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    07/18/2014
    HME News Staff

    NASHVILLE, Tenn. – Verus Healthcare has acquired its 85th CPAP business, it announced last week. The provider, which holds competitive bidding contracts nationwide, now serves more than 40,000 patients and processes 10,000 new orders per month, according to a press release. Verus, formerly Sleep Nation, got its start in sleep when it acquired CPAP Care Club in 2012 and used it as a platform to roll up other businesses. "When we bought this platform two years ago, attrition among the patient base was very high," said Richardson Roberts, CEO of Verus. "We've grown the patient base seven-fold, while decreasing our monthly attrition to approximately 1% per month.” The company changed its name earlier this year.

    Hoveround ups certification

    SARASOTA, Fla. – Hoveround has been certified in ISO9001 and, for the first time, ISO13485, the company announced this month. A team of ISO experts surveyed the company at its manufacturing, distribution and administrative facilities in April 2014 to determine its compliance with industry standards. The team found Hoveround met the “highest level of excellence in the design, manufacture, delivery, distribution and service of motorized wheelchairs, scooters and mobility related products and accessories,” according to a press release. Hoveround has been ISO9001 certified since 1997. New with the ISO13485 certification: the inclusion of rehab technology specialists in the field. Third-party certifiers will audit these specialists to ensure they meet standards, according to the release. “We have no doubt that adding ISO13485 will only help us enhance our quality of service,” stated President and Founder Tom Kruse.

    Bill watch: competitive bidding, audits

    WASHINGTON – A bill that would require providers to obtain bid bonds as part of future rounds of competitive bidding had 21 co-sponsors at press time on Friday. H.R. 4920, introduced in June, would also require providers to prove they meet licensure requirements before they submit bids…A bill that would require CMS contractors that perform audits to reinstate clinical inference and judgment to reduce error rates has six co-sponsors at press time on Friday. Other components of H.R. 5083, introduced last week, include reducing the document review period for all audits from five years to three years and excluding providers with low error rates from some or all audits during a two-year period.

    New audit website serves as ‘rallying point’

    WASHINGTON – AAHomecare has launched FixMedicareAudits.org to serve as one-stop shop for audit reform, the association announced this week. The cornerstone of the new site: H.R. 5083, The Audit Improvement and Reform Act (AIR Act), which was introduced by Rep. Renee Ellmers, R-N.C., on July 11. “The new site will serve as a rallying point for the HME community to come together in support of the AIR Act, which will apply common sense fixes to one of the most pressing challenges facing our industry today,” said AAHomecare President/CEO Tom Ryan. The site brings together AAHomecare’s multi-platform fight against audits, including its new HME Audit Key, educational resources and Share Your Audit Story.

    Home Care Medical lands insurance contract

    NEW BERLIN, Wis. – Home Care Medical has reached an agreement with Dean Health Plan to be an in-network provider for members in Milwaukee and Waukesha counties. Home Care Medical will offer infusion and enteral therapy, high-tech rehab equipment, respiratory care, HME and supplies, and bracing and compression garments to the plan’s 250,000 members. The provider has been actively seeking private pay contracts, including Network Health in October.

    DME MACs issue policy reminder for CPAP

    WASHINGTON – The DME MACs issued a policy reminder about CPAP therapy last week after a review of recent appeals identified denials associated with lack of compliance with requirements for continued coverage after the first three months of rental. At the end of the initial rental period, additional requirements must be met for rental and payments to continue: the treating physician must meet the beneficiary in person between the 31st and 91st days after initiating therapy for a re-evaluation documenting the benefits from PAP therapy and the physician must include objective evidence of the beneficiary’s adherence to the therapy in the medical record. Beneficiaries who fail the 12-week trial may re-qualify if they have a face-to-face re-evaluation to determine why they didn’t respond to therapy and if they repeat a sleep study. Also in the reminder: If an E0601 device is ineffective, substitution with an E0470 does not change the length of the trial if there are fewer than 30 days remaining; if there are more than 30 days remaining, the re-evaluation must be done between the 31st and 91st days and documentation of adherence to the E0470 device must be completed before the 91st day.

    MIT completes re-org

    FREDERICKSBURG, Va. – MIT Holding, a holding company with subsidiaries in infusion and DME services, has completed a turn-around, according to a release. The company, which eliminated millions in non-profitable revenues, says its subsidiaries are now operating with objectives of a 32% net profit. MIT now turns its attention to expansion and growth. “We have come through the re-organization with a company that now has strong, industry-respected management, and is lean and nimble enough to pivot and evolve to meet the demands of the daily changes in the healthcare industry,” stated CEO Walter Drakeford.

    Short takes

    A “Dear Colleague” letter that calls on the Office of Inspector General (OIG) to review the competitive bidding program before it is expanded in 2016 had been signed by 117 lawmakers by press time. The deadline for signing the letter was Friday…ResMed CEO Michael Farrell sold 3,200 shares of company stock on the open market July 15. The stock was sold at an average $49.22 for a total transaction of $157,504, according to news reports. Farrell now owns 106,655 shares of ResMed stock, worth about $5.2 million…AmeriCare Medical has been accredited by the Community Health Accreditation Program (CHAP) for nursing and staffing, specialty pharmacy, and medical equipment and supply. AmeriCare has three subsidiaries: AmeriStaff Nursing Services, Sun Medical Equipment and Rx IV Infusion Pharmacy.

    People news

    Shawn Stacyhas been promoted to CEO of Hometown Oxygen in Charlotte, N.C. Stacy has more than 10 years of experience in marketing and management in the HME industry. Previously, he led the sales and customer service operations at Hometown Oxygen. He has also worked at ResMed, Fisher & Paykel and American HomePatient…Chris Wilson is now chief marketing officer at Finnegan Health Services in Little Rock, Ark. Wilson will help the company promote itself to customers and healthcare professionals statewide, and assist its affiliated company, Finnegan Medical Supply, with a startup e-commerce venture. He was most recently director of public relations for the Arkansas Farm Bureau…Nonin Medical has named Ash Keswani vice president of marketing. Keswani has more than 20 years of experience marketing disposable medical devices, implantable devices and pharmaceuticals…BioScrip has appointed Thomas Pettit senior vice president and COO. Pettit succeeds Richard Jenkins, a managing director at Alvarez & Marsal, who has served as interim COO since November 2013. Jenkins will continue as a consultant to the company to ensure a smooth transition. Pettit has nearly 20 years of experience in operational management in several industries, with expertise in supply chain logistics and lean initiatives.


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    07/24/2014
    HME News Staff

    ELYRIA, Ohio – Invacare has reported a loss in net earnings of $13.6 million for the second quarter compared to a loss of $12.5 million for the same period last year.

    It reported net sales of $331.3 million vs. $344.8 million.

    “We are not pleased with the second quarter’s consolidated financial results,” said Gerald Blouch, president and CEO, who will retire July 31. “We are determined to turn around the business by focusing on improving free cash flow and restoring profitability in the North America/HME and Asia/Pacific businesses.”

    Invacare reported a loss in net earnings of $31.6 million for the first half of the year compared to net earnings of $22.7 million for the same period last year. It reported net sales of $640.4 million vs. $676.2 million.

    For North America/HME, Invacare reported a loss in net earnings of $12.4 million, excluding restructuring charges, for the second quarter compared to a loss of $10.3 million for the same period last year. It reported net sales of $138.7 million, a 13% decrease. The company reported a loss in net revenues of $28.4 million, excluding restricting charges, for the first six months of the year compared to $19.8 million for the same period last year. It reported net sales of $267.8 million vs. $311.2 million.

    Invacare says sales in lifestyle products were affected by Medicare’s audits of HME providers and by a focus on lower-cost products driven by the competitive bidding program.

    Sales of power wheelchairs from the Taylor Street facility, still under a consent decree with the Food and Drug Administration, in the second quarters of 2014 and 2013 represented only 8.8% and 14.5%, respectively, of the pre-consent decree units shipped during the same period in 2012.

    “We are continuing through the final certification audit process,” Blouch said. “In order to address these needs, we have engaged additional consultants to help us improve the functionality and capabilities of certain of our quality subsystems.”


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    ‘I’m already the last person standing’
    07/25/2014
    Theresa Flaherty

    YARMOUTH, Maine – If Medicare moves forward with plans to apply competitive bidding prices in remote areas of the country, providers there say they will have no choice but to stop accepting Medicare.

    “We have already come to the decision that if those numbers are put on us, we will stop taking Medicare,” said Paul Gammie, owner of Gammie Home Care, which has locations on the islands of Maui and Kauai in Hawaii. “We are already the last person standing on the island of Maui that’s full-service DME.”

    CMS in July announced plans to apply competitive bidding prices in non-bid areas in 2016 by using regional prices limited by a national ceiling (110% of the average of regional prices) and floor (90% of the average of regional prices).

    When you consider the 45% cut, on average, implemented as part of Round 2, that makes the cost of doing business with Medicare simply too high, say providers.

    “With the current rates, that extra 10% would just mean a slower death for providers,” said Greg Lord, director of Great Plains Rehabilitation Services in Bismarck, N.D. “Providers are barely making it on Medicare as it is, and any reduction is problematic.”

    It’s even worse outside the contiguous U.S., say providers based there.

    “The sheer cost of doing business in Alaska is 30% higher than in the lower 48,” said James McComas, CEO of Procare Home Medical in Fairbanks, Alaska. “Under no circumstances would this be workable for Alaska.”

    McComas estimates there are currently about eight traditional DME providers in Alaska. If the example of Honolulu, a Round 2 CBA, is anything to go by, the impact of fewer local providers on beneficiary access could be disastrous. In May, CMS had to award two additional contracts to local providers because so many contracts went to out-of-state providers that patients faced long wait times for equipment.

    Adding insult to injury: Providers in rural areas won’t see a volume increase as a result of competitive bidding, they say.

    “We are already serving everybody,” said Gammie. “So we are not going to get any additional business when they drive these numbers down.”


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    07/25/2014
    HME News Staff

    SAN DIEGO and BREA, Calif. – An International Trade Commission (ITC) ruled July 18 that the humidifier in Apex Medical’s iCH CPAP device infringes on ResMed patents, according to a press release from ResMed. Apex Medical had argued that it had redesigned the humidifier so that it no longer infringed on ResMed patents, the release states. “As a result, Apex should continue to be banned from selling the iCH humidifier in the United States,” ResMed states in the release. In its own press release, Apex Medical states it plans to introduce an upgraded iCH water tank in October. Apex Medical notes that the ITC found its newly designed XT series CPAP water tank free from patient claims asserted by ResMed. “Significantly, the ITC overruled the ALJ's negative finding regarding the newly designed XT series water tank,” Apex Medical stated in the release. The ITC also upheld a previous decision that Apex Medical’s Wizard 220 masks are free from patent claims. Apex Medical chose to withdraw its redesigned Wizard 210 nasal mask from the proceedings, according to the release from ResMed. The U.S. Patent and Trademark Office is also reviewing the validity of five patents from ResMed, including a claim related to the iCH water tank, through a procedure called inter partes review. The USPTO is expected to make a decision in early 2015.

    New prez to drive growth at NSM

    NASHVILLE – National Seating & Mobility (NSM) has named William Mixon president. “Bill is exactly the kind of talented executive we want to help us achieve the next phase of growth at NSM and continue to drive the company forward,” stated CEO Mike Ballard in a press release. Mixon has 24 years of experience in the healthcare and professional services industries, and more than 10 years of experience in general management, president and CEO roles. He most recently served as president for Universal Hospital Services, a provider of clinically focused asset management solutions and services involving mobile medical technology to the U.S. healthcare industry. Mixon has also worked at Philips Medical Systems, Baxter and American Hospital Supply Co.

    Costs associated with COPD on the rise, report says

    GLENVIEW, Ill. – Medical costs related to COPD will rise from $32.1 billion in 2010 to $49 billion in 2020, the American College of Chest Physicians estimates in a new report. The group, which presented its findings to the Centers for Disease Control and Prevention (CDC) on July 24, also estimate absenteeism costs were $3.9 billion in 2010, for a total of $36 billion in costs attributable to COPD. Private insurance picked up the tab for 18% of the medial costs associated with COPD, while Medicare paid 51% and Medicaid paid 25%, according to the report. "Evidence-based interventions that prevent and reduce tobacco use and reduce clinical complications of COPD may result in potential decreased COPD-attributable costs," said Earl Ford, MD, Division of Population Health, CDC, in a statement. In 2011, 12.7 million adults in the U.S. were believed to have COPD. However, nearly 24 million have evidence of impaired lung function, indicating an under-diagnosis of the disease, according to the report.

    OIG to CMS: Get all drug manufacturers to submit ASPs

    WASHINGTON – CMS lacks complete average sales price (ASP) data for certain drugs, hindering its ability to ensure that payment amounts are accurate and reflective of manufacturer sales prices, according to a new report from the Office of Inspector General (OIG). At least one-third of the more than 200 manufacturers of Part B drugs did not submit ASPs for some of their products in the third quarter of 2012, despite being required to do so, according to the report. Another 45 manufacturers were not required to report ASPs during the same quarter. The OIG also found a small number of inaccuracies in CMS’s ASP files, which may have affected Medicare payments. The OIG recommends that CMS:

    1.   Continue to work with the OIG to identify and penalize manufacturers that do not meet ASP reporting requirements;

    2.   Seek a legislative change to require all manufacturers of Part B drugs to submit ASPs;

    3.   Ensure the accuracy of product information for the national drug codes (NDCs) listed in the background and crosswalk files; and

    4.   Finalize the implementation of automated ASP-related procedures by using processes related to average manufacturer price as a model, and subsequently require all manufacturers to submit ASPs through the automated system.

    CMS concurred with the first, third, and fourth recommendations, but it did not concur with the second. The report is a follow up to a previous report that recommended CMS seek a legislative change to require all manufacturers of Part B drugs to report ASPs.

    AAH asks state associations to back audit bill

    WASHINGTON – AAHomecare is asking HME state associations to formally support H.R. 5083, the Medicare DMEPOS Audit Reform and Improvement (AIR) Act, by signing a letter that will be featured on the new website www.fixmedicareaudits.org. Seven state associations have signed the letter so far. AAHomecare will close the letter July 30. Associations that wish to sign the letter should contact Ashley Jackson, ashleyj@aahomecare.org, as soon as possible.

    Save My Medical Supplies campaign extended

    WASHINGTON – AAHomecare’s consumer communications campaign, Save My Medical Supplies, will continue through the end of 2014, the association has announced. After its April launch, the campaign generated 5,500 letters in 90 days asking Congress to reform Medicare. “One of our core responsibilities as healthcare providers is to educate patients and help them understand they are their own best advocate,” said Tom Ryan, president and CEO of AAHomecare. “We’re all in this fight together and engaging the people we serve in the legislative process—along with their families, friends and caregivers—is how we win.” The campaign’s website and Facebook page combine educational content and call-to-action links.

    At Home Medical makes push for consumers

    ATLANTA – At Home Medical, an online provider of medical supplies, has launched the iPush Foundation, a non-profit program offering resources and peer support though social media and the company’s website. “I’ve been in a wheelchair for nearly 25 years and hope to make the path you roll a little easier,” statead Chris Malcom, who founded the group, in a press release. “That’s why we created the iPush Foundation.” Get Social Consulting created the content and the website, which provides online communities, resources and services for those using wheelchairs.

    Brightree heads IT for HME Audit Key

    WASHINGTON – Brightree is now the IT lead for AAHomecare’s HME Audit Key, according to an AAHomecare bulletin. “Given Brightree’s expertise in billing and business management solutions for the HME sector and other healthcare industry segments, I’m confident their participation will play a major role in the success of the HME Audit Key,” stated Tom Ryan, AAHomecare president and CEO. The HME Audit Key is a data collection tool to help providers quantify the effects of audits. Brightree has also pledged additional funds to AAHomecare beyond its membership dues, according to the bulletin.

    EBS offers A/R Allegiance program

    OVERLAND PARK, Kan. – Electronic Billing Services (EBS) will offer the CollectPlus Program to its clients for private pay billing and collection services, according to a press release from A/R Allegiance. EBS believes the program can help its clients improve private pay recovery and cash flow, as well as provide a consistent follow-up process for billing and collections, according to a press release. “Anything we can do to speed up patient payments to our clients and provide both the patient and our client with an advanced level of customers service is a win-win for everyone,” stated Mary Stoner, president of EBS, in the release. A/R Allegiance has integrated a number of features into EBS’s billing software (Universal Software Solutions) that provide convenient payment options for the patient and greater efficiency in managing patient accounts, according to the release. Paving the way for the new relationship with EBS: A/R Allegiance announced earlier this month that it integrated its payment portal with Universal Software Solutions’ Healthcare Data Management System.

    Dynamic Healthcare Software, Instamed partner

    PHILADELPHIA – Dynamic Healthcare Software has teamed up with InstaMed to offer integrated healthcare clearinghouse solutions through its bflow 3 cloud-based billing and compliance platform, according to a release. bflow allows providers to streamline patient eligibility verification and claims status inquiries, while batching and processing claims and remittances manually or automatically. “The process to verify eligibility, submit claims and reconcile remittances is very complicated, involving multiple steps, systems and transactions,” stated Eric Williams, president and COO of bflow, in a press release. “This strategic partnership with InstaMed enables us to simplify these processes for our providers by enhancing the bflow system with ‘one click’ integration of InstaMed clearinghouse solutions.” With the integration, electronic payments post automatically to bflow systems, giving users real-time reporting on claims and payment details on InstaMed’s cloud-based network.

    Study shows benefit of therapeutic shoes

    MILWAUKEE – People with Type 2 diabetes who don’t wear therapeutic shoes have an increased risk of foot ulcers and lower limb amputations, according to a study released this week by Dr. Comfort. When therapeutic shoes were worn, foot ulceration decreased by 2% and 12% in the first and second years, respectively, while lower limb amputation decreased by 29% and 18%. The study involved a review of a retrospective claims database of patients over three years—one year before and two years after therapeutic shoe use began.

    OIG: Rhode Island can save on incontinence

    WASHINGTON – Rhode Island could have saved $1 million on selected incontinence items in one year by limiting reimbursements to the most frequently reimbursed usual and customary charge amounts, the Office of Inspector General (OIG) has found. From July 2010 to June 2011, Rhode Island Medicaid paid DME providers $7,725,191, including $3,257,455 for 16 selected incontinence items, including protective underwear, diapers and liners. The OIG recommends Rhode Island Medicaid develop a process to determine whether there are significant differences between the fee schedule payment amounts and the majority of providers’ usual and customary charges, and adjust the fee schedule payment amounts if it finds significant differences. The state agency concurred with the OIG’s conclusions.

    CareTouch to hike for hospice

    DENVER – CareTouch Communications has formed an employee-driven outreach program called CareTouch in the Community. Employees will provide hands-on support to various causes throughout the year to help people improve their health. First up: Hike for Hospice on Sept. 14. The team will climb the 7,600-foot Olinger Mount Lindo in Morrison, Colo., to raise money for the Butterfly Program of Porter Hospice. “Over the last year we’ve dialed in our company’s mission, which is to be compassionate communicators partnering to improve people’s health,” said Matthew Dolph, CEO of CareTouch, in a press release. CareTouch offers solutions that allow providers to communicate with patients who require resupplies for their sleep and diabetes therapies. Go *here for more information.

    Orthotics market poised for growth, innovation

    HAMILTON, N.Y. – The global orthotics device market is expected to reach $7.33 billion by 2020, a growth rate of 6.2%, according to a new report from IndustryARC. Prefabricated devices, which comprise a major segment of the market, are expected to reach $4.25 billion by 2020, while custom-made devices are expected to increase to $3.15 billion. Much of the demand can be attributed to the increase in chronic diseases and an aging population, according the report. The report also forecasts increased innovation in the manufacturing of such devices, including 3D printing and CAD/CAM-based models to specifically treat or support patients with specific disorders.

    Sigvaris commemorates 150 years

    PEACHTREE CITY, Ga. – Sigvaris, a family-owned manufacturer of medical and sports compression garments and stockings, celebrated 150 years in business with an event at the Westin in Atlanta. The company held a similar event at the Montreal Science Center in Quebec, Canada, on July 12. Both events included a historical exhibit showcasing the company’s history and performances that took attendees through the process of creating graduated compression products. Sigvaris is a Swiss company with North America headquarters in Peachtree City, Ga.

    Short takes: McKesson, Wright & Filippis, wound care

    McKesson Medical-Surgicalhas launched a compete line of incontinence resources as part of an increased investment in incontinence care. The line includes clinical, retail and business support, as well as skin care and incontinence products…Wright & Filippis now uses Brightree as its billing and business management platform. “With Brightree, we have a proven, scalable and integrated platform that takes care of our billing, business management and regulatory needs, ultimately freeing up our staff's time to focus on better serving our patients so that we can continue to expand our business," stated A.J. Filippis, owner and CEO, in a press release…The wound care market is projected to reach $20.5 billion globally by 2020, according to a new report by Allied Market Research. Driving growth: reducing hospital stays to limit surgical healthcare costs, and a rising demand for products that enhance therapeutic outcome.

    People news: CMS, Nonin Medical

    CMS has appointed a provider relations coordinator to improve communication between the agency and providers. Latesha Walker will work to increase program transparency and offer resolutions to providers impacted by audit issues, according to a bulletin from The VGM Group. “Although providers should continue to take questions about specific claims directly to the Recovery Auditor or Medicare Administrative Contractor (MAC) who conducted the review, providers can raise larger process issues to the coordinator,” the bulletin states…Mark VanderWerf, vice president of eHealth and OEM for Nonin Medical, a manufacturer of finger pulse oximeters and noninvasive medical monitoring solutions, has been elected chairman of the American Telemedicine Association’s Industry Council and has joined its board of directors.


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    07/25/2014
    HME News Staff

    GLENVIEW, Ill. – Medical costs related to COPD will rise from $32.1 billion in 2010 to $49 billion in 2020, the American College of Chest Physicians estimates in a new report.

    The group, which presented its findings to the Centers for Disease Control and Prevention (CDC) on July 24, also estimate absenteeism costs were $3.9 billion in 2010, for a total of $36 billion in costs attributable to COPD.

    Private insurance picked up the tab for 18% of the medial costs associated with COPD, while Medicare paid 51% and Medicaid paid 25%, according to the report.

    "Evidence-based interventions that prevent and reduce tobacco use and reduce clinical complications of COPD may result in potential decreased COPD-attributable costs," said Earl Ford, MD, Division of Population Health, CDC, in a statement.

    In 2011, 12.7 million adults in the U.S. were believed to have COPD. However, nearly 24 million have evidence of impaired lung function, indicating an under-diagnosis of the disease, according to the report.


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    07/30/2014
    HME News Staff

    BALTIMORE – The Medicare Trust Fund will remain solvent until 2030—four years longer than last year’s projections.

    The Medicare Trustees released a report this week that credits, in part, cost controls implemented as part of the Affordable Care Act (ACA) for the improved outlook.

    “Thanks to the ACA, we are taking important steps to improve the quality of care for Medicare beneficiaries, while improving Medicare’s long-term solvency,” said Marilyn Tavenner, administrator for CMS, in a release. “Specifically, we have made major progress in improving patient safety, decreasing hospital readmissions, and establishing new payment models, such as accountable care organizations, aimed at reducing costs and improving quality.”

    The improved outlook is also attributed to lower-than-expected spending in 2013, and lower projected utilization in the types of health care needed for Medicare beneficiaries.

    During the past four years, per capita Medicare spending growth has averaged 0.8% annually, much more slowly than the average 3.1% annual increase in per capita gross domestic product and national health expenditures over the same period.

    In 2013, Medicare covered 52.3 million beneficiaries: 43.5 million age 65 and older and 8.8 million with disabilities. 

    Total expenditures in 2013 were $582.9 billion and total income was $575.8 billion.


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    07/31/2014
    HME News Staff

    ATLANTA – Office-based physician visits made by diabetes patients rose 20% between 2005 and 2010, according to a new data brief from the Centers for Disease Control and Prevention (CDC).

    The largest increase in visits (34%) was made by adults in their mid-20s to mid-40s, according to the new brief.

    “Continuing to examine office-based physician visits by patients with diabetes is especially important given changes in standards of care that may influence such visits,” said Jill Ashman, a physician at the CDC’s National Center for Health Statistics, in the brief.

    The total number of visits was higher among older adults—those 65 and older made 53.7 million visits in 2010, while those younger than 25 made 2.6 million visits, according to the brief.

    Visits by patients with diabetes made up 11% of all office-based physician visits in 2010.

    Researchers say regardless of age, patients with diabetes use “extensive health resources,” with frequent doctor visits and multiple prescriptions, the brief states.


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    08/01/2014
    HME News Staff

    WASHINGTON – CMS will expand its PMD demonstration to 12 additional states on Oct. 1, the agency announced in a final rule published last week. CMS plans to require prior authorizations for PMDs in Pennsylvania, Ohio, Louisiana, Missouri, Washington, New Jersey, Maryland, Indiana, Kentucky, Georgia, Tennessee and Arizona—all of which have high expenditures and improper payments based on 2012 billing data, the agency states in the rule. CMS kicked off the PMD demo in California, Florida, Illinois, Michigan, New York, North Carolina and Texas on Sept. 1, 2012. Based on preliminary data, PMD spending in these states has decreased, indicating that physician ordering and supplier billing practices have changed as a result of the demo, the agency states. Together, the 19 states that will eventually be involved in the demo account for 71% of all expenditures for PMDs in 2012, CMS states.

    CMS formalizes Oct. 1, 2015, deadline for ICD-10

    WASHINGTON – Providers, health plans and healthcare clearinghouses have until Oct. 1, 2015, to transition to ICD-10, according to a final rule published July 31 by the Department of Health and Human Services. Earlier this year, Congress delayed implementation of the new code set for one year as part of its “doc fix” bill. “ICD-10 codes will provide better support for patient care and improve disease management, quality measurement and analytics,” said Marilyn Tavenner, CMS administrator. “For patients under the care of multiple providers, ICD-10 can help promote care coordination.” CMS says the newest code captures more information than its predecessor, so doctors can better understand the details of a patient’s health.

    Numotion names GE exec as new leader

    ROCKY HILL, Conn. – Numotion’s board of directors announced last week that Mike Swinford has taken over as CEO. Paul Bergantino, the company’s former CEO, will remain onboard as a consultant during the transition process, according to a press release. “Paul has been a leader in our industry for many years and his contributions, especially during the merger of ATG Rehab and United Seating & Mobility, are greatly appreciated,” stated Tim Burfield, one of Numotion’s directors, in the release. “This is a time of significant growth for our company, and we look forward to the addition of Mike to our team, as he has a demonstrated ability to grow and lead multi-location, service-based businesses.” Swinford joins Numotion after a 22-year career at GE, where he worked primarily in healthcare services. He ran businesses that ranged from $200 million in annual revenue to more than $5 billion. His most recent position there was president and CEO of GE Healthcare Global Services.

    NCART schedules awareness week

    WASHINGTON – NCART has declared the week of Aug. 18-24 National CRT Awareness Week. The group is calling on stakeholders to reach out to members of Congress during the August recess to help secure more support for bills to create a separate benefit for complex rehab. There are currently 146 co-sponsors for H.R. 942 and 19 co-sponsors for S. 948, according to an NCART bulletin. “We are gaining ground, but to continue making progress, we need CRT stakeholders to get their member’s attention and ask for their support,” Executive Director Don Clayback wrote. NCART suggests providers arrange face-to-face meetings with members of Congress in their stores or facilities. The group can assist providers in planning and structuring those meetings.

    BMC takes patent fight global

    LAKE WALES, Fla. – BMC Medical and 3B Medical announced last week that they have now filed challenges to ResMed patents in China, Germany and the United States. The move represents a “global strategy to go on (the) offense and seek to invalidate portions of ResMed’s patent portfolio” in all three countries, the company stated in a release. “We have to be proactive on the global landscape to assert our right to compete in this product space,” stated James Xu, president of BMC Medical, in the release. Additionally, BMC and 3B recently announced in July the formal filing of an Inter Partes Review (IPR) in the United States Patent and Trademark Office challenging the validity of a ResMed patent on a CPAP humidifier structure. “We are continuing to study ResMed’s patent portfolio to identify future challenges,” Xu stated. BMC and 3B are also awaiting the outcome of a trial before the International Trade Commission that concluded in April. The trial was the result of a complaint filed by ResMed in July 2013 alleging infringement on several patents.

    ResMed gets permanent injunction against Apex in Germany

    SAN DIEGO – ResMed announced last week that it has won a permanent injunction in Germany against Taiwanese medical device manufacturer Apex Medical, prohibiting sales of infringing headgear used on Apex’s Wizard 210 and 220 masks. The judgment, entered by the Regional District Court in Munich, can be appealed. The permanent injunction continues a preliminary injunction that was entered by the same court in November 2013. The judgment also requires Apex to forfeit its inventory of infringing products, to report on its sales of the infringing products and to pay damages to ResMed. ResMed has also filed separate patent infringement lawsuits in the same court seeking damages and permanent injunctions to stop infringement of other patents. The trials of those cases will occur this fall.

    CDC reports rise in doc visits by diabetes patients

    ATLANTA – Office-based physician visits made by diabetes patients rose 20% between 2005 and 2010, according to a new data brief from the Centers for Disease Control and Prevention (CDC). The largest increase in visits (34%) was made by adults in their mid-20s to mid-40s, according to the new brief. “Continuing to examine office-based physician visits by patients with diabetes is especially important given changes in standards of care that may influence such visits,” said Jill Ashman, a physician at the CDC’s National Center for Health Statistics, in the brief. The total number of visits was higher among older adults—those 65 and older made 53.7 million visits in 2010, while those younger than 25 made 2.6 million visits, according to the brief. Visits by patients with diabetes made up 11% of all office-based physician visits in 2010.

    Trustees report improved outlook for Medicare

    BALTIMORE – The Medicare Trust Fund will remain solvent until 2030—four years longer than last year’s projections. The Medicare Trustees released a report last week that credits, in part, cost controls implemented as part of the Affordable Care Act (ACA) for the improved outlook. “Thanks to the ACA, we are taking important steps to improve the quality of care for Medicare beneficiaries, while improving Medicare’s long-term solvency,” said Marilyn Tavenner, administrator for CMS, in a release. “Specifically, we have made major progress in improving patient safety, decreasing hospital readmissions, and establishing new payment models, such as accountable care organizations, aimed at reducing costs and improving quality.” The improved outlook is also attributed to lower-than-expected spending in 2013, and lower projected utilization in the types of health care needed for Medicare beneficiaries. During the past four years, per capita Medicare spending growth has averaged 0.8% annually, much more slowly than the average 3.1% annual increase in per capita gross domestic product and national health expenditures over the same period. In 2013, Medicare covered 52.3 million beneficiaries: 43.5 million age 65 and older and 8.8 million with disabilities. Total expenditures in 2013 were $582.9 billion and total income was $575.8 billion.

    Longhorn buys Hallmark

    AUSTIN – Longhorn Health Solutions has purchased Hallmark Medical Supply, making it a competitive bidding contract supplier for DME across Texas, according to a press release. With the acquisition of Houston-based Hallmark Medical, Longhorn will add oxygen and CPAP to its existing offerings in wheelchairs, walkers, enterals and hospital beds. As one of the largest providers for Medicaid Managed Care in Texas, the acquisition will also allow Longhorn to service both Medicare and Medicaid patients with one referral from ordering facilities, HMOs and prescribers, according to the release. Frank and Kim Harmon, the previous owners of Hallmark Medical, will remain onboard to help integrate the company’s operations.

    Business group weighs in on H.R. 1717

    WASHINGTON – The National Federation of Independent Business (NFIB) has thrown its support behind H.R. 1717, a bill that would replace competitive bidding with a market-pricing program (MPP). In a letter to the bill’s sponsor, Rep. Tom Price, R-Ga., the NFIB states: “This flawed program forces small providers to submit unsustainable bids to compete for contracts, and restricts access to and choice of DMEPOS items and services.” The NFIB represents 350,000 members. H.R. 1717 has 180 co-sponsors.

    Jaysec, PPM Fulfillment integrate

    KNOXVILLE, Tenn. – Providers who use PPM Fulfillment to ship their sleep therapy equipment to patients, and use GoJaysec to contact and follow up with them now have the convenience of an integrated system, the companies have announced. Lincoln, Neb.-based PPM partners with manufacturers to assist providers in drop shipping CPAP supplies. Jaysec develops and provides web-based software applications for providers and their referral sources.

    Basic American Medical Products wins award

    ATLANTA – Basic American Medical Products earned the “Elite Supplier” distinction at the 2014 LINK Conference. The distinction is give to suppliers that took part in last year’s conference and have ranked as a top supplier based on provider evaluations of their level of preparation, consultation, innovation and overall value. “This seal identifies Basic American Medical Products as a progressive thought leader in long term care and senior living, and as an organization that understands how to build partnerships with clients and support providers’ strategic and operational needs,” stated David Ellis, managing director of LINK Conference, in a press release. The conference is produced by Lincoln Healthcare Group.

    National truck company opens sleep apnea clinic

    SPRINGFIELD, Mo. – Prime, a nationwide truck carrier, has opened a sleep apnea clinic to test and treat drivers for the disease. “The most important thing is to improve the quality of life for the driver,” said Steve Field, director of safety. “It’s something we’ve been working pretty hard at.” Prime has been testing all student drivers and drivers considered at risk based on weight, body mass index and neck circumference.

    Sigvaris launches new educational options

    PEACHTREE CITY, Ga. – Sigvaris is offering new educational sessions to expand training for fitters of medical compression stockings, the company announced July 29. The sessions, for those interested in becoming a Sigvaris Certified Fitter, include webinars, two online training courses, a two-hour in-service to increase product knowledge and a one-day in-person course, according to a press release. Sigvaris has also partnered with the International Lymphedema and Wound Care Training Institute to offer a two-day seminar on wound care and edema Sept. 24-25 at the manufacturer’s facility here. “These new opportunities make it easy to work continuing education into a busy schedule and still have the flexibility to also attend a seminar,” said Judith Brannan, educational and medical affairs manager in North America.

    HME Home Medical expands offerings

    GREEN BAY, Wis. – HME Home Medical has partnered with First Quality Products to distribute its incontinence products, including the Prevail brand, according to a press release. The partnership will enable the provider to expand its distribution division, GOHME. “This strategic alliance will allow us to expand our product base yet again as we reach out to distribute our high-quality products to even more facilities,” said Eric Hagen, director of business development at GOHME. In March, the provider launched GOHME to provideincontinence and skin care products and disposable gloves to skilled nursing homes, hospitals and other HME providers.

    The Compliance Team earns dual approvals

    SPRING HOUSE, Pa. – Florida’s Agency for Health Care Administration (AHCA) has approved The Compliance Team’s accreditation for HME/DMEPOS, in accordance with a recently enacted law that requires AHCA to ensure accreditors meet state licensing laws for HME providers. Also in July, CMS approved The Compliance Team as a national accrediting organization for rural health clinics. The Compliance Team was founded by Sandra Canally in 1994.


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    08/01/2014
    HME News Staff

    SAN DIEGO – ResMed’s fourth quarter revenues were $415.2 million, flat when compared to the same period last year, the company announced yesterday.

    Net income was $87.7 million for the three months ended June 30, a 20% increase.

    “Our fourth quarter results were lower than anticipated, the result of softer sales in the Americas, partially offset by good growth in international markets,” stated Mick Farrell, CEO, in a press release.

    Fourth quarter revenues in the Americas were $214.9 million, down 7% compared to the same period last year.

    For fiscal year 2014, revenues were $1.56 billion, a 3% increase over fiscal year 2013. Net income was $345.3 million, a 12% increase.


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    08/06/2014
    HME News Staff

    WASHINGTON – CMS has announced that the current recovery audit contractors (RACs) will restart some of their reviews.

    The RACs have been on hiatus from sending post-payment additional documentation requests (ADRs) since February, as part of the agency’s transition to new RACs.

    But, apparently, that transition is taking longer than CMS anticipated.

    “Due to the continued delay in awarding new recovery auditor contracts, CMS is initiating contract modifications to the current recovery auditor contracts to allow the recovery auditors to restart some reviews,” the agency states.

    CMS did not describe the reviews in detail.

    “Most reviews will be done on an automated basis, but a limited number will be complex reviews of topics selected by CMS,” the agency states.

    CMS still expects to award new contracts this year.


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  • 08/08/14--11:12: RACs are back
  • 08/08/2014
    Liz Beaulieu

    WASHINGTON – CMS announced last week that the recovery audit contractors (RACs) will restart some of their reviews, but industry stakeholders don’t expect any curveballs.

    Due to delays in awarding new contracts, the agency is giving the RACs the green light to get back to work on automated reviews and, on a limited basis, complex reviews.

    “It doesn’t sound like they’re authorizing new audits, just reactivating the audits that they previously allowed,” said Andrea Stark, a reimbursement consultant with MiraVista. “It’s new claims, but not new concepts.”

    The RACs have been on hiatus from sending post-payment additional documentation requests (ADRs) since February, as part of CMS’s transition to new RACs.

    While stakeholders agree that the bulk of the reviews affecting DME will likely be automated reviews (for example, a patient was in a skilled-nursing facility on the date of service), they’re not ruling out complex reviews.

    “CMS has done so many things with the RACs to make it clear that DME is a focus, my guess is, if they’re going to pick one area to reinstate complex reviews, DME is an easy target,” said Wayne van Halem, president of The van Halem Group, a division of The VGM Group.

    In the past, the RACs have performed complex reviews on respiratory assist devices (RADs) and power mobility devices (PMDs), stakeholders say.

    “With so much focus on the prior approval process for PMDs, hopefully, they’ll shy away from those,” said Kim Brummett, senior director of regulatory affairs for AAHomecare.

    In the wake of the news, stakeholders were keeping an eye on the RAC websites, where they’re obligated to detail their activities.

    “The decision to restart the reviews isn’t illogical,” Brummett said. “The RACs aren’t making money if they’re not auditing claims.”

    As always, documentation is the best defense against audits, stakeholders remind providers.

    “The RACs go where the money is,” van Halem said.

    CMS says it still expects to award new contracts some time this year.


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    08/08/2014
    HME News Staff

    WASHINGTON – The DME MACs have issued clarifying guidance on written order prior to delivery (WOPD) document corrections and proof of delivery (POD) requirements. For WOPD, if errors are found before delivery, suppliers may amend the WOPD or create a new one to send to the physician for signature and date, the MACs say. If an error is discovered prior to claim submission, the original supplier may recover the item(s); obtain a compliant, complete WOPD; and re-deliver the item. If an error is found after a claim is submitted, the original supplier can recover the item(s) and a new supplier must complete the transaction after complying with all requirements. As for proof of delivery (POD), the date element may be entered by the beneficiary/designee or the supplier, the MACs say, but the beneficiary/designee is not required to personally fill in the date element. Additionally, the date entered must be the actual date of delivery. In the event that the supplier’s delivery documents have both a supplier entered date and a beneficiary/designee entered date, the beneficiary/designee entered date is considered to be the delivery date and thus the date of service.

    People for Quality Care launches interactive map

    WATERLOO, Iowa – People for Quality Care has launched an interactive map with data on Medicare patient complaints across the United States. Features of the map include the latest number of patient complaints (updated daily), the ability to filter complaints by medical equipment type and state, and an online form for visitors to add complaints. People for Quality Care has collected 3,200 patient complaints in one year through its Medicare Beneficiary Complaint Hotline. “We created this tool so Congress and the public can see the unfortunate reality—Medicare’s competitive bidding program is not working,” stated Kelly Turner, director of advocacy, in a press release.

    Advanced Home Care adds Central Georgia Home Care

    HIGH POINT, N.C. – Advanced Home Care and Macon, Ga.-based Central Georgia Home Care Services have merged, the providers announced last week. Central Georgia Home Care Services, a provider of home medical equipment, home infusion and specialty pharmacy services to a 20-county region of central Georgia, will become a branch of Advanced Home Care. The merger allows Advanced Home Care, which has already partnered with 13 other health systems and hospitals, to further strengthen its presence in the Southeast. It allows Central Georgia Home Care to provide additional services to the communities and patients it serves. Advanced Home Care will continue to operate Central Georgia Home Care’s location in Macon. Advanced Home Care also has locations in Norcross and Marietta.

    CMS schedules special forum on PMD demo

    WASHINGTON – CMS will host a Special Open Door Forum on Aug. 12 to allow DMEPOS suppliers and others to ask questions about the expanding PMD demon. The agency plans to expand the demo, which requires suppliers to submit prior authorizations, to 12 additional states on Oct. 1. The demo was first implemented in seven states Sept. 1, 2012. CMS previously held a forum on the PMD demo in June. This latest forum is scheduled for 2 p.m. to 3:30 p.m. EST. To participate, call 800-603-1774 and use the ID 70084507.

    MESA asks: Can providers get off set to respond to audits, too?

    ORLANDO, Fla. – The Medical Equipment Suppliers Association (MESA) has heard back from CMS about why DME providers, unlike hospitals, aren’t reimbursed for the costs of providing copies of records to respond to audits. Following a Senate roundtable on audits in July, where it was revealed that the RACs pay hospitals up to $25 per audit, the association recommended the agency change the policy. Acting Director of the Provider Compliance Group Melanie Combs-Dyer told Executive Director Liz Moran in an Aug. 6 letter: “Suppliers under the fee schedule, such as DMEPOS suppliers, generally do not receive additional payments for copy and mailing expenses, as these are included in the indirect costs associated with the fee schedule amount.” MESA was encouraged, however, that Combs-Dyer also stated, “Regarding your recommendations that CMS direct recovery auditors to compensate DMEPOS suppliers for submitting medical records, I have directed my staff to further research this issue and explore the possibility of revising future recovery auditor contracts as you suggest.”

    Know a Homecare Champion?

    WASHINGTON – AAHomecare is calling for nominations for its Homecare Champion Award, which recognizes those making a significant impact in the HME community. “The Homecare Champion Award is the opportunity to honor and thank someone in our community for their hard work and dedication,” the association stated in a bulletin. AAHomecare is also reminding providers to sign up for its Stand Up for Homecare fundraising reception at Medtrade in October. The Homecare Champion will be named and honored at the event.

    Physicians release guidelines for diagnosing sleep disorders

    PHILADELPHIA – The American College of Physicians, in a clinical practice guideline published Aug. 5 in the Annals of Internal Medicine, recommends a sleep study for patients with unexplained daytime sleepiness. It also recommends polysomnography for diagnostic testing in patients suspected of obstructive sleep apnea. It recommends portable sleep monitors in patients without serious comorbidities as an alternative to polysomnography when polysomnography is not available for diagnostic testing. The group grades the first recommendation “weak” with low-quality evidence and the second “weak” with moderate-quality evidence. “Considerable controversy surrounds the type and level of respiratory abnormality, the presence and type of signs or symptoms, and the most appropriate sleep monitoring device for diagnosing OSA,” the group states. “The purpose of this guideline is to address the screening and diagnosis of OSA by presenting a comparison of the effectiveness of the available diagnostic methods.”

    BioScrip’s home infusion revenues jump nearly 50%

    ELMSFORD, N.Y. – BioScrip has reported revenues of $247.1 million and a net loss of $18.6 million for the second quarter of 2014. Total revenues increased by $74.8 million or 43.4% compared to the same period last year. Revenues from home infusion, specifically, increased $74.6 million or 47.8%. The growth in home infusion was driven primarily by continued strong double-digit organic growth and the acquisition of CarePoint Partners, the company stated.

    ResMed officials sell shares

    SAN DIEGO – ResMed Director Peter Farrell on Aug. 1 sold 25,000 shares of stock at an average price of $49.04 for a total transaction of about $1.23 million. Farrell now owns 279,990 shares valued at about $13.73 million. Also on Aug. 1, COO Robert Andrew Douglas sold 8,000 shares at an average price of $48.95 for a total transaction of $391,600. The day before the transactions, ResMed reported earnings for the fourth quarter and fiscal year ended June 30.

    Patient sues NSM, Invacare for damages

    CHARLESTON, W.Va. – A West Virginia man has filed a lawsuit in Kanawha Circuit Court against National Seating & Mobility (NSM) and Invacare Outcomes Management, claiming their negligence is responsible for injuries he sustained from his power wheelchair. Terry Hicks claims the chair accelerated at an improper time, causing him to incur serious and permanent physical injuries, including a broken leg, and medical costs, according to local media reports. Hicks claims NSM had recently repaired the chair, for which Invacare had issued a recall and was aware of defects causing unintended acceleration. Hicks seeks judgment of unspecified compensatory damages.

    Short takes

    Life After Spinal Cord Injury (LASCI),a motivational program offered by Suwanee, Ga.-based UroMed, has hit 35,000 followers on Facebook. LASCI was created in 2010 to help people who use wheelchairs find more information about motivational speaking programs and other resources to assist them with daily living…Appleton, Wis.-based Bill-Ray Home Mobility, maker of “Friendly Beds,” has a new location at 3000 E Enterprise Avenue with a bigger display area. “Friendly Beds” is a bed mobility system that includes a transfer bar option for safe and independent transfers for those with no leg strength…Michael Johnson Racing will visit Home Care Medical’s Milwaukee retail store Aug. 13 from 11 a.m. to 1 p.m. Johnson was paralyzed from the mid-chest down in a 2005 dirt-track accident; he hopes to be the first paralyzed driver to race in the Indianapolis 500…HASCO Medical now has the rights to market BraunAbility and Vantage Mobility International wheelchair-accessible vans in Miami. The company plans to offer wheelchair lifts, transfer seating, hand controls, and wheelchair-accessible vehicle service and rentals at a new location there.

    People news

    Dave Cormack, president and CEO of Brightree, has been elected to the AAHomecare board of directors. AAHomecare President and CEO Tom Ryan said of Cormack, who has led Brightree since 2005: “He is exactly the kind of voice we need to hear more of in this organization as we navigate the rough terrain the HME industry faces.”…George Kucka, president of Schererville, Ind.-based Fairmeadows Home Health Center, has been appointed chairman of the Home Medical Equipment/Respiratory Therapy Council at AAHomecare. Kuchka is currently a member of the association’s board of directors…Heather Rider has been elected to Inogen’s board of directors, effective immediately. Rider, who fills a vacancy created by Charles Larsen’s resignation, has 25 years of experience in global human resources, having held executive level positions for Alphatec Spine, Sunrise Medical and Biosense Webster.


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    08/08/2014
    HME News Staff

    WASHINGTON – The DME MACs have issued clarifying guidance on written order prior to delivery (WOPD) document corrections and proof of delivery (POD) requirements.

    For WOPD, if errors are found before delivery, suppliers may amend the WOPD or create a new one to send to the physician for signature and date, the MACs say.

    If an error is discovered prior to claim submission, the original supplier may recover the item(s); obtain a compliant, complete WOPD; and re-deliver the item.

    If an error is found after a claim is submitted, the original supplier can recover the item(s) and a new supplier must complete the transaction after complying with all requirements.

    As for POD, the date element may be entered by the beneficiary/designee or the supplier, the MACs say, but the beneficiary/designee is not required to personally fill in the date element.

    Additionally, the date entered must be the actual date of delivery. In the event that the supplier’s delivery documents have both a supplier entered date and a beneficiary/designee entered date, the beneficiary/designee entered date is considered to be the delivery date and thus the date of service.


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    08/15/2014
    Theresa Flaherty

    WASHINGTON – It’s game time for the industry’s efforts to reform the audit and competitive bidding programs, industry stakeholders say.

    “We need to do everything we can to build support for our bills to put ourselves in the best possible position to be attached to a moving vehicle prior to the end of the year,” said Seth Johnson, vice president of government relations for Pride Mobility. “There’s plenty of opportunity to address all our issues.”

    To that end, during the August legislative recess, stakeholders are talking up H.R. 5083, a bill to reform the audit program, and H.R. 4920, a bill to require binding bids as part of the competitive bidding program to lawmakers in their districts. The bills, introduced earlier this summer, have 14 and 29 co-sponsors, respectively.

    Case in point: Karyn Estrella is spending August crisscrossing New England. She has meetings scheduled with 19 of the 21 congressional offices in those six states. The executive director of the Home Medical Equipment and Services Association of New England (HOMES) says there’s much more interest in the industry’s issues this year.

    “They really seem to understand the burden that’s been put on the industry,” she said. “When we start talking about audits and they hear that people have to wait two years or more, they just can’t believe it.”

    Stakeholders report successful meetings in several states, including Montana, where providers visited with Republican Rep. Steve Daines last week.

    “He was focused on what our ‘ask’ was going be and that is to stop the roll out of bidding nationwide,” said John Gallagher, vice president of government relations for The VGM Group, who attended the meeting. “He’s also getting engaged on audits. His folks are talking (about) signing onto H.R. 5083 when he gets back.”

    Following the August recess, the House Ways and Means Committee is planning a hearing on audits. A report released last week by the Government Accountability Office (GAO) says CMS needs to provide audit contractors with additional guidance and oversight.

    “That adds more fuel to the fire of why we need guidance and regulation in terms of the audit legislation,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “I think momentum will increase with the report out.”

    Lawmakers are due back in Washington, D.C., on Sept. 8, but with the looming elections, they will be in and out—mostly out, stakeholders predict. That’s not necessarily a bad thing, stakeholders say.

    “I always find, as we get closer to an election, where all of the House and one-third of the Senate will be standing for election, they tend to be a little more attuned to their constituency and what they can do to help to ensure that they will vote to re-elect them,” Johnson said.


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    08/15/2014
    HME News Staff

    WASHINGTON – The Government Accountability Office (GAO) is calling on CMS to improve the efficiency and effectiveness of its post-payment review efforts by providing contractors with additional guidance and oversight.

    The GAO reviewed MACs, ZPICs, RAs and CERT contractors because “questions have been raised about their effectiveness and efficiency, and the burden on providers.”

    While CMS has taken steps to prevent contractors from conducting duplicative post-payment claims reviews, the GAO found, “CMS neither has reliable data nor provides sufficient oversight and guidance to measure and fully prevent duplication.”

    Specifically, the GAO called on CMS to:

    ·      monitor the Recovery Audit Data Warehouse to ensure contractors are submitting required data and that the data in the database are accurate and complete;

    ·      develop complete guidance defining contractors’ responsibilities regarding duplicative claims reviews, including specifying whether and when MACs and ZPICs can duplicate other contractors’ reviews;

    ·      regularly assess whether contractors are complying with CMS requirements for the content of correspondence sent to providers; and

    ·      clarify current requirements for content of additional documentation requests and results letters, and standardize the requirements as much as possible for greater consistency.

    The Department of Health and Human Services agreed with the GAO’s recommendations and noted plans to improve CMS guidance and oversight.

    Investments pay off at Liberator Medical

    STUART, Fla. – Liberator Medical has reported $11.75 million in gross profits for the third quarter of 2014 compared to $10.89 million for the same period last year, a 7.6% increase.  Net sales increased 6.2% to $18.58 million as a result of a direct response advertising campaign to new customers and an emphasis on customer service to maximize reorders. “During our fiscal third quarter, we made key investments in our organizational infrastructure to improve the efficiency and performance of our customer-facing staff,” said Mark Libratore, president and CEO, in a press release. “We are investing in acquiring and serving our customers, which is central to our mission as a healthcare products provider and to achieving the maximum return on our advertising expenditures.” Net income, however, dropped 1.5% to $1.98 million. For the nine months ended June 30, 2014, Liberator reported gross profits of $34.42 million, a 5.9% increase over the same period last year; net sales of $54.83 million, a 5.9% increase; and net income of $5.72 million, a 19.4% increase.

    ResMed launches comprehensive platform for sleep therapy

    SAN DIEGO – ResMed announced last week the launch of Air Solutions, a connected care platform for treating sleep disordered breathing from diagnosis to treatment to compliance management to patient engagement. Two components of the solution: The AirSense 10 series of flow generators and the AirFit family of masks. The AirSense 10 CPAP and APAP devices will be available in the U.S. on Aug. 18. The AirFit masks were launched earlier this year. Other components include ApneaLink Air, a home sleep testing device, and AirView, a monitoring and compliance management system that provides data on demand.

    MED schedules fly-in

    LUBBOCK, Texas – The MED Group, in conjunction with AAHomecare, will host a legislative fly-in at the W Hotel in Washington, D.C., on Sept. 10. The focus of the fly-in in will be to promote H.R. 4920 and H.R. 5083, bills to reform the competitive bidding and audit programs, respectively. The fly-in will kick off with a pre-meeting on Sept. 9 from 7 p.m. to 9 p.m. for attendees to pick up lists of appointments and leave-behind information. “This legislative fly-in is open to all DME providers so that industry stakeholders can show solidarity on these issues,” stated Jeff Woodham, senior vice president and general manager of The MED Group, in a press release. To register, call MED at 800-825-5633 and ask to speak to a customer support representative.

    PHS offers homecare education to students

    ST. PAUL, Minn. – Pediatric Home Service (PHS) has launched partnerships with area colleges and universities to educate students about homecare services. The provider believes educating students about home care is just as important as hospital care. “Through these opportunities, students can see the benefits and complexity of home care firsthand,” stated Judy Giel, senior vice president of clinical service, in a press release. “We’re dedicated to expanding students’ knowledge base and their understanding of how these services are provided at home.” Fields of study include respiratory therapy, infusion nursing, homecare nursing, nutrition service and social work.

    The road to Medtrade: Audit sessions and call for presentations

    LAS VEGAS – Medtrade has no fewer than 10 audit-related sessions planned for the Oct. 20-23 event in Atlanta. “Our surveys revealed that attendees wanted more educational sessions dealing with audits,” stated Group Show Director Kevin Gaffney in a press release. “We responded in a big way.” See a complete schedule of these and other sessions at www.medtrade.com… Show organizers are already gearing up for Medtrade Spring: They’ve put out a call for presentations for the March 31-April 1 event in Las Vegas. Interested speakers must submit their ideas by Aug. 22; show organizers will notify selected speakers by Dec. 1. Go here to submit: http://n2b.goexposoftware.com/events/cfp/goExpo/public/form.php?fi=1006.

    Dr. Comfort steps out for diabetes

    MILWAUKEE – Dr. Comfort, a manufacturer of therapeutic footwear, has committed to raising $100,000 in 2014 as a National Team for the American Diabetes Association’s Step Out: Walk to Stop Diabetes. Dr. Comfort’s employees, friends, family members, customers and vendors are invited to join the company’s corporate team in participating in any of the 110 Step Out events nationwide. Every mile walked and dollar raised supports the ADA’s research and advocacy efforts to improve the lives of those affected by diabetes. In addition to participating in the walks, Dr. Comfort is donating to the ADA $10 from the sale of every pair of shoes from its athletic shoe line.

    Diabetes risk increases sharply

    NEW YORK — The risk of diabetes has doubled, with 40% of Americans born between 2001 and 2011 at risk of developing the disease, according to a new study published in The Lancet Diabetes & Endocrinology. For minorities, the risk is higher: More than half of all Hispanics and non-Hispanic black women will develop diabetes. For black men, the risk is 5%. “That’s a very real statistic not only for the public but also for the people treating and trying to prevent diabetes,” said Edward Gregg, the lead study author and an epidemiologist at the U.S. Centers for Disease Control and Prevention. “I hope this will be a stimulus really to find ways to prevent diabetes in the first place and reduce incidence.”

    IntelliWheels receives grant

    CHAMPAIGN, Ill. — IntelliWheels has secured a $1.5 million grant to further its development of ultra-lightweight, multi-geared wheels for manual wheelchairs. “By using simple gearing we can create a more dynamic method of mobility, providing wheelchair users greater ability to interact in their environment,” said Marissa Siero, co-founder of IntelliWheels, in the release. The grant was awarded by the National Institutes of Health, National Center for Medical Rehabilitation Research at the Eunice Kennedy Shriver National Institute of Child Health & Human Development.

    Good works: Invacare, CareTouch

    Invacareserved as a national host sponsor for the 34th National Veterans Wheelchair Games, Aug. 12-17 in Philadelphia. Invacare has been a supporter of the Games since 1981 and has also supported similar events. In addition to financial support, the manufacturer provided assistance with transporting veterans and their luggage from the airport and performing maintenance throughout the games…CareTouch has raised $1,000 to support the Butterfly Program of Porter Hospice Hike for Hospice event and is now aiming to double that by the Sept. 14 event. A team of CareTouch employees will participate in the hike.

    Short take: Invacare

    The board of directors of Elyria, Ohio-based Invacare has declared a cash dividend of $.0125 per share on its common shares and $.011364 per share on its Class B common shares payable Oct. 10, 2014, to shareholders on record on Oct. 2, 2014. Invacare recently reported a net loss in earnings of $13.6 million for the second quarter compared to a loss of $12.5 million for the same period last year. It also announced recently that Rob Gudbranson would become its interim president and CEO.

    People in the news

    AAHomecare has added Mina Uehara as a regulatory affairs associate. Uehara recently received a Master of Public Policy from American University. Her graduate work there focused on Medicaid. Uehara will work closely with Kim Brummett, vice president of regulatory affairs, on the association’s regulatory initiatives.


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    08/15/2014
    HME News Staff

    WASHINGTON – The Government Accountability Office (GAO) is calling on CMS to improve the efficiency and effectiveness of its post-payment review efforts by providing contractors with additional guidance and more oversight.

    The GAO reviewed MACs, ZPICs, RAs and CERT contractors because “questions have been raised about their effectiveness and efficiency, and the burden on providers.” 

    While CMS has taken steps to prevent contractors from conducting duplicative post-payment claims reviews, the GAO found, “CMS neither has reliable data nor provides sufficient oversight and guidance to measure and fully prevent duplication.”

    Specifically, the GAO report called on CMS to:

    • monitor the Recovery Audit Data Warehouse to ensure contractors are submitting required data and that the data in the database are accurate and complete;

    • develop complete guidance defining contractors’ responsibilities regarding duplicative claims reviews, including specifying whether and when MACs and ZPICs can duplicate other contractors’ reviews;

    • regularly assess whether contractors are complying with CMS requirements for the content of correspondence sent to providers; and

    • clarify current requirements for content of additional documentation requests and results letters, and standardize the requirements as much as possible for greater consistency.

    The Department of Health and Human Services agreed with the GAO’s recommendations and noted plans to improve CMS guidance and oversight.


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  • 08/22/14--11:32: Bid lawsuit just got bigger
  • 08/22/2014
    Liz Beaulieu

    WASHINGTON – There are now 10 lawsuits representing 17 HME providers suing the federal government for breach of contract as part of the original Round 1 of competitive bidding, says Jerry Stouck, a shareholder with Greenberg Traurig, the law firm representing Cardiosom.

    Cardiosom paved the way for the lawsuits when a U.S. Court of Federal Claims judge ruled in its favor in late June, saying the provider is entitled to damages for being awarded contracts and then having them rescinded as part of an 18-month delay to the program in 2008.

    “We’ve been in touch with all the attorneys involved,” Stouck said. “There are going to be some individual issues—the damages in terms of lost profits are going to depend on the company—but I think it makes a lot of sense for there to be coordination among the cases.”

    Because of a six-year statute of limitations, providers had until July 14 to file lawsuits against the government.

    In addition to filing a lawsuit on behalf of eight providers, Munsch Hardt has also filed a class action complaint on behalf of all the providers that were awarded contracts, says Ross Parker, a shareholder in the law firm’s litigation section.

    “Each of these 325 providers that had their contracts unilaterally terminated have a right to be heard and seek redress,” he said. “They relied upon governmental contracts that were awarded to them and then were taken from them with the stroke of a pen. If ever a private corporate citizen had the right to sue the government, this is such a case.”

    The eight providers are: Advacare Home Services, Life Healthcare Services, Health Systems Services, Pulmocair Respiratory, Coastal Care Medical Supply, All Star Oxygen & Home Medical Equipment, DSI Midwest Associates and Care Touch Medical Equipment.

    While the firms work with the judge in the case, Patricia Campbell-Smith, to coordinate the lawsuits, Cardiosom is also taking its next step: seeking damages. To put together a package, the provider will first need some records from CMS, Stouck says.

    “During that three-year period covered by the contracts, (once they were implemented), those CPAP machines were sold by someone—how much was sold, what were the prices,” he said.

    Ultimately, the lawsuits are subject to appeal, a course of action the government will likely take, the attorneys involved believe.

    “Even though it’s not a case of first impression, the government could possibly appeal this as high as the Supreme Court,” said Edward Vishnevetsky, an associate with Munsch Hardt. “If the government loses, the damages could be in the hundreds of millions of dollars. They certainly don’t want to lose that.”


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    08/22/2014
    HME News Staff

    WASHINGTON – CMS began requiring fingerprint-based background checks for certain providers on Aug. 6, according to an MLN Matters article. The checks will first impact individuals with a 5% or greater ownership interest in a provider that falls into the high-risk category and is currently enrolled in Medicare or has submitted an initial enrollment application. The checks will be implemented in phases—not all providers in the high-risk category will be part of the first phase. Providers will receive notification that they must meet the requirement from their MAC. Those that do receive a notification have 30 days from the date of the letter to be fingerprinted. Previously, CMS had stated that it would start requiring the checks some time this year.

    NCART’s Don Clayback answers Ice Bucket Challenge

    BUFFALO, N.Y. – NCART Executive Director Don Clayback answered the ALS Association’s Ice Bucket Challenge last week. Clayback tied the challenge with National CRT Awareness Week, Aug. 18-24. “Things that go naturally together: salt and pepper, Abbott and Costello, peanut butter and jelly, ALS Association Ice Bucket Challenge and National CRT Awareness Week,” he wrote to members in an email with a link to a video of him performing the challenge. Before he poured a bucket of ice water over his head, Clayback said, “I just want to say to my friends, Jimmy Fallon, Justin Timberlake and Bill Gates, stop with the emails, stop with the phone calls. I’m here. I’m going to do it.” In turn, Clayback challenged Gary Gilberti of Numotion, Doug Westerdahl of Monroe Wheelchair and Greg Packer of U.S. Rehab, all members of the NCART board of directors. “The ball, or I should say, the bucket, is in your court,” he said in the video.

    Jurisdiction B releases review results for support surfaces, CPAP devices

    YARMOUTH, Maine – Group 2 pressure reducing support surfaces had a claims error rate of 73.7% from April 1, 2014, to June 30, 2014, the Jurisdiction B DME MAC has reported. Top denial reasons included insufficient documentation of larger or multiple stage III or stage IV pressure ulcers on trunk or pelvis that have not improved over the last month, and insufficient documentation due to a missing signature. CPAP devices had a claims error rate of 67% for the same timeframe, the MAC reported. Top denial reasons included no documentation that the beneficiary continues to use and benefit from the device for replacement following a five-year reasonable useful lifetime, and no documentation of a face-to-face evaluation by the treating physician for replacement.

    NST patients use app to ‘master’ sleep therapy

    BOSTON – National Sleep Therapy (NST) has developed a proprietary iPad app to train new sleep therapy patients on how to use their CPAP devices, the provider announced this month. “Educators have shown that people retain new information better when: (1) they’re able to proceed at their own pace; (2) they learn and retain better with visuals; (3) they feel they’re in control; (4) they’re engaged and feel special; and (5) they can hold the teaching device in their own hands,” stated Eric Cohen, co-founder and president of NST, in a release. Cohen, a trained engineer, developed the app. Respiratory therapists (RTs) will oversee patient use of the app. “Our RTs methodically guide patients through the training,” Cohen said. “As the patient becomes comfortable with each section, they check off the boxes. Items left unchecked are revisited, so the clinician can explain, answer questions, and visually demonstrate. The RT asks the patient to show they’ve mastered their CPAP.” The app will be instrumental in ensuring patients are trained consistently, thoroughly and correctly in the use, care and maintenance of their CPAP machines, Cohen says. “Doctors are often on a tight schedule so they can’t always spend 60-90 minutes with a patient,” he said. “We have carefully orchestrated every minute of the setup process to maximize engagement and retention.” NST believes this approach is applicable to other types of chronic conditions, such as diabetes.

    HME companies make annual list

    NEW YORK – A quick scroll through Inc. Magazine’s annual 500|5000 list, published yesterday, contains several names familiar in the HME industry. In the overall list, HME providers include Charlotte, N.C.-based Carolina’s Home Medical Equipment (4,561); Charlotte, N.C.-based BlueDot Medical (4051); and Sandwich, Mass.-based Cape Medical Supply (4039). All three providers have made the list previously. Also on the list were two Atlanta-based billing systems and services companies: Brightree (2237) and Patientco (405).

    Liberator declares dividend

    STUART, Fla. – Liberator Medical on Aug. 18 declared a cash dividend of $.0325 per common share to its shareholders, an 8.3% increase from the last dividend paid on July 10. The new dividend will be paid Oct. 10. Last week, Liberator reported $11.75 million in gross profits for the third quarter of 2014, a 7.6% increase over the same period in 2013.

    ActiveForever acquired by investment firm

    SCOTTSDALE, Ariz. – ActiveForever has been acquired by an East Coast investment firm specializing in direct marketing of health products, according to a press release. Larry Fugleberg and Erika Feinberg purchased Independent Living Products in 2003, and rebranded it ActiveForever. It provides medical, fitness and assistive technology equipment and devices. The firm is keeping the current management team in place, with Feinberg as CEO and chief outcomes officer, and Fugleberg as director of programming and IT infrastructure.

    CMS clarifies payments for wheelchair accessories

    WASHINGTON – CMS has published a change request (8864) that instructs contractors to update systems allowing payment for wheelchair accessories when provided for use with non-competitively bid wheelchair base units after the end date of the certificate of medical necessity and when the modifier “KY” is present. The change applies to payments for wheelchair accessories furnished for use with Group 2 and Group 3 power wheelchairs by contractors in a competitive bid area (CBA); for competitively bid wheelchair accessories furnished for use with wheelchair base units not bid in Round 1 or Round 2 by contract and non-contract suppliers for beneficiaries living in a CBA; for competitively-bid wheelchair accessories not bid in Round 1 but furnished for use with any wheelchair base to beneficiaries living outside a CBA; and for competitively bid wheelchair accessories not bid in Round 1 and that were furnished for use with wheelchair base units not competitively bid in Round 2 to beneficiaries living in a CBA. The changes take effect for claims processed starting Jan. 5, 2015.

    ‘Local Hero’ drives off in new accessible van

    PHOENIX – Vantage Mobility International (VMI), Toyota and the National Mobility Equipment Dealers Association (NMEDA) this week handed the keys to a 2014 Sienna with VMI Northstar conversion to Courtney Boyll. The Alabama teacher, coach, wife and mother of three was paralyzed in a car accident 20 years ago. She won the national Local Hero Contest that was part of National Mobility Awareness Month, an annual campaign to educate people with disabilities and caregivers about adaptive mobility solutions. “I think anything is possible when you put your mind to it,” said Boyll. “I take it one day at a time and make it the best I can. And, I am thankful for the van that VMI, Toyota and NMEDA are providing to make my life easier.”

    Bay Pharmacy sticks with HME

    STURGEON BAY, Wis. – Bay Pharmacy has sold its pharmacy business to CVS, but CEO Tom Voegele will continue to run the company’s HME business, according to local news reports. “We will be coming up with a new name,” he said. The HME business will remain in the company’s current location in the Cherry Point Mall. Thirty employees will be affected by the move; 14 will continue to work in the HME business. The pharmacy business will move to a new location that CVS is building a few blocks away.

    Big Sky adds Wyoming

    ANACONDA, Mont. – The Big Sky Association of Medical Equipment Suppliers (Big Sky AMES) has added Wyoming to the fold, according to a bulletin from The VGM Group. The state association, which made the announcement at its annual convention here last week, covers Montana and Idaho. “The addition of Wyoming seemed like a natural fit,” said Dedra Haworth of Harrington Surgical in Montana. Big Sky AMES has unveiled a new logo that includes a picture of that state of Wyoming, along with Montana and Idaho.

    Qualcomm Life collaborates with ResMed

    SAN DIEGO – Qualcomm Life, a subsidiary of Qualcomm, has announced a collaboration with ResMed to develop connected health solutions. ResMed is using Qualcomm Life’s technology to streamline transitions of care from the hospital into the home. It is integrating Qualcomm Life’s 2net Hub and Platform with its Astral vents to capture and transfer near real-time biometric data to the HealthyCircles Care coordination platform. It’s also using HealthyCircles with its CPAP devices to enable hospitals and care providers to closely monitor patients to prevent hospital readmissions. “Working with Qualcomm Life extends our data solutions in the next-generation of remote patient monitoring solutions,” stated Jeremy Malecha, senior director, product management for ResMed Americas, in a release. “The 2net and HealthyCircles Platforms infrastructure streamlines data collection and transmission, enabling continuous, quality respiratory care for patients beyond the hospital.”

    Home Care Medical ramps up online services

    NEW BERLIN, Wis. – Home Care Medical has launched a Shop Online Store that allows customers to easily shop for HME and other products online. The new site, www.homecaremedicalshoponline.com, offers detailed product descriptions with informational videos and brochures; new, featured and sale products; and free shipping on most orders over $50. The site also allows customers to pay their bills online—full or partial payments or set up recurring payments. “Our company is always looking for new and innovative ways to meet the needs of our clients,” said Kandy Raether, vice president of sales and marketing for Home Care Medical, in a release. “With our website’s new features, we are pleased to offer the most advanced technologies and products available—24/7.”


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    08/22/2014
    Leah Hoenen

    RICHMOND, Va. – The other shoe has dropped in Virginia: The state’s Medicaid program on July 1 adopted competitive bidding rates for products that have been included in the program.

    This will be the final blow for a number of providers in the state, says Sam Clay, president of Clay Home Medical, whose business is in a bid area.

    “There’ve been a number of companies—as many as eight—that have changed hands or closed since bidding started and I fully think this will push some more over the edge,” he said.

    Additionally, the state’s move expands competitive bidding rates into areas that hadn’t yet been affected by the bid program, Clay said. 

    Previously, the state paid 10% less than the Medicare fee-for-service rate. Now it will pay that rate or the Medicare competitive bidding rate, whichever is lower. 

    The state’s move means, on average, a 45% drop in payment on bid items like oxygen concentrators and CPAP devices, Clay said. 

    “For some items, that puts it below cost,” he said. “So we’re concerned there’ll be an access problem.”

    The state’s industry association, the Virginia Association of Durable Medical Equipment Companies, lobbied against the change, but to no avail, said Executive Director Beth Bowen.

    “(Providers) are just alarmed at the continued beating down of an industry that’s supposed to help save money and care for people at home,” she said.


    0 0

    08/29/2014
    HME News Staff

    WASHINGTON – CMS would like to limit the provision of custom fitted prefabricated orthotics to “individuals with specialized training” like physicians. In addition to physicians, the agency defines those individuals as orthotists, physical therapists, occupational therapists and advanced-practical nurses. Not included on the list: certified orthotic fitters. CMS is accepting comments on the change, published in a recent proposed rule, until Sept. 2.

    DeRoyal receives patent for automated system

    KNOXVILLE, Tenn. – DeRoyal Industries has received a patent for Continuum, an automated system for medical item dispensing, billing and inventory management. “Our Continuum system automatically reorders durable medical equipment when the product is removed from its storage bin and correctly associates the product with the fitter, the patient and the billing codes, while automatically replenishing inventory,” stated President and COO Bill Pittman in a release. The patent was issued Aug. 26. The inventors named in the patent are Pittman; Angie Sewell, vice president of information technology; Greg Hodge, vice president of marketing; Kevin Lynch, manager of advanced technologies; and John Jacobs, director of technical services.

    Sunrise Medical, VGM renew relationship

    FRESNO, Calif. – Sunrise Medical has signed a new multi-year agreement with The VGM Group and U.S. Rehab, the companies announced in Aug. 25 press releases. The agreement, which is effective Sept. 1, re-establishes a past relationship between the companies. Sunrise and VGM believe the agreement will better position providers to stay in business and succeed. “We share a common goal of helping our valued providers achieve profitable top-line revenue growth through product solutions and operational efficiencies,” stated Pete Coburn, president of U.S. commercial operations at Sunrise Medical, in the release.

    RESNA announces board members, seating course

    ARLINGTON, Va. – Incoming RESNA President Ray Grott has nominated five new members to the association’s board: Patricia Bahr of St. Paul, Minn.-based Gillette Children’s Specialty Healthcare, treasurer; Meghan Donahue of Menomonie, Wis.-based Stout Vocational Rehabilitation Institute, board member; Patricia Karg of the University of Pittsburgh, board member; Jamie Arasz Prioli of the Pennsylvania Initiative on Assistive Technology, board member; and Maria Luisa Toro Hernandez of the University of Pittsburgh, board member. They join newly elected board members Roger Smith, president-elect; Maureen Linden, secretary; Barbara Crane, board member; Rajesh Pagadala, board member; and Julie Piriano, board member. In separate news, RESNA will offer its “Advanced Seating & Mobility” workshop in conjunction with Medtrade at the Georgia World Congress Center in Atlanta. In the Oct. 23-24 course, instructor Michelle Lange will address advanced seating and power wheelchair issues. Attendees will receive a complimentary Medtrade Expo pass with registration.

    State association welcomes new leaders

    SALT LAKE CITY – The Utah Home Medical Equipment Dealers (UTMED) has reorganized its leadership, the association announced Aug. 14. Leaders now include Jay Broadbent of Alpine Home Medical Equipment as president; Shane Mecham of Cache Valley Oxygen as vice president; and Kurt Walker of Cache Valley Oxygen as secretary. Tom Bradley of Peterson Medical has been leading UTMED for the past five years.

    Convaid partners with Dream Foundation

    TORRANCE, Calif. – Convaid recently donated a new wheelchair to the Dream Foundation, helping a 24-year-old woman with Rett syndrome more safely and comfortably engage with her community. Cherlynn has been making due with an adult wheelchair, but due to severe scoliosis, she can’t sit upright in the wheelchair without padding. The Dream Foundation is a national nonprofit that grants dreams to adults who are facing life-threatening illnesses and who are in their last year of life. Rett syndrome is a rare genetic postnatal neurological disorder that occurs almost exclusively in girls and leads to severe impairments, affecting their ability to speak, walk, eat and even breathe easily.

    Advocates sue over ‘broken’ appeals system

    WILLIMANTIC, Conn. – The Center for Medicare Advocacy has filed a nationwide class action lawsuit over lengthy Medicare appeals. Five named plaintiffs from Connecticut, New York and Ohio have all waited longer than the statutory 90-day limit to receive decisions on their Medicare appeals. The current average wait time is more than five times the limit mandated by Congress, according to a release. The group says the ALJ, the third level of appeal, is the first chance for a meaningful review of an appeal. “This lawsuit is necessary because of a broken Medicare appeals system,” said Gill Deford, director of litigation. “We’re suing to fix it for the plaintiffs and the thousands of beneficiaries in similar circumstances who are struggling to pay health care bills or going without needed care while stuck in bureaucratic limbo.”

    CPAP: It’s for older people, too

    LONDON – CPAP should be offered routinely to older patients to reduce daytime sleepiness, according to a study published in Lancet Respiratory Medicine. Previous studies have established the benefits of CPAP in middle-aged people, but until now, there has been no research on the benefits in older people, according to a press release. The study, led by researchers at Imperial College London and the Royal Infirmary of Edinburgh, involved 278 patients aged 65 or over. Obstructive sleep apnea (OSA) is thought to be more common in older people, but the true prevalence of the condition is unknown, in part because patients and their relatives may attribute their sleepiness to old age or patients can compensate for their sleepiness by napping, according to the release.

    Short takes

    Joseph Lewarskihas joined GRQ, a Vienna, Va.-based consulting firm, as a principal. Lewarski, a registered respiratory therapist, has been with Invacare for seven years, most recently as vice president of clinical affairs and vice president/general manager of the company’s global respiratory business. Lewarski has been working in health care for more than 30 years and has held numerous senior management and executive leadership positions in a variety of organizations and environments, including acute care, home care, pharmacy, group purchasing, consulting and medical device companies…Two HME companies completed the ALS Ice Bucket Challenge last week: Bridgeport, Mich.-based Amigo Mobility, which made a donation to ALS of Michigan, and Sandwich, Mass.-based Cape Medical Supply,which made a donation to Compassionate Care ALS and challenged The VGM Group, AAHomecare and DeRoyal IndustriesLake Wales, Fla.-based 3B Medical has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its new auto bi-level (BPAP) device. The BPAP 25A comes standard with features like RESlex Exhalation Relief and integrates with iCodeConnect, a software program that allows users to retrieve compliance data. 3B Medical plans to make BPAP 25A available Oct. 1…A/R Allegiance Group is ranked 4,890 on this year’s Inc. 500|5000 list. The Overland Park, Kan.-based billing and collections company also ranked among the Top 100 Kansas companies.


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