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    10/06/2015
    HME News Staff

    WASHINGTON – CMS has released a revised fee schedule format and a preliminary list of rural zip codes for the national roll out of competitive bidding.

    The agency had previously announced plans to apply bid pricing in non-bid areas on Jan. 1, 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). Pricing will be slightly higher in rural areas.

    While industry stakeholders were still digging through the new info at press time on Tuesday morning, during a recent webcast, Andrea Stark, a reimbursement consultant with MiraVista, used Bartlesville, Okla., as an example and calculated that, once fully phased in, the cut for oxygen concentrators would be $86.36 per month, representing a 47% reduction, if the town is considered a standard MSA, and $77.94, a 43% reduction, if it’s considered a rural area.

    CMS plans to phase in the national roll out this way: On Jan. 1, it will use pricing comprised of 50% of the new fee schedule and 50% of the original fee schedule; on July 1, it will transition to 100% of the new fee schedule.

    Using Bartlesville and oxygen concentrators again as an example, pricing would be $137.74 in non-rural areas on Jan. 1, and $94.56 on July 1; in rural areas, it would be $141.95 on Jan. 1 and $102.98 on July 1, according to Stark.


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    10/07/2015
    HME News Staff

    BALTIMORE – CMS has scrapped plans to discontinue several codes for miscellaneous DME.

    In a notice this week, the agency simply stated: “We appreciate the comments received on the proposed coding changes below and will continue to consider the issue further. Additional information will be provided on the status of these coding changes in the future.” 

    The changes were slated to take effect Jan. 1, 2016.

    In June, CMS proposed replacing HCPC codes E1399 and K0108 with six new codes to reflect more accurate payment of Medicare claims.

    Industry stakeholders, particularly those specializing in complex rehab, raised objections, citing concerns over the accompanying reimbursement, which, in some cases, was based on payment amounts from the 1980s.


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    10/08/2015
    HME News Staff

    WASHINGTON – Four states could have saved an additional $12 million on certain DME items by using pricing comparable to Round 2 of competitive bidding and the national mail-order programs, according to a recent report from the Office of Inspector General.

    In previous audits, the OIG found the states could have saved $18.1 million with pricing comparable to Round 1.

    “We determined that opportunities exist for these states to lower provider reimbursement rates, resulting in approximately $30.1 million in potential cost savings for the states and the federal government,” stated the OIG in its report.

    The OIG has recommended that CMS seek legislative authority to limit state reimbursement rates to Medicare rates and to encourage a further reduction of state reimbursement rates through competitive bidding or manufacturer rebates. CMS agreed.

    This isn’t the first time the OIG has encouraged states to use competitive bid pricing. In June, the OIG made similar recommendations after it found that New York could have saved $8.9 million on select DME items; in 2014, it found that California could have saved $3.9 million.

     

     


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    List of rural zip codes is out, pricing is not far behind
    10/09/2015
    Liz Beaulieu

    WASHINGTON – All eyes last week were on CMS’s preliminary list of rural zip codes for the national roll out of competitive bidding, with HME providers doing business in those areas set to feel a little less of a cut.

    CMS plans to implement bid pricing nationwide on Jan. 1, 2016, with separate fee schedules for regional and rural areas. For regional areas, the agency will base pricing on the average pricing in the competitive bidding areas in the region; for rural areas, it plans to base pricing on the national weighted average plus 10%.

    “It’s about a 3% or 4% difference, but when you’re taking cuts this severe, that’s way better,” said Kim Brummett, vice president of regulatory affairs for AAHomecare.

    There are more than 16,000 rural zip codes, about 37.8% of all zip codes in the U.S. The remaining zip codes break down like this: 8.6% in Round 1, 32.3% in Round 2, and 20.9% in regional areas, according to an analysis by AAHomecare.

    Stakeholders were mapping the list of rural zip codes to population figures to better determine the number of affected Medicare beneficiaries, who will likely experience reduced access to products and services.

    “The percent of Medicare beneficiaries that resides in those zip codes is really the important thing for us to know,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “That’s how we understand the scope.”

    CMS also released the file formats for the new fee schedules. The actual fee schedules probably won’t be far behind, stakeholders say.

    “I expect CMS already has them,” said Andrea Stark, a reimbursement consultant with MiraVista. “But because the pricing is going to be so different, they’re being conservative and diligent.”

    Then, in a few months, providers will be faced with potentially having a handful of different fee schedules to contend with—those for bid areas, regional areas, rural areas and, if they’re in a border state, possibly more.

    “CMS has definitely upped the complication of figuring out how to accurately project your expected allowables,” Stark said. “What you might find providers doing is setting allowables at the lowest rate possible and adjusting up from there if they get higher reimbursement.”

    Bid pricing is already in effect in 100 cities as part of the first two rounds of the program, with average reimbursement cuts ranging from 32% to 45%.

     


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    10/09/2015
    HME News Staff

    BALTIMORE – CMS has scrapped plans to discontinue several codes for miscellaneous DME.

    In a notice last week, the agency simply stated: “We appreciate the comments received on the proposed coding changes below and will continue to consider the issue further. Additional information will be provided on the status of these coding changes in the future.” 

    The changes were slated to take effect Jan. 1, 2016.

    In June, CMS proposed replacing HCPC codes E1399 and K0108 with six new codes to reflect more accurate payment of Medicare claims.

    Industry stakeholders, particularly those specializing in complex rehab, raised objections, citing concerns over the accompanying reimbursement, which, in some cases, was based on payment amounts from the 1980s.

    CMS posts DMEPOS data dump

    WASHINGTON – CMS has posted a new data set that provides information on more than 385,000 physicians and other healthcare professionals who referred DMEPOS products and services.

    In all, the data set represents more than 100 million claims and $11 billion in Medicare allowed amounts.

    “The data set is part of a wider set of initiatives by the administration to achieve better care, smarter spending and healthier people throughout our healthcare system,” stated Andrew Slavitt, acting CMS administrator. “CMS is providing this data to support insight and innovations in healthcare delivery.”

    The data set contains information on utilization, payment (allowed amount and Medicare payment) and submitted charges organized by NPI, HCPCS code and supplier rental indicator.

    Based on the data, users can find out, for example, patterns of DMEPOS utilization and Medicare allowed amounts for the 10 largest referring provider specialties. Internal medicine tops the list with 87,107 referring providers and $29,954 average allowed amount; and family practice is not far behind, with 81,603 referring providers and $27,982 average allowed amount.

    OIG once again highlights savings associated with bid program

    WASHINGTON – Four states could have saved an additional $12 million on certain DME items by using pricing comparable to Round 2 of competitive bidding and the national mail-order programs, according to a recent report from the Office of Inspector General.

    In previous audits, the OIG found the states could have saved $18.1 million with pricing comparable to Round 1.

    “We determined that opportunities exist for these states to lower provider reimbursement rates, resulting in approximately $30.1 million in potential cost savings for the states and the federal government,” stated the OIG in its report.

    The OIG has recommended that CMS seek legislative authority to limit state reimbursement rates to Medicare rates and to encourage a further reduction of state reimbursement rates through competitive bidding or manufacturer rebates. CMS agreed.

    This isn’t the first time the OIG has encouraged states to use competitive bid pricing. In June, the OIG made similar recommendations after it found that New York could have saved $8.9 million on select DME items; in 2014, it found that California could have saved $3.9 million.

    Medical Service Co. buys Clark’s RX Home Medical

    CLEVELAND – Medical Service Co. has expanded its growing empire in Ohio. The company has acquired Clark’s RX Home Medical in Centerville, Ohio, also known as Dayton Home Medical, according to the Dayton Business Journal. Joel Marx, the company’s chairman and CEO, told the journal that he plans to double the size of the Centerville office, which has 10 employees, to grow its respiratory equipment business. “Clark’s was a perfect fit, the business has a strong pharmacy presence but wasn’t deeply invested in the medical equipment business,” he told the journal. Medical Service Co. has 23 offices and 250 employees, mostly in Ohio. Clark’s RX Home Medical operated under the Clark’s RX pharmacy chain, which has 16 locations in Ohio, Illinois and Missouri.

    Convaid launches new dealer resource

    TORRANCE, Calif. – Convaid has published the 2016 Seating and Mobility Guide for dealers. “Convaid knows that improved client outcome starts with application of rehabilitation principles in prescribing a pediatric wheelchair and seating system that is optimized for each child's specific mobility impairment,” it stated. The inaugural brochure features information on frame considerations, seating options, trunk and extremity positioning, and head support.

    QS/1 introduces new look

    SPARTANBURG, S.C. – QS/1 has revamped its image with a fresh new logo and website. “Rebranding is not something a company does lightly,” said Tammy Devine, president, in a release. “With growth and new products on the horizon, we felt this was the perfect time to release a new look to reflect the direction of the company.” The new website continues to feature industry news, product information and testimonials, but now offers easier navigation. 

    ARI goes to work for Drive customers

    MILWAUKEE – ARI Network Services will offer custom website and digital marketing services to Drive Medical customers, it announced Oct. 7. As part of the arrangement, ARI will offer branded websites, email marketing templates, Google optimization, and access to a library of graphics and other Drive Medical-branded marketing collateral, according to a release. “This program offers HME providers a distinct advantage by attracting online shoppers and driving qualified leads, ultimately resulting in increased online and in-store sales for Drive Medical’s provider network,” said Roy Olivier, president and CEO of ARI.

    Philips reaches out to OSA patients

    MURRYSVILLE, Pa. – Philips Respironics has launched a campaign to help OSA patients re-engage with their sleep therapy. The campaign centers on the company’s new Wisp mask, which is designed for minimal contact and improved patient adherence, according to a release. The campaign will include a mix of paid search and banner ads driving patients to the Wisp web page on SleepApnea.com.

    People in the news

    Home Care Medical was recognized for several awards at the WAMES 2015 Convention this week. Jim Spellman, director of operations and 2015 WAMES President, received the Industry Excellence Award, as well as the Distinguished Service Award for his efforts on the WAMES Legislative Committee. Donna Smith, director of respiratory care, received the Outstanding Contribution Award for her efforts on the WAMES Respiratory Committee…Tina Roesler recently joined the Motion Composites team. Roesler will be responsible for expanding the manufacturer’s global and domestic markets…Stratice Healthcare, developer of eDMEplus, has hired Ken Majkowski as chief strategy officer and Jeff Benning as CFO...Beth Thieme, vice president and CEO of Amigo Mobility International, celebrates 40 years with the company this year. Under Thieme’s leadership, the DME manufacturer’s sales to retail stores have more than tripled over the last 10 years.


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  • 10/09/15--07:04: CMS posts DMEPOS data dump
  • 10/09/2015
    HME News Staff

    WASHINGTON – CMS has posted a new data set that provides information on more than 385,000 physicians and other healthcare professionals who referred DMEPOS products and services.

    In all, the data set represents more than 100 million claims and $11 billion in Medicare allowed amounts.

    “The data set is part of a wider set of initiatives by the administration to achieve better care, smarter spending and healthier people throughout our healthcare system,” stated Andrew Slavitt, acting CMS administrator. “CMS is providing this data to support insight and innovations in healthcare delivery.”

    The data set contains information on utilization, payment (allowed amount and Medicare payment) and submitted charges organized by NPI, HCPCS code and supplier rental indicator.

    Based on the data, users can find out, for example, patterns of DMEPOS utilization and Medicare allowed amounts for the 10 largest referring provider specialties. Internal medicine tops the list with 87,107 referring providers and $29,954 average allowed amount; and family practice is not far behind, with 81,603 referring providers and $27,982 average allowed amount.


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    10/15/2015
    Liz Beaulieu

    When Laurie Orlov heard Joe Coughlin, director of MIT’s AgeLab, talk about the need for a unified vision for the growing number of technologies that allow seniors to age in place, she felt he was talking to her directly.

    “He said we need a cathedral builder,” she said.

    Here’s what Orlov, the founder of Aging in Place Technology Watch and Boomer Health Tech Watch, had to say about how technology can reduce costs and improve care for the wave of roughly 10,000 baby boomers turning 65 each day.

    The cost conundrum

    Orlov says seniors are delaying moving into assisted living facilities not only because they prefer to stay at home but also because they’re living longer and can’t afford to pay for these facilities for 10, 20, even 30 years.

    “The cost of care for assisted living will be $51,000 per year by 2020,” she said. “Where are we going to be in our later years, with our longevity and the price of assisted living facilities?”

    The business of health care

    Orlov says technology can grease the wheels for the seniors who want—and need—to stay in their homes longer, an opportunity not lost on businesses and investors. She points out that Silicone Valley-startup Honor, an online marketplace for caregiving services, recently received $20 million in venture capital funding.

    Tech trends

    Orlov says the biggest trends in technology that allow seniors to age in place include predictive analytics, wearables, proximity awareness and voice activation.

    In predictive analytics, for example, Orlov used as an example CareSage from Philips, a cloud-based “engine” that collects and analyzes data from the company’s Lifeline wearable device to identify patients that are most likely to have health issues. The idea: Clinicians can intervene before problems occur, helping these patients stay healthier and reducing avoidable hospitalizations.


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    10/16/2015
    Liz Beaulieu

    YARMOUTH, Maine – The increasing number of states turning to managed care to run their Medicaid programs is creating a logistical nightmare for providers.

    Many of the respondents to a recent HME Newspoll report that working with managed care companies can mean a cumbersome prior authorization process, slow payments, irregular policies and inconsistent reimbursement rates.

    “They’re very slow to pay, if at all,” wrote in Steve Williams of Motion Mobility in Canton, Ohio. “Prior authorizations are challenged when a claim is submitted. There’s lost paperwork and poor customer service. Approvals are given with no dollar amounts listed. Dealer invoice is requested frequently, even for coded items.”

    Unfortunately, for most respondents, this is the new reality of serving Medicaid recipients. Eighty-four percent of respondents say their states have turned to managed care to run their Medicaid programs and 11% say if they haven’t made the move yet, they’re thinking about it.

    Having to work with more than one managed care company in each state and having to deal with Medicaid recipients switching from company to company at will compounds the problem, respondents say.

    “There has been a huge increase in administrative burden,” wrote in William Hill of Mediquip Homecare in Bethpage, N.Y. “We had to hire a person dedicated to managing the managed care contracts and vagaries of billing from each one.”

    It’d be one thing if the extra work meant better reimbursement, but that hasn’t been the case, respondents say.

    “I owned a large DME business in Pennsylvania when it switched over from traditional Medicaid to an MCO model,” said Scott Dinning of Hometown Oxygen in Charlotte, N.C. “This resulted in a reduction averaging 35% of the traditional fee schedule amount, which was very disruptive to the services and products we could afford to provide.”

    Respondents say what they’re experiencing with managed care companies pales in comparison to what’s being felt by Medicaid recipients.

    “Patients have to find out who can help them, then wait for an auth, and then wait for the product to be shipped to them if their provider is out of town,” wrote in Jeremy Lloyd of Perkins Medical Supply in Vero Beach, Fla. “As a company, we can overcome the reimbursement challenge, but patients are being affected negatively.”


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    10/16/2015
    Jeff Rowe

    ATLANTA - Among the changes in the Affordable Care Act is a requirement for non-grandfathered health plans to cover breastfeeding support and supplies. At Medtrade in Atlanta, in a session titled “How to Reap the Benefits of Health Care Reform to Reach the Millennial Consumer & Expand Retail Sales,” Juli Goldstein, managed care channel manager for Medela, will help attendees understand how best to serve this new generation of consumers.

    HME News:How has health insurance coverage for breast pumps changed that market?

    Juli Goldstein:The coverage of breast pumps and supplies under the ACA has opened up a broader community of breastfeeding moms, so that now we see an interest across the socioeconomic spectrum and in diverse populations. 

    HME:What are the opportunities for HME providers in this new market?

    Goldstein:The opportunity is for HME providers to diversify their product and market portfolios.

    HME:What are the challenges, and how do HME providers overcome those challenges?

    Goldstein:As providers are diversifying their portfolios, revenue streams and the markets they serve, they need to understand how to message and reach into a very different consumer base. It’s a whole new generation—the millennials—and it’s very technologically savvy.

    HME:Once an HME provider provides a customer with a breast pump, how can it keep that customer coming back, either for related supplies or for other HME?

    Goldstein:First, by speaking and relating to consumers in a way that’s meaningful to them when it comes to their primary experience. And second, by conveying the added value of essential breastfeeding support products available beyond what is covered by insurance.

    HME:What’s the one thing you hope attendees learn from your session?

    Goldstein:It’s essential to understand that to move into wellness, HMEs must be able to speak to consumer in ways that are meaningful to them. The majority of the consumers taking advantage of these supplies are millennials, so providers need a keen understanding of that market.

    Session info

    Speaker: Juli Goldstein, managed care channel manager, Medela

    Session: “How to Reap the Benefits of Health Care Reform to Reach the Millennial Consumer & Expand Retail Sales”

    When: Wed, Oct. 28, 2015, 8:00 am to 9:00 am 


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    10/16/2015
    HME News Staff

    BRENTWOOD, Tenn. – CMS has begun returning paid electronic remittance advice or ERAs for claims submitted using ICD-10 codes, according to TeamDME!, a medical billing software company. This is welcome news to providers: 70% of respondents to a recent HME Newspoll reported concern over a disruption in cash flow. But providers aren’t out of the woods yet. Depending on the type of claim, providers can expect to wait up to 30 days to receive payment, said CMS Deputy Administrator Sean Cavanaugh in a recent blog post. The transition to ICD-10 kicked off Oct. 1.

    Amigo Mobility expands offerings to include mounting products

    BRIDGEPORT, Mich. – Amigo Mobility International now offers mounting products through a distributorship with Seattle-based RAM Mounts. Distributing these products, including cell phone and tablet holders, increases the level of customization and comfort that Amigo Mobility can offer its customers, the company stated in a press release. “RAM Mount products are a natural complement to the Amigo product line,” stated COO Joe Mooney in a press release. “Many of our healthcare customers spend most of their day using their Amigo, so the more accessories we can offer to make their lives easier, the better.” Amigo Mobility manufacturers a complete line of mobility products, including power-operated vehicles/scooters, trunk and van lifts, and electronic shopping carts.

    Quantum’s seating system passes crash test

    EXETER, Pa. – Quantum Rehab’s Tru-Balance 3 and iLevel power seating systems are now crash tested and WC19 compliant, the company has announced. WC19 is the ANSI/RESNA testing standard that mobility devices must pass to serve as an occupied seat in a motor vehicle, according to a press release. “Occupied power chair transport in vehicles is vital, and we’ve known the historical limitations on non-crash-tested power seating systems,” said Jean Sayre, senior director of clinical development for Quantum Rehab. “We’re pleased to be the first in the industry to have power seating that’s fully crash tested and WC19-compliant for safer transport.” WC19-compliant power seating is available on the Quantum Q6 Edge with Tru-Balance 3 Tilt-and-Recline, Articulating Foot Platform, and iLevel elevation technology, configured individually or together, with up to a 300-pound weight capacity.

    Judges narrow down top retail products

    ATLANTA – Eight finalists have been chosen for Medtrade’s Innovative HME Retail Product Awards. The purpose of the competition is to promote and recognize products suited for cash sales. The finalists will present their products Tuesday, Oct 27, during a session at the show titled “The Best New Retail/Cash Opportunities.” After, attendees will vote for three winners. The finalists are:

    ·      Back Joy Care Bath Seat (bath safety product), Booth 2202

    ·      Drive Hurry Cane (walking cane), Booth 911

    ·      Golden Technologies DayDreamer (lift chair), Booth 1305

    ·      ING Calf Sleeve and Wrist Sleeve (compression/orthopedic support), Booth 1950

    ·      KT Tape Recovery + Patches (elastic tape for pain relief), Booth 2153

    ·      MMJ Labs Buzzy Vibracool (massaging ice therapy), Booth 1064

    ·      Pik Stiks TelescoPik (reacher/activity of daily living product), Booth 633

    ·      Pride Go Go Folding Scooter (rehab/mobility), Booth 1911

    NCPA approves resolutions, elects officers

    NATIONAL HARBOR, Md. – Community pharmacists adopted several resolutions to advance patient care and improve reimbursement yesterday during the 2015 NCPA Annual Convention. The NCPA committed to, among other things, supporting policies that facilitate community pharmacists serving as outpatient health care centers, and pursuing solutions to direct and indirect remuneration practices. During the House of Delegates session, Bradley Arthur, co-owner of Black Rock Pharmacy and Brighton Eggert Pharmacy in Buffalo, N.Y., was named NCPA president. Also elected: DeAnn Mullins, Lynn Haven, Fla., president-elect; David Smith, Indiana, Pa., chairman; and Bill Osborn, Brian Caswell, Michele Belcher, Hugh Chancy and Jeff Carson, board of directors.

    Association names Joe Moose top community pharmacist

    NATIONAL HARBOR, Mich. – The National Community Pharmacists Association has named Joe Moose, RPh, co-owner of Moose Pharmacy, as its 2015 Willard B. Simmons Independent Pharmacist of the Year. Moose, who has multiple locations in and around Concord, N.C., was recognized for, among other things, his role as the lead community pharmacy coordinator for Community Care of North Carolina, a network of more than 200 community pharmacies that strive to offer enhanced value to payers. The award recognizes an independent pharmacist for exemplary leadership and commitment to independent pharmacy and to their community. Willard B. Simmons, the award’s namesake, was a former executive secretary of NCPA and a long-time trustee of the NCPA Foundation.


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    10/20/2015
    HME News Staff

    WATERLOO, Iowa – Jim Walsh has been named chairman of the board of directors and interim CEO of the VGM Group.

    Walsh has been a long-time business partner of Van Miller and was most recently president and general counsel for the company. The board will meet in person next month to determine next steps.

    In recent years, Miller had set in place plans for his succession. In 2008, he and minority shareholders Walsh and John Deery Jr. sold 100% of the stock of the company to its employees through an employee stock option plan or ESOP.

    Miller died on Sunday of an apparent heart attack. His funeral is tentatively set for Saturday at 11 a.m. at Walnut Ridge Baptist Church in Waterloo. Visitation is the day before, from 3 p.m. to 8 p.m., at Parrott and Wood Funeral Service, also in Waterloo.

    The family requests, in lieu of flowers, that memorials be made to AAHomecare’s Stand Up for Homecare event, which raises money to help the association build supportive relationships with HME consumers and patient groups, and fund outreach and educational efforts aimed at policymakers and the media. The event takes place Oct. 27 from 5:30 p.m. to 7 p.m. at the Metro Atlanta Chamber of Commerce as part of Medtrade.


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  • 10/21/15--07:57: Women on the upswing
  • Organization wants women at HME companies to join the conversation
    10/21/2015
    Liz Beaulieu

    A growing organization dedicated to the development of women in healthcare businesses has opened its doors to those working in the HME industry.

    The current members of Professional Women in Healthcare are working primarily at medical device and surgical companies, but the leaders of the organization say, “The conversation has changed.”

    “When you think about health care, it’s no longer just about products and how to get them to market,” said Heather Llorca-Kropp, chairwoman of PWH’s executive committee and vice president of marketing and communications and channel management for Dukal Corp., a company that supplies disposable products and patient care items for all medical markets. “The providers are a big part of the conversation.”

    PWH launched 10 years ago with 16 founding members, including Llorca-Kropp, and will hit close to 600 members this year. At its core: education, networking and mentoring opportunities that take place in person (a national meeting that coincides with HIDA and various regional meetings in large cities), online (webinars) and by phone (coffee chats).

    That’s something that women working in the HME industry, in particular, could use, says Lisa Wells, who became a member earlier this year.

    “Many HME companies have less than 20 employees,” said Wells, a marketing consultant and president of Get Social Consulting. “They don’t have career tracks.”

    Llorca-Kropp holds herself up as an example of the difference PWH can make—she started out as a director, and now she’s a vice president.

    “It took being involved in the organization for me to realize, I have to go after and ask for opportunities,” she said. 

    PWH won’t attend Medtrade this year, but it probably will in the future, Llorca-Kropp says.

    “We want to hear from a few champions on what’s needed in this industry,” she said.


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    10/22/2015
    Liz Beaulieu

    NASHVILLE, Tenn. – Post-acute care, including HME, is the Wild Wild West of health care, and that’s a good thing, several speakers said at the 11th annual HME News Business Summit in September.

    In response to government pressure, hospitals are flooding their systems with data (think zettabytes) and changing their delivery models (think value vs. fee for service), but where and how they plug in post-acute care, while an increasing priority, is still very much to be determined.

    “It’s a big opportunity,” said Fletcher Lance, managing director and national healthcare lead for the North Highland Company, who kicked off the Summit on Sept. 14 at the Nashville Marriott on the Vanderbilt University campus.

    Lance offered up as an example of the opportunity a recent move by Cardinal Health, which distributes pharmaceuticals and medical products to hospitals, to spend $290 million to buy 71% of naviHealth, a three-year-old company that manages post-acute care services for those hospitals.

    As providers jockey for position in a changing marketplace, they’ll want to keep a hyper-local focus, speakers said. Why? All hospitals may be focused on disease management, for example, but they’re probably doing it in different ways, they said.

    “If you’ve seen one hospital, you’ve seen one hospital,” said Jim Hollingshead, president of ResMed Americas, during a panel on the HME provider’s role in connected health. “You need to talk to your actual customer because there’s so much variability.”

    When they have these conversations with hospitals, providers will also want to walk the talk, speakers said.

    “Use the language the referral source is looking for,” said Robin Randolph, marketing manager for North America for Fisher & Paykel.

    While the short-term focus of hospitals may be on collecting data and changing delivery models, providers shouldn’t lose sight of the reason behind all the activity: improving care and reducing cost.

    “The $100 million question is, what are you doing about it?” said Dave Gilbert, CEO of Evermind, a technology that tracks the use of home electrical appliances and powered medical equipment.


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    10/23/2015
    HME News Staff

    ATLANTA – Joey Tart and Billy Tart, co-founders of Family Medical Supply in Dunn, N.C., have been chosen to receive this year’s Homecare Champion Award. The award recognizes AAHomecare members who have made exceptional contributions to the homecare community throughout their careers. “Their advocacy is helped by their community involvement,” said Beth Bowen, executive director of the North Carolina Association for Medical Equipment Services, who nominated the Tart brothers, in a release. “Anyone who is an elected official in their district pays attention, because they are well respected and work hard. Joey and Billy are professionals when it comes to presenting their case, and presenting the industry’s issues to people who may or may not understand those issues.” AAHomecare will present the award to the Tarts on Tuesday, Oct. 27, during the Stand Up for Homecare event at Medtrade. Family Medical Supply offers oxygen and HME at 17 locations in throughout central and eastern North Carolina.

    Rotech gains ‘critical mass’ in Oklahoma

    ORLANDO, Fla. – Rotech Healthcare has acquired the respiratory equipment assets of Tulsa, Okla.-based Home Health Warehouse. Rotech already operates in the area as American Medical Rental & Sales and will move that location into the Home Health Warehouse location. “This asset purchase not only expands our services in Tulsa, but also provides more critical mass and a larger footprint for quality patient care,” said Rotech CEO Tim Pigg. Rotech currently operates in eight markets in Oklahoma. Rotech made several acquisitions earlier this year, including four in February. Duckridge Advisors served as the M&A advisor to Home Health Warehouse.

    Epic Health makes second buy in two months

    DALLAS – Epic Health Services, a provider of pediatric skilled nursing, therapy and enteral services, has acquired Medco. The Houston-based Medco is a provider of enteral therapy, respiratory equipment and supplies, including diabetes, urological and wound care, throughout Texas and Louisiana. It also offers specialty pharmacy services. It’s the second buy in as many months for Epic Health, which in *September acquired Chandler, Ariz.-based Option 1 Healthcare Solutions. Medco will combine with Option 1. With this latest deal, Epic Health will now serve 34,000 patients in 17 states.

    Roscoe Medical, ARI ink web deal

    MILWAUKEE - ARI Network Services has signed an agreement with Roscoe Medical to become the preferred website provider for more the manufacturer’s network of more than 5,000 HME providers. According to the deal, ARI will offer providers exclusive Roscoe-branded product pages featuring more than 4,000 homecare products. "We look forward to working with ARI and providing a solution to our HME dealers to help drive more traffic, leads and sales, not only to their websites, but also to their brick-and-mortar stores," said Paul Guth, president and CEO of Roscoe, in a release. ARI's provider websites offer fully optimized search engines, a prescription refill module and secure online bill pay.

    O&P stakeholders receive response from petition

    YARMOUTH, Maine – O&P stakeholders are underwhelmed by the president’s response to their “We the People” petition asking the White House to rescind Medicare’s proposed coverage requirements for prostheses. It took only 17 days for 100,000 people to sign the petition, the number required to prompt a response from the president. Part of the response reads: “The coverage determination process is still ongoing, but CMS wants to make clear that they’re committed to providing high quality care to all Medicare beneficiaries. They also wanted to make sure you know that HHS has met with stakeholders on this important issue, and both CMS and its contractors understand the questions that have been raised about access to the right prosthetic care. We will be in touch with another update.” Stakeholders point out that the response comes 60 days after the petition hit 100,000 signatures. “While we remain confident that the final resolution of this draft LCD will be a favorable one for the O&P professional and the patients we serve, the question remains: Is the ‘We the People’ promise merely PR fluff, or will it ultimately prove more substantive? Whichever, it clearly does not reflect timeliness, fairness and responsiveness,” stated the American Orthotic & Prosthetic Association.

    PMDRX in running for $250K in funding

    GLENDALE, Ariz. – PMDRX has been named one of 25 semifinalists in the Arizona Innovation Challenge. The Arizona Commerce Authority will now select six winners and award them each $250,000. The challenge is a bi-annual business plan competition for promising early-stage companies in high-growth industries. A panel of judges narrowed down 131 applicants to the 25 semifinalists based on a set of criteria that included technology potential, marketing strategy, quality of management team and economic impact. PMDRX, based in Glendale, Ariz., is among companies from California, Ohio, Utah and Virginia, participating in the challenge. Fifty-six percent of the companies, like PMDRX, are IT and software related.

    Medtrade short takes

    Cairewill launch its FreshAire customer portal at Medtrade next week. Attendees will be able sign up early at booth 1419. The portal offers a clinical and patient knowledge center; exclusive monthly discounts; and a frequent buyer program…Breathe will launch its latest app at the show. The app, available for iPhone and Android, allows users to capture electronic physician signatures directly on their mobile devices. Breathe is at booth 1600…NOVO Home will debut the Serta Perfect Lift Chair Collection at booth 1045. Check out the chairs and meet the Serta sheep on Tuesday at 11 a.m. Medtrade takes place Oct. 26-29 in Atlanta.


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    10/28/2015
    Theresa Flaherty

    ATLANTA – Traffic was steady on the Medtrade show floor on Tuesday, and attendees and exhibitors alike were smiling.

    “It looks good, feels good, feels different,” said Kevin Gaffney, group show director. “People seem less cautious and more optimistic. They are dealing with this bidding thing and figuring it out.”

    It’s the expansion of bid pricing to rural areas that brought Tara Ellington from Alaska to Atlanta.

    “It’s super important for us to talk to people who have been dealing with it and gaining insight from that,” said Ellington, director of reimbursement for Geneva Woods Pharmacy in Anchorage. “We want to know how it’s going to impact the market.”

    Ellington also hit several sessions at the show, including the Audit Power Panel and Roundtable held on Monday.

    “That session alone was worth the cost of the ticket,” she said.

    There were plenty of first timers at this year’s show. Jeremy Mason, who’s just getting into the industry, said Medtrade came “highly recommended.”

    “We’ve been working with people to see if we wanted to add HME,” said Mason, director of supply chain management for Beaver Dam Community Hospital, in Beaver Dam, Wis.

    Mason was impressed with the breadth of products available.

    “When I think of crutches, canes and wheelchairs—I didn’t think there were that many manufacturers,” he said.

    While final figures aren’t available yet, Gaffney said attendance was tracking 10% higher than projected. The show also drew 400 exhibitors, some new, many long timers, like Drive Medical, now Drive | DeVilbiss.

    “This is a big year for us with the new brand,” said Ed Link, chief marketing officer. “It’s important to us; it’s important to our customers.”

    Link said traffic at the booth had been “busy from the start.”

    The same was true for Sunset Healthcare.

    “I feel there’s a few less people every year, but the people that are here are stopping by every booth,” said P.J. Ruflin, director of sales. “There’s always a lot of interest—the patient base is growing.”


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    10/30/2015
    HME News Staff

    WASHINGTON – AAHomecare members will receive discounted pricing on DMEPOS surety bonds and liability insurance from VGM insurance, per an agreement hammered out at Medtrade last week. Under the new agreement, AAHomecare memebrs will receive a 10% discount on surety bond and liability insurance premiums. VGM also offers other insurance products specifically for HME providers, including property, business auto, workers' compensation and cyber liability. The agreement is timely, the two groups say, as these kinds of bonds will be required to participate in future rounds of competitive bidding. The discounts will be available to AAHomecare members purchasing directly from VGM Insurance, as well as those purchasing through their insurance agent of choice.

    Aeroflow picks up hospital’s HME biz

    ASHEVILLE, N.C. – Aeroflow Healthcare has acquired Abbeville Area Medical Center’s Home Medical Equipment business out of Greenwood, S.C., to further enhance its position in the upstate of South Carolina. Aeroflow already has offices in Greer, Gastonia and Hendersonville. In addition to lending their experience, resource and support to Abbeville Area Medical Center, Aeroflow has made a donation to the center’s foundation for education, research and continued service to the area and its residents.

    Drive | DeVilbiss products can now be ordered direct from Brightree

    PORT WASHINGTON, N.Y. – Drive | DeVilbiss has partnered with Brightree as an integrated electronic purchasing partner. As a result, HME providers can now order equipment from Drive | DeVilbiss directly from Brightree’s integrated e-purchasing platform. Added benefits: Providers can receive automatic order confirmations and one-touch drop-shipments. “Partnering with Brightree will not only reduce expenses, streamline efficiencies and strengthen the business opportunities of our provider/dealers,” said Harvey Diamond, CEO of Drive | DeVilbiss in a press release. “It will also allow our providers to continually improve care for their patients.” ResMed, McKesson and other manufacturers have hammered out similar partnerships with Brightree.

    Digital health app boosts CPAP compliance, according to study

    SAN DIEGO – A new retrospective study of 2,343 de-identified patient records shows a connection between CPAP usage, digital health applications and high compliance. Researchers found 83.9% of CPAP users who received standard care and used the ResMed myAir application achieved Medicare adherence in the first 90 days of their treatment. “The high level of CPAP adherence this study shows is evidence that myAir is a best practice for getting patients engaged in their care,” said Raj Sodhi, president of ResMed’s Healthcare Informatics Global Business Unit. “It reflects the potential for connected patient engagement tools to spur compliance in a cost- and resource-effective manner, for the benefit of providers, health systems, payers and patients alike.” myAir is a web program that allows patients using ResMed’s AirSense 10 or AirCurve 10 devices to wirelessly track their own nightly sleep data and to receive interactive coaching.

    Medforce provides power for productivity

    SUFFANY, N.Y. – Medforce Technologies has revealed a new brand identity—logo, tag line, product names and website. “Frankly, we’ve been so focused on investing in our technology, our brand and marketing had been neglected,” said Esther Apter, Medforce’s founder and CEO. “Now, our identity accurately reflects our sophistication, our broad suite offerings, and our ability to improve productivity in all areas and departments within a healthcare organization.” Medforce’s new product names—Command Center, RemitCenter, Forms Center, ZipMit—describe how the company’s system can be used as a hub to connect disparate business applications through a centralized resource for workflow management and data storage. “Our new tagline, ‘The Power of Productivity,’ really captures it all,” Apter said.


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    10/30/2015
    HME News Staff

    ATLANTA – Mark Higley laid to bare his predictions for the upcoming Round 2 re-compete during a session at Medtrade last week.

    Higley, vice president of regulatory affairs at the VGM Group, says that the next round of competitive bidding, scheduled to go into effect July 1, 2016, will see more contract offers, with fewer to out-of-state providers and low-ball bidders.

    Higley based his findings on surveys of hundreds of HME providers that submitted bids as part of the program, and data requests to CMS.

    The Round 2 re-compete will see more contract offers because providers are getting “smarter and smarter” about their bids, Higley said. About 15,000 out of the more than 48,000 bids that providers submitted in Round 2 were tossed out, most for incomplete or inaccurate documentation or not meeting state licensure requirements, he said.

    “Many of you didn’t have a chance to play the game, not because you bid too high, but because you made a mistake,” he said.

    There will be fewer out-of-state contract providers because in the Round 2 re-compete CMS has combined product categories like oxygen and sleep, decreasing the number of sleep providers who “bid everywhere” in previous rounds of the program, Higley said.

    “This time around, the category also included liquid oxygen,” he said. “Many CPAP drop-ship suppliers didn’t bid all of the 100 metro areas. That’s good.”

    In the previous round of the program, Higley estimates that half of the providers offered contracts were out of area.

    There will be fewer low-ball bidders because there are fewer bidders, plain and simple, Higley said. From 2010 to 2014, the number of pure-play providers dropped from 13,163 to 11,326. But when you throw out the national chains, that number drops to 5,200, he said.

    The impact of all of these variables on the bid amounts submitted by providers in the Round 2 re-compete will be a 10% overall reduction from the amounts in the previous round, Higley said. For oxygen concentrators, for example, the cut will be 3%, he predicts.

    “It won’t be the 15% that some have suggested,” he said.


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    Democratic co-sponsor, Senate lead have signed on
    10/30/2015
    Liz Beaulieu

    ATLANTA – A bill that would soften the blow of the national expansion of competitive bidding is coming, AAHomecare officials told Medtrade attendees last week.

    Stakeholders already have Rep. Tom Price, R-Ga., committed to introduce the bill, but recently they were able to sign on Rep. Tammy Duckworth, D-Ill., as a lead co-sponsor, making the effort bi-partisan; and Sen. John Thune, R-S.D., as the lead on a companion bill.

    “You want to see the bill already,” said Tom Ryan, president and CEO of AAHomecare. “We kept hearing the first week in September. Then the pope comes to visit and the speaker (steps down). We’re working it. We’re gaining the support. We want this bill here already (too).”

    The bill would add 30% to pricing, softening the blow of what will likely be 45% to 50% cuts in non-bid areas on Jan. 1, and phase in the cuts over four years instead of six months as currently planned.

    Adding 30% to pricing may seem like a tough sell to Congress, but Ryan pointed out that, based on an internal score, the bill would still save $5.5 billion.

    “When you re-message that, it opens their eyes,” he said.

    Also planned to be part of the bill: a demonstration project of the market pricing program or MPP. Price has been a champion of the alternative to the competitive bidding program for four years, but the effort has stalled in the Congressional Budget Office waiting for a score.

    “He still believes MPP is the way to go,” said Jay Witter, vice president of public policy for AAHomecare. “He wants to do the demo and prove that it’s cost effective and then they won’t have a choice.”

    AAHomecare officials also addressed efforts to expand prior authorizations on a national level (“This one Congress loves,” Witter said); to reform the audit program; and to stop scheduled cuts to accessories for complex power wheelchairs (Ryan gave a shout out to Don Clayback, executive director of NCART, which last week succeeded in getting a companion bill to stop the cuts introduced in the Senate).

    To keep all of these initiatives moving forward, AAHomecare officials say they need help. The success of the Midwest Association for Medical Equipment Services and the seven providers in South Dakota in getting Thune’s support is a good example of what can be done, they said.

    “This is what we need to do,” Witter said.

    Ryan said the battles the industry faces are “outrageous,” but wins like getting legislation passed to make binding bids and proof of licensure a requirement of the bidding program prove that it can be done.

    “Be optimistic about the industry,” he said. “You have to be optimistic.”


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    11/05/2015
    HME News Staff

    WASHINGTON – Rep. Scott Tipton, R-Colo., is collecting signatures for a “Dear Colleague” letter that asks for legislative relief from impending Medicare cuts for HME providers in rural areas, VGM announced yesterday.

    On Jan. 1, CMS plans to apply bid pricing in non-bid areas. Though pricing will be slightly higher in rural areas, the agency intends to use regional prices limited by a national ceiling (110% of the average of regional prices) and floor (90% of the average of regional prices).

    “There are already larger barriers to access for home health services in rural parts of the country, and decreasing compensation for the services required to deliver equipment to this area reduces the likelihood that providers will continue to operate there,” wrote Tipton.

    Tipton noted that the 10% adjustment to reimbursement in rural areas will not cover the cost of services provided and questions whether CMS’s phase-in timeline is realistic. He also highlighted concerns about the potential impact the cuts will have on beneficiary access.

    VGM encourages stakeholders to contact their representatives and ask them to sign on to the letter by Nov. 16 before it makes its way to leaders of the House Ways and Means Committee.

     


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    11/06/2015
    HME News Staff

    WASHINGTON – Orthotics and vents are among the HME that the Office of Inspector General plans to focus on in fiscal year 2016, according to a work plan published last week.

    The OIG plans to determine the reasonableness of Medicare fee schedule amounts for orthotic braces. The agency will compare Medicare payments made for braces to amounts paid by non-Medicare payers to identify potentially wasteful spending. It will also estimate the financial impact on Medicare and on beneficiaries of aligning the fee schedule for braces with those of non-Medicare payers.

    Also for orthotics, the OIG plans to review Medicare Part B payments for braces to determine whether the claims of DME providers were medical necessary and were supported in accordance with Medicare requirements. Prior work by the OIG has indicated that some providers were billing for services that were medical unnecessary or were not documented in accordance with Medicare requirements.

    The OIG also plans to describe billing trends for vents, RAD and CPAP devices from 2011-14, as well as examine factors associated with the increase in vent claims. From 2013-14, there has been a 127% increase in allowed amounts for E0464, and during that same period, the number of beneficiaries receiving the devices increased from 8,633 to19,085. The OIG says providers may be inappropriately billing for vents for beneficiaries with non-life threatening conditions, which would not meet the medical necessity criteria for vents and might instead be more appropriately billed to codes for RADs or CPAPs.

    In addition to orthotic braces and vents, the OIG plans to examine provider compliance with payment requirements for power mobility devices, and nebulizer machines and related drugs.

    The agency also plans to examine the effectiveness of system edits to prevent inappropriate payments for blood glucose test strips and lancets to multiple providers, and access to DME in competitive bidding areas.

    Rep. Tipton throws support behind rural providers

    WASHINGTON – Rep. Scott Tipton, R-Colo., is collecting signatures for a “Dear Colleague” letter that asks for legislative relief from impending Medicare cuts for HME providers in rural areas, VGM announced yesterday.

    On Jan. 1, CMS plans to apply bid pricing in non-bid areas. Though pricing will be slightly higher in rural areas, the agency intends to use regional prices limited by a national ceiling (110% of the average of regional prices) and floor (90% of the average of regional prices).

    “There are already larger barriers to access for home health services in rural parts of the country, and decreasing compensation for the services required to deliver equipment to this area reduces the likelihood that providers will continue to operate there,” wrote Tipton.

    Tipton noted that the 10% adjustment to reimbursement in rural areas will not cover the cost of services provided and questions whether CMS’s phase-in timeline is realistic. He also highlighted concerns about the potential impact the cuts will have on beneficiary access.

    VGM encourages stakeholders to contact their representatives and ask them to sign on to the letter by Nov. 16before it makes its way to leaders of the House Ways and Means Committee.

    Max Mobility gets smarter

    ANTIOCH, Tenn. – Max Mobility has created a new position, SmartDrive Educator, and has named Devon Doebele, the Florida territory manager for MSL Associates, to fill it. He will oversee the strategic direction, expansion and education of the company’s SmartDrive wheelchair power assist technology, working with manufacturers like Easystand, Ki Mobility, Roho and TiLite. Doebele will be a member of the company’s executive team and report to President Mark Richter.

    Mediware stands by existing platforms

    LENEXA, Kan. – Mediware will not “sunset” any of its existing platforms in the near future, it told its providers customers in an email blast last week. “We are allowing customers to plan and prepare for any future migration, which we anticipate will occur over several years,” the company stated. “In the meantime, we continue to invest in and update our established products with regulatory revisions, defect changes and enhancements, as required.” In the past few years, Mediware has acquired a number of platforms from different software vendors, including Definitive Homecare Solutions, Fastrack and CareCentric.

    Former Numotion execs launch company

    HARTFORD, Conn. – Well-known industry execs Paul Bergantino and Tim Burfield have launched Lifeway Mobility, which will provide home accessibility equipment like ramps, lifts and bath safety solutions. Bergantino, president of Lifeway, has held several high-profile positions, most recently CEO of Numotion. He also spent five years as CEO of ATG Rehab; Numotion was formed when ATG Rehab and United Seating & Mobility merged in 2013. Burfield, chairman of Lifeway, has worked side by side with Bergantino, holding the CEO post at ATG Rehab prior to Bergantino, and serving as a director at Numotion. "Paul and I look forward to building another company that will enhance the wellbeing of those who face extraordinary challenges every day from the effects of accidents, illnesses and aging," Burfield stated in a press release.

    NSM makes second buy of year

    NASHVILLE - National Seating & Mobility has acquired Garden City, N.Y.-based Home Medical Equipment, the provider announced this week. HME provides seating and mobility systems and home accessibility equipment to all five New York City boroughs. “As we continue to grow our footprint in the Northeast, we’re pleased to add the expertise and dedication of all the HME staff members,” said Bill Mixon, president and CEO of NSM. “Bill (Tobia) and his team have created a great company that we are proud to bring into the NSM family.” Prior to HME, NSM’s most recent acquisition was Denver-based USA Mobility in June.

    BioScrip shows progress

    ELMSFORD, N.Y. – BioScrip today reported third quarter revenues from continuing operations of $247.3 million, a 6.8% increase over the same period last year. Gross profit was $63.1 million, a 3.9% increase, and net loss was $24.2 million, the company reported. BioScrip announced last quarter that it was refocusing on its core infusion business. It sold its non-core pharmacy benefit management business for $25 million, and reduced its workforce by 12%.

    Medtrade exhibitors snag product, booth awards

    ATLANTA – Before Medtrade closed on Thursday afternoon, show organizers bestowed awards on several exhibitors for their products and booths. The Providers Choice Gold Award went to Urifunnel, a product that enhances bathroom sanitation and safety; The Providers Choice Silver Award to EZ-Sit, a product that attaches “arms” to an armless chair, helping the user to stand independently; and the Providers Choice Bronze Award to College Canes, canes decorated with college logos. The Best Booth Award went to Mediware, and the Creative Concept Booth Award went to McKesson Medical-Surgical.

    Renfro launches wholesale website for hosiery

    MOUNT AIRY, N.C. – Renfro in October launched an online store (www.medicalprosocks.com) to provide licensed medical professionals and businesses the opportunity to order hosiery for a variety of medical conditions. While product information on the website is viewable by anyone, medical professionals must request an account to access wholesale pricing and place an order. Once the account is approved, professionals can log in anytime to place orders using a credit card. Orders ship between two to three business days. “The new website gives medical offices, pharmacies and medical supply retailers a quick and easy way to order new or replenishment stock of all our medical hosiery,” said Brad Ballentine, senior vice president. “They can order 24/7 from any device, including desktop and mobile device.” All hosiery is produced under the Dr. Scholl’s or Copper Sole brands.

    Sigvaris marks start of expansion

    PEACHTREE CITY, Ga. – Sigvaris held a groundbreaking ceremony on Nov. 2, kicking off its plans to build a 40,000-square-foot facility with office, manufacturing and warehouse space. The new North American headquarters will allow Sigvaris to move manufacturing, warehouse and customer care all under one roof. Currently, the company occupies two locations. Sigvaris expects the expansion to provide growth opportunities for 10 years and create more than 70 new jobs.

    Short takes: Medtrade, ING Source, Laboratory Tactical, TiLite, BOC

    Attendance for Medtrade, held Oct. 26-29 in Atlanta,was up overall. Registration for educational sessions was up 17%, while non-exhibitor attendance was up 1% compared to last year...ING Source’spending patent application for the FS6 Compression Foot Sleeve has been approved by the U.S. Patent and Trademark Office. “We can now aggressively protect the invention and market creation for which we are so proud, but more importantly, protect the consumers from ineffective look-a-likes and imitators," said CEO Dave Higgins, in a press release…Laboratory Tactical Consultinghas named Bryan Hines COO. Hines previously lead Genpact’s venture into health care and will be responsible for development and operational excellence across the company…More than 50 TiLite employees participatedin the Trios Health Tri-Cities Marathon on Sunday, Oct. 26. Employees worked in teams of four, with each person rolling about 6.5 miles…Claudia Zacharias, president and CEO of the Board of Certification/Accreditation, recently took over as chairwoman of the Institute for Credentialing Excellence (ICE) board of directors. ICE is a professional membership association that advances credentialing through education, standards, research and advocacy.


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