WASHINGTON – In a sign that contract offers might be on their way, HME providers who submitted bids as part of the Round 2 and the national mail-order re-compete may now register for Connexion.

Contract offers and other correspondence for the Round 2 and national mail-order re-compete will be communicated only through Connexion, a new secure, online portal, according to an update posted to the CBIC website Feb. 17.

“These items will not be mailed,” the agency stated.

To respond to offers and receive correspondence, authorized officials (AOs) and backup authorized officials (BAOs) must be registered in the Enterprise Identity Management system (EIDM) and add Connexion to their access.

CMS plans to announce the single payment amounts for the Round 2 and national mail order re-compete, and begin the contracting process this winter. It plans to announce contract suppliers this spring.

CMS plans to implement new pricing and contracts on July 1.

WASHINGTON – Industry stakeholders and their champions in Congress are mapping out a strategy to stave off a second round of reimbursement cuts scheduled for July 1 in non-bid areas.

Members of the Senate Finance Committee are in the process of drafting a letter to CMS, asking the agency to use its regulatory authority to delay the second round of cuts, says Tom Ryan, president and CEO of AAHomecare.

“Six months is not long enough to determine the impact of the first cuts on access,” he said. “If we can get a delay, it buys us more time until we have a new Congress and it’s not an election year, and there could be an easier path for legislation.”

CMS implemented the first round of cuts to reimbursement in rural and regional areas on Jan. 1. Stakeholders argue that, with providers in those areas still receiving cash flow from 2015, it may be months before they, and just as importantly their patients, are impacted by the cuts.

At the same time, AAHomecare is also putting the pieces in place for legislation to freeze current reimbursement; delay any additional cuts, ideally for three years; and require CMS to publish a new rule that takes into consideration the costs of providing services in rural and regional areas. It has hired Dobson DaVanzo and Associates to determine the cost of various scenarios and delays. It has also engaged Prime Policy Group to ramp up support in the House Energy and Commerce Committee, where it believes it has lacked support for previous legislation calling for a 30% increase to reimbursement in rural areas and a 20% increase in regional areas.

“We were so close (to getting that legislation passed),” Ryan said. “We did a root-cause analysis and we found that we needed a little more support on Energy and Commerce. (Prime) has the right skill set in place to help move our issues.”

This is just a glimpse of the work being done behind the scenes to address reimbursement cuts in non-bid areas, stakeholders say.

“Although there’s not a lot to report about introducing bills and gaining co-sponsors, there’s a tremendous amount of activity at the highest level,” said Jay Witter, senior director of government affairs for AAHomecare.

With July 1 approaching and Congress looking to adjourn early for their August recess due to the upcoming elections, stakeholders acknowledge they have a small window to work with. But they have a strong foundation to work from, they say.

“The details have yet to be resolved, but the good news is we have bipartisan champions in both chambers who are committed to figuring out a way to stave this off,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

YARMOUTH, Maine – While 75% of respondents to a recent HME Newspoll admit they could be doing a better job educating patients about their therapies, many say they just don’t have the resources.

Since the nationwide roll out of competitive bidding on Jan. 1, respondents say they have had to cut costs by reducing services and staff, both of which take their toll on their ability to educate patients.

“Patient education is always a challenge in these decreasing reimbursement times,” wrote one respondent. “We need to be more efficient with our time.”

Even though resources are stretched thin, a whopping 90% of respondents say they still prefer teaching patients one-on-one, despite a movement by some to educate patients in groups, especially for CPAP therapy.

The reason: Respondents say they don’t want to lose their personal touch.

“We have never done group set ups and we never will,” said Aaron McDonald, owner of Olympia Respiratory Services in Olympia, Wash. “(Even though) I’m sure it would save some money on employee time.”

Limited resources may by why only 10% of respondents say they’re leveraging technology like iPads to provide hands-on, visual education, a business model recently adopted by providers like Cape Medical Supply.

Though, one respondent said, “We use iPads to show a quick safety video for our new oxygen patients.”

Outside resources may be an option for providers struggling to educate their patients, said one respondent. Dwight Hunsberger, owner of Savannah, Ga.-based MedView Systems, is currently developing a patient education system for homecare companies, hospitals and ancillary facilities.

“We’re developing a website that contains videos of medical equipment, respiratory therapy and infusions for homecare patients,” he said.

LAS VEGAS – With more than 12 million patients in the U.S. currently diagnosed with COPD, the ability to effectively manage COPD patients in the home is more important than ever.

At Medtrade Spring in Las Vegas, in a session titled “COPD Management in the Home: Patient Centered Care,” Katherine Royster, senior field marketing manager at Philips Respironics, will explore how treating the patient with advanced technology can help reduce readmissions and improve a patient’s overall quality of life.

HME News: What’s the scope of the HME provider’s role in caring for COPD patients?

Katherine Royster: The ability of the HME provider to show the physician, payer and hospital that they have a disease management program focused on reducing COPD readmissions is more important than ever. Technology, education, and connectivity can all work together to provide a seamless care experience geared toward patient satisfaction, better patient care, and reduced cost of care. 

HME: What more could HME providers be doing to keep these patients in the home and out of hospitals?

Royster: HME providers can expand their use of data. For example, risk-scoring algorithms make it possible for HMEs to identify potentially noncompliant patients and connect with RTs and patient support staff to adjust treatment as needed.

HME: How can home monitoring solutions help HME providers improve care for these patients in the home?

Royster: Home monitoring solutions need to provide insight and feedback options to help providers manage a large population of patients remotely so that they can spot trends, help patients who need extra support and intervene early to prevent an unnecessary hospital admission. 

HME: What’s the one thing you want attendees to take away from your session?

Royster: I want HMEs to know that they can differentiate themselves from the competition by building and marketing a strong COPD program that positions them as a partner in the patient’s care team.

Katherine Royster

Senior field marketing manager, Philips Respironics

Monday, Feb. 29, 10:30 am to 11:30 am

Session: “COPD Management in the Home: Patient Centered Care”

Contact: Rachel Martin, 617-986-5711, Rachel_Martin@lpp.com

WASHINGTON – In a sign that contract offers might be on their way, HME providers who submitted bids as part of the Round 2 and the national mail-order re-compete may now register for Connexion.

Contract offers and other correspondence for the Round 2 and national mail-order re-compete will be communicated only through Connexion, a new secure, online portal, according to an update posted to the CBIC website Feb. 17.

“These items will not be mailed,” the agency stated.

To respond to offers and receive correspondence, authorized officials (AOs) and backup authorized officials (BAOs) must be registered in the Enterprise Identity Management system (EIDM) and add Connexion to their access.

CMS plans to announce the single payment amounts for the Round 2 and national mail order re-compete, and begin the contracting process this winter. It plans to announce contract suppliers this spring.

CMS plans to implement new pricing and contracts on July 1.

Invacare offers $130M in senior notes

ELYRIA, Ohio – Invacare announced last week that it’s offering $130 million aggregate principal amount of 5% convertible senior notes due 2021 in a private offering to qualified institutional buyers.

In connection with the offering, the company has granted the initial purchasers an option to purchase up to an additional $20 million aggregate principal amount of notes.

The conversion rate for the offering will be 60.0492 common shares per $1,000 principal amount of notes, equivalent to an initial conversion price of approximately $16.65 per common share. This represents a premium of about 30% to the $12.81 per share closing price on Feb. 17.

The sale of notes is expected to close Feb. 23.

Also in connection with the offering, Invacare entered into privately negotiated convertible note hedge transactions with JPMorgan Chase Bank, National Association, London Branch and one or more other financial institutions. These transactions will cover the number of the company’s common shares that will initially underlie the notes and are expected to reduce the potential equity dilution and/or offset any cash payments in excess of the principal amount due upon conversion of the notes.

Invacare estimates that the net proceeds from this offering will be about $124.8 million after deducting fees and estimated offering expenses.

Invacare expects to use $5 million of the net proceeds from this offering to repurchase the company’s common shares and $13.52 million to pay the cost of the convertible note hedge transactions. It intends to use the remaining net proceeds for working capital and general corporate purposes, which may include funding portions of the company’s ongoing turnaround.

AAH extends Audit Key deadline

WASHINGTON – Providers now have until Feb. 26 to enter their fourth quarter 2015 audit data into AAHomecare’s HME Audit Key. The association is seeking cumulative counts of pre- and post-payment audits and appeal claim outcomes for providers’ three largest product categories under DME MAC, RAC and SMRC reviews.The information gathered will be used to demonstrate the impact of audits on the HME industry and help AAHomecare advocate for common sense reforms. To register, click here.

Tashjian Insurance to offer DME insurance

MONROVIA, Calif. – The Hanover Insurance Group has chosen Tashjian Insurance Agency to offer Hanover Durable Medical Equipment Advantage, an insurance program for DME providers. "It's often difficult for durable medical equipment providers to find insurance that will appropriately cover their unique risks and exposures,” said Vik Tashjian, president of Tashjian Insurance Agency, in a release. “This enhanced program from Hanover addresses potential coverage gaps that durable medical equipment customers may have.” The program offers professional liability, general liability and property coverage options, as well as independent medical and non-medical contractors coverage, medical director's coverage, data breach coverage and employment practice liability.

3B Medical links up with Vodafone

WINTER HAVEN, Fla. – 3B Medical and BMC Medical have chosen Vodafone to deliver sleep data and compliance information wirelessly. The deal will allow patients using 3B Medical Luna devices who are traveling abroad or who don’t have Wi-Fi connections in their home to automatically upload sleep data in real-time to 3B’s cloud-based patient management system, iCodeConnect. “The addition of mobile data significantly enhances our wireless functionality with a device that automatically uploads to the cloud everywhere and anywhere, even across international borders on Vodafone's global mobile network," said Joe Toth, vice president of sales and marketing at 3B Medical, in a release. "Mobile data allows our devices to communicate with no patient involvement and makes sleep compliance reporting effortless.” 

Women’s conference moved to fall

WATERLOO, Iowa – Essentially Women’s annual education conference will be held Sept. 25-26 at the Sheraton Myrtle Beach Convention Center Hotel in Myrtle Beach, S.C. Though the conference has traditionally been held in the spring, “the change was made to allow time for a seamless transition and rebranding of the event” after The VGM Group acquired the organization in January, according to a press release. “With the additional resources and experience that the VGM team has to offer, conference attendees can expect enhanced exhibits, additional education sessions and networking opportunities—all in a fabulous setting,” said Melinda Smith, manager of membership services for Essentially Women, in the release.

Post-acute company to create 200 jobs

MURFREESBORO, Tenn. – Reeves-Sain Family of Medical Services will now operate as TwelveStone Health Partners. The new post-acute care pharmacy and medical supply company will invest $14.9 million into a new 30,000-square-foot headquartersand plans to create 200 new jobs by 2020. "We have combined our best people, products, processes and technology, and we're pursuing the best opportunities in the post-acute market," Shane Reeves, co-founder of the Reeves-Sain Family of Medical Services, told The Tennessean.The company plans to provide packaged medications, infusion services, respiratory services and durable medical equipment to all 95 counties statewide, according to the newspaper. TwelveStone is the latest iteration of Reeves-Sain, which soldits drug store and specialty pharmacy business to Fred’s Inc., aMemphis-based discount retailer, for $66 million last March.

Cigna stays with CareCentrix

HARTFORD, Conn. – CareCentrix and Cigna have extended their contract for two years. The contract gives Cigna’s customers continued access to CareCentrix’s core services, including home health/nursing care, DME and home infusion. It also gives them access to a testing and therapy adherence program for sleep-related disorders coordinated by Sleep Management Solutions, a CareCentrix company. CareCentrix has offered homecare and sleep services to millions of Cigna customers since 1996. It has a national network of 8,000 credentialed provider locations.

Short takes: RRI, DeRoyal

St. Louis, Miss.-based Responsive Respiratory Inc. has published its new oxygen solutions catalog for 2016. The catalog highlights conservers, regulators and cases, carts, racks, cylinders and accessory items, as well as the company’s expanded customization program. “RRI doubled its offering of customized products over the course of last year,” stated Tom Bannon, president…Bill Pittman, president and COO of Knoxville, Tenn.-based DeRoyal, plans to retire at the end of the first quarter of 2016, after 32 years with the company. He will take over the investment portfolio that he and his father have developed under the brand Pittman Properties. Pittman’s career at DeRoyal included spearheading the development and launch of hundreds of healthcare products, and expanding the company’s presence internationally into 70 countries. His successor has not been named.

CAPE GIRARDEAU, Mo. – Pat Naeger, president of the Midwest Association for Medical Equipment Services, found a receptive audience when he went on a local radio show to discuss the recent slashes in Medicare reimbursement.

Naeger, who also owns Healthcare Equipment & Supply Co. in Perryville, Mo., was invited in January to talk about how CMS’s plan to apply competitive bid rates will affect rural beneficiaries on Pure Country C106.1’s Cousin Carl Show.

Naeger, who advertises with the station, says the show has a large senior citizen audience.

“(Carl) cares about his listeners and he knew this was something that would benefit them,” he said.

Due to the high volume of phone calls pouring into the station, the normally 20-minute guest spot stretched into an hour.

“It angered a lot of folks,” said Naeger. “Everything’s going up and they said, ‘How dare Medicare make these kinds of cuts.’”

What started out as a crash course on Medicare’s new reimbursement rates quickly turned into a call to action.

“All of them were calling in and saying, ‘We’re going to call (our lawmakers). We’re going to have our voice heard,’ and we gave them the phone numbers,” said Naeger. “100% of people didn’t know about (the cuts).”

Naeger says the key to reversing the cuts is educating beneficiaries and getting them to voice their concerns to Congress.

“They don’t know if we don’t tell them,” he said. “And it’s pretty amazing that once you start talking to them—and you give them the resources to make the call—they’ll make the call.” hme

WASHINGTON – CMS will strengthen strategies designed to reinforce provider screening activities by increasing site visits to Medicare-enrolled providers and suppliers. The agency says it will enhance and improve IT systems, and implement continuous data monitoring practices to help make sure practice location data is accurate and in compliance with enrollment requirements. More specifically, CMS says it will use National Site Visit Contractor to increase the number of site visits to Medicare-enrolled providers and suppliers; enhance address verification software in PECOS to better detect vacant or invalid addresses or commercial mail reporting agencies; analyze enrollment data to allow it to identify and deactivate providers meeting specific criteria that have not billed Medicare in the last 13 months; and monitor and identify potentially invalid addresses on a monthly basis through additional data analysis by checking against the U.S. Postal Service address verification database.

Mediware releases analytics solution

LENEXA, Kan. – Mediware Information Systems and Rock-Pond Solutions have released a custom business intelligence solution for Fastrack customers. Fastrack BI integrates with the current Fastrack application to provide real-time reporting and data analysis for HME and home infusion providers, according to a press release. Fastrack customers can access an analysis package that includes detailed analytic cubes, real-time advanced reporting, and dashboards with trending metrics and key performance indicators. Fastrack BI also gives the option to create custom pivot-table analysis based on metrics of their choice with analytic cube technology. These tools will also transition seamlessly to Mediware’s CareTend product when customers move to that new technology. Mediware and Rock-Pond in 2015 announced plans to partner on software distribution and new product development.

Insulet sells Neighborhood Diabetes

BEDFORD, Mass. – Insulet Corp. has announced plans to sell Neighborhood Diabetes to Liberty Medical for $5 million. Insulet acquired Woburn, Mass.-based Neighborhood Diabetes for $63 million in 2011. "This transaction is an important step in positioning Insulet as a more focused organization, enabling us to direct our operational and financial resources toward driving continued growth of our innovative OmniPod and drug delivery products, while improving our financial profile for profitable growth over the long term,” said Patrick Sullivan, president and CEO of Insulet. “Together with Liberty Medical's comprehensive product portfolio, Neighborhood Diabetes will have the investment opportunities necessary to further develop and scale the business.” Liberty Medical was acquired by private equity firm Palm Beach Capital in 2014 for $68.5 million. The Insulet-Liberty Medical deal is expected close in the first quarter of 2016.

At Insulet, revenues grow, but so do net losses

BILLERICA, Mass. – Insulet Corp. has reported fourth quarter revenues of $100.1 million, representing year-over-year growth of 38%. It has reported full-year revenues of $324.2 million, year-over-year growth of 12%. Revenues from the company’s signature product, the OmniPod Insulin Management System, were up 21% in the fourth quarter and 8% for the year. Net loss for the fourth quarter was $27.3 million, compared to a net loss of $5.4 million for the same period in 2014. Net loss for the year was $73.5 million, compared to a net loss of $51.5 million for 2014.

NHIA finalizes data definitions

ALEXANDRIA, Va. – The National Home Infusion Association has released its final set of Standard Definitions for Patient Outcomes Data to establish national benchmarks. The definitions, developed by a volunteer task force, include: adverse drug reaction, emergency department use, unplanned hospitalization, and medication error. "By collecting uniform data, the home and specialty infusion industry will take an important step toward describing and quantifying the value of home infusion as a critical component of the community-based health care continuum,” said NHIA President & CEO Tyler Wilson. The association in 2010 launched its multi-year Industry-Wide Data Initiative, an effort to define outcomes data elements and standards of care.

Brightree, McKesson to offer interoperability services

BOSTON –CommonWell Health Alliance, a not-for-profit trade association of health IT companies, has made its cross-vendor interoperability services available to its members, including Brightree and McKesson. Of the 10 million Medicare beneficiaries who are discharged from acute care hospitals every year, more than 66% have two or more chronic conditions, while 14% have six or more. “This patient population typically requires care from multiple providers in a variety of highly divergent settings,” said Jitin Asnaani, executive director of CommonWell Health Alliance, in a release. “Our collective experience across the continuum can help break down the barriers to cross-vendor HIT interoperability and make a dramatic difference in care coordination among ambulatory, acute and post-acute settings of care, with the ultimate goal of better patient outcomes.” Brightree, Cerner and McKesson plan to deploy the services to its home health and hospice customers this year.

PharMerica’s revenues, income blow up

LOUISVILLE, Ky. – PharMerica Corp., a provider of pharmacy services, including specialty home infusion, has reported fourth quarter revenues of $520.6 million compared to $523.5 million for the same period in 2014. Net income was $20.2 million vs. $3.2 million. The company reported full-year revenues of $2.03 billion compared to $1.89 billion for 2014. Net income was $35.1 million vs. $6.8 million. PharMerica credited acquisitions, in part, with growing revenues. “During the fourth quarter, we completed two institutional pharmacy acquisitions, one specialty home infusion acquisition, and acquired a hospital pharmacy management business,” said CEO Greg Weishar. “These acquisitions are consistent with the company’s goal of adding at least $100 million in annualized revenues yearly through acquisitions, which we achieved once again in 2015.”

Idaho strikes down licensing bill

BOISE, Idaho –A bill that would have added new licensing requirements for DME providers in Idaho was voted down last week. The bill, S.B. 1264, would have required providers to have a location staffed during reasonable business hours, and to have sufficient inventory and staff to service or repair products under the state Board of Pharmacy. Idaho Lt. Gov. Brad Little cast the tie-breaking vote after the Senate deadlocked, according to The Spokesman-Review.

VGM, LifeTouch join forces

WATERLOO, Iowa –The VGM Group has partnered with LifeTouch to make its post-discharge services available to members. Based in Columbia, S.C., LifeTouchworks withhealthcare companies, hospitals and other homecare service providers to reduceextended length of stays and readmission rates. According to VGM’s blog: “VGM members receive service fees paid by LifeTouch for services provided by the members to LifeTouch clients. Service fees are payable within 15 days of the end of each month based upon the revenues received by LifeTouch clients that month.”

CMS proposes shakeup for Medicare Advantage

WASHINGTON – CMS has proposed changes to Medicare Advantage plans in 2017 that it believes will provide stable and fair payments, and improve the program. The net payment impact of the proposed changes would result in a modest increase of 1.35% on average Medicare Advantage plans, according to a press release. “This moderate growth is consistent with last year’s update and reflects a similar pattern in Medicare fee-for-service,” the agency states. “Plans that improve the quality of care they deliver to enrollees can see higher updates and can grow and enhance the benefits they offer to enrollees.” Proposed changes include implementing a new risk adjustment model, and making an adjustment to plan payments reflective of the statutory minimum. Medicare Advantage has reached record high enrollment each year since 2010, a trend continuing in 2016 with a cumulative increase of 50% to an all-time high of more than 17.1 million beneficiaries. Nearly 32% of Medicare beneficiaries are now enrolled in a Medicare Advantage plan. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-...

Short takes

Fisher & Paykel Healthcarehas signed a lease to operate a 125,000-square-foot facility in Moreno Valley, Calif., according to The Press Enterprise. The company already has an office in Irvine. City officials say the Auckland, New Zealand-based Fisher & Paykel plans to work with them to bring manufacturing jobs to Moreno Valley and to apply for Foreign Trade Zone designation…Algona, Wash.-based EZ-Access, a division of Homecare Products, Inc., has named Cy Corgan national sales manager to strengthen the company’s relationships with accessibility dealers. Corgan was most recently director of strategic accounts for Pride Mobility Products…Matthews, N.C.-based Carolina’s Home Medical Equipment has been named a SmartCEO Future 50 Award Winner. The program, sponsored by SmartCEO magazine, recognizes greater Charlotte’s 50 fastest-growing mid-sized companies that have experienced outsized growth based on a combined three-year average of revenue and employee growth…Aeroflow Breastpumps has partnered with Humana and Humana Beginnings as a preferred breast pump provider. The Ashville, N.C.-based Aeroflow Breastpumps is a subsidiary of Aeroflow Healthcare…RESNA’s ATP Certification Program has been re-accredited by the National Commission for Certifying Agencies. More than 3,800 professionals are certified to use the ATP designation.

LAS VEGAS – A power wheelchair that allows for 10 inches of seat elevation and speeds of 3.5 mph took the top prize at the Innovative HME Retail Product Awards at Medtrade Spring today.

The Jazzy Air Powerchair from Pride Mobility Products, which had its debut at the show this year, beat out eight other finalists for the award.

Taking second and third places, respectively, were the Free2go Rollator from Roscoe Healthcare/Compass Health Brands and a Pain Relief Cream from Topricin.

The awards, which take place at both Medtrade Spring and Medtrade, honor HME products that are particularly suited for retail sale.

“Caretailing is the evolution that we are looking to create,” said Jim Greatorex, business development, VGM Retail Services. “The awards were too close to call, and I was impressed by the quality of the entrants.”

The other finalists were: Flip a Grip from Drive Medical, Grip Lap Board from Grip Solutions, Nano Tek High Performance Fabric from Golden Technologies, Home Aware Home Alerting System from Sonic Alert, Swede-O Heel Pain Center from Swede-O and Vionic Pain Free Shoes from Vionic.

The panelists/judges for the awards were Mike Sperduti, CEO of the Mike Sperduti Companies; Cindi Ciardo, CEO of Knueppel Healthcare Services; and Rob Baumhover, director of retail for VGM Retail Services.

WASHINGTON – With no time to lose, HME industry stakeholders are ready for another run at the competitive bidding program.

Legislation in the works by Sen. John Thune, R-S.D., would delay the next round of cuts for nine to 12 months, depending on the CBO score.

“This proposal is fresh and new,” said Jay Witter, senior vice president of government relations for AAHomecare during the association’s legislative update at Medtrade Spring in Las Vegas last week. “There will be a bill here shortly. We need your help and we need it quickly.”

On Jan. 1, CMS implemented the first round of cuts* in regional and rural areas, basing reimbursement on a 50/50 blend of the current and adjusted rates. On July 1, reimbursement will be based only on the adjusted rates.

The plan is to get a bill introduced and passed through an expedited “hotline” process.

“The window of opportunity in this crazy election year is very small,” said Tom Ryan, president and CEO. “This is what’s in front of us today—we can’t go back.”

The pay-for for the bill: Move up the start date of an already planned Medicaid cut from calendar year 2019 (Jan. 1, 2019) to fiscal year 2019 (Oct. 1, 2018). The cut will match the federal portion of Medicaid allowables to adjusted Medicare reimbursement.

Other provisions in the bill: a ceiling for future rounds of competitive bidding set at the unadjusted fee schedule rates as of Jan. 1, 2015; and a requirement that CMS revisit adjusting pricing for non-bid areas that takes into account travel distance, clearing price and other associated costs for furnishing equipment that will be in effect Jan. 1, 2019.

“Our champs in the Senate are lining up allies,” said Witter. “(Rep. Tom Price, R-Ga.,) is raring to go in the House.”

Stakeholders are also working with Senate members to ask CMS to fix the bidding program without forcing the issue through legislation.

“Our contention is that CMS can do this on their own,” said Witter. “We have a number of heavy hitters on our side.”

http://www.hmenews.com/article/providers-hold-back-products-services

LAS VEGAS – Foot traffic was down slightly and there were fewer exhibitors at Medtrade Spring last week, but the mood was upbeat, say show organizers.

“There was considerable energy on days one and two with a positive vibe,” said Show Director Kevin Gaffney. “The overall buzz of the show floor on Tuesday was tremendous.”

The show, held Feb. 29–March 2 at the Mandalay Bay Convention Center, drew 215 exhibitors.

This was the second year in which educational sessions were frontloaded onto the first two days of the show, leaving day three dedicated to the show floor.

“It’s a constant pull and push on this issue, and it’s impossible to please everyone, but reaction has been positive,” said Gaffney. “Wednesday was the busiest final day I’ve seen in the last five years.”

Despite the national rollout of competitive bid pricing hanging over everyone’s heads, show attendees were resolved to keep moving forward.

“The show is an opportunity to figure out who we can partner with for growth opportunities,” said Wayne Slavitt, founder and CEO of Mobül.“I also like to see products from new vendors and new products from old vendors.”

That’s music to the ears of first-time exhibitor John Stocker.

“People are looking for the new and unusual, they are not looking for another wheelchair,” said Stocker, owner of E-Z Step, which makes a stair-climbing cane. “I’ve been pleasantly surprised. People are in a positive mood.”

On the education front, AAHomecare on Tuesday hosted its Washington Update, which drew its usual healthy crowd, despite the 8 a.m. start time.

“I’ve wanted to get more involved with the legislative stuff and hear what was new,” said Clark McInroy, owner of COPD Respiratory Services in Cheyenne, Wyo. “Now they are trying to stop the next round of cuts. I want to know what we can do in Wyoming to help with that.”

Show organizers are already looking forward, toward Medtrade, Oct. 31-Nov. 3 in Atlanta. The elephant in the room, says Gaffney, is the national rollout and how it will impact the industry.

“Medtrade Spring and Medtrade ultimately reflect the industry,” he said. “By the time Medtrade rolls around, we’ll have an even better understanding of where the industry stands.”

Pride Mobility tops retail awards

LAS VEGAS – A power wheelchair that allows for 10 inches of seat elevation and speeds of 3.5 mph took the top prize at the Innovative HME Retail Product Awards at Medtrade Spring last week.

The Jazzy Air Powerchair from Pride Mobility Products, which had its debut at the show this year, beat out eight other finalists for the award.

Taking second and third places, respectively, were the Free2go Rollator from Roscoe Healthcare/Compass Health Brands and a Pain Relief Cream from Topricin.

The awards, which take place at both Medtrade Spring and Medtrade, honor HME products that are particularly suited for retail sale.

The other finalist were: Flip a Grip from Drive Medical, Grip Lap Board from Grip Solutions, Nano Tek High Performance Fabric from Golden Technologies, Home Aware Home Alerting System from Sonic Alert, Swede-O Heel Pain Center from Swede-O and Vionic Pain Free Shoes from Vionic.

The panelists/judges for the awards were Mike Sperduti, CEO of the Mike Sperduti Companies; Cindi Ciardo, CEO of Knueppel Healthcare Services; and Rob Baumhover, director of retail for VGM Retail Services.

Attendees vote for best products, booths

LAS VEGAS – Medtrade Spring attendees tapped the DreamStation Positive Airway Pressure from Philips Respironics as the Providers’ Choice Gold Award last week at the Mandalay Bay Convention Center in Las Vegas. The Providers’ Choice Silver Award went to LifeWalker Upright by ProtoStar; and the Providers’ Choice Bronze Award to EZ Fold-N-Go Walker by Stander. The Best Booth Award went to Stars N Stripes for the company’s “dramatic runway look,” said Sarah Varner, marketing director for Medtrade.

HME, aging events to co-locate in 2017

LAS VEGAS – Medtrade Spring will co-locate with the Environments for Aging Expo & Conference next year, show organizers have announced. The events, both produced by Emerald Expositions, will take place side by side at the Mandalay Bay Convention Center from Feb. 27 to March 1. “There is a great deal of crossover appeal for attendees,” said Kevin Gaffney, group show director of Medtrade. “It will bring value to exhibitors and attendees of both shows.” The Environments for Aging Expo & Conference is a three-day event where attendees can network with peers and learn about the latest innovations in senior-friendly design for long-term and residential care settings.

WASHINGTON – The American Sleep Apnea Association (ASAA) and IBM have partnered on a SleepHealth app for the iPhone and Apple Watch and a SleepHealth Research Study to help identify connections between sleep habits and health outcomes.

The project uses the open source ResearchKit framework designed by Apple to allow participants to complete tasks and submit surveys from the SleepHealth app. That data will be stored on the Watson Health Cloud, where researchers will be able to conduct extensive analysis to uncover patterns and connections.

"This study marks the association's commitment to patient-led research and data-driven discovery,” said Carl Stepnowsky, the principal investigator for the study, associate professor at University of California at San Diego and ASAA's chief science officer, in a release. “With ResearchKit and Watson Health Cloud, this new app will help us build the world's largest longitudinal study to collect data on both healthy and unhealthy sleepers that can be published as an open study and shared with other researchers."

In the future, researchers hope to develop personalized and public health interventions for a variety of sleep-related health issues, such as helping athletes optimize training before a big event, mitigating fatigue in the workplace, and detecting early symptoms of Alzheimer's and mental health disorders.

The SleepHealth app is available to anyone in the U.S. as a free download from the App Store.

Etac reorganizes leadership

TORRANCE, Calif. – The Etac Group, which recently acquired Convaid, has appointed Chris Braun president for North America and has reorganized its sales team. Braun, who has served as Convaid’s president since 2008, will take on an expanded role, providing leadership for all of Etac’s brands in North America, including R82, Etac, Molift, Immedia and Convaid. He will also remain Convaid’s president. Braun’s first order of business as president of Etac NA was forming a new sales organization and appointing three sales managers to run it. Sales for the expanded pediatric channel, comprised of both Convaid and R82, will be jointly managed by Derek Fletcher, formerly R82’s East Coast sales manager, and Charles Larose, formerly Convaid’s North American business development manager. Fletcher will manage the East Coast, while Larose the West Coast. Scott Crosswhite, formerly vice president of R82, has been appointed manager of the adult distribution channel, handling products from Etac, Molift and Immedia. Additionally, Nanneke Dinklo, formerly Convaid’s director, global marketing and business development, takes on an expanded role in marketing and channel strategy for all Etac brands in North America.

Respironics connects care with software

MURRYSVILLE, Pa. – Philips Respironics has received 510(k) clearance from the U.S. Food and Drug Administration for Care Orchestrator, its cloud-based clinical management software application. Care Orchestrator offers a full view of sleep and respiratory care patients and makes it easier for healthcare providers to share and exchange information, addressing critical needs like treatment adherence, patient and provider engagement, and billing and reimbursement. Care Orchestrator builds on Encore Anywhere, a patient compliance management system that has supported more than 7 million patients, and DreamMapper, an app and web-based software that helps patients remain compliant with their therapies. The application will interact with Philips’ sleep and respiratory devices, electronic medical records, insurance claims and billing systems, as well as other Philips and third-party applications on the HealthSuite digital platform, an open and cloud-based platform of services, capabilities and tools.

PromptCare buys Boston Home Infusion

CLARK, N.J. – PromptCare has bought Stoughton, Mass.-based Boston Home Infusion. The deal will help PromptCare, whose presence spans the mid-Atlantic to the Northeastern U.S., expand respiratory services to the greater Boston area. “This acquisition offers us an ideal platform for launching our disease focused infusion programs as a complement to their current range of therapy offerings,” CEO and President Tom Voorhes said in a prepared statement. “It is also a natural extension of our strong presence in complex respiratory and nutritional support already in this area.” Terms of the deal were not disclosed.

Oxford Finance closes $50M credit facility for home infusion provider

ALEXANDRIA, Va. – Oxford Finance has served as a co-lender and documentation agent for the closing of a $35 million term loan and a $15 million revolving line of credit for Superior Biologics, a home infusion and specialty pharmacy provider. Hawthorne, N.Y.-based Superior Biologics will use the funds to support a recapitalization and refinancing of existing debt. The provider services the tri-state area of New York, New Jersey and Connecticut. Oxford Finance is a specialty finance firm that provides senior debt to life sciences and healthcare services companies.

eSolutions buys healthcare clearinghouse

OVERLAND PARK, Kan. – eSolutions has acquired ClaimRemedi, a provider of billing system and clearinghouse services for the healthcare industry, it announced this week. The deal will allow eSolutions to better serve the needs of its existing customers and create new opportunities for growth in the markets they serve. “Combining ClaimRemedi with eSolutions provides the scale and product depth we need to serve the evolving challenges our customers have,” said Peter Bowhall, founder and CEO of ClaimRemedi, in a release. Founded in 1999, eSolutions provides revenue cycle management analytics and cloud-based workflow solutions to a customer base of more than 2,800 organizations, including more than 15,000 hospitals, home health and hospice agencies, skilled nursing facilities, DME companies and other provider types.

RESNA tweaks ATP exam

ARLINGTON, Va. – RESNA will begin administering a new, updated ATP exam in July 2016 to better reflect current practice. “We’re grateful to all of the AT professionals from a wide variety of backgrounds who participated in the exam update,“ said Daniel Cochrane, chair of RESNA’s Professional Standards Board, in a release. “Hundreds of AT practitioners participated in the job validation survey alone.” While the new exam will remain the same length and scope, it will no longer include U.S.-centric funding questions. Candidates can choose whether to apply for the old exam or the new exam until March 15. Those who take the new exam between July 1 and Oct. 31, 2016, will receive a $100 discount off of the regular $500 exam fee. The last time the exam was updated was in 2009.

Study bolsters use of telemedicine for sleep therapy

DARIEN, Ill. – A new study suggests that telemedicine-based management for obstructive sleep apnea is as effective as in-person care. Results of the study, published in the March 1 issue of the journal Sleep, show that there was no significant difference in functional outcomes changes, dropout rates, or objectively measured positive airway pressure adherence between patients having a clinical video telehealth-based visit or an in-person physician visit at the initial evaluation. Additionally, participants in the study reported high satisfaction with telemedicine, citing the advantages of decreased travel and greater convenience. The study involved 60 veterans at the Philadelphia Veterans Affairs Medical Center and two affiliated community based outpatient clinics located 33 and 46 miles away. Participants were randomized to the telemedicine or standard care pathway. Those in the telemedicine pathway used a platform launched by the American Academy of Sleep Medicine in January. A core component of the platform is a secure, web-based video platform that facilitates live, interactive consultations and follow-up visits between patients and sleep medicine clinicians.

Stock movement: Invacare, ResMed, Inogen

Invacare CEO Matthew Monaghan bought 8,000 company shares at an average price of $12.31 per share in a transaction on Feb. 29. He now owns 82,327 shares worth about $1 million. CFO Robert Gudbranson bought 4,200 company shares at an average price of $12.01 per share in a transaction on Feb. 29 worth $50,442. He now owns 101,821 shares worth about $1.2 million. Additionally, Invacare Vice President Anthony Laplaca bought 1,000 company shares at an average price of $12.38 per share in a transaction on Feb. 29 worth about $12,400. Invacare announced in February that it is preparing to submit a final report to lift its consent decree with the Food and Drug Administration…ResMed CFO Brett Sandercock sold 30,000 company shares for an average of $57.61 per share in a transaction on Feb. 26 worth about $1.7 million. He now has 132,136 shares worth about $7.6 million. Janus Capital Management increased its number of shares in ResMed by 345,234 in the third quarter for a total of 494,328 shares. It now has a $25.2 million stake in the company. ResMed has made headlines recently by buying Brightree and Inova Technologies. Anne Reiser, president of ResMed’s EMEA-APAC region, sold 1,946 shares at an average price of $57.06 per share in a transaction on Feb. 29 valued at about $111,038…Rockefeller Financial Services cut its stake in Inogen by 1.2% during the fourth quarter. The institutional investor now owns 232,525 shares after selling 2,743 shares. Rockefeller owned 1.18% of Inogen, worth $9.32 million at the end of the most recent quarter.

Short take: Medela

Medela has appointed Melissa Gonzales managing director of the Medela USA business unit. In this role, she will manage the largest market within the Medela group, overseeing both the human milk and healthcare businesses. Gonzales will focus on providing the most technologically advanced breast pumps and break milk feeding accessories to hospitals and nursing mothers, as well as advancing the company’s negative pressure wound therapy portfolio. Previously, she was vice president of sales and channel management for human milk.

JACKSONVILLE, Fla. – C2C Innovative Solutions, the Qualified Independent Contractor or QIC for the second level of Medicare appeals, is conducting a demonstration project that allows HME providers to discuss denied claims over the phone before a decision is made.

The QIC is conducting the demo project in Jurisdictions C and D for diabetes testing supplies and oxygen equipment, according to its website.

“The Formal Telephone Discussion Demonstration gives suppliers the opportunity to speak with a reconsideration professional to provide verbal testimony and any additional documentation that would assist in a possible favorable demonstration,” it states.

The demo project is limited to a maximum of five claims per National Provider Identifier or NPI.

The QIC expects the demo project to have the following benefits:

·      Provide an opportunity for providers to verbally discuss their case with a decision maker before a QIC decision is made;

·      Allow the appellants to understand what documents the decision maker has in the QIC case file and what documents are missing that are critical to the outcome of a case;

·      Provide the opportunity for additional documentation that supports a favorable appeals decision to be faxed or transmitted through other secured media to the QIC prior to the reconsideration decision being made; and

·      Educate suppliers on CMS policies and requirements.

When an appeal is selected for the demo project, the QIC will notify the provider via mail with a scheduled time and date for a telephone discussion. A provider that wants to participate must mail or fax the form enclosed with the letter within the timeframe indicated.

WASHINGTON – The federal government is seeking public input on whether it should require sleep tests for commercial drivers and railroad workers. 

The U.S. Department of Transportation’s Federal Motor Carrier Safety Administration and Federal Railroad Administration announced the proposal March 8. The National Transportation Safety Board has recommended the DOT take action to address OSA screening.

“It is imperative for everyone’s safety that commercial motor vehicle drivers and train operators be fully focused and immediately responsive at all times,” said U.S. Transportation Secretary Anthony Foxx. “DOT strongly encourages comment from the public on how to best respond to this national health and transportation safety issue.”

The FMCSA has been working on guidelines for testing and treating commercial drivers for nearly a decade.

The joint advance notice of proposed rulemaking is the first step as both agencies consider proposing the requirement.

The FMCSA and the FRA will hold three public sessions, in Washington, D.C., Chicago and Los Angeles, to get input.

To read the notice or provide comment, go here.

JACKSONVILLE, Fla. – Certain HME providers will now have a voice at Medicare’s second level of appeals as part of a new demonstration project.

C2C Innovative Solutions, Medicare’s Qualified Independent Contractor or QIC, has launched a demo project that allows providers in Jurisdictions C and D to speak with a reconsideration professional by phone to try and resolve their cases.

“This is the first real solution that anyone has brought forward that could potentially have an impact on reducing the tremendous backlog at the administrative law judge level,” said Wayne van Halem, president of the van Halem Group.

The QIC will randomly select up to five claims per National Provider Identifier or NPI for diabetes testing supplies and oxygen equipment, and then notify providers by mail with a scheduled date and time for a phone conversation.

Until now, providers had to wait until the ALJ, the third level of appeals, before the process became more than just reviewing the same paper trail of documents, stakeholders say.

“For providers, going through redetermination (the first level of appeals) and reconsideration (the second level) feels the same, because they’re shut out and can’t talk to anybody,” said Andrea Stark, a reimbursement consultant with MiraVista. “It’s a different dynamic at the ALJ and that’s why we see the great reversal rate at that level.”

Stakeholders say opening up a dialogue with the QIC will likely result in more reversals at the second level and fewer appeals escalating to the ALJ.

“I do feel like there’s great potential for that to happen,” Stark said.

If the QIC sides with providers on the initial claims, it will then consider appeals for other similar claims dating back to Jan. 1, 2013, including those stuck at the ALJ.

“I’m assuming that there are a lot of cases from 2013 that are just sitting at the ALJ and have been for some time,” van Halem said.

Based on conversations with officials from C2C, stakeholders believe the demo project will be expanded to other jurisdictions and other product categories.

“That’s the ultimate goal,” Stark said.

Providers that are invited to participate in the demo project should jump at the chance, but they need to keep one thing in mind, stakeholders say.

“The contractors are bound by the policies,” van Halem said. “This is not something where providers can argue the relevance of the policies. Providers need to respect that.”

LAS VEGAS – The most valuable property an HME provider has today is not physical inventory, but patient data.

“On the black market, personal health information is the most sought after data of anything out there,” said Bill Wilson, vice president of sales and marketing for VGM Insurance, during a session at Medtrade Spring. “With that information, hackers can steal identities.”

When Target suffered a breach in 2014, the hackers didn’t target the retail giant itself; instead, they gained access to customer data through a small HVAC company that Target contracted with. It was easier for thieves to target the company with weaker cyber security, says Rob Duryea, president of VGM Forbin.

A similar scenario could happen in the HME industry, where a provider is linked to a healthcare system and trading patient data through electronic referrals.

“Look at the average HME dealer, with a limited budget to go after strong security,” he said. “It’s a weakness and (hackers) know it.”

While people often associate the idea of cyber attacks with a hacker in China or elsewhere, the biggest risk to the safety of your information is your employees, says Wilson.

“It’s human error,” he said. “An employee opens an email they shouldn’t and they expose us.”

About 60% of businesses hit with a data breach will close within six months because they can’t afford the average cost of $3.5 million to reconcile the breach, said Duryea.

Duryea offered some basic advice to help providers limit risk, including: make sure you’re in compliance with the latest PCI DSS; have an SSL certificate; make sure hosting is secure; and stay on top of domain registration.

For employees, teach them to spot fraudulent emails and phishing attempts; and establish remote access protocol, Duryea said.

And, while it seems obvious, protect vital files by ensuring they are encrypted and restricted, Duryea said. Too often, breaches are the result of lost or stolen devices—even from an employee vehicle.

“Why is that person carrying around that laptop?” he said. “Employees shouldn’t even want that information.”

WASHINGTON – The federal government is seeking public input on whether it should require sleep tests for commercial drivers and railroad workers. 

The U.S. Department of Transportation’s Federal Motor Carrier Safety Administration and Federal Railroad Administration announced the proposal March 8. The National Transportation Safety Board has recommended the DOT take action to address OSA screening.

“It is imperative for everyone’s safety that commercial motor vehicle drivers and train operators be fully focused and immediately responsive at all times,” said U.S. Transportation Secretary Anthony Foxx. “DOT strongly encourages comment from the public on how to best respond to this national health and transportation safety issue.”

The FMCSA has been working on guidelines for testing and treating commercial drivers for nearly a decade.

The joint advance notice of proposed rulemaking is the first step as both agencies consider proposing the requirement.

The FMCSA and the FRA will hold three public sessions, in Washington, D.C., Chicago and Los Angeles, to get input.

To read the notice or provide comment, go here.

No link between CPAP and glycemic control, study says

MELBOURNE, Australia – CPAP therapy may not improve glycemic control for people with Type 2 diabetes and obstructive sleep apnea after all, according to a new study in the American Journal of Respiratory and Critical Care Medicine.

“Some uncontrolled studies have reported improved glucose control after starting CPAP, but some small controlled trials did not support this,” said lead study author Jonathan Shaw, head of population health at Melbourne’s Baker IDI Heart and Diabetes Institute, in a release.

Researchers in Australia and the U.S. randomly assigned 298 patients with “relatively well-controlled” Type 2 diabetes and newly diagnosed OSA to treat their sleep apnea with CPAP or receive usual care.

After three and six months, researchers found no difference between the two groups in glycated hemoglobin; however, daytime sleepiness improved significantly among CPAP users. Overall, the quality of life between the two groups was not statistically significant.

“OSA is common in people with Type 2 diabetes, and although we did not find a glycemic benefit for its treatment, clinicians should have a high index of suspicion for its presence when patients experience daytime sleepiness, snoring and resistant hypertension,” said Shaw.

3B Medical enters oxygen market

WINTER HAVEN, Fla. – 3B Medical has entered the home oxygen therapy market with the launch of its 5-liter stationary oxygen concentrator, the Cirrus 5. The manufacturer has, up to this point, been focused on the sleep therapy market. 3B Medical says the Cirrus 5 has features like a cooling system to protect the sieve beds and a monitor to measure oxygen purity. “Once you remove the back panel and explore the internal design, it is easy to see that it was designed for performance and low maintenance, and will set a new standard for durability,” said Joe Toth, vice president of sales and marketing. The Cirrus 5 will be available in April and pre-orders will be accepted on March 15.

Coming soon: HME cost study

WASHINGTON – AAHomecare has partnered with healthcare consulting firm Dobson DaVanzo & Associates to develop a study on the cost of providing HME products and related services. The study, prompted by recent reimbursement cuts in non-bid areas, will look at costs for HME providers at all size levels and break down the results on a statewide/regional basis. Stakeholders hope the data will encourage fair reimbursement rates going forward. The study is expected to be completed in six months.

AAHomecare prioritizes managed care

WASHINGTON – AAHomecare has created a new to position to help its provider members in their dealings with Medicare Advantage, managed care and Medicaid payers. The new senior director of payer relations will be tasked with developing relationships and reference materials to assist members in navigating relationships and concerns related to these payers, and with keeping abreast of regulations covering these groups to make sure they are compliant.

ACU-Serve revamps website

CUYAHOGA FALLS, Ohio – ACU-Serve has launched a redesigned website. The site, acuservecorp.com will give users a first look at the company’s “Right Sourcing” model, which allows providers to keep their current staff while using its ACU-Insight workflow tool, according to a press release. ACU-Serve, a biller of HME and home infusion services, also hopes the site will provide a more useful and informative portal for customers to learn about its services.

Rotech automates fleet delivery

ORLANDO, Fla. – Rotech Healthcare has selected the cloud-based Route Planner on-demand solution from Descartes to automate planning, dispatch and data collection processes for its fleet delivering medical equipment and services. “As the current tide of healthcare reform adds more margin pressure to the HME industry, we are making significant technology investments to increase efficiency and drive down unnecessary logistics costs without sacrificing high quality service for our customers,” said Tim Pigg, president and CEO. The solution from Waterloo, Ontario-based Descartes provides fast “time-to-value” for rapidly growing companies that need to consolidate delivery operations, and move away from manual and paper-based practices, according to a press release. It offers advanced capabilities to optimize both static and dynamic routes by taking into account business rules, delivery assets, and customer requirements. Mobile solution integration provides real-time GPS-based tracking, planned vs. actual performance monitoring, and the electronic capture of proof-of-delivery information.

MED gets tactical about marketing

LUBBOCK, Texas, and ATLANTA – The MED Group has teamed up with Laboratory Tactical Consulting to present the 2016 Marketing Bootcamp Webinar Series. “It’s time to get back to basics and take your marketing from ‘good’ to ‘better,’” MED stated in a press release. Anna McDevitt, president of Laboratory Tactical Consulting, will discuss the following topics in a four-part series: Establishing your presence: Are you saying what you want to say; Get Involved. Stay Involved: Are you actively developing your brand; Make more happen: Creating momentum with your marketing; and Review & Repeat: Making Marketing habits stick. Providers do not need to be MED members to attend this series.

General Dynamics awarded $75 million CMS contract

TOWSON, Md. – General Dynamics has been awarded a potential five-year $75M contract to supply and maintain software for CMS and Medicaid. “We are committed to CMS and to supporting its efforts to ensure that Medicare beneficiaries receive the highest quality of care,” said Marcus Collier, senior vice president of the IT unit’s health and civilian solutions division, in a release. The software will be used to process claims submitted by providers.

TravelScoot revamps website

CHEHALIS, Wash. – TravelScoot, manufacturer and distributor of the TravelScoot electric scooter, has re-launched its website, www.travelscoot.com. The new, mobile-friendly website offers comprehensive information about the company’s products as well as video demonstrations and other media.

MELBOURNE, Australia – CPAP therapy may not improve glycemic control for people with Type 2 diabetes and obstructive sleep apnea after all, according to a new study in the American Journal of Respiratory and Critical Care Medicine.

“Some uncontrolled studies have reported improved glucose control after starting CPAP, but some small controlled trials did not support this,” said lead study author Jonathan Shaw, head of population health at Melbourne’s Baker IDI Heart and Diabetes Institute, in a release.

Researchers in Australia and the U.S. randomly assigned 298 patients with “relatively well-controlled” Type 2 diabetes and newly diagnosed OSA to treat their sleep apnea with CPAP or receive usual care.

After three and six months, researchers found no difference between the two groups in glycated hemoglobin; however, daytime sleepiness improved significantly among CPAP users. Overall, the quality of life between the two groups was not statistically significant.

“OSA is common in people with Type 2 diabetes, and although we did not find a glycemic benefit for its treatment, clinicians should have a high index of suspicion for its presence when patients experience daytime sleepiness, snoring and resistant hypertension,” said Shaw.

BALTIMORE – CMS today announced the new single payment amounts for the Round 2 re-compete of competitive bidding.

CMS will now begin the contracting process. The agency will offer 12,181 contracts to 637 bidders. Of these offers, 93% are to bidders who currently furnish items in the area or within the product category. CMS will offer nine contracts for the national mail-order program.

CMS estimates that the first two years of Round 2 and the national mail-order program (July 1, 2013 and June 30, 2015) have saved approximately $3.6 billion.

Reimbursement rates for certain HME have been, on average, 45% lower as part of the previous Round 2. Medicare beneficiaries saved, on average, 72% of diabetic testing supplies as part of the previous national mail-order program.

CMS’s next steps:

•    It will now begin the contracting process.

•    In the spring of 2016, it plans to announce the contract suppliers.

•    On July 1, 2016, it plans to go live with the payment amounts and contract suppliers.

For single payment amounts:

Midwest Region

Northeast Region

South Region

South Region

West Region

For CMS's fact sheet:

The Round 2 re-compete applies to 90 metropolitan statistical areas for seven product categories:

·      Enteral nutrients, equipment and supplies

·      General home equipment and related supplies and accessories, including hospitals beds, Group 1 and 2 support surfaces, commode chairs, and patient and seat lifts

·      Nebulizers and related supplies

·      Negative pressure wound therapy pumps and related supplies

·      Respiratory equipment and related supplies and accessories, including oxygen, oxygen equipment and supplies; CPAP devices and RADs and related supplies and accessories

·      Standard mobility equipment and related accessories, including walkers, standard power and manual wheelchairs, scooters and related accessories

·      Transcutaneous electrical nerve stimulation devices and supplies

CMS launched Round 2 on July 1, 2013, in 91 cities for eight product categories:

•    Oxygen supplies and equipment;

•    Standard manual and power wheelchairs and scooters and related accessories;

•    Enteral nutrients, equipment and supplies;

•    CPAP devices, respiratory assist devices and related supplies and accessories;

•    Hospital beds and related accessories;

•    Walkers and related accessories;

•    Support surfaces; and

•    Negative pressure wound therapy pumps and related supplies and accessories

WASHINGTON – Just days after CMS released new payment amounts for the latest round of its competitive bidding program, two senators have introduced a bill that would delay a second round of cuts planned for non-bid areas on July 1, 2016.

Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., introduced S. 2736 to delay the cuts 15 months to Oct. 1, 2017. A first round of cuts went into effect in non-bid areas on Jan. 1.

CMS earlier this week released the new payments amounts for the Round 2 re-compete. The agency will offer 12,181 contracts to 637 bidders. It plans to announce contract suppliers this spring, and go live with the new pricing and contract suppliers on July 1.

Other provisions of S. 2736, which already has 14 co-sponsors, include:

• The ceiling for a bid submitted for applicable covered items may not be less than the fee schedule amount that would otherwise be determined for such items on Jan. 1, 2015;
• In the case of items and services furnished on or after Jan. 1, 2019, the secretary shall solicit and take into account stakeholder input; and take into account the average travel distance and cost associated with furnishing items and services in the area, any barriers to access, the average delivery time, the average volume and the number of suppliers;
• Not later than the first of each month, beginning with May 1, 2016, and ending with Sept. 1, 2017, the secretary shall publish on CMS’s website the results its monitoring of access of Medicare beneficiaries to DME and of health outcomes.

As a “pay for,” the bill advances plans to limit federal Medicaid reimbursement to states for DME to the Medicare payment rates from Jan. 1, 2019, to Oct. 1, 2018.

The senators co-sponsoring the bill are: Sens. Mike Crapo, R-Idaho; Jon Tester, D-Mont.; Pat Roberts, R-Kan.; Chuck Grassley, R-Iowa; Joe Manchin, D-W.Va.; Shelley Moore Capito, R-W.Va.; Mike Rounds, R-S.D.; Steve Daines, R-Mont.; John Barrasso, R-Wyo.; Thad Cochran, R-Miss.; Mazie Hirono, D-Hawaii; Michael Bennet, D-Colo.; Angus King, I-Maine; and Joni Ernst, R-Iowa.

WASHINGTON – Last week was busy for the HME industry as both CMS and stakeholders pushed and pulled against the competitive bidding program.

CMS released the new single payment amounts for the Round 2 re-compete on March 15. With 117 geographic regions and thousands of HCPCS codes, stakeholders were faced with the daunting task of going through the numbers code by code to compare these allowables with those from the previous Round 2.

So far, reductions are ranging from a few percentage points to 15% to 20%, they say.

“I’m seeing 3% to 7% reductions in the items I’ve looked at so far,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “You see a few items that went up, but when you average out a whole product category, it’s lower.”

Reimbursement rates for HME have been, on average, 45% lower as part of the previous Round 2.

Unlike with previous rounds of competitive bidding, CMS didn’t include in its announcement savings from the program, stakeholders point out.

“I think CMS probably expected further reductions,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “I just think we’ve hit rock bottom; the pricing has gotten to a point where it’s just barely sustainable for many providers.”

CMS will now begin the contracting process and said it will offer 12,181 contracts to 637 bidders.

“We are hearing people say, ‘I got a contract, but I bid much higher,’” said Brummett. “If the median is that much lower, that means there had to be some serious low-ball bids in there.”

Meanwhile, Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., on March 17 introduced a bill that would delay a second round of cuts in non-bid areas from July 1 to Oct. 1, 2017.

“That 15 months is fantastic,” said Tom Ryan, president and CEO of AAHomecare. “We think that’s going to buy us a lot more time to have a play next year.”

As a “pay for,” the bill, S. 2736, advances plans to limit federal Medicaid reimbursement to states for DME to the Medicare payment rates from Jan. 1, 2019, to Oct. 1, 2018.

With no legislative vehicle expected in the next few months, it will be necessary to get the bill passed via a “hotline process.”  Stakeholders are working to add co-sponsors to the original 14, as well as get a key Democratic co-sponsor for a House version of the bill, lead by Rep. Tom Price, R-Ga., possibly as early as this week.

“It’s a good bill and we are going to work it and work it hard,” said Ryan.