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    03/18/2016
    Liz Beaulieu

    NEW ORLEANS – Whether it’s PERS, telehealth or remote health monitoring, tech-enabled home care is here and it’s here to stay, said the speakers at the Home Health Technology Summit last week.

    Britney Treadaway, who spoke on a panel about telehealth, told attendees to, at the very least, “pick one thing to implement,” because technology is not going away.

    “What we’re really waiting on, here, is you,” said Treadaway, director of strategy and implementation for Ideal Life, a tech-based remote health monitoring company.

    Execs from home health and hospice agencies, visiting nurse associations and HME companies gathered March 13-15 at the Hotel Monteleone to learn how technology can reduce costs, increase efficiency and improve care.

    Dr. Steven Landers told attendees that he hasn’t “cracked the code yet” on how to best use technology in home care, but he has created a Connected Health Institute at his organization to explore the use of technology and has become a “serial piloter,” because he knows it’s the future.

    “The core concepts that make home care so special—technology elevates the humanity and compassion in home care,” said Landers, president and CEO of the Visiting Nurse Association Health Group, who spoke about his strategic approach to incorporating technology.

    Technology also improves business, says David Taylor, supervisor of telehealth services for the VNA MercyRockford. He shared with attendees how telehealth helped him reduce the readmission rates of affiliated hospitals from 27% in 2012—resulting in a penalty from Medicare—to about 16% in 2015.

    Speakers acknowledged, however, that there are “bottlenecks” to implementing and leveraging technology, and one of the biggest is the behavior change required. Technology requires providers to transform the way they think about and do business, they said.

    “If you don’t understand that you have to tear your business down, you’re not going to succeed,” said Jim Reilly, vice president of telehealth for Connect America, who spoke about the policy and reimbursement landscape for PERS and telehealth, and challenged attendees to do like GM leaders once did and “put your business out of business.”

    Another bottleneck: reimbursement by insurers, or the lack thereof. Speakers said waiting for the government, or even private payers, to catch up with business—though they will at some point—misdirects your energy.

    “People think of telemonitoring as not paid,” said Jeremy Malecha, vice president of product management, Global Healthcare Informatics, at ResMed, who spoke about the power of the data and predictive analytics that technology allows. “What technology has the ability to do is allow you to do business differently and more efficiently.”


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    03/18/2016
    HME News Staff

    LAKE FOREST, Calif. – Apria Healthcare has stepped back into the home enterals market with the launch of Refresh, its new support program.

    “With our re-entry into the home enteral market, Apria is responding to the rapidly increasing requirements of the healthcare industry for an enteral program that consistently delivers positive patient experiences and achieves optimal clinical outcomes,” said Dan Starck, CEO of Apria Healthcare, in a release. “Through our commitment to an industry-leading enteral program, Apria is safely and effectively transitioning patients, delivering high quality products and services, and allowing patients to remain at home in the most effective, lowest cost care setting.”

    Apria sold its Coram home infusion business, with incuded enterals, to CVS Caremark in 2013.

    As part of the Refresh program, Apria provides dieticians to assess the patient’s nutritional risks, assist in the development of care plans and help monitor therapy.

    Apria won several contracts to provide enterals as part of Round 2 of competitive bidding.

    HME providers make their case before SBA

    CHEYENNE, Wy. – HME providers from across Wyoming and parts of Colorado shared their stories of how Medicare policies have affected them and the beneficiaries they serve during the Small Business Administration’s Regulatory Fairness Meeting here last week. The SBA’s National Ombudsman, Earl Gay, is hosting such meetings throughout the U.S. The VGM Group invited local providers to the meeting to share their concerns about reimbursement cuts and extensive auditing. Staff members from the offices of Sen. Michael Enzi, John Barrasso and Cynthia Lummis also attended. The next meetings will take place March 23 in Bismarck, N.D., and March 24 in Sioux Falls, S.D.

    Hospital system buys Pittsburgh home infusion pharmacy

    PITTSBURGH, Pa. – Allegheny Health Network, a nonprofit hospital system, has expanded its home health business by acquiring a home infusion pharmacy in Sharpsburg, Pa., from Infusion Partners, a subsidiary of Elmsford, N.Y.-based BioScrip. The pharmacy employs 20 workers and provides antibiotics, pain management, hydration, chemotherapy and other medications that are administered intravenously at home. The deal will allow AHN to increase the capacity and geographic reach of its existing infusion pharmacy in Meadville. Terms of the deal were not disclosed. In December 2014, AHN acquired Klingensmith Healthcare, an independent provider of HME and respiratory services with 195 employees serving more than 9,000 patients in Western Pennsylvania and parts of West Virginia and Ohio.

    AAHomecare offers input on O2 e-template

    WASHINGTON – AAHomecare hosted a conference call last week with CMS, EPIC Software and an association member supplier to lay the groundwork for an oxygen e-template pilot program. The group reviewed the steps involved in rolling out the pilot in two health systems that use EPIC, and the specific data elements that would need to be incorporated into the software and adopted by the health systems. “The goal of this pilot is to create order for oxygen therapy, documentation of lab values and clinical documentation that meet all of the required elements for Medicare,” AAHomecare stated. The long-term goal: Roll out the e-template with EPIC and other health systems nationally.

    Invacare goes virtual

    ELYRIA, Ohio –Invacare has teamed up with the Cleveland-based digital marketing agency Think Media to create a virtual reality world for viewers to experience its products. "We want everyone—providers, therapists, and most importantly, consumers—to experience what it's like to be in an Invacare product," said Maegen Hurtado, digital marketing manager at Invacare, in a release. "We want people to be inspired and know that they truly can do anything they put their mind to."Viewers experience a 360-degree view as Paralympian Paul Schulte rides on his Invacare Top End Force RX Handcycle in Clearwater Beach, Fla.

    Precision, Luxfer partner on EU distribution

    NOTTINGHAM, England – Precision Medical has partnered with Luxfer Gas Cylinders to add portable oxygen concentrators to Luxfer’s product offerings in Europe. Beginning in April, Luxfer will offer both dial and push-button versions of three and five liter lightweight POCs manufactured by Precision for Luxfer. “Luxfer will enable the supply of market-leading POCs—manufactured by Precision Medical—into the EU, while enabling Luxfer to offer customers a complete line of oxygen-delivery devices,” said Tim Clark, executive vice president of global sales and marketing for Precision Medical.

    Prism gets lift from Shoppers

    TORONTO – Prism Medical has agreed to acquire certain assets of the lift and elevating business of Shoppers Home Health Care in the provinces of Ontario, Saskatchewan and Alberta. Prism will pay about $2.1 million for inventory and equipment, with a deferred payment respecting good will, according to a press release. The two companies have also agreed to enter into a sales agreement whereby Shoppers will be a non-exclusive sales agent for Prism of specified lift and elevating products and services for residential business in Ontario, Saskatchewan and Alberta. The transaction is scheduled to close May 31.

    Women’s health event seeks speakers

    WATERLOO, Iowa – Event organizers for this year’s “Focus: The EW Conference” are now accepting presentation submissions. The event, hosted by Essentially Women for its members, will take place Sept. 25-26 at the Sheraton Myrtle Beach Convention Center Hotel in Myrtle Beach, S.C. Event organizers expect more than 300 women’s healthcare providers and manufacturer representatives to attend the event. Education sessions will tackle audits and compliance, marketing, professional and personal development, retail sales and more. Essentially Women became a division of The VGM Group earlier this year.

    New blood glucose monitoring system hits U.S. market

    CAESAREA, Israel – The Dario Blood Glucose Monitoring System is now available in the United States, its developer, LabStyle Innovations, has announced. Through its U.S. headquarters in Massachusetts, the Israeli company is working with insurers to establish reimbursement and arrange agreements with distributors. Direct-to-consumer sales are available at usa.mydario.com/shop and are supported through a U.S.-based customer service center and hotline. "The U.S. is the world's largest market for glucose monitoring and the launch of national availability represents a transformative achievement not only for Dario, but more importantly for users," said Erez Raphael, Chairman and CEO of LabStyle Innovations.

    Short takes: GF Health Products, Responsive Respiratory, BOC

    GF Health Productshas received the Georgia Department of Economic Development’s annual GLOBE Award for international sales achievement. Sandra Parker, the company’s vice president of Medical-Surgical SBU, accepted the award at the Annual Go Global Reception on March 8 in Atlanta before 400 attendees…Responsive Respiratory has revamped its website to include intuitive ordering capabilities and enhanced product listings. RRI also restructured the website, www.respondo2.com, into core markets (home care, emergency medical services, and industrial filling and distribution), allowing direct access to product specifications, manuals, images and real-time inventory stock alerts…The Board of Certification/Accreditation has won a bronze Stevie Award for “E-Commerce Customer Service” for its customer service and social media efforts. It’s the fifth time in four years BOC has won a Stevie Award.


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    03/21/2016
    Tracy Orzel

    JUNEAU, Alaska – A year after Alaska lawmakers passed a bill to allow Medicaid reimbursement for used DME, providers say they still haven’t gotten their marching orders from the state.

    Medicaid beneficiaries may be required to purchase used or refurbished DME if the equipment is available; is less expensive; is able to withstand three years of use; and meets the needs of the recipient. The law, passed in April 2015, is meant to reduce costs to the Medicaid program.

    “You need to pass regulations to actually implement it and we’ve not seen that yet,” said Dan Afrasiabi, president of Anchorage, Alaska-based Geneva Woods Pharmacy. “So until we can actually see how they want to implement the law, it’s very difficult to know what it means to us.”

    Afrasiabi’s biggest concern: that the law could lead to even more documentation and audits, tying up resources. 

    “Legislation like this is subject to so many interpretations relative to the quality of the used equipment,” he said. “And then you’ve got issues around warranties and repairs.” 

    This isn’t the first time reuse programs have been attempted. Texas and Kansas passed similar bills, but the programs have had difficulty gaining traction, due to sanitation concerns and liability issues. hme


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    03/21/2016
    Liz Beaulieu

    YARMOUTH, Maine – With more scrutiny than ever from Medicare for popular back, knee and ankle braces, some HME providers are getting a little too creative to capture business in this market, industry attorneys fear.

    Some providers who are trying to improve their chances of obtaining and qualifying Medicare beneficiaries for braces are setting up questionable arrangements with companies that provide leads and companies that provide remote physician services, says healthcare attorney Jeff Baird, chairman of the Health Care Group at Brown & Fortunato in Amarillo, Texas.

    “We’re seeing everyone and their mother looking to put these types of arrangements together,” he said. 

    What makes arrangements between HME providers and lead generation and telehealth companies problematic is how the telehealth companies get paid, Baird says. In a properly structured arrangement, the telehealth companies are management companies, not medical practices or healthcare providers; and they’re paid by group health plans, self-funded employers and patients, he said.

    HME providers can’t directly pay telehealth companies for orders, or indirectly through lead generation companies, Baird says.

    “We’re seeing some attorneys approve these types of arrangements, which is nuts,” he said. “It’s only a matter of time before we see a whistleblower lawsuit or the Department of Justice intervene.”

    Even if providers are steering clear of arrangements with lead generation and telehealth companies, they’re still under a microscope, which makes billing Medicare for braces increasingly difficult, says Neil Caesar, president of the Health Law Center in Greenville, S.C.  

    “We’ve seen it affect turnaround time, or the amount of supplementary records that they want to see,” he said.

    Ultimately, braces could be Medicare’s next “code killer,” like power wheelchairs and diabetic testing strips before it, Baird says.

    “This party is starting to come to a halt,” he said.


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    03/25/2016
    Liz Beaulieu

    YARMOUTH, Maine – When two companies as big and different as ResMed and Brightree merge, there’s more than likely going to be an impact on their HME provider customers, the majority of respondents to a recent HME Newspoll say.

    Sixty percent of respondents expect the mega deal to affect their businesses, some say in good ways and some say in potentially concerning ways.

    “Mergers and acquisitions have become common in our industry,” wrote John Reed, CEO of Walnut Medical Services. “We have relationships with both Brightree and ResMed. We’ll wait and see.”

    ResMed announced plans to buy Brightree for $800 million in February. Sixty percent of respondents said they were shocked by the news.

    Some respondents, most of them customers of one or both companies like Reed, expect the deal to result in more streamlined and efficient products, and better integration between products.

    “If there’s any effect at all, due to our relationships with both Brightree and ResMed, I hope it would be positive,” said Deb Swaim, a manager at Riverside Health Equipment.

    But just as many, if not more, respondents have concerns. One of the most frequently cited: That ResMed now has access to pricing information.

    “Having access to Brightree means that ResMed will have the ability to set our pricing using factors not always available, such as our reimbursement, total items bought and their competitors’ prices,” wrote one respondent.

    This is a reason the deal even has some customers of both companies feeling uncomfortable.

    “We’re Brightree users and ResMed buyers,” wrote Lori Sears, owner of Active Home Medical. “I can't imagine how the deal would be worth it to ResMed if they didn't plan on using that information to their advantage somehow.”

    More concerning for others: Will access to pricing information, as well as patient data, set the stage for ResMed to sell directly to consumers?

    “Look at ResMed’s acquisitions of late: Jaysec, CareTouch, Inova and Brightree,” pointed out one respondent. “They have the document management piece, billing system, re-supply and oxygen. They’re only missing the delivery piece to go direct to consumers. It may not happen in the next 10 years, but they are aligning the stars.” 

    For some respondents, the concerns are more immediate and practical. Will the deal force them to change products and services?

    “I’m worried this will steer Brightree to becoming exclusive with ResMed, and affect our relationship and integration with other vendors,” wrote one respondent. “As someone who primarily doesn't use ResMed, I am not a fan of this at all.”

    Another respondent added: “I’m also concerned about the ability to maintain our current business relationship with Philips Respironics in the long term, given that at some point in the future the connectivity between Encore Anywhere and Brightree could be eliminated, or ‘taxed’ by Brightree, making it financially burdensome.”

    Regardless of its impact on HME provider customers, some respondents acknowledge this is a smart move by ResMed in a highly competitive and quickly changing healthcare market.

    “This vertical integration gives them the ability to be flexible and to scale to take advantage of new healthcare value-based models if the opportunity presents itself,” the respondent wrote. “They have the ability to present themselves as a solution at a much higher level than they ever could have being an equipment manufacturer.”

    ResMed, in a statement to HME News, said, “Our customers can rely on Brightree and ResMed to do what we say we’re going to do,” including safeguard patient data and pricing information. To read the full statement, click here.


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    03/25/2016
    Tracy Orzel

    WASHINGTON – With the Office of Civil Rights gearing up for phase 2 of its HIPAA Audit Program, HME providers could be doing a better job of protecting patient information, legal experts say.

    “For the most part, they probably do not take it as seriously as they should,” said healthcare attorney Denise Leard with Brown & Fortunatoin Amarillo, Texas. “I think there are a lot of opportunities to go wrong.”

    Last week, the OCR announced plans to obtain and verify contact information for various types of covered entities, including individual and organizational health providers, health plans and healthcare clearinghouses, as well as business associates, to examine compliance with HIPAA and HITECH privacy, security and breach notification rules.

    When it comes to protecting patient information, healthcare attorney Edward Vishnevetsky says everyone knows they need to, they might just not know how—or for how long.

    “A lot of businesses that close down think they can throw the information away,” said Vishnevetsky with K&L Gates LLPin Dallas. “That’s not necessarily the case. Under HIPPA, you still have to maintain the information even after you’ve shut down.”

    Another common mistake HME businesses make is sending sensitive information via email, Drop Box or Google Drive. These services are often not encrypted.

    “Providers don’t need to know everything,” said Vishnevetsky. “Just what needs to be protected, how to protect it and what to do if the information gets out.”

    In the event of a data breach, providers need to have a plan in place to mitigate the damage. If they fail to, they could face significant penalties, similar to those associated with False Claims Act violations.

    “They have to notify the patients, report the breach to the OCR, and if the breach includes more than 500 patients, they have to publish that in the local newspaper,” said Leard.

    When it comes to understanding and adapting to evolving security regulations, HME companies, which tend to be smaller, may have their work cut out for them.

    “It takes time to modify policies,” said Leard. “It’s the small ones with less than 10 employees that just don’t have the resources.”

     


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    03/25/2016
    HME News Staff

    ORLANDO, Fla. – Rotech Healthcare announced last week that it has received contract offers for general HME and standard mobility for all 117 competitive bidding areas as part of the Round 2 re-compete.

    The national provider has also received offers for respiratory equipment for 116 CBAs.

    The offers are a bittersweet, Rotech says.

    “While we are excited about winning oxygen and CPAP in 116 CBAs, we are also disappointed bid pricing rates continue to reach levels that are devastating to the industry,” said Tim Pigg, CEO, in a press release.

    CMS released new single payment amounts for the Round 2 re-compete on March 15, doling out cuts that range from a few percentage points to up to 20% above and beyond the original Round 2. It plans to announce contract suppliers this spring and apply new pricing July 1.

    Rotech says it expects the reimbursement cuts to force providers to close their doors, resulting in “extreme” access to care issues.

    “Rotech will be ready to assist patients stranded by their current provider,” the company stated.

    Universal Software acquires document management system

    DAVISON, Mich. – Universal Software Solutions has purchased Metridoc, the content management and document imaging asset of Certerline, Mich.-based Titan Solutions.Metridoc provides a flexible application programming interface for both web-based and premise solutions, allowing third party components to be added for further enhancements, such as OCR, 2D and 3D barcode recognition, document conversions, translation services and handwriting recognition. “With the addition of this product, in very short order, it will soon evolve into a tightly integrated component within HDMS and will greatly improve the end-user experience within a single system,” said Christopher Dobiesz, president of USS, in a release. USS will assume the ongoing customer service to the current users of Metridoc as it develops additional functionality. The Metridoc name will remain the property of Titan Solutions; a new product name has not been officially announced. 

    WHILL targets Medicare market

    SAN FRANCISCO – WHILL has received FDA clearance for its Model M, paving the way for doctors to prescribe the power wheelchair as a medical device. WHILL already offers its Model A for cash sale. Model M keeps the four-wheel drive, patented all-direction wheels and sleek design of the Model A, but also offers customizable features like arm and back supports, and ankle huggers. WHILL also plans to apply for a HCPCS code for Medicare reimbursement. “FDA clearance is inline with our mission to change the perception of mobility devices, such as wheelchairs and scooters, which are often stigmatized for having a clinical appearance,” the company stated in an email.

    Apothecary by Design buys pharmacy

    PITTSBURGH, Pa. – Apothecary by Design, a specialty pharmacy, has acquired Warrenville, Ill.-based Healy Pharmacy. Both pharmacies specialize in infertility treatment, serving complementary geographic markets with little overlap. The deal allows them to share resources to better serve patients and prescribers, they say. "In addition, the partnership blends each pharmacy's unique areas of expertise, such as Healy's strength in oncology and ABD's experience in infectious and inflammatory diseases," said ABD CEO Mark McAuliffe in a release. The Braff Group originated the transaction, and served as the exclusive mergers and acquisitions advisor to Healy Pharmacy.

    ASAA receives funding for study

    WASHINGTON – The Patient-Centered Outcomes Research Institute Board of Governors has approved a three-year, $2.5 million demonstration project called the O2VERLAP Study, the American Sleep Apnea Association (ASAA) has announced. The multi-partner demonstration project will compare the effectiveness of proactive care (web-based peer coaching education and support intervention) versus reactive care on improving adherence to nocturnal oxygen and CPAP therapies in patients diagnosed with both COPD and OSA. It will also compare the effectiveness of the two intervention groups on patient-centered outcomes, including sleep quality and symptoms. The award has been approved pending completion of a business and program review by PCORI staff, and issuance of a formal award contract.

    Mediware extends reach of new tool

    LENEXA, Kan. – Mediware Information Systems and its business intelligence partner, Rock-Pond Solutions, have released real-time BI reporting for current HME, home infusion and specialty pharmacy CPR+ customers. Once incorporated into CPR+, the BI suite will allow users to analyze trends, track current performance and anticipate future needs. “The new reporting suite is designed to help CPR+ customers save time managing their data every day with real-time custom reporting, easy-to-follow dashboards and ad-hoc analysis,” the company states in a release. “Providers will also have access to automated exception reporting that instantly notifies staff when key performance metrics are above preset limits.” Mediware recently released a BI solution for Fastrack customers.

    PMDRX launches seating evaluation tool

    GLENDALE, Ariz. – PMDRX has launched the Therapist Functional Mobility and Seating Evaluation tool. The cloud-based tool will enable therapists to assess all parameters of clinical assessment to determine patient-specific seating and mobility needs, according to a press release. Upon completing the evaluation, therapists can auto-format the completed exam into a CMS-compliant report of the assessment, and can electronically authenticate and sign the final documentation with their password-protected electronic signature.

    Study: Patient monitoring limits adverse drug effects

    NEW ORLEANS – Close monitoring of patients receiving infusions of infliximab prevented adverse drug events, according to a new study from Option Care. The study included 291 Option Care patients who received 1,866 infusions of infliximab, an immune system suppressant used to treat a variety of autoimmune disorders, including rheumatoid arthritis and Crohn’s disease. Among the study’s findings: None of the infusions were associated with a severe ADE; 13 were associated with a moderate ADE, such as fever; and 65 were associated with a mild ADE, such as a headache. “Our findings add to the growing body of evidence that home infusion administered by a high quality provider is safe and effective,” said Kendra Curry, PharmD, corporate director of Option Care Specialty Infusion Programs, in a release.

    Arkansas recognizes BOC for licensure

    OWINGS MILLS, Md. – Arkansas is the latest state to recognize Board of Certification/Accreditation examinations for licensure of providers in the orthotic, prosthetic and pedorthic professions. The Arkansas Department of Health made the rule change in January following a recommendation by the Arkansas Orthotics, Prosthetics & Pedorthics Advisory Board. CMS, Veterans Affairs and other states have recognized BOC credentials to ensure requisite knowledge and competence to provide quality care. The Arkansas decision follows similar recent decisions in Iowa and Pennsylvania. “This will help reduce some of the unintended consequences of licensure, and allow well-established O&P professionals to relocate and continue practicing in these licensure states,” stated Claudia Zacharias, BOC president and CEO, in a press release.

     


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    03/31/2016
    HME News Staff

    WASHINGTON - Reimbursement rates will decrease, on average, 7.1% when the Round 2 re-compete kicks off July 1, according to an analysis from AAHomecare.

    On average, providers will see a 6.2% reduction in the Midwest; 8% reduction in the Northeast; 5.9% reduction in the south; and an 8.8% reduction in the West as part of the Round 2 re-compete compared to the original Round 2.

    Of the product categories included in the Round 2 re-compete, support surfaces will see the largest cuts, ranging from 22.7% to 31.3%, depending on the region. Close behind: Negative pressure wound therapy pumps, which will see cuts ranging from 17.8% to 21%.

    There were a few categories that showed modest increases, including manual hospital beds, walkers, wheelchair accessories and negative pressure wound therapy supplies.

    CMS is in the process of offering12,181 contracts to 637 bidders. Of those, 93% are to bidders who currently furnish items in the area or within the product category.

    The agency plans to announce the contract suppliers in the spring of 2015 and intends to go live with the payment amounts and contract suppliers on July 1, 2016.


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    04/01/2016
    Theresa Flaherty

    WASHINGTON – Efforts to develop an electronic template for oxygen have taken an important step forward, but there’s still “a long way to go,” says AAHomecare.

    “We’ve been saying it’d be great if we could work with CMS and an EHR to incorporate required data elements,” said Kim Brummett, vice president of regulatory affairs for the association.

    And that happened in March, when the association hosted a conference call with CMS; EPIC Software, an electronic health record system that is widely used by healthcare systems; and two HME providers to discuss developing a pilot for an oxygen e-template.

    “We’re putting together the stages of the pilot—how do we prove success,” said Brummett.

    The goal of the pilot is to create an order for oxygen therapy, with clinical documentation and documentation of lab values, and to find a way to incorporate that information into EPIC, Brummett said.

    CMS has for some time been considering e-templates for not only oxygen concentrators, but also power mobility devices and lower limb prostheses. While HME provider opinions are often mixed on whether or not e-templates would be helpful, there’s little doubt that health care is shifting in that direction, they say.

    “I am in favor of anything that can standardize the ordering process,” said Steve Ackerman, owner of Spectrum Medical in Silver Spring, Md.“I’ve seen many companies that are looking to get portals installed so we can have the interoperability with our bigger referral sources.”

    HME providers that have close ties with health systems and physician practices and that have worked with their IT programs and EPIC to incorporate all the needed items on orders and documentation have seen some success, Brummett said.

    “But they are working system by system,” she said. “Really, we’ve got a long way to go.”


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    04/01/2016
    HME News Staff

    WASHINGTON - Reimbursement rates will decrease, on average, 7.1% when the Round 2 re-compete kicks off July 1, according to an analysis from AAHomecare.

    On average, providers will see a 6.2% reduction in the Midwest; 8% reduction in the Northeast; 5.9% reduction in the south; and an 8.8% reduction in the West as part of the Round 2 re-compete compared to the original Round 2.

    Of the product categories included in the Round 2 re-compete, support surfaces will see the largest cuts, ranging from 22.7% to 31.3%, depending on the region. Close behind: Negative pressure wound therapy pumps, which will see cuts ranging from 17.8% to 21%.

    There were a few categories that showed modest increases, including manual hospital beds, walkers, wheelchair accessories and negative pressure wound therapy supplies.

    CMS is in the process of offering 12,181 contracts to 637 bidders. Of those, 93% are to bidders who currently furnish items in the area or within the product category.

    The agency plans to announce the contract suppliers in the spring of 2015 and intends to go live with the payment amounts and contract suppliers on July 1, 2016.

    CGS readies transition

    NASHVILLE – CGS Administrators will take over the Jurisdiction B DME MAC contract July 5. The myCGS portal registration window for suppliers will open three weeks prior, and the process is expected to be a simplified, express registration to ease the transition, the agency said during a recent call. Jurisdiction B suppliers will receive a written invitation to pre-register. Any unfinished claims processing, appeals and other work will be officially transitioned from the previous contractor, National Government Services, to CGS for completion. CGS was awarded the Jurisdiction B contract in January.

    NCART shows and tells for lawmakers

    WASHINGTON – NCART is holding a “CRT briefing and Product Expo” on Capitol Hill April 21 to educate lawmakers about complex rehab and get their support for current legislation. The group is hosting the event along with the United Spinal Association and the National Multiple Sclerosis Society, in coordination with the offices of Reps. Jim Sensenbrenner, R-Wis., and Joe Crowley, D-N.Y. NCART is asking providers to encourage lawmakers to attend the event, which will comprise 20-minute briefings from 1 p.m. to 5 p.m. People with disabilities, clinicians, providers, manufacturers and other advocates will be in attendance to provide demonstrations and answer questions. NCART hopes the event will help stakeholders increase support for bills in the House of Representatives and the Senate that would prevent competitive bidding pricing from being applied to accessories for complex manual and power wheelchairs, and would create a separate benefit for complex rehab products.

    Oklahoma Medicaid announces 25% cuts

    OKLAHOMA CITY – The Oklahoma Health Care Authority, which oversees the state’s Medicaid program, is cutting reimbursement rates for more than 46,000 providers by 25%, according to local news reports. Due to a roughly $1.3 billion hole in next year's state budget, state agencies are being directed to prepare for cuts of 15% or more to their budgets. The cuts, which will affect DME providers, hospitals, physicians, pharmacies and nursing facilities, are slated to take effect July 1. "This is a market-changing development in terms of hospitals' and other providers' ability to satisfactorily treat those that are on Medicaid," Craig Jones, president of the Oklahoma Hospital Association told a local news outlet.

    Lifeway Mobility taps Medforce Technologies

    SUFFERN, N.Y. – Lifeway Mobility has selected Medforce Technologies’ cloud-based CommandCenter business process management platform and ContentCenter document management system to run its operations. “The Medforce system allows us to connect to all of our vital documentation, forms and workflow activities right from the field and have instant data exchange with employees back at the office,” said Paul Bergantino, president of Lifeway Mobility, in a release. “It gives us the tools we need to maximize our productivity, minimize wait time, and ensure the best customer service possible.” Medforce recently revealed a new brand identity complete with logo, tag line, product names and website.

    GF Health debuts new look

    ATLANTA – Graham-Field Health has a new brand identity, the manufacturer has announced. The re-launch includes a new logo and a new mobile-responsive website featuring educational articles and resources. “Graham-Field’s diverse business mix and ever-growing global reach demanded a fresh look at how the organization supports its markets,” said Lisa Wells, president of Get Social Consulting, who helped GF Health develop its new brand strategy. “Their new brand concept and resource community were designed with the guidance of a skilled team of marketers and product managers, as well as business unit leaders. The strategic effort came together from the ground up within the organization.” The GF family of brands includes Basic American Medical Products, Everest & Jennings, Grafco, Hausted, John Bunn, Lahtron, Lumex and Lumiscope.

    McKesson joins forces with online provider

    NEW YORK – McKesson has partnered with Shoplet to offer medical products online, the companies announced March 29. Shoplet, an online provider of office and cleaning supplies and furniture, entered the medical supplies market three years ago, according to a release. “This partnership is going to go a long way in providing more high-quality supplies to our customers,” said Tony Ellison, founder and CEO of Shoplet. “We are thrilled to work together.” Shoplet will offer DME, wheelchairs, incontinence products, gowns and gloves, among other products.

    Convaid ramps up donations

    TORRANCE, Calif. – Convaid has expanded its collaboration with United Cerebral Palsy. The company has committed to “a schedule of planned giving” to the organization, with its first donation scheduled for the UCP National Conference, April 4-6. Convaid will donate a lightweight, folding, pediatric wheelchair and a Carrot 3 child restraint system for raffle at the event. Convaid has long-standing relationships with United Cerebral Palsy of Los Angeles, Ventura, Santa Barbara, and Orange counties in California, and United Cerebral Palsy of Philadelphia in Pennsylvania.

    Untreated sleep apnea increases crash risk

    MORRIS, Minn. – Commercial truck drivers with untreated obstructive sleep apnea crash five times more often than those without sleep apnea, according to a new study from the University of Minnesota. Drivers with OSA who somewhat or completely complied with their therapy had a crash rate similar to drivers without OSA, the study says. The study included 1,613 truck drivers at a large trucking firm who had OSA and the same number of truck drivers who did not have the condition but who had similar experience and tenure. Drivers with OSA were given positive airway pressure therapy and an auto-adjusting machine for use at home or in their truck. Nearly 700 drivers fully followed treatment requirements, almost 600 partially did, and nearly 400 never adhered. The Federal Motor Carrier Safety Administration and the Federal Railroad Administration recently announced they are considering requiring sleep testing for transportation workers. The FMCSA has been working on guidelines for testing and treating commercial drivers for nearly a decade.

    VGM has ‘Big Ideas’ for Heartland Conference

    WATERLOO, Iowa – The VGM Group has released the educational lineup for the Heartland Conference, June 13-16. This year’s event, themed “Ignite Ideas and Cultivate Connections,” organizes education into 16 categories, with more than 50 industry experts tackling topics ranging from billing and reimbursement to retail to accessibility to compliance. New this year: an education track to help generate and foster “Big Ideas.” The track, still in development, will include a creative boot camp and a “speed networking” event. VGM also plans to host a special event to honor women in the HME industry. This year will be the event’s 15th and VGM officials expect the usual crowd of more than 1,000.

    bflow to host user conference

    LOS ANGELES – bflow Solutions will host its first annual industry summit May 17 in Burbank, Calif. The event will bring together billing, compliance, accreditation, exemptee and managed care clients to learn how to optimize their businesses. Speakers will include Harlan Louie, sector chief, California Department of Public Health; Janelle Waynack of Instamed; and Abe Weinberger of WTI Outsourcing. The event is open to current bflow users, as well as those looking to test drive the solution. bflow is a cloud-based HME billing and compliance software solution that hit the market in 2011. The company launched bflowAcademy.com, which provides California Exemptee Certification, accreditation and compliance training, and healthcare continuing education services, in 2012.

     

     


    0 0

    04/07/2016
    HME News Staff

    WASHINGTON – HME stakeholders have added two co-sponsors to a bill in the Senate that would delay a second round of Medicare reimbursement cuts slated for July 1.

    Sens. Debbie Stabenow, D-Mich., and James Lankford, R-Okla., signed on to S. 2736 on April 6. They join 15 other senators, a mix of Democrats and Republicans.

    The bill, introduced by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., on March 17, would delay the cuts slated for non-competitive bidding areas from July 1, 2016, to Oct. 1, 2017. A first round of cuts went into effect in these areas on Jan. 1.

    A companion bill in the House of Representatives is still a work in progress, stakeholders say.

    The bill also states: 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. 2, 2015.”

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


    0 0

    04/08/2016
    HME News Staff

    In brief: Two senators back bid bill, groups seek vent changes

    WASHINGTON – HME stakeholders have added two co-sponsors to a bill in the Senate that would delay a second round of Medicare reimbursement cuts slated for July 1.

    Sens. Debbie Stabenow, D-Mich., and James Lankford, R-Okla., signed on to S. 2736 on April 6. They join 15 other senators, a mix of Democrats and Republicans.

    The bill, introduced by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., on March 17, would delay the cuts slated for non-competitive bidding areas from July 1, 2016, to Oct. 1, 2017. A first round of cuts went into effect in these areas on Jan. 1.

    A companion bill in the House of Representatives is still a work in progress, stakeholders say.

    The bill also states: 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. 2, 2015.”

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

    Respiratory groups seek changes to ventilator NCD

    WASHINGTON – The American Association of Respiratory Care, the American College of Chest Physicians and the National Association for Medical Direction of Respiratory Care have submitted a request for a reconsideration of the current Medicare National Coverage Determination for home ventilators, including bi-level devices. The groups would like Medicare to establish specific definitions for chronic respiratory failure, as well as for mechanical ventilators/ventilation, and to create objective, consistent criteria for providing these products. Their suggested definition of respiratory failure is the inability of the respiratory system to maintain gas exchange within normal limits; oxygenation failure is the inability to maintain PaO2 of 60mmHg or greater on room air; and ventilatory failure is the inability to maintain PaCO2 of 45mmHg or below. Late last year, CMS overhauled the vent product category, reducing the number of codes from five to two, and reducing reimbursement by about 33%.

    Program for joint conference announced

    ARLINGTON, Va. – RESNA, NCART and NRRTS have announced the program for the first-ever Assistive Technology Collaborative Conference. The event, slated July 12-15 at the Hyatt Regency Crystal City in Arlington, Va., will include interactive exhibits; more than 50 workshops on best practices in assistive technology; research platforms and poster sessions; Capitol Hill visits; pre-conference instructional courses, including RESNA’s Fundamentals in Assistive Technology Course; networking events; and student competitions. For a list of events, sessions and workshops, click here.

    Insulin prices increased threefold over 11-year period

    YARMOUTH, Maine – The cost of insulin more than tripled—from $231 per year per patient in 2002 to $736 per year per patient in 2013, according to an analysis published in the Journal of the American Medical Association. The price for a milliliter of insulin increased 197%, from $4.34 to $12.92 during the same period. “Insulin is a life-saving medication,” said Dr. William Herman, a coauthor of the analysis and a professor of epidemiology at the University of Michigan School of Public Health. “While there have been incremental benefits in insulin products, prices have been rising.” 

    ASP: Budesonide takes a dive

    BALTIMORE – Second quarter payments for respiratory drugs are up in most cases, with the exception of Budesonide (J7626), which decreased sharply, down nearly 73 cents per dose. Perforomist (J7606) saw the biggest increase, up 41 cents to $9.82 per dose, according to the latest average sales price (ASP) figures. Brovana (J7605) increased 24 cents to $8.50 per dose. Albuterol (J7613) and ipratropium (J7644) stayed fairly flat, at 12.5 cents per dose and 10.5 cents per dose, respectively.

    Feds tweak Medicare Advantage pricing for 2017

    WASHINGTON – Payments to insurers that offer Medicare Advantage plans won’t be as high as initially expected. Medicare Advantage payments will increase 0.85%, on average, for 2017, and insurers will likely see overall revenue increases of 3.05%, according to news reports. Earlier this year, CMS had indicated that payments would increase 1.35% and that insurers would see overall revenue increases of 3.55%. As part of a final rule published this week, the Obama administration has also proposed several tweaks to the program, including changing the way the quality of plans is rated if they serve a large population of low income and disabled beneficiaries, and shifting the way plans are reimbursed if they take on sicker-than-expected beneficiaries, according to reports.

    ResMed closes deal, promotes Price

    SAN DIEGO – ResMed has completed its acquisition of Brightree. The $800 million cash transaction is expected to be immediately accretive to gross margins and non-GAAP diluted earnings per share, the company stated in a press release headlined “It’s a New Day for HME Business Efficiency.” In connection with the acquisition, ResMed has entered into a first amendment to its credit agreement, increasing the size of its senior unsecured revolving credit facility from $700 million to $1 billion, according to Reuters. The amendment includes an uncommitted option to increase its revolving credit facility by an additional $300 million. In other news, ResMed has appointed Andrew Price president of Innovation and Operations. Previously, he was the company’s senior vice president, Global Manufacturing and Logistics. Before that, Price was vice president of marketing for Asia Pacific, and vice president of product development and marketing for the company’s Sleep Disordered Breathing business unit.

    Philips takes home awards

    MURRYSVILLE, Pa. – Philips has received 37 “Red Dot Awards” for product design, including a “high design” award for its DreamWeaver CPAP mask. The DreamWeaver features an under-the-nose cushion and a hollow frame to allow airflow to pass through. The “Red Dot” jury comprises 41 independent designers, design professors and specialized journalists. They evaluate entries based on degree of innovation, functionality, ergonomics, quality, symbolic and emotional content, ecological compatibility and durability. The “Red Dot” award follows an iF Design Award for the DreamWeaver and a Providers’ Choice Gold Award at Medtrade Spring for the DreamStation CPAP machine. Philips has a team of more than 400 designers in 15 studios around the world, from the Netherlands to Asia.

    Texas providers charged with healthcare fraud

    MCALLEN, Texas – Federal charges have been filed against two DME owners for allegedly defrauding Texas Medicaid/Medicare through false billings, the Southern District of Texas U.S. Attorney’s Office has announced. Manuel Gomez, owner of two Illusion Medical Equipment locations, and Elva Santos, owner of Hope & Miracle DME, were charged separately in difference cases, but in similar schemes involving incontinence supplies and diabetic supplies. Both allegedly forged the signatures of physicians on the required DME prescription forms.Gomez submitted $2.3 million in claims to Texas Medicaid, while Santos allegedly submitted false and fraudulent claims for approximately $714,000.


    0 0

    04/13/2016
    HME News Staff

    WASHINGTON – The Office of Inspector General has reiterated its recommendation that CMS match Medicaid reimbursement rates for HME to Medicare rates.

    The recommendation, published this week in the OIG’s April 2016 “Compendium of Unimplemented Recommendations,” suggests that CMS seek legislative authority to limit Medicaid reimbursement rates for DMEPOS to Medicare rates and further reduce those rates through competitive bidding or manufacturer rebates.

    Lowered reimbursement rates could result in approximately $30.1 million in potential savings for states and the federal government, according to the OIG.

    CMS concurred with the OIG’s recommendation. The agency says it has sought legislative authority to make the changes but additional congressional action is needed.

    CMS also pointed out that the president’s proposed budget for fiscal year 2016 includes a similar proposal for lowering Medicaid reimbursement rates.

    Additionally, “States have the flexibility to administer their Medicaid programs in accordance with a CMS-approved state plan,” the agency says. “CMS communicates frequently…to inform them of all available options, including manufacturer rebates and competitive bidding procedures.”

    The OIG believes that, if enacted, the expected savings would be $4.27 billion over a 10-year period.


    0 0

    04/14/2016
    HME News Staff

    WASHINGTON – Twelve percent of HME claims for new patients, on average, were subject to MAC prepayment audits in the fourth quarter of 2015, according to data collected through AAHomecare’s HME Audit Key.

    Drilling down by product category, 22% of hospital beds, support surfaces and manual wheelchair claims were subject to audits, followed by 16% of orthotics and prosthetics, and 14% of respiratory equipment.

    “These results are a first step in a comprehensive effort to collect data that demonstrates the burdensome nature of audits, in terms of volumes and overturn rates,” AAHomecare stated in its weekly bulletin.

    Nationwide, 78% of providers appealed denials, with O&P leading the way with a 98% appeal rate, followed by ostomy, urological and wound care supplies at 87%.

    Upon review, 60% of claims for hospital beds, support surfaces and manual wheelchairs were paid. For O&P and respiratory equipment, 15% and 74%, respectively were paid.

    AAHomecare will begin accepting data for the first quarter of 2016 on April 16.

    “The HME industry needs reliable and representative data to better demonstrate the burdensome nature of audits,” the association stated. “We must build our capabilities to accurately detail how the industry is being impacted to finally secure much-needed reform to the audit process.”

    AAHomecare went live with the HME Audit Key earlier this year. Prior to its launch, the association raised $250,000 to develop the tool.


    0 0

    04/15/2016
    Theresa Flaherty

    WASHINGTON – One month after the introduction of a Senate bill to delay competitive bidding cuts, industry stakeholders are still working to get a Democratic co-sponsor for a House companion bill.

    The sticking point: The bill’s “pay-for,” which would speed up plans to limit federal Medicaid reimbursement for DME to the Medicare payment rates from Jan. 1, 2019, to Oct. 1, 2018.

    “There’s a concern that, from a policy standpoint, we don’t want a pay-for that affects the senior or disability population,” Tom Ryan, president and CEO of AAHomecare. “We are trying to get some of that population to respond that the reality is that to move up the Medicaid pay-for three months on just those competitive bid items, that is not going to be as devastating as another 25% cut across rural America and the non-bid areas.”

    The first round of cuts in non-bid areas went into effect Jan. 1. The second round of cuts are scheduled for July 1. The Senate bill, S. 2736, would delay the second round of cuts until Oct. 1, 2017.

    Stakeholders say the good news is that lawmakers in the House are receptive to the meat of the bill. They believe the companion bill will drop in the next few weeks.

    “There are always hurdles and this is just another hurdle we have to work through,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “The cuts, just on the face of it, are so dramatic.”

    The Senate bill, introduced March 17 by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., currently has 19 co-sponsors, including Sen. Rob Portman, R-Ohio, who signed on April 13. To boost support, AAHomecare last week hired an additional lobbyist, Jenn Higgins, a partner with Chamber Hill Strategies.

    “She knows our issues extremely well and she’s passionate about our issues,” Ryan said.

    Adding fuel to the fire that bid program is unsustainable: the recently released single payment amounts for the Round 2 re-compete, which saw an average reduction of 7.1%, over and above the original Round 2, according to an analysis by AAHomecare. CMS is in the process of offering 12,181 contracts to 637 bidders, but word on the street is that many providers are turning down the business.

    “We are seeing a lot of folks backing away,” said John Gallagher, vice president of government relations for The VGM Group. “They are saying they can’t do it.”


    0 0

    04/15/2016
    Tracy Orzel

    YARMOUTH, Maine – Respondents to a recent HME NewsPoll are split over whether accepting a competitive bidding contract from Medicare is a good idea.

    Fifty-four percent of respondents said that, in general, they did not accept the majority of the contracts they were offered, while 32% said they accepted a contract the first time around, but not the second.

    One reason: “(It’s) not worth it,” said Jill Duda, business operations manager at Philadelphia-based Flagship Medical, of the decrease in reimbursement rates and the increase in paperwork.

    Another respondent, who only accepted one of six contracts (for enteral) during Round 2, said the threat of damaging their reputation of providing quality products and service far outweighed the threat of losing business.

    Others say business is doing just fine without contracts—in some cases, better.

    David Beshoar, president of MedServ Equipment based inPalatine, Ill., was awarded contracts for Round 2, but did not accept any due to low reimbursement, nor did he submit bids for the Round 2 re-compete.

    “In spite of not being able to bill Medicare for the last two-and-a-half years, our revenue and profits continue to increase,” he said.

    Meanwhile, some providers felt they had to accept the contracts to survive.

    “I hate to say (it), but we have no choice, even if it means these patients are going to get less care than ever,” wrote another.

    One health system-owned HME company said it accepted Round 2 re-compete contracts so it can provide better care. It failed to receive contracts for Round 2, resulting in late discharges, longer lengths of stay and an increased chance of readmissions.

    “The Round 2 re-compete allowed us to bid aggressively to be able to support the continuum of care throughout our community and ensure timely, fluid and safe discharges from all campuses,” the respondent said. “While the margins are thin, the outcomes will counter the risk associated with fragmented providers.”

    Thin as they are, those who accepted contracts say they’re committed to making it work.

    “We will look into getting price concessions from vendors; scale down our workforce; deliver less; and seek operational efficiencies,” said another respondent. “We will also look to continue focusing our business on non-Medicare patients and non-competitive bid items.”


    0 0

    04/15/2016
    Liz Beaulieu

    WASHINGTON – From a regulatory perspective, the first several months of 2016 have brought pain, and a little bit of relief, to HME providers.

    Among the pain points, says Wayne van Halem, is the new level of aggressiveness in the actions taken by the ZPICs. The contractors are handing out payment suspensions where, previously, they may have handed out overpayment demands, he says.

    “Some of the reasons for suspensions are ridiculous,” said van Halem, president of The van Halem Group. “Because CMS is reorganizing their contracts, I have a sneaking suspicion the ZPICs are trying to show CMS that they meet all of the contract requirements.”

    An example of a reason for suspension, van Halem says: allegedly leading a physician on an order by using a form titled “Power Mobility Device Order,” even though the form came from the DME MAC.

    Another pain point is a new rule that went into effect in March that requires providers to disclose overpayments within 60 days, something that has been an expectation in the past but is now in writing.

    “It depends on your volume of claims, but this is a pretty common occurrence,” van Halem says.

    Additionally, there’s a new batch of SMRC audits, this time focusing on oxygen equipment, nebulizers and CPAP devices.

    The SMRC audits, which involve submitting additional documentation, are straightforward but time consuming, especially for larger providers, says Stephanie Morgan Greene, a healthcare attorney who’s executive vice president of business development for ACU-Serve.

    “Our larger clients that have multiple locations are getting SMRC audits for each location for each of the product categories,” she said. “One client has received its 10th audit at 40 claims a piece. It’s a lot of work.”

    On the other side of the spectrum: The RACs have started rewarding providers with low error rates by exempting them from certain audits. Three hundred and thirty PTANs have received exemption letters in one or more categories in Jurisdiction C, says Andrea Stark.

    “We’ve also seen letters in Jurisdiction D,” said Stark, a reimbursement consultant with MiraVista. “We’re definitely seeing that in action.”


    0 0

    04/15/2016
    HME News Staff

    WASHINGTON – Twelve percent of HME claims for new patients, on average, were subject to MAC prepayment audits in the fourth quarter of 2015, according to data collected through AAHomecare’s HME Audit Key.

    Drilling down by product category, 22% of hospital beds, support surfaces and manual wheelchair claims were subject to audits, followed by 16% of orthotics and prosthetics, and 14% of respiratory equipment.

    “These results are a first step in a comprehensive effort to collect data that demonstrates the burdensome nature of audits, in terms of volumes and overturn rates,” AAHomecare stated in its weekly bulletin.

    Nationwide, 78% of providers appealed denials, with O&P leading the way with a 98% appeal rate, followed by ostomy, urological and wound care supplies at 87%.

    Upon review, 60% of claims for hospital beds, support surfaces and manual wheelchairs were paid. For O&P and respiratory equipment, 15% and 74%, respectively were paid.

    AAHomecare will begin accepting data for the first quarter of 2016 on April 16.

    “The HME industry needs reliable and representative data to better demonstrate the burdensome nature of audits,” the association stated. “We must build our capabilities to accurately detail how the industry is being impacted to finally secure much-needed reform to the audit process.”

    AAHomecare went live with the HME Audit Key earlier this year. Prior to its launch, the association raised $250,000 to develop the tool.


    0 0

    04/15/2016
    HME News Staff

    WASHINGTON – The Office of Inspector General has reiterated its recommendation that CMS match Medicaid reimbursement rates for HME to Medicare rates.

    The recommendation, published this week in the OIG’s April 2016 “Compendium of Unimplemented Recommendations,” suggests that CMS seek legislative authority to limit Medicaid reimbursement rates for DMEPOS to Medicare rates and further reduce those rates through competitive bidding or manufacturer rebates.

    Lowered reimbursement rates could result in approximately $30.1 million in potential savings for states and the federal government, according to the OIG.

    CMS concurred with the OIG’s recommendation. The agency says it has sought legislative authority to make the changes but additional congressional action is needed.

    CMS also pointed out that the president’s proposed budget for fiscal year 2016 includes a similar proposal for lowering Medicaid reimbursement rates.

    Additionally, “States have the flexibility to administer their Medicaid programs in accordance with a CMS-approved state plan,” the agency says. “CMS communicates frequently…to inform them of all available options, including manufacturer rebates and competitive bidding procedures.”

    The OIG believes that, if enacted, the expected savings would be $4.27 billion over a 10-year period.

    Aeroflow lands 645 bid contracts, seeks subcontractors

    ASHVILLE, N.C. – Aeroflow Healthcare has received 645 contract offers for 108 competitive bidding areas as part of the Round 2 re-compete, the provider has announced. Aeroflow, which already works with more than 100 subcontractors in 39 states as part of previous rounds of the program, plans to add more subcontractors for the Round 2 re-compete. “Aeroflow supports its partners through continued use of technology, increased marketing support, and leverage of its infrastructure that allows partners to continue growing market share,” the company stated in a press release. Aeroflow has a dedicated team that works solely with subcontractors. For the Round 2 re-compete, it received contract offers for enteral, general HME, nebulizers, negative pressure wound therapy pumps, respiratory equipment, standard mobility and transcutaneous electrical nerve stimulation.

    Wheel:Life partners with BLVD.com

    ATLANTA – Wheel:Life and BLVD.com have joined forces to help more disabled consumers locate and acquire adaptive vehicles for personal use. Wheel:Life readers will have access to a series of informational articles on accessible vehicles and direct links to locate them on BLVD.com, a website that connects individuals with accessible vehicle dealers. They will also have the ability to list their adapted vehicle on the “for sale by owner” section of the website. “One of the most urgent needs within our audience is finding reliable, accessible transportation,” said Lisa Wells, director of Wheel: Life, in a release. “Not everyone has the financial resources to buy a brand new, customized vehicle straight off the lot.”

    Court orders PharMerica to pay $48.5M tab

    LOUISVILLE, Ky. – A circuit court judge has told PharMerica Corp., a national provider with 17 specialty home infusion pharmacies, to honor outstanding invoices from AmerisourceBergen Drug Corp. for about $48.5 million. PharMerica has withheld payment and applied the invoice amounts against rebates and other amounts that it believes AmerisourceBergen owes the provider, which are in excess of $48.5 million. But the Jefferson County Kentucky Circuit Court ruled on April 1 that PharMerica must pay the invoices even if AmerisourceBergen failed to pay the provider for rebates and other amounts owed. PharMerica plans to appeal. It says it is in the process of obtaining a bond that will prevent it from having to pay AmerisourceBergen while an appeal is pending. In addition to the specialty home infusion pharmacies, PharMerica operates 94 institutional pharmacies, and five specialty oncology pharmacies in five states. AmerisourceBergen is the provider’s former wholesale supplier of pharmaceutical products.

    ResMed files new claim against 3B Medical

    SAN DIEGO – ResMed has filed new legal action with the United States International Trade Commission seeking to stop what it claims is patent infringement by Chinese manufacturer BMC Medical and its U.S. distributor 3B Medical. ResMed claims that two of the manufacturer’s flow generators, the RESmart and Luna, infringe on two claims of ResMed’s patent.In response, 3B issued a press release stating that ResMed’s filing of another patent case is an attempt to “stifle legitimate and fair competition.” 3B also pointed out that, most recently, the United States Patent and Trademark Office issued a series of judgments declaring certain patent claims by ResMed as invalid.

    Universal Software, IMCO partner up

    DAVISON, Mich., and TAMPA, Fla. – Universal Software Solutions has partnered with IMCO Home Care to offer Healthcare Data Management System—its fully integrated practice management solution—to HME providers. “This new relationship we have with IMCO Home Care is a winning combination for everyone,” said Christopher Dobiesz, president of Universal Software. “The logical and commonsense approach within HDMS creates an environment that is fast to learn, easy to use, and provides built-in intelligence that all directly create noticeable efficiencies.” IMCO is a member services group for independent medical wholesalers serving the acute care, long term care, primary care and home care markets.

    HOMES names award winners

    NEW BEDFORD, Mass. – The Home Medical Equipment and Services Association of New England has announced its 2016 award recipients. They are: Outstanding Volunteer Award, Jason Morin of Home Care Specialists and Thomas French of Apria Healthcare; Christopher J. Denmark Commitment to Excellence Award, Tamme Dustin of Herron & Smith; and April Mason Homecare Advocacy Award, Rep. Bill Keating, D-Mass. The awards will be presented at the HOMES/NYMEP annual meeting in May.

    SpinLife offers scholarship opportunity

    COLUMBUS, Ohio – SpinLife, a direct-to-consumer DME retailer, is now accepting applications for its 2016 SpinLife Innovation in Motion Scholarship program. The annual competition is open to manual and power wheelchair users enrolled at an accredited four-year college or university. Applicants must submit an essay or poem, painting, or another medium to expresses what "life in motion"—this year’s theme—means to them. SpinLife will award a $1,000 scholarship to the winner and $500 gift cards to SpinLife.com to two runners-up.

    Responsive Respiratory expands offering

    ST. LOUIS – Responsive Respiratory has added M6 and E cylinder sizes to their selection of home filling cylinders. The expanded line integrates with the manufacturer’s home filling system, allowing providers a choice in obtaining cylinders and accessories to fill patient needs. “We know providers are feeling the pain of reduced reimbursements and are looking at every avenue available to reduce costs and streamline their business, while continuing to service the needs of their patients,” said Tom Bannon, president, in a release. “The expansion into M6 and E home filling cylinders was driven by customer need—the need to adapt existing equipment to meet the changing service and ambulatory requirements of their patients.”

     

     


    0 0

    04/19/2016
    HME News Staff

    WASHINGTON – The National Federation of Independent Business has written a letter of support for S. 2736, a bill that would delay a second round of Medicare reimbursement cuts scheduled for July 1.

    The NFIB cites the high proportion of HME providers that are small businesses and the high level of service those companies provide in its letter.

    “The next round of the competitive bidding cuts threaten the viability of these small businesses,” the group stated.

    AAHomecare says the NFIB represents 325,000 small and independent business owners nationwide and its endorsement carries significant weight on Capitol Hill.

    AAHomecare gave a shout-out to Don Jones, president of Southern Medical Equipment Corp., and director of federal affairs for the Alabama Durable Medical Equipment Dealers Association, for securing the NFIB’s support.

    The Senate bill would delay the upcoming cuts until Oct. 1, 2017. Stakeholders are working on a companion bill in the House of Representatives.


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