensure that all victims “will walk and run again,” according to the release.

Vendor news

The Strategic Partnerships Division of Harrington Management Group (HMG) has introduced a new direct-response marketing model for certain product categories in the HME industry. HMG provides the proprietary material and ad placement service, and handles all inbound calls…Philips Respironics has launched a new mobile self-management system for obstructive sleep apnea (OSA) patients. The SleepMapper, a web-based solution, allows patients to access personalized feedback, education and interactive tools…Convaid, a manufacturer of custom pediatric wheelchairs, was recently awarded the 2013 Long-Term Investor Award by the city of Torrance, Calif. The award recognized Convaid for its service and contributions to greater Los Angeles County, and for its innovative strategies and partnerships with the city…The Food and Drug Administration (FDA) has cleared ResMed’s variable positive airway pressure (VPAP) device for the treatment of COPD. The ResMed VPAP COPD, which will be sold in the United States, is designed to mitigate acute symptoms for COPD suffers, reducing hospital readmissions…With 22 mergers and acquisitions completed last year, Thomson Reuters has ranked The Braff Group as the leading healthcare M&A advisor for 2012. This was the second year in a row that The Braff Group received top billing.

People news

U.S. Rehab, The VGM Group’s alliance for complex rehab providers, has promoted Greg Packer to president. Packer, whose background includes stints in sales management positions at Pride Mobility Products and Biocore Medical Technologies, has been with VGM since 2009…CarePoint Medicalhas hired Ronald Reed as vice president of business development. Reed will be responsible for helping the company expand into new categories and grow its revenue base…At its 2013 Spring Convention & Exhibition earlier this month, the Midwest Association for Medical Equipment Services (MAMES) presented its “Above and Beyond Award” to John Gallagher, vice president of government relations for Waterloo, Iowa-based The VGM Group; and Lehn Straub, formerly of Lincoln, Neb.-based Jim’s Home Health.

Provider news

Through its acquisition of complex rehab provider Rehab Health Care (RHC), National Seating & Mobility (NSM) has added four new branch offices in Virginia. Founded in 1986, RHC provides products and services in four Virginia cities: Norfolk, Richmond, Fishersville and Charlottesville. 

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