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    05/24/2013
    Theresa Flaherty

    PROVIDENCE, R.I. – State officials have delayed a rate cut to the Medicaid program in response to concerns from HME providers. 

    On April 19, Medicaid officials announced new rates based on the Medicare fee schedule minus 15%. The state planned to implement the cuts retroactive to July 1, 2012, over a period of five payment cycles, starting May 10.

    Needless to say, this didn’t go over well with providers.

    “How can they call it a new rate and go backward?” asked one provider who didn’t want to be named. “Is that legal?”

    It may not be. Last July, the state sent out contracts to providers with rates that now differed from the rates announced in April.

    “You have the companies that did sign those contracts last year and nine months later learn that the state is going to take all this money back,” said Karyn Estrella, executive director of the New England Medical Equipment Dealers.

    There’s also some confusion about whether the new rates affect every product category because there is no fee schedule for certain items, like incontinence supplies.

    “I am assuming they are including incontinence,” said the provider. “No one has been able to answer that question for me.”

    NEMED in May planned to meet with state officials to discuss the change.


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    05/24/2013
    Elizabeth Deprey

    SALT LAKE CITY – Would having a physical therapist (PT) prescribe HME speed up a patient’s discharge from the hospital? 

    Lori Pearlmutter thinks so. 

    “We make the decision on what the patient needs and then we have to wait for the physician—maybe a hospitalist whose shift has ended or a doctor who gets called into surgery,” said Pearlmutter, director of therapy and cardiac rehab at Flagstaff Medical Center in Flagstaff, Ariz. 

    That wait time can keep patients in the hospital for up to a day longer, she said.

    Pearlmutter has introduced a motion for consideration by the American Physical Therapy Association (APTA) at its House of Delegates meeting in June that, if passed, would clear the way for the APTA to support allowing PTs to prescribe HME. (Ultimately, making such a change to Medicare policy would require a bill amending the Social Security Act.) 

    Whether the motion passes or not, Laura Cohen says having the proposal on the floor will shine a much-needed spotlight on HME and industry issues like competitive bidding.

    “Probably less than 1% of the PTs in the country even know what competitive bidding is,” said Cohen, executive director of The Clinician Task Force. “They’re going to be rudely awoken July 1 when competitive bidding is introduced in their neighborhood.”

    For their part, providers agree having PTs prescribe HME makes sense. 

    “Most of the time, we’re working with the PTs, anyway,” said Scott Soderquist, president of Rehab Equipment Associates in Manchester, N.H. “This would take a layer out of the bureaucracy.”

    Still, provider Doug Westerdahl would like to ensure PTs receive special training to prescribe complex rehab.

    “The majority of PTs are not familiar with seating and positioning,” said Westerdahl. “Some kind of specialty credential, like the ATP, would be needed.”


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    05/24/2013
    Theresa Flaherty

    WASHINGTON – Rep. Glenn Thompson, R-Pa., told attendees at AAHomecare’s Washington Legislative Conference last week that he plans to introduce legislation seeking a delay in Round 2 of competitive bidding.

    The move is necessary in light of licensing issues in multiple bid areas, he said.

    “The awarding of bids to unlicensed suppliers is (an issue) truly in need of a subcommittee hearing and I plan to ask for that,” Thompson told attendees. “We will need people to go to the floor to elevate this.”

    Licensure requirements were a hot-button issue at the conference and even lawmakers have taken up the rally cry. Rep. Tom Price, R-Ga., met with CMS officials May 21 to discuss the problem.

    Members of the Tennessee delegation have also sent a letter to CMS Acting Administrator Marilyn Tavenner on May 20 voicing their concerns.

    “We saw how blatantly CMS is violating its own rules,” Rep. Marsha Blackburn, R-Tenn., told attendees.

    With the July 1start date of Round 2 of competitive bidding right around the corner, the HME industry needs to shift into crisis mode, say stakeholders.

    “We have a calamity on our hands,” Tom Ryan, founder and CEO of Farmingdale, N.Y.-based Homecare Concepts, told attendees. “Nearly 80% of good businesses will be excluded from providing (Medicare). There is no room for apathy in this industry any more.”

    The approximately 260 attendees had two tasks during their 300 visits on Capitol Hill: Ask lawmakers to support H.R. 1717, a bill to replace competitive bidding with a market-pricing program (MPP), and to support the delay.

    “It’s time to have some candid conversations about H.R. 1717,” Price told attendees. “Tell your members it’s bipartisan, it doesn’t cost any more money. (Tell them) if you don’t like the way we’ve solved it, tell us what you want us to do.”

    Price introduced H.R. 1717 on April 24. It currently has 96 co-sponsors, with more expected in the wake of the conference. What about a Senate companion bill?

    “It’s just not going to happen,” Dean Rosen with Mehlman Vogel Castagnetti, a lobbying firm, told attendees. “The Senate Democrats are extremely gun shy about health care because they don’t want to provide any opportunity for Republicans to attack the Affordable Care Act.”

    Despite everything, providers remain both resolute and upbeat.

    “Somehow or another, I still believe that Round 2 will be at least delayed,” said attendee Scott Soderquist, president of Manchester, N.H.-based Rehab Equipment Associates. “I just can’t see how it can’t.”


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    'We’re trying to put the cow back in the barn,' she says
    05/24/2013
    Leif Kothe

    WASHINGTON – Of the two providers that were subpoenaed to testify at a second congressional hearing on HME business practices on May 22, one invoked the Fifth Amendment and the other said he “wants to play by the rules.”

    Jon Letko, president of Milford, N.J.-based U.S. Healthcare Supply, invoked the Fifth Amendment before the Senate Subcommittee on Financial and Contracting Oversight, leaving Sen. Claire McCaskill, D-Mo., visibly surprised.

    “We are hopeful that, at some point in time, your company will be in a position that you can speak to the committee under oath in the same manner that you were willing to speak to the press,” said McCaskill, who chairs the subcommittee.

    After receiving invitations to testify at the subcommittee’s opening hearing on April 24, both Letko and Dr. Steve Silverman, president of Boca Raton, Fla.-based Med-Care Diabetic Medical Supplies, declined to attend. McCaskill said she regretted that the subcommittee had to resort to issuing subpoenas.

    McCaskill questioned Silverman for the better part of an hour. Of particular concern for the senator was the aggression with which Silverman’s company allegedly markets its products to elderly citizens. Med-Care Diabetic was recently the object of complaints by a Missouri beneficiary and a physician for what they believe are overbearing tactics.

    “Regarding the rules and regulations, we are regulated, we are inspected, and whatever rules and regulations there are, I give it my best effort for myself and all my employees for us to follow this,” Silverman said. “I want to play by the rules.”

    McCaskill was not so quick to blame aggressive marketing on providers. She said it was less a symptom of unscrupulous providers than, prior to competitive bidding, an unregulated system.

    “The government set up a system that people believed would be a free market of competition that would drive costs down,” she said. “It turns out that without competitive bidding and with the free-for-all among seniors with marketing, it didn’t work out that way.”

    She added, “We’re trying to put the cow back in the barn.”

    When asked to discuss competitive bidding, Silverman was guardedly optimistic.

    “I’m in favor of competitive bidding, but I have some concerns based on pricing (and) I have some concerns based upon capacity,” he said. “There are 25 million diabetic patients in the country and competitive bid contracts were awarded to only 10-15 providers.”


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    05/24/2013
    Elizabeth Deprey

    WASHINGTON – Three recent changes to the Program Integrity Manual could give providers some relief from common documentation woes, say industry attorneys.

    At the top of the list: a clarification of CMS’s policy on templates.

    “CMS does not prohibit the use of templates to facilitate record-keeping,” reads the new language in the manual, published in March.

    Other clarifying language addresses attestations and physician responsibility.

    Templates

    Providers have been conflicted about the use of templates and forms to help physicians document the information needed to qualify a patient for HME, since many of these tools haven’t held up under CMS’s scrutiny. They should still be cautious, says Edward Vishnevetsky, an associate with Munsch Hardt in Dallas.

    “The template cannot take the place of the physician’s documentation,” he said. “It can be a blueprint for a physician to know what to address, but you need the clinical documentation to support what’s in the template.”

    Attestations

    Attorney Neil Caesar says language allowing physician attestations for clinical issues that are not adequately documented in the progress notes is a “huge improvement.”

    “CMS has taken a dim view of anything that altered the record, even if that alteration was remedial,” said Caesar, president of the Health Law Center in Greenville, S.C. “Allowing physicians to add things will benefit all suppliers.”

    Still, attestations can’t justify medical necessity by themselves, and providers should try to fill in documentation gaps as soon as possible, says Denise Fletcher, an attorney with Amarillo, Texas-based Brown & Fortunato.

    “It has to be contemporaneous with the provision of the equipment—how would the doctor remember seeing the patient two years later?” she said. “This could be a valuable tool, but if you’re too far removed, it won’t be effective.”

    Physician responsibility

    New language in the manual also makes doctors responsible for providing patient records. If they don’t provide those records, they could face a MAC or RAC review, the manual states.

    While Fletcher is unsure of how this will be enforced, it has the potential to provide extra leverage for providers struggling to get the documentation they need. 

    “It could be a chance for providers to say, ‘You have to give us the records, and here’s why,’” she said.


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    05/24/2013
    Liz Beaulieu

    OKLAHOMA CITY – Though they weren’t directly affected by the devastating tornado that plowed through nearby Moore on May 20, it hasn’t been business as usual for two HME providers in Oklahoma City.

    Provider Larry Pierce says the biggest obstacle immediately following the tornado was trying to maintain communication with patients.

    “At 5, our phones roll over to an answering service and that went down the night of the tornado, so we had to rely on cell phones,” said Pierce, president and executive director of CareSource. “But those went down, too. Some texts got through, some didn’t.”

    The tornado hit Moore at about 2:45 p.m., damaging or destroying thousands of homes, businesses, schools and hospitals. At its peak, the tornado packed winds of 210 miles per hour, according to news reports.

    Pierce was able to account for all of his patients in the affected area—although, for one patient, it was touch-and-go for a while, he says.

    “We couldn’t get ahold of one patient and his son was the secondary number and when we reached him he said he couldn’t get ahold of him, either,” he said. “But we got him oxygen before it got too bad.”

    While phone service is back up, an obstacle that continues to affect providers: poor travel conditions due to the flash floods that followed the tornado and the heavy presence of law enforcement and other officials, Pierce says.

    “Usually, we can get to patients in two to four hours, now it’s five to six,” he said.

    Provider Thomas Hoover says he’s also standing by to provide replacement medical equipment to those affected.

    “We’ve given away a couple of things, and we’re ready to do more,” said Hoover, CFO of Advantage Mobility. “We have so much stuff for demos, and even if it’s not a perfect fit, it’s enough to keep them rolling until they can get something more specific.

    “Everyone’s trying to do the right thing,” he added. 


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    05/24/2013
    HME News Staff

    WASHINGTON – More than a dozen consumer groups are throwing their support behind H. R. 1717, a bill to replace competitive bidding with a market-pricing program (MPP), according to AAHomecare. The groups are lining up to sign a letter from United Spinal Association endorsing the bill. The letter began circulating on May 20, just as stakeholders hit the Hill as part of the AAHomecare Washington Legislative Conference. “When you call or email your members of Congress, make sure they know that the bill has strong support from patient and consumer groups,” AAHomecare told members in its weekly Wednesday in Washington report. Consumer organizations backing the bill include Shepherd Center, Disability Rights Center and Christopher and Dana Reeves Foundation.

    Fisher & Paykel breaks records

    AUCKLAND, New Zealand – Fisher & Paykel Healthcare reported net profit after tax of NZ$77.1 million for the year ended March 31, 2013, according to a press release. The record earnings reflect a 20% increase compared to the prior year. Full-year operating revenue climbed 8% above the prior year to NZ$556.3 million, also a record. Growth was fueled primarily by strong demand for products in two groups: respiratory and acute care, and obstructive sleep apnea (OSA). Michael Daniell, CEO of Fisher & Paykel, said in the release that the company’s Pilairo nasal pillow and Eson nasal masks drove OSA revenue growth of 16% in the second half of the year. The company increased expenses on research and development by 9% from the previous year, as it looks to expand its product lines. “We expect our underlying revenue growth to continue to be robust this year, driven by a broad range of new products and applications,” Daniell stated. 

    Inova secures $12M in financing

    AUSTIN, Texas – Inova Labs, maker of the LifeChoice oxygen concentrator, has completed a $12 million round of financing, according to an article from the Austin Business Journal. The company collected the capital from six investors, according to a recent filing with the U.S. Securities and Exchange Commission. In 2011, Inova Labs raised $3.1 million of a planned $17.5 million Series B round of funding from five investors. In 2010, the company secured a $10 million Series A round of funding from a sole investor, Three Arch Partners, according to the article.

    Norco acquires two providers 

    BOISE, Idaho – Norco, a full-line HME provider based here, has made two acquisitions in the Northwest, according to a press release. Care Medical is a respiratory and medical supply company with six locations in the Portland and Seattle region, and Walgreens Respiratory Services has four locations in the Seattle and Vancouver region. Norco adds 200 employees as a result of the deals; it already employs 950. Norco operates branches in Idaho, Montana, Oregon, Nevada, Utah, Washington and Wyoming. It now has 26 branches in Oregon and Washington. Norco was awarded competitive bidding contracts in the Seattle and Portland areas.

    Wright & Filippis exits diabetes market

    ROCHESTER HILLS, Mich. – Wright & Filippis has entered into an agreement to divest its diabetic supply business to US MED. The reason: The company did not receive a contract to provide diabetes supplies as part of a national mail-order program that will go into effect July 1. US MED, along with 17 others, did receive a contract. “Because of this change, we decided it was an appropriate time to sell our diabetes supply business to US MED,” stated AJ Filippis, president of Wright & Filippis, in a press release. Due to the divestiture, Wright & Filippis will reduce its workforce by 3% over a 60-day period, according to the release. The company operates 35 locations and employs more than 900. Wright & Filippis will now focus on its “traditional strengths” of orthotics and prosthetics, Filippis stated. Earlier this year, the company bought a controlling share of Carolina Orthotics & Prosthetics in North Charleston, S.C.

    Study: CPAP may benefit those with prediabetes

    PHILADELPHIA –Prediabetic patients with obstructive sleep apnea (OSA) saw significant improvement in their glucose levels after CPAP treatment, according to a small clinical trial. The study, conducted by researchers at McGill University and the American Thoracic Society (ATS), found that glucose levels declined to favorable levels for patients treated with CPAP devices, while those levels increased in a control group, according to a press release from the ATS. “We found that optimal treatment of sleep apnea with positive airway pressure for two weeks led to significant improvements in glucose levels,” stated Shumita Pamidi, MD, of McGill University, who led the study. Pamidi added that this may signal “an improvement in insulin sensitivity” among those who receive CPAP treatment, according to the release. 

    CVS sticks with diabetes supplies

    WOONSOCKET, R.I. – Despite drastic changes set to take effect July 1, CVS will continue to provide diabetes supplies to Medicare patients, according to a press release. On that date, only 18 contract suppliers will be able to provide diabetes supplies through mail order. Providers with retail locations, like CVS, may continue to provide supplies but they must do so at the mail-order rates, which are 72% below the current fee schedule. CVS also plans to stock all major brands of diabetes supplies. The company’s pharmacists will be available to assist patients with any new paperwork that may be required as part of the changes, the release noted.

    Gov’t, TENS provider resolve lawsuit

    COLUMBIA, S.C. – The government and RS Medical, a provider of TENS units and orthotics supplies, have reached a settlement for more than $1.2 million to resolve claims that employees at the company submitted false claims for several products, according to a press release from the Department of Justice. The documents lacked physician orders, the required documentation and/or medical necessity, according to the DOJ. The investigation began in February 2011 when whistleblower Sally Balentine filed a qui tam lawsuit in federal court under the False Claims Act. A whistleblower provision allowed Balentine to file a lawsuit on behalf of the government because she had information that the defendant violated the act. In addition to submitting false claims for TENS units, two RS Medical locations in South Carolina and Illinois submitted false claims for back braces, knee braces, muscle stimulators and cervical traction systems, the release noted. Balentine will receive more than $242,9333 from the proceeds of the settlement, plus $80,000 to cover attorney fees and costs. 

    John McCain to accept award from United Spinal

    NEW YORK – U.S. Sen. John McCain, R-Ariz., will be on hand at United Spinal Association’s annual legislative conference in June to accept an award for his support of disabilities rights, according to a press release. At the association’s 2nd annual Roll on Capitol Hill, scheduled for June 16-19 in Washington, D.C., McCain will be awarded the VetsFirst Congressional Bronze Star Award for his efforts to ratify the UN Convention on the Rights of Persons with Disabilities, a treaty addressing disability rights on a global level. VetsFirst is a program within the United Spinal Association. Other lawmakers receiving recognition at the event will include Sen. Jay Rockefeller, D-W.V., and Sen. Xavier Becerra, D-Calif., who will receive, respectively, the James J. Peters Disability Rights Champion Award, and the Junius A. Kellogg Award for Outstanding Congressional Leadership, the release noted.

    CMS wants feedback on template for prostheses

    WASHINGTON – CMS plans to host a conference call May 28 to allow providers, physicians and other parties to weigh in on a possible nationwide electronic clinical template for lower limb prostheses. CMS is exploring the development of a template to assist providers with data collection and documentation submission, and to enhance physician understanding of documentation requirements. The template will describe data elements that CMS believes would support proper documentation requirements. The call is slated for 2-3 p.m. EST. To participate, call 800-837-1935 and use the ID 75391152.

    Carolina’s HME teams up with hospice provider

    CHARLOTTE, N.C. – Carolina’s Home Medical Equipment has entered into a preferred provider relationship with Hospice & Palliative Care Charlotte Region (HPCCR), a not-for-profit organization for patients with advanced illnesses, according to a press release. The relationship will offer HCPPR better control over costs, forecasting and budgeting, the release noted. “This enhanced collaboration will allow us to provide more efficient care to our patients, while at the same time help us to manage our costs and control our budget,” stated Peter Brunnick, HPCCR president and CEO. The organizations anticipate a smooth transfer of services under the partnership.

    Docs to CMS: Streamline prescription process

    LEAWOOD, Kan. – The American Academy of Family Physicians, an organization representing family doctors and medical students, is calling on CMS to simplify the Medicare requirements for prescribing diabetic supplies, according to a press release. The organization wants CMS to allow physicians to use more generic terms when writing prescriptions and to allow them to write open-ended prescriptions, the release noted. AAFP Board Chair Glen Stream, M.D., said in a letter to CMS that lengthy requirements for Medicare glucose testing supplies often result in processing errors. He also said that having to specify the exact brand of machine, test strips or lancets needed by the patient can be onerous, and that the information is often immaterial. “Family physicians simply want to be able to efficiently and effectively prescribe what their diabetic patients need to help manage their condition in a way that maintains their health,” Stream wrote in the letter. “The current Medicare rules surrounding prescription of diabetic supplies impede this goal and add no discernible value to the care of such patients.”

    People news

    Mike Klooshas been named president of VGM Insurance, replacing Tom Jones, who retires May 31. Kloos joins VGM from TCF Equipment Finance, where he was senior vice president of strategic business development…James Binson, president of Binson’s Home Health Care Centers was honored recently with the 2013 Alumni Achievement Award from Northwood University in Midland, Mich. With seven locations in Michigan and two in Florida, Binson’s Home Health Care Centers will be celebrating its 60th anniversary in July…All-States Medical Supply has promoted Jason De Los Santos to president. Previously, he was vice president of operations.


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    05/28/2013
    HME News Staff

    ELYRIA, Ohio – A shareholder of Invacare Corporation has filed a lawsuit in the U.S. District Court for the Northern District of Ohio over alleged violations of federal securities laws by the company, according to a press release.

    On behalf of certain Invacare investors, the plaintiff accuses Invacare and certain senior executives of violating provisions of the Securities Exchange Act of 1934 by issuing “false and misleading press releases, financial statements, filings with the Securities and Exchange Commission (SEC), and statements during investor conference calls,” according to the release. The allegedly false statements were made between July 22, 2010, and Dec. 7, 2011, the release noted.

    More specifically, the plaintiff alleges that Invacare and certain senior executives misled investors with respect to the company’s noncompliance with Food and Drug Administration (FDA) guidelines and Current Good Manufacturing Practices (CGMP.)

    The plaintiff accuses the company of concealing from investors a series of FDA warnings, known as Forms 483, which identified compliance violations, and with masking the fact that the company suffered from “widespread operational, quality, and regulatory deficiencies,” the release noted.

    In the months after July 8, 2011, when Invacare shares reached a high of $34.00 per share, the plaintiff alleges that the company “downplayed the scope and significance of Invacare’s compliance issues, despite its receipts of two additional Forms 483 in August 2011, which were allegedly concealed from investors,” the released stated.

    Earlier this month, Invacare, as part of a consent decree with the FDA, announced that the federal agency had approved the first of three audits, allowing the company to resume certain production at its Taylor Street facility. The company is waiting to hear about the second audit submitted for approval, which would allow the company to resume design activities. The third and final audit, a review of the company’s compliance with the FDA’s Quality System Regulation, is underway.


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    05/29/2013
    HME News Staff

    WASHINGTON – The Office of the Inspector General (OIG) is calling for improvements to the Provider Enrollment, Chain, and Ownership System (PECOS) and the National Plan and Provider Enumeration System (NPPES), after a sample of stored Medicare provider records contained errors.

    In a report issued May 28, the agency also found that CMS did not verify most provider information in either enrollment database.

    “Medicare provider data in NPPES and PECOS were often inaccurate and occasionally incomplete and were generally inconsistent between the two databases,” an OIG press release stated.

    In PECOS, provider data were inaccurate in 58% of records, while in NPPES, 48% of records were inaccurate.

    Moreover, provider data were inconsistent between NPPES and PECOS for 97% of records. The most common inaccuracies were with addresses, necessary for contacting providers and identifying trends in fraud and waste, according to the release.

    The OIG recommends that CMS implement program integrity safeguards for Medicare provider enrollment, require more verification of enrollment data, and better detect and correct inaccurate and incomplete data for new and established records, according to the release. CMS concurred with all three recommendations.

    Once implemented, PECOS edits, whose start date was recently delayed due to technical issues, will deny claims that contain the names of physicians not enrolled in the system.


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    05/30/2013
    HME News Staff

    SEATTLE – The Small Business Administration (SBA) plans to conduct a field hearing in which providers can voice their concerns about the negative impact of competitive bidding and Medicare audits on small businesses, according to a bulletin from the VGM Group.

    To testify at SBA’s Regulatory Fairness Hearing, slated for June 6 at The Rainier Club in Seattle, providers should register in advance by contacting VGM Government Relations. Those unable to testify in person have the option of submitting written testimony here.

    A CMS representative will be present at the hearing, the bulletin noted.

    Even before the expansion of competitive bidding, set to go into effect July 1, providers—particularly small business owners—were already feeling the adverse effects of the program. Last July, AAHomecare, in conjunction with The VGM Group, NAIMES and several other industry associations, gathered a list of more than 450 businesses negatively affected by Round 1 of competitive bidding in response to a request from Rep. Pat Tiberi, R-Ohio.


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    05/30/2013
    HME News Staff

    SEATTLE – The Small Business Administration (SBA) plans to conduct a field hearing in which providers can voice their concerns about the negative impact of competitive bidding and Medicare audits on small businesses, according to a bulletin from the VGM Group.

    To testify at SBA’s Regulatory Fairness Hearing, slated for June 6 at The Rainier Club in Seattle, providers should register in advance by contacting VGM Government Relations. Those unable to testify in person have the option of submitting written testimony here.

    A CMS representative will be present at the hearing, the bulletin noted.

    Even before the expansion of competitive bidding, set to go into effect July 1, providers—particularly small business owners—were already feeling the adverse effects of the program. Last July, AAHomecare, in conjunction with The VGM Group, NAIMES and several other industry associations, gathered a list of more than 450 businesses negatively affected by Round 1 of competitive bidding in response to a request from Rep. Pat Tiberi, R-Ohio.


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  • 05/31/13--12:02: Proposed rule goes too far
  • 05/31/2013
    Elizabeth Deprey

    WASHINGTON – Providers with high error rates could lose their billing privileges if a proposed rule takes effect.

    The Department of Health and Human Services published a proposed rule in the Federal Register April 29 that contains a provision that would expand Medicare’s authority to revoke billing privileges to cases where the provider “has a pattern or practice of billing for services that do not meet Medicare requirements.”

    That’s going too far, say stakeholders.

    “This is not revocation for fraud,” said Steve Azia, counsel at Washington, D.C.-based Baker Donelson. “A provider could lose billing privileges based on an error rate that’s often overturned.”

    The provision basically does away with due process, said Azia.

    “What’s the point of the appeals process if this goes through?” he said.

    The criteria for revoking billing privileges are still unknown. The provision outlines a likely scenario—revocation based on a significant number of denials for medical necessity over time—but seeks input on the number of claim denials that might trigger the review, and the length of time over which those denials occur. CMS also seeks input on whether the amount of time a provider was enrolled in Medicare before the denials should be taken into consideration. 

    “They’re not laying out guidelines,” said Azia. “They’re asking for this authority, but they’re also asking for input on the standards. It’s very important for the provider community to weigh in and protect their rights.”

    Providers have until June 28 to comment on the proposed rule. To comment electronically, providers can go to www.regulations.gov.


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    05/31/2013
    HME News Staff

    WASHINGTON – With Congress on recess until June 3, industry stakeholders hope extending the deadline for a “Dear Colleague” letter will allow time to get more signatures. The letter to CMS, co-authored by Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, urges lawmakers and CMS to support an administrative delay for Round 2 of competitive bidding. "It should provide the opportunity to get well over 100 signatures," said Seth Johnson, vice president of government affairs for Pride Mobility. Johnson, who believes the deadline could be extended through next week, said the number of signatures, as of press time, was about 72. The letter, which highlights congressional concerns about CMS's lack of transparency, and about CMS's violation of certain state licensure requirements, may be the best means of applying pressure to achieve a delay, stakeholders say. "From our perspective our focus is on a political push; a legislative push is much tougher," says Cara Bachenheimer, senior vice president of government relations for Invacare. "With the licensure issues we have a pretty compelling message that a lot of folks on Capitol Hill can support." A delay would give the industry more time to get H.R. 1717, a bill to replace competitive bidding with a market pricing program, passed and implemented. It currently has 96 co-sponsors.

    Reps. to CMS: Reconsider delivery restrictions on diabetes supplies

    WASHINGTON – A bipartisan group of congressmen, led by Reps. Aaron Schock, R-Ill., and Peter Welch, D-Vt., are questioning Medicare’s decision to prohibit independent community pharmacies from providing same-day, home delivery of diabetes testing supplies to homebound seniors, according to an National Community Pharmacy Association (NCPA) press release. “If implemented in July 2013, this policy will cause disruption in the care provided to Medicare patients,” the letter stated. “Now that retail and mail order suppliers receive the same level of reimbursements, we believe there is no further reason to prohibit home delivery by retail pharmacies.” In the release, Douglas Hoey, RPh, MBA, NCPA CEO, characterized the policy as “absurd” and “indefensible,” and said it must be overturned. The American Taxpayer and Relief Act, passed in January, lowered the payment rate for diabetes testing supplies obtained at retail locations to the national mail-order program rates.

    OIG: PECOS, NPPES data 'inaccurate'
    WASHINGTON – The Office of the Inspector General (OIG) is calling for improvements to the Provider Enrollment, Chain, and Ownership System (PECOS) and the National Plan and Provider Enumeration System (NPPES), after a sample of stored Medicare provider records contained errors. In a report issued May 28, the agency also found that CMS did not verify most provider information in either enrollment database. “Medicare provider data in NPPES and PECOS were often inaccurate and occasionally incomplete and were generally inconsistent between the two databases,” an OIG press release stated. In PECOS, provider data were inaccurate in 58% of records, while in NPPES, 48% of records were inaccurate. The most common inaccuracies were with addresses, necessary for contacting providers and identifying trends in fraud and waste, according to the release. The OIG recommends that CMS implement program integrity safeguards for Medicare provider enrollment, require more verification of enrollment data, and better detect and correct inaccurate and incomplete data for new and established records. CMS concurred with all three recommendations.

    VGM calls on providers to testify at small business hearing
    SEATTLE – The Small Business Administration (SBA) plans to conduct a field hearing in which providers can voice their concerns about the negative impact of competitive bidding and Medicare audits on small businesses, according to a bulletin from the VGM Group. To testify at SBA’s Regulatory Fairness Hearing, slated for June 6 at The Rainier Club in Seattle, providers should register in advance by contacting VGM Government Relations. Those unable to testify in person have the option of submitting written testimony here. A CMS representative will be present at the hearing, the bulletin noted.

    DeVilbiss moves home

    SOMERSET, Pa. – DeVilbiss Healthcare, a provider of respiratory supplies, plans to create between 20 and 25 full-time jobs by moving its manufacturing operations from China back to Somerset, Pa., according to a press release. The company expects to complete the move by the end of September 2013. Production lines for the DeVilbiss iFill Portable Oxygen Filling Station have returned to the United States, and the company is in the process of moving several lines of compressor nebulizers and oxygen concentrators back as well, the release noted. The relocation was facilitated by a U.S. Department of Agriculture rural development loan, which will help cover the costs of purchasing and installing manufacturing equipment. DeVilbiss in 2007 moved several production lines to China to decrease costs. The company cited improving economic circumstances and product efficiencies as catalysts for bringing the jobs back to the United States.

    Providers clean up

    SALT LAKE CITY – For the fifth straight year Alpine Home Medical Equipment received Utah’s Best of State award in the merchandising and consumer services category, according to a press release. Criteria for the nomination include the company’s background and mission, financial achievements, customer satisfaction, product quality, workforce skills, innovations, acquisitions and membership affiliations, to name a few. Alpine Home Medical also won the Pro Patria Award, presented annually by the Employer Support of the Guard and Reserve (ESGR) to companies demonstrating support to National Guard and Reserve employees through their leadership and practices….Home Care Medical, based in New Berlin, Wis., reeled in a community partnership award from the University of Wisconsin-Milwaukee, according to a press release. Home Care won the award for the multiple workshops focusing on mobility products that the company's complex rehab team presented at the university.

    AAHomecare members elect new directors

    WASHINGTON – AAHomecare bid farewell to several directors, while welcoming others to the board during its annual membership meeting held during the association’s Washington Legislative Conference May 22-23, according to a bulletin from the organization. During the meeting, in which AAHomecare and NAIMES officially merged, Robert Steedley, president of Barnes Healthcare Services in Valdosta, Ga., was appointed as chairman. In addition to Steedley, the executive officers at AAHomecare include: John Letizia, vice chair, of Laurel Medical Supplies; Scott Meuser, secretary, of Pride Mobility Products; Alan Landauer, treasurer, of Landauer Metropolitan.

    Woman sentenced for $11M fraud scheme

    LAS VEGAS – A Nevada woman who defrauded Medicare of $11.1 million in an HME billing scheme was sentenced to more than four years in prison, according to a press release. Her sentence also includes three years of supervised release, and criminal forfeiture of $11.1 million in assets. Alegria Phankonsy, 43, formerly of Orange County, Calif., pleaded guilty in November 2012 to one count of healthcare fraud and one count of tax evasion. Between March 2005 and Feb. 2011, Phankonsy operated several HME companies in Las Vegas, using multiple aliases. During that time, she fraudulent billed Medicare for medical equipment, including leg prostheses and power wheelchairs, which had not been ordered by a physician, were not needed by clients or were not provided to clients at all. To identify clients, Phankonsy enlisted marketers in southern California to obtain Medicare information from individuals, which was then used to bill Medicare for the unnecessary items. In addition, Phankonsy, by underreporting $7.8 million in gross receipts, bilked the government out of approximately $2.4 million, according to the release.

    Vendor short takes

    Covidien received approval to offload its pharmaceuticals division, Mallinckrodt, which will take place June 28 … The VGM Group has partnered with the van Halem Group to offer members discounted rates for monthly compliance packages … Breathe Technologieshas received Food and Drug Administration approval for its Breathe Sleep System…Invacare is sponsoring the 27th annual National Veterans Golden Age Games, scheduled for May 30-June 4 in Buffalo, N.Y. … Convaid created a new Fund-A-Chair Program designed to raise funds for families toward the purchase of a Convaid wheelchair… CPAP Horizon Project’s new software application for providers, ManageMyCPAP, is now in the beta testing phase … The Action Bag Company was named one of the 2013 best places to work in Illinois by the Daily Herald Business Ledger, in partnership with the Human Resources Management Association of Chicago, the Illinois State Chamber of Commerce, and the Workforce Boards of Metropolitan Chicago.


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    06/05/2013
    HME News Staff

    BALTIMORE – Add Maryland to the growing list of states where there are confirmed reports of Round 2 contract suppliers that don’t meet licensure requirements.

    The Maryland Office of Healthcare Quality, which licenses and certifies healthcare facilities, has confirmed to the Maryland National Capital Homecare Association (MNCHA) that there are more than 100 contract suppliers that don’t have the licenses they need to legally serve patients.

    “Across Maryland, licensed providers are outraged at the prospect of transferring their patients to unlicensed providers,” stated Ann Horton, executive director of MNCHA in a press release. “It is shocking that Medicare can simply choose not to follow their own rules, while awarding the majority of Maryland contracts to out-of-state providers.”

    Per Medicare’s rules, providers that submitted bids had to meet licensure requirements in the areas they submitted bids by May 1, 2012. The three areas in Maryland are Baltimore-Towson, Washington-Arlington-Alexandria and Philadelphia-Camden-Wilmington.

    Other states that have reported similar issues include Tennessee, Ohio and Michigan.

    Industry stakeholders have used the information to press lawmakers for a delay in the July 1 start date of Round 2. A “Dear Colleague” letter being circulated by Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, currently has 143 signatures with more expected by its June 7 deadline.

    CMS has sent letters to unlicensed and/or unaccredited contract suppliers stating that they must have licensing in place by July 1, but stakeholders say, in many cases, that isn’t feasible.


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    06/06/2013
    HME News Staff

    WASHINGTON – CMS says its anti-fraud efforts in 2011 and 2012 have recovered more than $14.9 billion in healthcare fraud, judgments, settlements and administrative impositions, according to a press release.

    A big reason for the agency’s success: new fraud-fighting powers and tools in the Affordable Care Act (ACA).

    Since March 2011, when the ACA was signed into law, the agency has revoked the ability of 14,663 providers to bill the Medicare program, compared with 6,307 revocations in the two years prior. Revocations have doubled in 35 states. Those removed from the program had felony convictions, were not operational at the filed address, or were not in compliance with rules, according to the release.

    As part of its ongoing efforts to enlist seniors in the fight against fraud, CMS also says it’s redesigning its Medicare Summary Notices, which Administrator Marilyn Tavenner describes as an easier way for seniors to understand the services they’re receiving.

    “It’s an important tool for staying informed on benefits, and for spotting potential Medicare fraud by making the claims history easier to review,” she stated.

    The updated summary notices are also intended to simplify the process of filing appeals if claims are denied, and to make it easier to identify claims for services that were never received.

    In April, CMS announced a proposed rule that would increase up to $9.9 million the rewards paid to Medicare beneficiaries and other parties whose tips lead to successful recoveries of fraudulent claims. 


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    06/07/2013
    Liz Beaulieu

    LOUISVILLE, Ky. – When it comes to the steep cuts Medicare plans to implement as part of Round 2 of competitive bidding, industry stakeholders have been waiting for the other shoe to drop.

    In the wake of the announcement of the cuts—on average, 45% below the current fee schedule—there have been reports of private payers and Medicaid programs looking to slash pricing. But now, it looks like it’s happening on a much bigger scale.

    Health insurance giant Humana on May 30 notified providers via a notice on its website that it will follow Medicare’s lead and, starting July 1, pay for DME and mail-order diabetes supplies in 91 cities using pricing from Round 2 for its Medicare Advantage (MA) plans. Humana also notified members of those plans by mail.

    The notice on Humana’s website appeared to be down much of last week but a spokesman for the company provided this new link late on Friday: https://www.humana.com/provider/medical-providers/education/whats-new/dm....

    Stakeholders had thought maybe Humana was having second thoughts.

    “We thought they may be relooking at it,” said said Jay Witter, vice president of government affairs for AAHomecare.

    But that may have been wishful thinking for a company that hasn’t exactly ingratiated itself with providers. Two years ago, Humana announced on its website that it had established a “long-term relationship” with Apria Healthcare and that it was terminating relationships with “several providers.”

    Stakeholders are still puzzled by this sentence in the notice: “This implementation affects only non-network providers.” Does this mean in-network providers won’t be subjected to the reduced pricing?

    “That could be interpreted many different ways,” Witter said.

    Humana would be jumping the gun if it adopts pricing from Round 2 right off the bat, says provider Cory Baker, who has been negatively impacted by the company’s relationship with Apria.

    “It hasn’t even been proven that these rates are sustainable,” said Baker, general manager and compliance officer at Choice Medical Supply in Abilene, Texas.


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    06/07/2013
    Theresa Flaherty

    WASHINGTON – Amid growing concerns on Capitol Hill, CMS officials have been asked to report to Senate staff on Round 2 of competitive bidding at a briefing on Tuesday.

    “The pressure’s on,” said Jay Witter, vice president of government affairs for AAHomecare. “The licensure issue is one that CMS has not been able to answer.”

    The Maryland Office of Healthcare Quality confirmed recently that there are more than 100 contract suppliers that don’t meet licensure requirements in the state. Other states that have reported similar issues include Tennessee, Michigan and Ohio.

    Ohio lawmakers expressed their concerns on the issue in two separate letters to CMS Administrator Marilyn Tavenner last week. A “Dear Colleague” letter by Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, asking CMS to delay the July 1 start date of Round 2 garnered 175 signatures by its June 7 deadline.

    “The collective points of all of this activity is a mounting concern from Congress to CMS focusing on the licensing issue,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “They are basically saying, ‘What is going on? How does this happen?’”

    Congress has called CMS on the carpet before with regard to competitive bidding, but so far, it has given the agency the benefit of the doubt. That’s changing, say stakeholders.

    “There’s a point where you can sweep things under the rug,” said Witter. “But, there will be a point where there’s so much evidence, that benefit of the doubt will change to doubt and then they will start really pressing CMS for change.”

    With the start date of Round 2 just a few weeks away, time is of the essence. Stakeholders say it’s important to ratchet up the noise level on the need for a delay and H.R. 1717, a bill to replace competitive bidding with a market-pricing program (MPP). Introduced April 24 by Rep. Tom Price, R-Ga., it has 115 cosponsors.

    “Congress and Medicare wait till things get hot and it is always the hottest the closest you get to implementation,” said Seth Johnson, vice president of government relations for Pride. “The ultimate goal is to fix this program.”


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    06/07/2013
    Elizabeth Deprey

    WASHINGTON – Recent educational outreach by CMS has beneficiaries more baffled about competitive bidding than ever, HME providers say.

    “They’ve raised awareness, but they’re also creating confusion,” said Chris Rice, CEO of Riverside, Calif.-based Diamond Respiratory Care. “(The beneficiaries) don’t understand what’s going on.”

    Within the past couple of weeks, Medicare sent a letter to beneficiaries stating competitive bidding would begin July 1, and outlining their options.

    After reading the letters, beneficiaries either think they need to immediately switch suppliers, or have no idea what to do, providers say. And calls to CMS don’t seem to clear up matters.

    “When one of our customers called, they told her we were not grandfathering and she’d have to switch,” said Bruno Scalzo, president of Hickory Hills, Ill.-based Family Medical.

    Scalzo, who does plan to grandfather, called Medicare and was told he hadn’t filled out a form to notify the agency of his plans. After an hour of talking with three different phone representatives, Medicare acknowledged no such form existed.

    “I sent out letters and 99% of my patients want to stay with me, but Medicare is making it hard,” said Scalzo.

    Provider Woody O’Neal, who did win Round 2 contracts, says the letters have prompted misguided beneficiaries to visit his location to “kick the tires,” and see what he has to offer them.

    “They come in to look around and say, ‘I’m not sure if I’m going to switch,’” said O’Neal, vice president at Pelham, Ala.-based O2Neal Medical. “They don’t know they don’t have any choice.”

    Providers are trying to go toe to toe with CMS by conducting their own education about how beneficiaries can speak out against the program.

    “When we explain competitive bidding, they don’t understand why this is happening and they don’t think it’s fair,” said Mike Kernes, general manager at Hackensack, N.J.-based Reliable Medical. “We tell them to let CMS and Congress know.”

    There’s a new hotline to make it as easy as possible for beneficiaries, says former provider Rob Brant: 855-322-8295.

    “The industry needs a simple way for patients to say we are having some issues,” said Brant, CEO of AMEPA.


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    06/07/2013
    Theresa Flaherty

    ALEXANDRIA, Va. – AAHomecare has asked CMS to delay the July 1 start date of its new face-to-face requirement, citing a need for clarifications and expressing concerns over the timing.

    “You have this huge new requirement coming on the same day as the start of Round 2 of competitive bidding,” said Jay Witter, vice president of government affairs for AAHomecare.

    In November 2012, CMS issued a final rule that requires a face-to-face exam with a physician within 90 days for certain high-cost DME.

    Since then, however, the agency has done minimal—and last minute—provider education, say stakeholders, who have sought several clarifications. With millions of beneficiaries being forced to switch providers when Round 2 starts, the biggest question is whether those beneficiaries will need a new face-to-face exam, they say.

    “I know how hard it is to get a quick appointment for something that is not urgent,” said Mary Ellen Conway, president of Health Care Information Consultants. “Getting a face-to-face exam to document that the patient is on oxygen because they are now switching to a contract supplier is not going to be on any physician’s urgent list.”

    Providers are not likely to take patients until they’ve had the face-to-face exam because there’s no guarantee once they provide equipment they will be paid for it, Conway said.

    “CMS is going to have to figure out how those people are going to survive without it because if they pick up the phone and call on July 1, and the first day they give for an office visit is Aug. 15, they have a problem,” she said.

    AAHomecare is working on a set of Q&As to help providers understand the new requirement, but it needs clarifications from CMS before it can make them available, said Witter. HME


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    06/07/2013
    HME News Staff

    WASHINGTON – CMS says its anti-fraud efforts in 2011 and 2012 have recovered more than $14.9 billion in healthcare fraud judgments, settlements and administrative impositions, according to a press release. A big reason for the agency’s success: new fraud-fighting powers and tools in the Affordable Care Act (ACA). Since March 2011, when the ACA was signed into law, the agency has revoked the ability of 14,663 providers to bill the Medicare program, compared with 6,307 revocations in the two years prior. Revocations have doubled in 35 states. Those removed from the program had felony convictions, were not operational at the filed address, or were not in compliance with rules, according to the release. As part of its ongoing efforts to enlist seniors in the fight against fraud, CMS also says it’s redesigning its Medicare Summary Notices, which Administrator Marilyn Tavenner describes as an easier way for seniors to understand the services they’re receiving.

    Graham-Field buys Hausted

    ATLANTA – Graham-Field (GF) Health Products, a manufacturer of home health products, has completed the acquisition of Hausted, a manufacturer of patient handling equipment, including stretchers and chairs, according to a press release. GF is currently a supply partner to Hausted for steel components. Upon completion of the transaction, GF will relocate the Hausted manufacturing and processing facilities to its expanded Fond du Lac, Wis.-based steel fabrication facility, and its Doraville, Ga.-based mattress facilities, the release noted. “Our investment in automated, lean manufacturing technology and engineering in our Fond du Lac facility will allow Graham-Field to build on the great heritage of Hausted,” stated Ken Spett, president and CEO of GF. The transaction is scheduled to close June 30.

    Law firms file class action lawsuits against Invacare

    ELYRIA, Ohio – Two law firms have filed class action lawsuits against Invacare on behalf of investors who bought stock between July 22, 2010, and Dec. 7, 2011, according to press releases. The lawsuits accuse Invacare of issuing false and misleading statements during that time regarding its operations and compliance with U.S. Food and Drug Administration (FDA) guidelines and Current Good Manufacturing Practices (CGMP) provisions. They allege that Invacare “misrepresented or failed to disclose widespread operational, quality, and regulatory deficiencies” at the company’s corporate headquarters and Taylor Street wheelchair manufacturing facility in Elyria, Ohio. Glancy, Binkow & Goldberg in Los Angeles and Bernstein Liebhard in New York encourage investors who incurred losses of $100,000 or more to contact the firms.

    3B Medical will fight lawsuit

    SAN DIEGO – 3B Medical/BMC Medical, a manufacturer of sleep diagnostics and therapy devices, says it will fight a lawsuit filed by ResMed for alleged patent infringement, according to a press release. ResMed claims 3B Medical infringed on three patents involving the elbow swivel of a nasal pillow mask and the water flow-back valve of a humidifier. 3B disputes the allegations, claiming the lawsuit is just a ploy for reducing competition. “In 3B/BMC’s estimation the lawsuit is intended to do little more than erect huge hurdles to market entry by forcing crippling litigation costs,” stated Alex Lucio, vice president. 3B Medical says it will defend any intellectual property challenges in court, according to the release. ResMed has also sued Drive Medical to stop alleged patient infringement. In light of the lawsuit, Drive has suspended the sale and marketing of several of its CPAP masks.

    Providers make case against bid program at hearing

    SEATTLE – Several providers testified about the potentially damaging consequences of Medicare’s competitive bidding program at a recent regulatory fairness hearing hosted by the U.S. Small Business Administration, according to a press release from VGM & Associates. Those who testified voiced concerns that the program’s lack of accountability encourages a “race to the bottom” regarding service and quality, and that beneficiaries are the ones who stand to suffer most, the release noted. Providers also argued that nearly half of small providers will go out of business, creating joblessness and patients “without their trusted caretakers and suppliers,” according to the release. “These hearings are great a great opportunity for independent providers to voice our frustrations and concerns to a federal agency and to educate the public that they will likely lose their small, local provider in favor of a national company that is hundreds of miles away,” stated Ryan Ball, director of state policy at VGM & Associates.

    Medtrade opens early bird registration

    ATLANTA – Early bird registration is now open for Medtrade, scheduled for Oct. 7-10 at the Orange County Convention Center in Orlando, according to a press release. “Whatever happens in the next few months from a legislative standpoint, Medicare will be the ideal place to regroup, plan and get inspired for the work ahead,” stated Kevin Gaffney, group show director. “Our educational advisory board is working to ensure that all facets of Medtrade will be highly relevant to the realities faced by today’s providers.” Those who register in the next two months will receive significant savings with the early bird rates.

    CareTouch tailors sleep therapy product to truck drivers

    DENVER – CareTouch Communications has launched a sleep therapy compliance program designed specifically for commercial trucking companies, according to a press release. The CareTouch 360 platform tracks drivers diagnosed with sleep apnea and manages their compliance. By communicating with drivers at certain intervals, the system automatically retrieves objective data to document compliance. Proposed Federal Motor Carrier Safety Administration (FMCSA) guidelines state that drivers should be disqualified if they are found to be non-compliant with their CPAP treatment, the release noted. “Our goal is to ensure drivers are compliant, which we know helps keep them safe on the road,” stated Matthew Dolph, vice president of CareTouch.

    101 Mobility opens in Atlanta

    ATLANTA – A trio of experienced entrepreneurs have opened a 101 Mobility franchise in Atlanta, according to a press release. Wayne Offenhauer, Garol Orr and Bill Orr, all veterans of the residential home construction industry, are making the transition to HME. 101 Mobility offers a range of products: power wheelchairs and motorized scooters, along with mobility installation options for the home, such as wheelchair ramps, stair lifts and porch lifts. “We want to become the most recognized name in mobility products in the North Georgia marketplace,” stated Garol Orr. The franchise plans to celebrate its grand opening when it successfully serves its 100th customer, the release noted.

    Binson’s celebrates 60 years with expansion

    CENTER LINE, Mich. – On the strength of its success in the competitive bidding program, Binson’s Home Health Care is celebrating its 60th anniversary by hiring up to 100 new employees, according to a press release. Binson’s, which was awarded Round 2 contracts for walkers, oxygen supplies, CPAP devices, enteral therapy, and negative pressure wound therapy, has upgraded and enlarged its departments to make room for the new employees. “The Medicare contracts awarded to Binson’s for durable medical equipment will enable our organization to expand its presence in Michigan and Florida,” stated Kenneth Fasse, executive vice president and COO. The 100 new positions will be added in the metro Detroit area, and include customer service and warehouse jobs, the release noted.

    Vent market poised to expand, report says

    SAN JOSE, Calif. – An increasing prevalence of respiratory diseases, including chronic obstructive pulmonary disease (COPD), is among several factors expected to fuel a rise in demand for mechanical ventilators, according to a study conducted by Global Industry Analysts, a market research firm. Other factors contributing to growth in the global market, which is expected to reach $3.9 billion by 2013, include technological advancements, a spike in popularity with homecare ventilation, and an aging global population, the firm noted. Among the technological advancements, the move from invasive to non-invasive ventilation is one of the most significant, as it reduces the risk of infection and the need for sedation. North America and Western Europe remain relatively mature markets for vents, leaving manufacturers there angling to improve pricing and innovation to increase share. Asia, Eastern Europe and Latin America represent relatively untapped markets.

    Report: home healthcare market to reach $130.4B by 2017

    DALLAS – The North American home healthcare market is poised to reach $130.4 billion by 2017, expanding at a compound annual growth rate (CAGR) of 7.5%, according to a new study from Markets and Markets, a global research and consulting firm. In 2012, the North American home healthcare market was valued at $90 billion. Higher incidences of chronic diseases, in conjunction with increasing healthcare costs, are expected to fuel demand for more affordable treatment options at home. Cuts in Medicare payments to home health companies figure to limit the growth, the report noted. Authors of the report anticipate that the U.S. will maintain its eminent position in the North American market, a prediction supported by the country’s aging population, increasing incidence of chronic diseases, and various technological advancements for home use applications, among other factors.

    CPAP may also improve diabetes, AASM says

    BALTIMORE – Citing a study conducted by researchers at the University of Chicago, physicians at the American Academy of Sleep Medicine (AASM) say CPAP treatment may also relieve symptoms of Type 2 diabetes, according to a press release. As a result, the group is urging diabetes patients to get evaluated for sleep apnea. “Diagnosis and treatment of sleep apnea from a board-certified sleep medicine physician will promote improvement in these conditions—including improved insulin sensitivity, blood pressure and cholesterol,” stated M. Safwan Badr, MD, president of AASM. The one-week study also found that CPAP treatment may have as much of a positive effect on glucose levels for diabetes patients as prescribed oral medications. “The dawn phenomenon, an early-morning increase in blood sugar in people who have Type 2 diabetes, was reduced by 45% as a result of CPAP therapy,” stated Esra Tasali, MD, lead author of the study, assistant professor of medicine, pulmonary and critical care medicine at the University of Chicago Department of Medicine.

    Report: COPD on the rise among women

    WASHINGTON – Women are 37% more likely to have chronic obstructive pulmonary disease (COPD) than men and now account for more than half of all deaths attributed to the disease in the United States, according to a report from the American Lung Association. Once considered a disease that primarily affected men, incidence of COPD in women has increased substantially in recent years, largely due to an increase in smoking by women, the report said. “What we now know is that more women than men in this country are dying from COPD—and nearly half of women currently living with COPD don’t even know they have it,” stated MeiLan Han, M.D., medical director, Women’s Respiratory Health Program at the University of Michigan Health System. The report identifies a constellation of factors responsible for the disproportionate impact of COPD on women, including exposure to tobacco and air pollution, biological susceptibility, and sociocultural factors.

    Vendor short takes

    Harrington Management Grouphas launched Prepaid Audit Services, a program that allows providers to pay a monthly fee and make a minimum one-year commitment in exchange for a bucket of audit and appeal services…Somnetics International has received the CE Mark for the Transcend Heated Humidifier, a water-based humidifier unit that integrates with the Transcend CPAP system to provide warm, most air comfort during therapy…The Corridor Group, which provides consulting and other services to the homecare industry, including HME, has launched TCG Compliance Solutions to meet the growing state and federal regulatory and compliance challenges providers are facing…DeVilbiss Healthcare is one five finalists for the Pennsylvania Governor’s Impact Awards in the export impact category for the Southern Alleghenies Region. The awards program honors Pennsylvania companies that have a positive impact on growing the economy and contributing to job growth and retention.

    People news

    Ali Bauerlein, co-founder and CFO of Inogen, has been honored with the “Champions in Health Care Award” in the research category from the Pacific Coast Business Times and the annual entrepreneurship award in the medical category from the Spirit of Entrepreneurship Foundation…As part of its move to Lubbock, Texas, NRRTS has promoted Amy Odom to director of marketing and operations and hired Amy Stripling as association affairs coordinator. Odom will oversee operations, and Stripling will be responsible for webinar activities and registrant services. The phone number for the new office: 800-976-7787…The van Halem Group, an audit and compliance consulting firm, has hired Kelly Grahovac to serve as a senior consultant. Grahovac has ten years of experience in Medicare, including stints with a DME Contractor, a Qualified Independent Contractor (QIC), and an A/B Medicare Administrative Contractor (MAC)

    Provider short takes

    J&B Medical Supply Companyhas a new website, www.jandbmedicalinsurance.com, that offers patients information on diabetic and incontinence supplies, as well as catheters.


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