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    02/10/2017
    HME News Staff

    WASHINGTON – Suppliers won’t need to resubmit claims to get retroactive payment adjustments mandated by the 21st Century Cures Act, according to guidance released Feb. 9 by CMS.

    The Cures Act, signed into law in December, rolled back cuts that went into effect in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016, allowing providers in those areas to recoup six months worth of payments.

    In guidance released to the DME MACs, CMS said it will recalculate the fee schedule to extend the 50/50 blended fee schedule in effect from the Jan. 1 to June 1, 2016, timeframe to the July 1 to Dec. 31, 2016, timeframe, according to a bulletin from AAHomecare.

    The revised fee schedule will be available to the DME MACs on or after May 1, 2017. The DME MACs can start processing affected claims as soon as the revised schedule–expected to be available May 1—is loaded into their systems.

    Suppliers don’t need to submit new claims or other materials. Instead, the DME MACs will create a one-time process to validate and adjust claims, and will automatically perform a mass reprocessing of claims. Suppliers who believe that their claims weren’t reprocessed will then need to submit a request.

    OIG updates Medicare market shares for diabetes test strips

    WASHINGTON – Suppliers in Medicare’s national mail-order program provided 18 types of diabetes test strips to beneficiaries from July through September 2016, according to a new report from the Office of Inspector General.

    The top strip type accounted for 43% of the mail-order market, and the top 10 strip types accounted for 98% of the market, the OIG found.

    The OIG conducted its report by sampling 1,210 claims from a population of 456,784 claims for mail-order test strips.

    Suppliers must comply with a rule outlined in the Medicare Improvements for Patients and Providers Act (MIPPA) that they provide at least 50% (by volume) of the types of test strips provided to beneficiaries. The OIG states suppliers could comply with this rule by committing to provide at least two strip types.

    This is the second of three reports from the OIG to determine the market shares of diabetes test strips for the periods April through June 2016; July through September 2016; and October through December 2016. This most recent report assesses the market shares for test strips for the three-month period after the implementation of the current mail-order program, which started on July 1.

    The OIG’s previous report for the period April through June 2016 found two strip types accounted for about half of the mail-order market, and the top 10 strip types accounted for 93% of the market.

    AAH paper makes case for preserving Medicaid rates

    WASHINGTON – AAHomecare has released a briefing paper designed to help HME providers engage state Medicaid programs now that a new law has been passed that limits the federal contribution for HME to these programs to the Medicare rates starting Jan. 1, 2018. The paper, “States Should Not Accept Flawed Medicare Rates,” notes the unsustainable rates facing providers operating under competitive bidding-derived Medicare rates and provides perspectives on the problems with applying these rates to state Medicaid programs. The paper focuses on four arguments: 1) the distinct patient populations and differing missions of Medicare vs. state Medicaid programs; 2) the defective and unsustainable Medicare bidding program; 3) major differences in reimbursement structure between the two programs; and 4) significant geographic variances in patient populations that Medicare rates do not adequately account for. AAHomecare argues “there is no federal requirement for a state Medicaid program to tie its payment limits to Medicare rates,” and that states are, in fact, directed to set their own rates as needed to maintain beneficiary access and a sufficient number of participating providers.

    MTA taps Respira, HomeSleep for sleep screening, treatment

    PARAMUS, N.J. – The board of the Metropolitan Transportation Authority of New York has awarded Respira-HomeSleep a contract to provide medical services to screen, treat, manage and monitor select MTA employees for obstructive sleep apnea. “We look forward to collaborating with HomeSleep and local DME companies in creating this groundbreaking model of care for the transportation industry,” said Yolanda, Mara Martinez, founder and CEO of Respira. Respira is a respiratory therapy, sleep medicine, DME and healthcare management company. Its custom-tailored programs serve more than 80,000 patients. HomeSleep is a diagnostic company in sleep medicine, providing home sleep devices to patients in their homes to diagnose OSA. “We have put a tremendous amount of time and effort into building a comprehensive sleep program with the Respira team and are confident that together we can assist the MTA and their employees,” said Jonathan Perrone, founder and CFO of HomeSleep.

    VGM carves out new role for Clark as chief leadership officer

    WATERLOO, Iowa – VGM Group has promoted Dennis Clark, president of its Orthotic Prosthetic Group of America division, to serve as chief leadership officer. In this new role, Clark will lead the advancement of values, mission and brand for the employee-owned company. He will also serve as “post-acute health care visionary and ambassador” across all of VGM’s health care membership communities, according to a press release. Clark is a nationally known prosthetist who has served as president of OPGA for the past 20 years. “I’m proud to have Dennis serving in this important new leadership role,” said Mike Mallaro, CEO of VGM. “Dennis has a unique and powerful insight into VGM’s history, culture and values. He is particularly brilliant at connecting people and ideas, as we as building teams.” Todd Eagan, vice president of the OPGA, will step up to president. He has been with OPGA for six years.

    AOPA celebrates centennial

    WASHINGTON – The American Orthotic & Prosthetic Association has launched www.aopa100.org, a commemorative website in honor of its 100th anniversary. The website features AOPA’s history, an interactive timeline, photo gallery, personal stories from members, and the association’s plans for the future. “The website celebrates our members’ deep roots and rich history in working together to ensure the viability of O&P for the patients we serve,” said Traci Dralle, chairwoman of AOPA’s Centennial Committee. AOPA will mark its anniversary in other ways this year, including events at the AOPA World Congress Sept. 6-9 in Las Vegas, and Throwback Thursday posts on social media platforms each week.

    Lodi Health closes HME store

    LODI, Calif. – Lodi Health is closing Memorial Home Med-Equip due to changes in Medicare reimbursement, according to the Lodi News-Sentinel. The full-service store has provided area residents with medical equipment like hospital beds, walkers, canes and oxygen equipment for 33 years. Company officials cite a 50% reduction in reimbursement as the driving factor in the decision. Lodi Health is not alone. There were once three medical equipment supply stores in the city at one time, but they have all disappeared, the newspaper reports. Memorial Home Med-Equip is expected to close some time in February.

    Chart Industries taps Quality Medical for repairs

    BALL GROUND, Ga. – Chart Industries has appointed Largo, Fla.-based Quality Medical as the authorized service center for its customers in the Southeast. Quality Medical will perform both warranty and non-warranty service for Chart products from its new service facility in Cartersville, Ga. Chart manufactures the AirSep, CAIRE and SeQual brands of stationary and portable oxygen concentrators. “Quality Medical is an experienced service provider for a wide range of biomedical equipment and will play an important role in maintaining the high level of service our customers have come to expect from Chart Industries,” said Miguel Cervantes of Chart Industries.

    Quality Medical opens new service facility

    LARGO, Fla. – Quality Medical has opened a new service facility in Cartersville, Ga., to better serve customers in Georgia, Alabama, Tennessee, North Carolina and South Carolina. “One of the most important elements of great service is turnaround time and this new facility helps us deliver great service in less time,” said PK Bala, CEO of Quality Medical. The new facility services and repairs respiratory, infusion, and patient monitoring equipment from a variety of healthcare companies throughout the Southeast. Its customers include Chart Industries, Philips Respironics, CareFusion, Flight Medical, B. Braun, Baxter and Abbott. Quality Medical aims to have five locations nationwide by 2020. “This location in Georgia is an important milestone toward this goal as we implement standard procedures of excellence across several locations,” said Jim Worrell, senior vice president of corporate development.

    Sperduti picks up the tab at Medtrade Spring

    LAS VEGAS – Sales guru Mike Sperduti will lead a free, four-part sales training workshop at Medtrade Spring, Feb. 27-March 1, at the Mandalay Bay Convention Center. All show attendees are eligible to attend, and may pick and choose among the four sessions, held Monday and Tuesday, or attend all four. “I recognize how thankful I am to the HME industry,” said Sperduti, president/founder of the Mike Sperduti Companies/Emerge Sales. “This year I want to pick up the tab for anybody who wants to attend any of the sessions, or all four.” For session descriptions, Click Here. To register, Click Here.

    Short takes

    BioScrip has joined Keep My Infusion Care at Home, a coalition formed in response to a change in the payment model for Medicare Part B home infusion drugs. The Denver-based BioScrip is a leading provider of infusion and home care management solutions…Staff members of the Board of Certification and Accreditation (BOC)are finalists for two Stevie Awards: Front-Line Customer Service Team of the Year and Business Development Professional of the Year. Finalists were chosen from more than 2,300 nominations. Winners will be announced Feb. 24 at a banquet at Caesars Palace in Las Vegas…Mediware Information Systems is now contracted with more than 30 customers for its CareTend software. Mediware released its latest version of the point-of-sale system in June…The National Association of Specialty Pharmacy has released the NASP Member App. Available for Android and iOS, it allows users to network, strategize and communicate…Rancho Cucamonga, Calif.-based PSP Homecare has launched a targeted marketing strategy featuring new radio, online and direct mail advertising. “We are all very excited to now be positioned to start a greatly expanded advertising campaign for our products and services, all supported by our own new dedicated call center,” said Michelle Ricco, CEO of Proto Script Pharmaceutical Corp, the parent company of PSP Homecare…Exeter, Pa.-based Quantum Rehab will have a theme of “To Be As Independent As Possible” at the International Seating Symposium, March 2-4 in Nashville. It will showcase its Q6 Edge 2.0 power base, iLevel seat elevation and Q-Logic 3 Advanced Drive Control technologies at the event.


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    ResMed leads sleep vertical, market research firm says
    02/14/2017
    HME News Staff

    GOTHENBURG, Sweden – The number of remotely monitored patients grew by 44% to 7.1 million in 2016, according a new report from Berg Insight.

    What’s more, the number of remotely monitored patients will grow at a compound annual growth rate (CAGR) of 47.9% to reach 50.2 million by 2021, says the market research firm.

    The two main applications in the market are monitoring patients with sleep therapy devices and monitoring patients with implantable cardiac rhythm management (CRM) devices. Berg Insight says these two verticals accounted for 80% of all connected home medical monitoring systems in 2016.

    “The number of remotely monitored sleep therapy patients grew by 70% in 2016, mainly driven by ResMed, which has made connected healthcare a cornerstone of its strategy,” says Anders Frick, senior analyst at Berg Insight.

    Other leading vendors in this segment are Philips Respironics and SRETT.

    Telehealth is the third largest segment with half a million connections at the end of 2016, Berg Insight says. Leading telehealth vendors include Tunstall Healthcare, Honeywell, Cardiocom, Philips and Qualcomm Life.

    All other device categories, including ECG, glucose level, medication adherence and others, stood for less than 1 million connections all together, the firm says.

    Cellular connectivity has already replaced PSTN and LAN as the de-facto standard communication technology for most types of connected home medical monitoring devices, according to Berg Insight.


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    02/17/2017
    Theresa Flaherty

    WASHINGTON – CMS has said it plans to use the lower payment amounts that went into effect July 1 as part of its calculation for retroactive adjustments, but that’s not what Congress intended, say industry stakeholders.

    “The intent was to use the same rates that were in effect from January to June, for the rest of the year,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Instead, they factored in the lower July 1 Round 2 re-compete numbers in their calculation.”

    A provision in the 21st Century Cures Act that was signed into law in December rolled back that start date for cuts that went into effect in non-competitive bidding areas from July 1, 2016, to Jan. 1, 2017, paving the way for providers to recoup six months of payments.

    In guidance released to the DME MACs on Feb. 9, however, CMS stated: “To implement section 16007 for dates of service July 1, 2016, through Dec. 31, 2016, the 50/50 blend fee schedules have been recalculated so that the adjusted portion of the payment blend utilizes July 1, 2016, adjusted fees.”

    “They are recalculating, not simply putting back in the rates they had before,” said Kim Brummett, vice president of government relations for AAHomecare.

    That’s not fair for providers who may have made planning decisions based on the higher rates, say stakeholders.

    “I think a lot of people made changes based on thinking it would go back to the Jan. 1, 2016, rate,” Brummett said.

    Stakeholders also take issue with the timeline for the relief, which sets an implementation date of July 3, although the DME MACs can start processing affected claims as soon as the revised fee schedules are available—on or after May 1. That’s a long time to wait to be paid, they say.

    “Some providers probably haven’t even submitted claims,” Brummett said. “Instead, they’re waiting for the right fee schedule to be loaded as opposed to getting a partial payment.”


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  • 02/17/17--09:12: Providers cheer bid delay
  • ‘It needs to be replaced with a whole new program that actually works,’ wrote one respondent to recent HME Newspoll
    02/17/2017
    Liz Beaulieu

    YARMOUTH, Maine – CMS’s recent decision to temporarily delay Round 2019 of competitive bidding has given HME providers a ray of hope that substantive changes will be made to the program.

    The agency said it was delaying Round 2019 to give the new administration—not only President Donald Trump but also recently confirmed HHS Secretary Tom Price—time to review the program.

    “Dr. Price has a history of being a champion for our industry,” wrote Bruce Sandler of Wishing U Well Medical in Granada Hills, Calif., in response to a recent HME Newspoll. “I’m confident he’ll come up with a plan to alter or replace competitive bidding. Delaying competitive bidding as it stands, in the meantime, is a good idea. It will save a lot of companies a lot of time and money.”

    An overwhelming majority of respondents to the poll (90%) said they approve CMS’s decision to temporarily delay Round 2019.

    While providers acknowledge that the delay is likely a standard move in response to a new administration, they also believe that years of access issues created by competitive bidding are finally getting through to CMS.

    “I feel that bidding has been delayed because too many providers have either dropped out of Medicare altogether or stopped taking assignment,” said Paul Reses of Lincoln Medical Supply in Pleasantville, N.J. “It is too difficult for discharge planners to coordinate care, and I feel that consumer complaints and industry complaints are maybe starting to be heard.”

    Providers do give CMS some credit for making changes to competitive bidding along the way. Planned changes for Round 2019 include moving the bid ceiling to 2015 fee schedule amounts and requiring bidders to obtain a $50,000 surety bond for each competitive bidding area in which they submit bids

    “CMS has recently made some big changes to the program, but it still has problems, like lack of access due to low rates, too few providers and audit threats,” wrote one provider. “They’ve temporarily delayed the program because it needs to be replaced with a whole new program that actually works.”

    There are those, of course, that wish the whole idea of competitive bidding would go away.

    “Don’t just delay the program,” wrote one provider. “Put a stake in its heart, garlic around its neck and bury it in the CMS Hall of Shame.”

    Providers acknowledge, however, that CMS will likely be back on track with competitive bidding, in one form another, before too long.

    “I’m not reading too much into the delay,” wrote one provider.


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    02/17/2017
    HME News Staff

    GOTHENBURG, Sweden – The number of remotely monitored patients, including CPAP patients, grew by 44% to 7.1 million in 2016, according a new report from Berg Insight.

    What’s more, the number of remotely monitored patients will grow at a compound annual growth rate (CAGR) of 47.9% to reach 50.2 million by 2021, says the market research firm.

    The two main applications in the market are monitoring patients with sleep therapy devices and monitoring patients with implantable cardiac rhythm management (CRM) devices. Berg Insight says these two verticals accounted for 80% of all connected home medical monitoring systems in 2016.

    “The number of remotely monitored sleep therapy patients grew by 70% in 2016, mainly driven by ResMed, which has made connected healthcare a cornerstone of its strategy,” says Anders Frick, senior analyst at Berg Insight.

    Other leading vendors in this segment are Philips Respironics and SRETT.

    Telehealth is the third largest segment with half a million connections at the end of 2016, Berg Insight says. Leading telehealth vendors include Tunstall Healthcare, Honeywell, Cardiocom, Philips and Qualcomm Life.

    All other device categories, including ECG, glucose level, medication adherence and others, stood for less than 1 million connections all together, the firm says.

    Cellular connectivity has already replaced PSTN and LAN as the de-facto standard communication technology for most types of connected home medical monitoring devices, according to Berg Insight.

    Nominee Verma faces Senate committee

    WASHINGTON – Seema Verma, President Trump’s pick to run CMS, appeared before the Senate Finance Committee Thursday. Verma has an extensive background in Medicaid health policy, and helped design Healthy Indiana Plan, the nation’s first consumer-directed Medicaid program. Tom Price was confirmed as secretary of the Department of Health and Human Services on Feb. 10.

    MAMES adopts Wisconsin

    STILLWATER, Minn. – The Midwest Association of Medical Equipment Suppliers will extend its geographical coverage to Wisconsin starting March 1. “The WAMES board of directors faced an emotional and difficult decision in deciding that moving to be part of MAMES was our strongest move forward,” said Rick Adamich, president of WAMES and president of Oxygen One in Waukesha, Wis. “As we evaluated the strengths and outstanding benefits being offered to our Wisconsin members, we realized it was without question the best avenue forward.”  MAMES is a regional association that serves Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota. Ann Barrett, the executive director of WAMES, retired in September. She led the association for nearly 25 years. WAMES’s decision to join MAMES follows other consolidation among state associations, including the recent decision by the Virginia Association of Durable Medical Equipment Companies and the North Carolina Association of Medical Equipment Services to form the Atlantic Coast Medical Equipment Suppliers.

    Somnoware launches care management module

    SANTA CLARA, Calif. – Somnoware has launched a new care management module that sleep physicians can use to track and improve CPAP adherence for their patients. By using machine learning models, the module is able to classify patients who are at risk and on track for compliance. The module features a panel that displays those at risk, ranked by the severity of their sleep apnea. Physicians can engage with patients by clicking on their names to send them emails or text messages. When physicians double-click on a patient’s name, a screen appears that provides them with detailed testing data, such as CPAP mask usage, leak and AHI. “Our platform arms physicians with critical tools that allow them to effectively monitor and manage CPAP adherence,” said Subath Kamalasan, CEO of Somnoware.

    Parallax Health, TeliVita enter agreement

    SANTA MONICA, Calif. – Parallax Health Management, a provider of remote patient technology and services, has entered into a distribution and sales agreement with TeliVita, a DME provider, to cross-market and sell their products and services. Through the agreement, PHM will receive 14% of TeliVita’s gross aggregate sales on DME and incontinence products. “TeliVita understands our business and how our remote patient monitoring systems generate the highest quality communication channels directly to patients in their homes,” said Nathan Bradley, president of PHM. PHM’s systems have been integrated with TeliVita’s Compliance 1st Technology, enabling manufacturers and healthcare organizations to control, manage, track, sell and invoice consigned DME products directly to patients at hospitals and other healthcare facilities.

    Caire now covers all of Florida

    BALL GROUND, Ga. – Caire, a Chart Industries company, has opened a new authorized service center in Lake City, Fla. Through a partnership with Oxygen Sales & Service, the new 3,500-square-foot facility will have eight employees. Services at the new center include pick-up and delivery in select locations, fast turnaround, and factory-authorized warranty and out-of-warranty repairs for the Caire portfolio of oxygen concentrators, according to a press release. “Expanding our capabilities to cover all of Florida addresses a need many of our providers have desired for some time,” said Miguel Cervantes, a service manager at Caire, in the release. Oxygen Sales & Service is a well-known resource for respiratory equipment repair. In August, Caire opened a new service center in Corpus Christi, Texas, in partnership with ReOx Medical Services.

    AAHomecare boosts corporate partnership

    WASHINGTON – AAHomecare has added several new companies to its corporate partners program. They are: Acelity, AeroCare USA, Domtar Personal Care, Med-South, and Rotech Healthcare. The program, which launched in 2012, now has 23 members. “The generosity of these companies is reflected not only in their financial support of the association, but in their active and enthusiastic participation in AAHomecare councils and work groups,” said Tom Ryan, president and CEO in a bulletin. “These companies are leaders in our industry who are putting their resources to work in their national association for the benefit of HME suppliers of every shape and size—and we are proud to be working with them on many levels to lift up our entire industry.” AAHomecare ramped up its efforts to bring on board more corporate partners in 2014.

    FODAC lights up…its mortgage

    STONE MOUNTAIN, Ga. – Friends of Disable Adults and Children surpassed its $1.5 million fundraising goal. The money was used to pay off the mortgage on its corporate headquarters, according to a press release. “This is a significant milestone for the organization,” said Chris Brand, president and CEO of FODAC. “Paying off the mortgage relieves us of a large financial burden and prepares us to meet the ever-growing needs of the disabled community. Recent cuts in Medicare and Medicaid funding have left more people needing more help with equipment costs, and now FODAC will have more resources to meet those needs.” The organization, which provides refurbished DME for people with injuries and disabilities, held a mortgage burning ceremony to celebrate.

    Patients often don’t get correct home nutrition, Option Care study finds

    ORLANDO, Fla. – Orders upon discharge from the hospital for home parenteral (intravenous) nutrition (HPN) did not meet the needs of patients nearly one-quarter of the time, according to research from Option Care. If orders are not corrected, patients may be overfed or underfed, both of which put them at health risk, and in the case of overfeeding, adds unnecessary costs, the provider says. For 187 HPN patients, Option Care registered dieticians reviewed all orders; performed nutritional assessments when the patients were discharged to home care; and made recommended changes to the nutrition order if warranted, based on the patient’s lab values, activity level and overall medical condition. They determined the original orders did not meet the patient’s needs 23% of the time on average. They found 22% did not meet fluid needs; 26% did not meet amino acid needs; 21% did not meet dextrose needs; 18% did not meet lipid needs; and 27% did not meet total caloric needs. Option Care will present its data at the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Clinical Nutrition Week conference Feb. 18-21.

    CPAP franchise goes national

    LAS VEGAS – CPAP Store USA is expanding its franchise nationally, it announced Feb. 14. The company, which currently has franchise locations in Los Angeles and Las Vegas, says it has opportunities available in every state. Founded in 2011, CPAP Store USA is an online sleep supply store that sells the latest CPAP and BiPAP equipment and supplies direct to consumers. As of the end of January, the company’s website, www.CPAPstoreUSA.com, was the most popular website devoted to sleep apnea, according to Alexa.com.

    Short takes: Numotion, Binson’s, Legacy Healthcare

    Numotionhas expanded its offering of the popular Spinergy wheels at shopnumotion.com. The Rocky Hill, Conn.-based provider launched its online store in 2016 … Center Line, Mich.-based Binson’s Medical Equipment and Supplies received the 2017 Corporate Citizen Award as part of the Macomb Business Awards. The Center Line, Mich.-based provider has a long history of supporting its community…Legacy Healthcare, a provider of home health, hospice and home medical equipment in New Mexico, has licensed CareTend software from Mediware Information Systems for its HME services. The software will allow the provider to automate its delivery process.

     


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    02/23/2017
    HME News Staff

    WATERLOO, Iowa – Upfront spending on durable medical equipment saves Medicare money in the long run, according to an updated study conducted by Leitten Consulting for The VGM Group.

    For every dollar spent on DME, CMS could save from $11 to $29 in direct treatment payment, according to the study, titled “The Case for Medicare Investment in Durable Medical Equipment.” Overall, annual savings range from $23 to $41 for every dollar spent on DME.

    “This study continues to reaffirm the true value of DME within health care and the savings that it offers,” said John Gallagher, director of government relations for VGM. “DME providers have been able to save the health care system millions of dollars annually by taking care of patients in their homes.”

    The study updates a previous study conducted in 2014.

    Since that initial study, CMS has expanded bid pricing to non-bid areas, escalating reimbursement cuts.

    “This has led to a dramatic drop in DME providers serving the Medicare population, profit margins that are often thin or non-existent, and reduced access for beneficiaries,” the study says.


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    ‘This is really the first CMS innovation that is really worth a darn,’ says Andrea Stark
    02/24/2017
    Liz Beaulieu

    WASHINGTON – Industry stakeholders are throwing their support behind expanding a demonstration project that allows providers to speak with reconsideration professionals by phone to try and resolve their appeals.

    AAHomecare on Feb. 22 submitted comments to CMS, recommending that the agency also consider applying the phone demo to the first level of appeals. Currently, it applies only to the second level of appeals.

    “Although the demonstration at the second level of appeals has been a positive experience for suppliers, we believe instituting a discussion at the first level of appeals will enable CMS to significantly reduce the backlog at the Office of Medicare Hearings and Appeals,” wrote Kim Brummett, vice president of regulatory affairs for the association.

    The backlog at the administrative law judge level, the third level of appeals, was 877.2 days in fiscal year 2016, according to AAHomecare.

    The association also recommends that CMS gather data on the type and volume of denials that are overturned and that are found to be errors by the processing contractor.

    “To improve the appeals backlog, education on claims processing must target both suppliers and contractors,” Brummett wrote.

    Finally, AAHomecare recommends that CMS “evaluate policies that are disproportionally contributing to the appeals backlog and adjust the language to meet the intent of the requirement by allowing for some flexibility,” Brummett wrote.

    C2C Innovative Solutions, the Qualified Independent Contractor that is conducting the phone demo, is already doing this on an informal basis, says Andrea Stark, a reimbursement consultant with MiraVista. CMS has made the unprecedented move of giving C2C “discretion” to overlook minor technical errors that would, otherwise, sink a claim, she says.

    “That’s something we haven’t seen before,” she said. “For example, if there’s a doctor’s signature and there’s a fax date, they can accept that as the signature date as long as it’s before claim submission, versus saying there’s no signature date. C2C can make those kinds of connections that give providers the benefit of the doubt.”

    CMS has also been expanding the demonstration on its own. In March, C2C Innovative Solutions will begin considering cases for manual wheelchairs, external infusion pumps, power wheelchairs, prosthetics, miscellaneous respiratory products and surgical dressings.

    “Where the ALJ is seriously backlogged, this is really the first CMS innovation that is really worth a darn,” Stark said.

    In February, C2C began considering cases for orthotics, medications, NPWT, lymphedema pumps and repairs; and in January, for CPAP devices, hospital beds, enteral nutrition, support surfaces, nebulizer meds, ostomy and urological supplies, and therapeutic shoes. When C2C kicked off the five-year demo in 2016, it considered cases only for oxygen equipment and diabetes testing supplies.

    C2C is also working with larger providers to work on consolidating multiple cases to make the process more streamlined, Stark says.

    “Otherwise, they’re doing them all onesie-twosie,” she said.


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    02/24/2017
    HME News Staff

    WATERLOO, Iowa – Upfront spending on durable medical equipment saves Medicare money in the long run, according to an updated study conducted by Leitten Consulting for The VGM Group.

    For every dollar spent on DME, CMS could save from $11 to $29 in direct treatment payment, according to the study, titled “The Case for Medicare Investment in Durable Medical Equipment.” Overall, annual savings range from $23 to $41 for every dollar spent on DME.

    “This study continues to reaffirm the true value of DME within health care and the savings that it offers,” said John Gallagher, director of government relations for VGM. “DME providers have been able to save the health care system millions of dollars annually by taking care of patients in their homes.”

    The study updates a previous study conducted in 2014.

    Since that initial study, CMS has expanded bid pricing to non-bid areas, escalating reimbursement cuts.

    “This has led to a dramatic drop in DME providers serving the Medicare population, profit margins that are often thin or non-existent, and reduced access for beneficiaries,” the study says.

    Tricare contractor agrees that rollback provision applies

    WASHINGTON – Health Net Federal Services, the Tricare contractor for the north region, agrees that a provision in the 21st Century Cures Act impacts its payments for home medical equipment, according to AAHomecare. The association had called on the three Tricare contractors to reprocess six months of claims for HME, since its reimbursement rates are pegged to Medicare reimbursement rates by law and by current network agreements. The provision in the Cures Act rolls back Medicare reimbursement cuts for HME in rural areas from July 1, 2016, to Jan, 1, 2017. Health Net says it will need a directive issued by the Defense Health Agency to be able to reprocess these claims.

    Verma hearing includes comments on bid program

    WASHINGTON – Seema Verma, President Donald Trump’s nominee to run CMS, said during a hearing before the Senate Finance Committee on Feb. 16 that one-size-fits-all approaches to health care, like the agency’s competitive bidding program, don’t always work. Verma made the comment in response to a question from Sen. Mike Enzi, R-Wis., about whether or not she would be willing to continue to have a dialogue about how the program can ensure Medicare beneficiaries, especially those in rural states, get the medical equipment they need, according to The VGM Group. Verma told the senator: “I think what you're bringing up in terms of the competitive bidding is an excellent example where, we've got some providers who are being paid—they're rural providers, but they're being paid at a rate that's more appropriate for an urban area. And, so I think that's the type of policy where understanding how that's going to impact our rural provider on the front-end and having that discussion so that we're not having problems later on down the line. And, if we are having issues, we need to be responsive to that because we want to make sure…that seniors and other folks that depend on CMS programs always have high quality care and that they have accessibility. We don't want to see that our policies and our programs are actually preventing providers—that we're losing providers and that they don't want to see Medicaid or Medicare beneficiaries anymore. So, we'll be very careful with policies so that we're not pushing providers out of the system, but that we're actually attracting providers to the program.”

    New RAC posts new reviews

    WASHINGTON – Performant Recovery, the new national recovery audit contractor (RAC) for DMEPOS and home health/hospice, has posted seven new reviews on its workload page, according to AAHomecare. They are: complex medical necessity chest wall oscillation devices; complex medical necessity tracheotomy suction catheters, suction pumps, catheters and other related supplies and equipment; automated nebulizers not in accordance with billing requirements; automated DME billed while inpatient; complex review osteogenesis stimulators; automated CPM billed without total knee replacement; complex Group 2 support surfaces without correct diagnosis of condition.

    Brightree, ADSI close loop on oximetry, sleep testing

    ATLANTA – Brightree has entered into an agreement to develop ordering and processing capabilities for overnight pulse oximetry and home sleep apnea testing with Advanced Diagnostic Solutions, Inc. (ADSI). Having those capabilities in Brightree’s software will create a “closed-loop diagnostic testing order and result workflow,” Brightree says. It will allow HME providers to order oximetry and sleep testing from ADSI directly in their workflow. Providers will be able to send information electronically through the interface to complete the ordering process, avoiding duplicate data entry and automating inbound results delivery as they order tests and process results. It will replace manual paper submissions done by fax and phone, or through a testing partner’s website. “Via our partnership with Brightree, we have created a solution that will streamline orders and enhance delivery processes, and thereby decrease paperwork and overall expenses,” said Brandon Womack, president of ADSI. “This integration will save HME providers a considerable amount of work and will speed up the entire ordering and results process.”

    Permobil creates philanthropic arm

    NASHVILLE, Tenn. – Permobil will launch the Permobil Cares Foundation at the International Seating Symposium on March 1. The manufacturer will donate proceeds from every Permobil, TiLite and Roho product sold toward funding the foundation. “With the help of the Permobil Foundation we hope that we can build impactful relationships with our customers and non-profit partners helping to fulfill a life of independence,” said Larry Jackson, president of Permobil North America. The foundation will work in partnership with non-profit organizations and agencies to provide support and services so individuals can “live a life without limitations.” Some areas of support will include sponsoring fundraising events, providing college scholarships, volunteering in the community and donating products. The foundation, which has the tagline “It’s a Work of Heart,” will be led by Ashley Davis, executive director.

    Invacare brings Swiss brand to U.S.

    ELYRIA, OHIO – Invacare has launched the kuschall brand of high-active custom manual wheelchairs in the United States with three new wheelchairs: the K-Series attract, the Advance and the Champion. The kuschall brand features sleek designs for an active lifestyle, Swiss engineering and superior drivability and handling, according to a press release. “The kuschall brand is established in Europe as the leader in the high-active wheelchair category because they have a single focus: the user,” said Brian LaDuke, vice president of rehab product and channel marketing for Invacare. “This commitment to promoting independence and confidence for users excites us to bring kuschall products to the U.S.”

    PharMerica sees significant decreases in net income

    LOUISVILLE, Ky. – PharMerica Corporation, a national provider of specialty home infusion and other pharmacy services, has reported $534.4 million in revenue for the fourth quarter of 2016, a 2.7% increase compared to the same quarter in 2015. Net income was $7.7 million, a 61.9% decrease. PharMerica reported $2.091 billion in revenue for all of 2016, an increase of 3.1%. Net income was $21.6 million, a 38.5% decrease. For 2017, PharMerica projects revenue in the range of $2.3 billion to $2.4 billion for 2017.

    Numotion offers ‘test drive’ of SoftWheels

    BRENTWOOD, Tenn. – Numotion has launched a new demo program that allows manual wheelchair users to “test drive” a set of SoftWheels by Numotion for one week, free of charge and with no obligation to purchase. Numotion began making the offer available at its online store, www.shopnumotion.com, on Feb. 23. “People who have tried SoftWheels have described the experience as ‘life-changing,’” said John Pryles, senior vice president of sales for Numotion. “We want more people to have the benefits these wheels offer first hand so they can experience more comfort and advance their level of mobility.” SoftWheels is an in-wheel suspension system that absorbs bumps and vibrations from uneven terrain and surfaces, resulting in a smoother more comfortable ride.

    NCPA reshuffles staff to boost advocacy efforts

    ALEXANDRIA, Va. – The National Community Pharmacists Association has combined its government affairs and communications departments into an Advocacy Center. As a result, the association has added one staff member, and realigned others. NCPA has named Kevin Schweers director of the  Advocacy Center and senior vice president of government and public affairs. He has served as the association’s senior vice president of public affairs since 2011. NCPA has named Scott Brunner as senior vice president of communications and state government affairs. He was previously CEO of the Georgia Pharmacy Association. It has also named Karry La Violette, who has been with the association since 2011, vice president of government affairs and advocacy; and Stephanie DuBois, who has been with the association since 2013, senior director of marketing communications.

    AOPA World Congress gains two new partners

    WASHINGTON – The American Orthotic & Prosthetic Association has announced that the Orthotics and Prosthetics Association of India (OPAI) and the Charcot-Marie-Tooth Association (CMTA) will participate in the 2017 AOPA World Congress, Sept. 6-9 at the Mandalay Bay Resort in Las Vegas. “CMTA recognizes that the use of orthoses improve the quality of life for people living with CMT, so it was a very natural partnership,” said Michael Oros, president of AOPA. “And OPAI serves a growing population of orthotic and prosthetic users in such an important market. We look forward to collaborating with members of OPAI at the World Congress.” Other partners are: Amputee Coalition, ConFairMed, Mexico-National Member Society of ISPO, Orthotics Prosthetics Canada, US Member Society of ISPO, and Uniting Frontiers.

    BOC establishes award

    OWINGS MILLS, Md. – The Board of Certification/Accreditation has established the Jim Newberry Award for Extraordinary Service. The award will recognize individuals who perform outstanding service to BOC and its community. Newberry, a BOC board member with more than four decades in practice, died in 2016. “Jim was completely devoted to BOC and to the O&P profession,” said wife Lynne Newberry. “He cared so deeply about helping others and wanted nothing more than to make a positive difference in this world.” To submit a nomination: www.bocusa.org/NewberryAward.

    Pedors launches mobile-friendly website

    ROSWELL, Ga. – Pedors has re-designed its B2B ordering website to be mobile responsive. The site now enables foot care professionals to easily order product using a smart phone, laptop or desktop device 24/7. “The rapid advances in mobile technology over the past two years have had an enormous impact on how healthcare is delivered,” said John O’Hare, co-founder and CEO of Pedors. “The advent of electronic health records allows a patient health record to move with them. Most practitioners use a mobile device for one purpose or another while delivering care.” Pedors manufactures orthopedic footwear, including the Pedors Classic, which features Pedoprene heat moldable technology that can be easily modified to accommodate the most severe forefoot deformity.

    State roundup: Colorado, New York, Kentucky

    The Colorado Department of Health Care Policy and Financing has issued a proposed rule requiring a face-to-face exam no more than six months prior to the initiation of certain durable medical equipment and services. The rule further defines DME and disposable medical supplies, and adds a previously approved benefit coverage standards for speech generating devices. Comments on the proposed rule are due April 12 and a hearing is scheduled for April 17 in Denver…The New York Department of Health has delayed a reimbursement cut for incontinence supplies until March 15. The cut of nearly 30% was scheduled to go into effect Feb. 15. Stakeholders, including AAHomecare and the Northeast Medical Equipment Providers Association, have expressed concerns regarding the unsustainability of the cuts…Provider David Chesnut has been elected president of the Kentucky Medical Equipment Suppliers Association. Chesnut, owner and president of Pennyrile Home Medical in Cadiz, Ky., has been a member of the association for more than 25 years.

    Changes at top for Home Care Medical

    NEW BERLIN, Wis. ­– John Teevan, president and CEO of Home Care Medical, plans to retire April 1 from the role he’s held since 1990. Kandette Raether, current vice president of sales and marketing, will assume the role of interim president March 1. During Teevan’s tenure, Home Care Medical has enjoyed substantial organizational growth, financial stability and industry recognition. It was named the WAMES Provider of Year in 2014, 2013 and 2012. "It has been an honor to lead this great company with its 43-year legacy of enhancing the lives of those we serve,” said Teevan in a press release. “As Kandette takes the helm, I am confident that Home Care Medical will continue to build upon our strong foundation of serving our referrals, our customers and the community."

    Doug Kerr joins VGM Canada

    WATERLOO, Iowa – Doug Kerr has joined VGM Canada as director of member and supplier relations. He will be responsible for expanding the offerings provided by VGM to HME providers in Canada. “I look forward to leveraging my experience in the industry to assist VGM help suppliers save money and grow together,” Kerr said. Most recently, Kerr ended his tenure as executive vice president of Motion Specialties, a company he co-founded in 1985, steered through an acquisition in 2012 and left in late 2014. Motion Specialties is a mobility and accessibility solutions provider with locations throughout Ontario, Alberta and British Columbia. He also founded The Motion Group, which was acquired by VGM in 2003. VGM Canada, established in 1998, is a division of The VGM Group.


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    02/24/2017
    Liz Beaulieu

    REDMOND, Wash. – There’s a good reason why you haven’t seen HME consultant Roberta Domos on the speaking circuit in a few years.

    “We’ve been downsizing,” said Domos, owner of Domos HME Consulting Group, which has been in business since 1999. “We’ve done the same thing HME providers have been doing: We’re not bothering with not-profitable businesses anymore. If there’s one thing I know how to do, it’s take my own consulting advice.”

    Over the years, the group’s business has shifted from helping entrepreneurs with startups (“I used to have 15 to 20 going at a time; now I have one or two”), to helping providers with the accreditation process (“We did a bang up business with that through 2009”), to helping them with the billing process (“There’s not less work to do. There’s just as much to do, but the revenue has been cut like crazy”).

    Most recently, Domos has focused her consulting work more specifically on helping providers shift billing overseas.

    “We long believed that the front-end—insurance verification and documentation—was easy to do overseas,” she said. “Outsourcing the billing and collections piece is more risky, but with such huge cuts in reimbursement, it has to be an option for billing, too. The margins are just too tiny not to consider it.”

     With business slowing down, Domos, 56, has retirement in her sights, but not quite yet.

    “You always have to be looking at the next thing and be ready to pivot,” she said. “You have to diversify. You have to outsource. You have to offshore. You always have to be thinking.”

    “The providers in this industry have helped a lot of people,” Domos continued. “It’s sad it’s not respected more than it is. There are providers out there with hearts of gold. They’re really good people.”

     


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  • 03/02/17--11:36: Verma one step closer to CMS
  • 03/02/2017
    HME News Staff

    WASHINGTON – Seema Verma is headed to the full Senate for confirmation as CMS Administrator.

    The Senate Finance Committee on Thursday voted 13-12 to advance Verma’s nomination.

    “We need experienced and responsible leadership at the helm of our federal agencies and CMS is no exception,” said Sen. Orrin Hatch, R-Utah, chairman of the committee. “The challenges plaguing both Medicare and Medicaid require a strong partnership between the administration and Congress to improve these programs and help enact the necessary reforms to ensure their solvency for future generations. Ms. Verma will help facilitate that partnership and as we work to repeal and replace Obamacare, she will play a vital role in realigning the focus on patient-centered solutions. I look forward to her nomination being considered by the full Senate.”

    It was the committee’s second vote on Verma. On Wednesday, it was deadlocked in a tie, 9-9.

    Verma is founder and CEO of SVC, a health policy consulting firm. She has worked with a number of states, most notably Indiana, to redesign their Medicaid programs in the wake of the Affordable Care Act.

    During a hearing before the Senate Finance Committee on Feb. 16, Verma said that one-size-fits-all approaches to healthcare, like CMS’s competitive bidding program, don’t always work. She made the comment in response to a question from Sen. Mike Enzi, R-Wyo., about whether or not she would be willing to continue to have a dialogue about how the bid program can ensure Medicare beneficiaries, especially those in rural states, get the medical equipment they need.


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    03/02/2017
    HME News Staff

    WASHINGTON – AAHomecare has asked newly minted Health and Human Service Secretary Tom Price to issue an interim final rule to repeal the fully adjusted Medicare rates that originally went into effect in non-competitive bidding areas on July 1, 2016.

    In a Feb. 28 letter, the association asks Price to, instead, freeze rates at the 50/50 blended rate that took effect Jan. 1, 2016, and amend the methodology for determining adjusted fee schedules.

    “I request for you to take immediate action to provide relief to DME providers and patients in non-CBAs, which have experienced dramatic reimbursement cuts over a short six-month period,” wrote Tom Ryan, president and CEO of AAHomecare.

    CMS implemented phased-in rate cuts on Jan. 1, 2016, and July 1, 2016. In December, however, Congress directed the agency to retroactively delay the July 1, 2016, cuts until Jan. 1, 2017.

    AAHomecare included in the letter a chart that depicts the severity of the rate cuts in non-bid areas. Rates for CPAP devices, for example, are $39.59 in 2017 compared to $104.58 in the 2015 fee schedule.

    “It is still too soon to have accurate figures on suppliers’ sales and closures in response to the adjusted rates, but we know from CMS data that there are 38% fewer suppliers enrolled in Medicare today than there were in 2013,” Ryan wrote. “Given the unprecedented magnitude of the payment cuts under the adjusted rates, it is reasonable to expect a high rate of supplier attrition in non-CBAs if adjusted rates remain at current levels.”

    AAHomecare argues that if Price waits for CMS to finalize overdue annual reports on the overall impact of competitive bidding—the last was published in 2011—and to publish a notice of proposed rulemaking, “access to DMEPOS in non-CBAs will deteriorate quickly.”

    “Using an IFR to suspend or repeal rules implementing the adjusted fee schedules would also allow the secretary to align the transition to DMEPOS adjusted fee schedules with similar transitions to payment adjustments in other Medicare benefits,” Ryan wrote.


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    03/03/2017
    Theresa Flaherty

    LAS VEGAS – The HME industry descended on Medtrade Spring last week with renewed vigor.

    “The challenges keep coming but we have an unprecedented opportunity to move the needle this year,” said Tom Ryan, president and CEO of AAHomecare, during the association’s Washington Update Feb. 28. “2017 is our year.”

    The key reason for the overall positive outlook: Tom Price, the new secretary of the Department of Health and Human Services, who the industry is looking to for help with everything from competitive bidding to the audit mess.

    In a Feb. 28 letter to Price, AAHomecare asked Price to repeal Medicare rates that went into effect in non-bid areas July 1, 2016.

    “We need to arm Dr. Price with information to work with CMS to make changes,” said Jay Witter, senior vice president of public policy for AAHomecare. “We need your continued stories; we need data.”

    The show, held Feb. 27–March 1 at the Mandalay Bay Convention Center, featured dozens of educational sessions that had a major format refresh. More panel discussions, new seating and a tight focus were the result of a “hard look” at attendee feedback from the fall show in Atlanta, says Show Director Kevin Gaffney.

    “We wanted to create a vibe of having a conversation instead of a classroom setting,” he said. “If providers are struggling, we want to address that. We wanted to focus on how we survive and thrive, and go from there.”

    On the show floor, which featured about 180 exhibitors, the mood was also upbeat. Although the show is smaller, exhibitors say foot traffic was better than expected.

    “There’s been a steady flow—people from all over,” said Tom Miller, with Charlottesville, Va.-based Human Design Medical. “This is still cost-effective way for us to meet customers.”

    Michelle Kimball, with Salem, Mass.-based Handy Cane said the company’s booth was packed on Tuesday, the day the exhibit hall opened. Show attendees voted for the *Handy Cane as the No. 1 new product in the show’s New Product Pavilion.

    “People want unique products and I think more are looking to do cash and carry,” she said. “It’s important we are connected with decision makers and we met lots of them—lots of distributors and DMEs of all sizes.”

    Miller echoed the need for providers to look at more cash items but say it’s a shift in mindset that is slow in coming.

    “They are not comfortable asking patients to pay for things beyond the co-pay,” he said. “But, the patients will just go somewhere else that has the products you don’t.”

    For their part, attendees came to the show ready to get to work.

    “I accomplished what I came to do,” said Hunter Cook, with Woodbury, Ten.-based Action DME, who said he usually goes to the Atlanta show. “Every time, I meet new people, make new opportunities. It’s a no brainer.”


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    ‘As soon as the Medicare fee schedule is updated, it will be easier’
    03/03/2017
    Liz Beaulieu

    WASHINGTON – The industry’s attempts to get other payers to honor a retroactive delay to Medicare reimbursement cuts are starting to pay off.

    Health Net Federal Services, the contractor for the Tricare North region, has indicated to AAHomecare that it believes the delay also applies to its reimbursement, but it needs a directive from the Defense Health Agency to reprocess claims.

    “It’s not a done deal, but we’re heading in the right direction,” said Laura Williard, senior director of payer relations for the association.

    The 21st Century Cures Act directed Medicare to delay a reimbursement cut in non-competitive bidding areas from July 1, 2016, to Jan. 1, 2017. Because Tricare and other payers often peg their reimbursement off of Medicare’s, the industry has made the case that they, too, should honor the delay, paving the way for providers to recoup six months of reimbursement.

    While trying to make inroads at the Defense Health Agency has been slow, Williard believes that once Medicare issues a new fee schedule for that timeframe—the agency says it will do that on May 1—that will help to speed up the process.

    “As soon as that fee schedule is updated, it will be easier,” she said. “Right now, we can tell them what we think will happen, but they want to see it.”

    Although there are two other Tricare contractors for the South and West regions, Wiliard says Palmetto GBA processes claims for all three regions. That should make it easy for Tricare to extend the delay across regions, and for Palmetto to reprocess claims instead of having providers resubmit them.

    “I feel positive about it,” she said.

    Outside of Tricare, however, the battles will be largely state-by-state. That’s why AAHomecare is arming stakeholders in each state with a packet of information that includes an attorney’s opinion on how to interpret the delay and a recent study that shows Medicare reimbursement covers, on average, only 88% of a provider’s overall costs.

    “We can’t go in and negotiate, but we can educate,” she said. “They don’t realize how drastic these cuts are. They just think, If Medicare made this cut, we can, too. They don’t understand the true impact of how much these rates have gone down.”

    Provider Robert Brown has been hard at work educating a large private payer in his state not to apply the cuts that went into effect Jan. 1 and July 1, 2016, in non-bid areas. That payer has agreed to a retroactive delay, but only going back to Sept. 1, 2016, he says.

    “We told them, ‘Sorry, we can’t do this anymore; we can’t afford to service your customers,’ and when they realized that, they came back to the table,” said Brown, vice president of operations for Andrew Brown’s in Scranton, Pa. “But what about the rest of 2016? That’s thousands, if not tens of thousands, in reimbursement that we didn’t get.”

    It’s slow but steady progress, Williard acknowledges.

    “We’ve started to see people be more open to these discussions,” she said. “But as part of those discussions, we now have data, so we hope to have more of an impact.”


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    03/03/2017
    HME News Staff

    WASHINGTON – Seema Verma is headed to the full Senate for confirmation as CMS Administrator.

    The Senate Finance Committee on Thursday voted 13-12 to advance Verma’s nomination.

    “We need experienced and responsible leadership at the helm of our federal agencies and CMS is no exception,” said Sen. Orrin Hatch, R-Utah, chairman of the committee. “The challenges plaguing both Medicare and Medicaid require a strong partnership between the administration and Congress to improve these programs and help enact the necessary reforms to ensure their solvency for future generations. Ms. Verma will help facilitate that partnership and as we work to repeal and replace Obamacare, she will play a vital role in realigning the focus on patient-centered solutions. I look forward to her nomination being considered by the full Senate.”

    It was the committee’s second vote on Verma. On Wednesday, it was deadlocked in a tie, 9-9.

    Verma is founder and CEO of SVC, a health policy consulting firm. She has worked with a number of states, most notably Indiana, to redesign their Medicaid programs in the wake of the Affordable Care Act.

    During a hearing before the Senate Finance Committee on Feb. 16, Verma said that one-size-fits-all approaches to healthcare, like CMS’s competitive bidding program, don’t always work. She made the comment in response to a question from Sen. Mike Enzi, R-Wyo., about whether she would be willing to continue to have a dialogue about how the bid program can ensure Medicare beneficiaries, especially those in rural states, get the medical equipment they need.

    Bills introduced to protect accessories

    WASHINGTON – Industry champions in the Senate and House of Representatives have introduced bills to permanently stave off Medicare’s plans to apply competitive bidding-influenced prices to accessories for complex wheelchairs.

    Sens. Bob Casey, D-Pa., and Rob Portman, D-Ohio, and Reps. Lee Zeldin, R-N.Y., and John Larson, D-Conn., have introduced S. 486 and H.R. 1361, NCART reported on Friday.

    “Our next step will be to secure co-sponsors,” NCART stated in a bulletin. “Stay tuned and polish up your advocacy skills. This is going to be a great year for CRT!”

    Stakeholders succeeded late in 2016 to secure a six-month delay in Medicare’s plans, pushing the implementation date to at least July 1, 2017.

    Hospice Cloud bulks up business with Genesis Healthcare

    ATLANTA and RICHLAND HILLS, Texas – Genesis Healthcare Services and Hospice Cloud, two providers of HME to hospice organizations, have merged, company officials announced Feb. 23.

    The acquisition of Atlanta-based Genesis Healthcare helps Richland Hills, Texas-based Hospice Cloud, which owns and operates 60 service centers and has partnerships with more than 200 HME providers, maintain its position as a “market leader” providing HME for the hospice industry.

    “The addition of Genesis Healthcare expands our presence in the Southeast and supports our vision of delivering the most comprehensive DME solution to our hospice patients and their partners,” said Bill Monast, president and CEO of Hospice Cloud.

    Indianapolis-based Home Health Depot, an HME provider, is the parent company of Genesis Healthcare. It became the majority shareholder of the five-location company in 2012.

    Genesis Healthcare represents the third major acquisition in a little over a year for Hospice Cloud.

    Hospice Cloud, a management platform and network for providers offering HME to the hospice industry, is the brainchild of National HME, a provider of HME to hospice organizations in the Dallas Forth Worth area.

    Tailwind Capital, a growth oriented middle-market private equity firm, is the lead investor in National HME and Hospice Cloud.

    Core Products buys Swede-O

    OSCEOLA, Wis. – Core Products International, a manufacturer of braces, supports, orthopedic soft goods and hot and cold therapy, has acquired Swede-O. North Branch, Minn.-based Swede-O manufactures products that help to prevent and rehabilitate ankle-related injuries. While Core Products is well known in the alternative healthcare and home healthcare markets, Swede-O is best known in the athletic, rehab and podiatry markets. “We are looking forward to leveraging our innovative capabilities, lean manufacturing process and marketing expertise to grow the Swede-O brand,” said Philip Mattison, president and founder of Core Products. Core Products will continue to operate Swede-O from North Branch. Customers will continue to place orders and receive customer service through the company.

    Insulet posts 24% increase in revenue

    BILLERICA, Mass. – Insulet Corp. has reported fourth quarter revenue of $103.6 million, representing year-over-year growth of 24%. Net loss was $9.2 million vs. $15.9 million. Fourth-quarter revenue in the U.S. for Omnipod was $61.3 million, a 17% increase, and internationally, $20.8 million, a 35% increase. Revenue from drug delivery was $19.6 million, a 34% increase. Insulet reported full year revenue of $367 million, representing year-over-year growth of 39%. Net loss was $27.2 million vs. $61.6 million. Full-year revenue in the U.S. for Omnipod was $229.8 million, a 21% increase, and internationally, $71.9 million, a 78% increase. Revenue from drug delivery was $65.3 million, a 92% increase. Among Insulet’s highlights in 2016: its divestiture of Neighborhood Diabetes’ medical supplies distribution business to focus on growth opportunities in insulin and drug delivery.

    Aetrex buys maker of 3D orthotics, software

    TEANECK, N.J. – Aetrex has acquired SOLS Systems, a New York-based company that provides 3D printed orthotics and software used to customize footwear, according to NJBIZ. SOLS will begin integrating its products with Aetrex’s newly launched Albert 3D foot scatter, it reported. “The integration of SOLS technology into our footwear and orthotics business will allow Aetrex to offer unmatched customization and adjustability across our product lines,” said Larry Schwartz, CEO of Aetrex.

    Community pharmacy opens new location in medical center

    MIDDLETOWN, N.Y. – NeighboRx Pharmacy has opened a new location within Orange Regional Medical Center’s outpatient building, according to Hudson Valley News. The location offers a full range of prescription medication services, as well as medical equipment and supplies, including walkers and rollators, diabetic supplies, wheelchairs, braces, crutches, and bath and safety supplies. “I can’t stress enough the importance of this new venture, which allows better collaboration among local physicians, pharmacists and other healthcare providers,” Rory Garland, a pharmacist and owner of NeighboRx Pharmacy, told the newspaper. “The collaborative effort among our established pharmacy and community hospital partner is indicative of effective relationships that should exist in the healthcare arena. These partnerships allow us to be more patient focused and deliver high-quality care.”

    Minnesota senators seek to soften blow of upcoming Medicaid cut

    SAINT PAUL, Minn. – Two senators in the Minnesota state legislature have introduced a bill to address a provision in the 21st Century Cures Act that would limit the federal portion of Medicaid reimbursement for HME to competitive bidding-influenced Medicare reimbursement starting in 2018. The bill, introduced by Sens. Jim Abeler and Greg Clausen and still in draft form, reads: “Effective for services provided on or after January 1, 2018, the commissioner shall make supplemental payments to providers of durable medical equipment and medical supplies, for those items for which application of the medical assistance federal match payment limit specified in United States Code, title 42, section 1396b(i)(27), would result in a reduction in payment from the medical assistance payment rate in effect on December 31, 2017. The supplemental payment for each item shall be no less than the difference between the medical assistance payment rate in effect on December 31, 2017, and the medical assistance payment rate under United States Code, title 42, section 1396b(i)(27).”“There is a lot of work that will continue to see this bill goes through,” the Midwest Association for Medical Equipment Services stated in a bulletin to members.

    Numotion gets exclusive for standing device

    BRENTWOOD, Tenn. – Numotion has become the exclusive distributor for Tek RMD by Matia Robotics in the United States. Tek RMD is a motorized standing movement device that offers the ability for those who are in a manual wheelchair to complete everyday activities from a standing position. Unlike other standers, users can board and control the device unassisted. “Tek RMD is a life-enhancing technology that enables wheelchair users to participate in everyday life in a way they may have previously thought was not possible,” said Mike Swinford, CEO of Numotion. “The ability to independently and safely sit, stand and navigate environments that were once inaccessible is now a reality.” Tek RMD is available through assistive technology professionals or online at ShopNumotion.com. Through ShopNumotion.com, customers will be prompted to schedule an evaluation for individually configured customization.

    Brightree helps providers get paid

    ATLANTA – Brightree has released an app that gives HME providers a quick way to process patient payments through smartphones or tablets anywhere in real time. The Brightree Patient Collections GetPaidHME app, which runs on Apple and Android devices, allows users to scan a sales order directly from a delivery ticket. From there, the patient is added to the delivery queue, and sales order data, including recipient and payment information, is integrated into the app, eliminating the need for paper invoices. The app then posts a payment back into the Brightree core platform, streamlining the manual entry process, and the patient receives an email receipt confirming payment. Additional features of the app include adding orders to the sales order currently in delivery and signing up clients for Brightree’s AutoPay so future payments can be processed automatically.

    VirtuOx keeps track with VirtuTrack

    CORAL SPRINGS, Fla. – VirtuOx, a home respiratory diagnostic provider, has released a device that allows HME providers to track their equipment in the patient’s home. VirtuTrack attaches to equipment and automatically sends data daily to VirtuOx, allowing providers to monitor whether or not it is plugged in and turned on. “With VirtuTrack, you will be able to monitor patient compliance to any medical device, which can improve health outcomes, reduce hospital readmissions and eliminate the risk of losing equipment,” said Kyle Miko, founder and COO for VirtuOx. VirtuTrack can also tell providers when equipment is lost: The device pings a portal every hour with its location.

    Medforce launches e-signature tool

    SUFFERN, N.Y. – Medforce Technologies has launched an electronic signature tool built specifically for the healthcare industry. SignCenter allows providers to “dictate the signing experience,” Medforce says, by determining where and when a document can be signed. It allows signatures to be captured remotely or in-person, and to be executed using a keyboard, mouse or touch screen from any web-enabled device. “Most providers we talk to are still printing out forms for signature and then scanning or faxing them afterward,” said Steve Bainnson, vice president of sales for Medforce. “Paper gets lost, filled out incorrectly, requires manual data entry and causes billing errors that lead to lower reimbursement. Moving to SignCenter and implementing an electronic process adds control and visibility, increases productivity, improves compliance, and decreases time spent chasing paper.”

    Medtrade Spring attendees pick top new products

    LAS VEGAS – Medtrade Spring attendees voted for the Handy Cane by The Handy Cane of Salem, Mass., as the No. 1 new product in the show’s New Product Pavilion. They voted for VirtuCLEAN by VirtuOx of Coral Springs, Fla., for the No. 2 spot; and the Hoverboard Buddy by Inventor Lady of Denver for the No. 3 spot. The pavilion featured the most innovative HME products that have been on the market for less than one year, according to a press release from show organizers. Medtrade Spring took place Feb. 26-28 at the Mandalay Bay Convention Center.

    Market for respiratory devices to hit $21.3B in five years

    PORTLAND, Ore. – The global respiratory care device market was valued at $12.8 billion in 2015 and is projected to value $21.3 billion by 2022, according to a report published by Allied Market Research in February. That represents a CAGR of 7.4% from 2016 to 2022. Dominating the market, according to the report: the therapeutic segment, which accounted for more than half of the total market share in 2015. “The global respiratory care devices market is driven by factors such as increase in prevalence of respiratory diseases, rapid urbanization, rise in pollution level, growth in geriatric population, and increase in tobacco consumption worldwide,” the report states. North America dominates the market, according to the report, and it’s expected to maintain that stronghold due to the high adoption rate of respiratory devices.

    AOPA: Send us your ideas for pilot programs

    WASHINGTON – The American Orthotic & Prosthetic Association, in partnership with the Center for O&P Learning & Evidence-Based Practice, has unveiled its 2017 requests for proposals for research. AOPA plans to give $15,000 each to four pilot programs in 16 potential areas of interest, including the effectiveness of custom vs. off-the-shelf ankle foot orthoses (AFOs), and the effect of prosthetic components on community activity level. “AOPA is dedicated to advancing the O&P evidence base, and these pilot grants give researchers a great opportunity to start projects that they can build on to secure more funding from NIH and other sources,” said Michael Oros, president of AOPA. “We have seen several researchers go on to publish their COPL-funded research, which speaks to the high quality of the research that is resulting from these funds.”

    Short takes: QS/1, Active Controls, EZ-DME

    Spartanburg, S.C.-based J M Smith, which operates QS/1 and other healthcare technology companies, has named A. Alan Turfe CEO and chairman of the board. Turfe succeeds William Cobb, long-time CEO and chairman. He joins J M Smith from Fresenius Medical Care, where he was senior vice president and chief procurement officer…Sewell, N.J.-based Active Controls has released a 20-page catalog featuring all of the products it offers. The 2017 Reference Guide includes new products like the Modular Harness Mounted Chin Controls and the Eclipse Trays featuring Stealth-linked driving technology…Bill Cobb, the CEO of Spartanburg, S.C.-based JM Smith, which operates QS/1 and other healthcare companies, will retire after 41 years. His successor will be named soon…FDS has named Michael Ziegler vice president, product and client services. He will be responsible for FDS’s reconciliation and claims management solutions, as well as its EZ-DME Billing Solution. “Michael has a strong background and understanding in a variety of pharmacy market segments, including retail pharmacy, home medical equipment and long-term care,” said Peter Fianu, president of FDS.


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    03/07/2017
    HME News Staff

    WASHINGTON – CMS has scheduled a call to solicit stakeholder input on its methodology for using information from the competitive bidding program for adjusting Medicare fee schedule amounts in non-bid areas.

    The 21st Century Cures Act mandated that the agency solicit and take into account stakeholder input on future pricing in non-bid areas.

    The act also mandated that CMS take into account the highest amount bid by a winning supplier in a bid area, as well as make comparisons in bid and non-bid areas for the average travel distance and costs associated with furnishing items and services in an area; the average volume of items and services furnished by suppliers in the area; and the number of suppliers in the area.

    The call is scheduled for March 23 from 2 p.m. to 3:30 p.m. EST. Register here.

    Stakeholders may also submit written comments at DMEPOS@cms.hhs.gov.


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    03/09/2017
    HME News Staff

    WASHINGTON – The Department of Health and Human Services says it won’t meet a deadline to clear a backlog of appeals unless it settles the claims without seeing if they have merit.

    In a status report, HHS told the D.C. Circuit court that its 687,382-claims backlog is projected to reach more than 1 million by the end of fiscal year 2021, according to Law360. The agency made a similar claim in February, saying it needed more money and cooperation from the provider community.

    “Although the initiatives undertaken by HHS have significantly slowed the growth of the backlog, the significant annual reductions that this court has directed are not possible given current funding and legislative authorities,” HHS says.

    The report also states that the Office of Medicare Hearings and Appeals would “violate its statutory obligations if it were to resolve cases without deciding them on the merits.”

    HHS was ordered in December 2016 to find a way to reduce the backlog of cases at the Administrative Law Judge level by 30% at the end of 2017; 60% at the end of 2018; 90% at the end of 2019; and completely by the end of 2020.

    Making things more challenging, HHS says: Hospitals and providers haven’t been as receptive to an initiative to settle claims as predicted.


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    03/10/2017
    HME News Staff

    WASHINGTON – CMS has scheduled a call to solicit stakeholder input on its methodology for using information from the competitive bidding program for adjusting Medicare fee schedule amounts in non-bid areas.

    The 21st Century Cures Act mandated that the agency solicit and take into account stakeholder input on future pricing in non-bid areas.

    The act also mandated that CMS take into account the highest amount bid by a winning supplier in a bid area, as well as make comparisons in bid and non-bid areas for the average travel distance and costs associated with furnishing items and services in an area; the average volume of items and services furnished by suppliers in the area; and the number of suppliers in the area.

    The call is scheduled for March 23 from 2 p.m. to 3:30 p.m. EST. Register here.

    Stakeholders may also submit written comments at DMEPOS@cms.hhs.gov.

    CMS schedules call for PA process

    WASHINGTON – After two cancellations, CMS has scheduled a Special Open Door Forum to discuss the prior authorization process for two complex rehab codes.

    The agency’s Center for Program Integrity will host the first in a series of Special Open Door Forums on March 16 to invite suppliers, physicians and other Medicare practitioners or interested parties to discuss the implementation of the prior authorization process for K0856 and K0861. CMS began accepting prior authorization requests for these two codes on March 6 for dates of delivery on March 20.

    CMS cancelled a previous Special Open Door Forum on this topic scheduled for January. It then removed the topic from the agenda of a general Open Door Forum in February.

    During the forum, CMS says it will outline the process for submitting a prior authorization request to the designated Medicare Administrative Contractor, the timeframes for the MAC to render their prior authorization decisions, and the process for subsequent claims submissions.

    To participate in the forum, scheduled from 2 p.m. to 3:30 p.m. EST, dial 800-837-1935 and use the ID 85144406.

    HHS still says it can’t meet appeals deadline

    WASHINGTON – The Department of Health and Human Services says it won’t meet a deadline to clear a backlog of appeals unless it settles the claims without seeing if they have merit.

    In a status report, HHS told the D.C. Circuit court that its 687,382-claims backlog is projected to reach more than 1 million by the end of fiscal year 2021, according to Law360. The agency made a similar claim in February, saying it needed more money and cooperation from the provider community.

    “Although the initiatives undertaken by HHS have significantly slowed the growth of the backlog, the significant annual reductions that this court has directed are not possible given current funding and legislative authorities,” HHS says.

    The report also states that the Office of Medicare Hearings and Appeals would “violate its statutory obligations if it were to resolve cases without deciding them on the merits.”

    HHS was ordered in December 2016 to find a way to reduce the backlog of cases at the Administrative Law Judge level by 30% at the end of 2017; 60% at the end of 2018; 90% at the end of 2019; and completely by the end of 2020.

    Making things more challenging, HHS says: Hospitals and providers haven’t been as receptive to an initiative to settle claims as predicted.

    Performant ready to roll

    LIVERMORE, Calif. – Performant Recovery, the new national recovery audit contractor for DMEPOS and home health/hospice, announced March 8 that it has officially received approval from CMS to begin audit activity. The RAC in February posted seven new reviews on its workload page: complex medical necessity chest wall oscillation devices; complex medical necessity tracheotomy suction catheters, suction pumps, catheters and other related supplies and equipment; automated nebulizers not in accordance with billing requirements; automated DME billed while inpatient; complex review osteogenesis stimulators; automated CPM billed without total knee replacement; and complex Group 2 support surfaces without correct diagnosis of condition.

    Two longtime complex rehab advocates honored

    NASHVILLE, Tenn. – Michele Gunn of Browning’s Pharmacy and Health Care, and Gerry Dickerson of National Seating and Mobility were named the inaugural recipients of the Simon Margolis Fellow Award at the International Seating Symposium this month. Gunn, a NRRTS registrant since 1996, currently serves on the NRRTS and NCART boards, and the Professional Standards Board. Dickerson, a NRRTS registrant since 1994, currently serves on the NRRTS Executive Board. Margolis, a longtime leader in the complex rehab industry, passed away in July 2016. This year also marks the 25th anniversary of NRRTS.

    New York reduces cut for incontinence supplies

    ALBANY, N.Y. – The New York Department of Health has announced an average reduction of 20% for incontinence supplies, according to a bulletin from AAHomecare. Previously, it had proposed a 30% reduction, but AAHomecare and the Northeast Medical Equipment Providers Association expressed concerns regarding the unsustainability of the cuts. The new rate takes effect April 3.

    VMI names sweepstakes winner

    CHEYENNE, Wyo. – Vantage Mobility International has named Michael Gallagher as the winner of its Claim More Space Sweepstakes. Gallagher, who suffers from degenerative spine disease, has a VMI Northstar side-entry in-floor conversion for wheelchair access to his 2016 Toyota Sienna. Gallagher, who was chosen from more than 7,000 entries, received $10,000 plus a year’s supply of gasoline. “We are proud to provide wheelchair accessible solutions to improve the quality of life for others,” said Doug Eaton, VMI president and CEO. “In Michael’s case, being the VMI Claim More Space Sweepstakes winner, the dependability of the conversion provides him with the freedom to travel and live to the fullest.”

    SoClean releases new video

    OXFORD, Mass. – SoClean recently launched the latest installment in its educational video series, “The Bacteria Family Reunion,” aimed at increasing awareness of the value of its CPAP cleaning machine. The animated video is also part of SoClean’s spring giveaway, which will award one winner a free SoClean machine. Deadline for the contest is March 31, 2017, at midnight PST. Go to: https://www.soclean.com/soclean-cpap-signup/.

    Philips expands Dream family of respiratory devices

    AMSTERDAM, the Netherlands – Royal Philips has expanded its Dream Family of products with the DreamStation Advanced Therapies BiPAP autoSV and AVAPS devices to provide care for patients with complex ventilation needs. The devices are currently available in select markets in the U.S., France and Australia, and will be available globally by the end of this year. They aim to deliver optimal ventilation with minimal intervention so patients experience comfortable, restful sleep and quality of life. The DreamStation Advanced Therapies devices are fully integrated through the Philips Encore Anywhere patient management tool, providing automated support for the patient’s changing needs, as well as remote monitoring capabilities support for physicians, HME providers and caretakers to intervene when needed to minimalize adverse effects. The Dream Family of products launched in 2015 as a full suite of sleep solutions that connect and support the patient, clinician and homecare provider to enhance patient care and quality of life.

    Short takes: Ryan French

    Ryan French, director of Jim’s Pharmacy & Home Health in Port Angeles, Wash., recently received the 2016 Ambassador Award from Brightree. The award is given to an individual with the greatest involvement and contributions to the Brightree Online Community. French’s contributions include helping to improve software design, answering questions, troubleshooting problems, providing best-practice recommendations and gathering information from other companies.


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    03/14/2017
    HME News Staff

    WASHINGTON – The Senate has voted 55-43 to approve the nomination of Seema Verma, a health policy consultant from Indiana, as CMS administrator.

    Verma, the president, CEO and founder of SVC, an Indianapolis-based national health policy consulting company, will oversee a $1 trillion agency that serves more than 100 million Americans that access healthcare services through Medicare, Medicaid, CHIP and the Marketplace.

    Verma, along with new Health and Human Services Secretary Tom Price, will be tasked with transforming Medicaid and overhauling the Affordable Care Act.

    Verma has made a name for herself redesigning Indiana’s Medicaid program. She helped the state expand eligibility, but she required recipients to pay premiums, contribute to health savings accounts and receive incentives for healthy behavior. She has also helped to develop many other Medicaid reforms, including waivers in Iowa, Ohio and Kentucky.

    Verma has comparatively little experience with Medicare.

    Prior to full approval by the Senate, Verma was approved by the Senate Finance Committee on March 2 by a vote of 13-12.

    During a hearing before that committee on Feb. 16, Verma said that one-size-fits-all approaches to healthcare, like CMS’s competitive bidding program, don’t always work. She made the comment in response to a question from Sen. Mike Enzi, R-Wyo., about whether or not she would be willing to continue to have a dialogue about how the bid program can ensure Medicare beneficiaries, especially those in rural states, get the medical equipment they need.

    “I think what you're bringing up in terms of the competitive bidding is an excellent example where, we've got some providers who are being paid—they're rural providers, but they're being paid at a rate that's more appropriate for an urban area. And, so I think that's the type of policy where understanding how that's going to impact our rural provider on the front-end and having that discussion so that we're not having problems later on down the line. And, if we are having issues, we need to be responsive to that because we want to make sure…that seniors and other folks that depend on CMS programs always have high quality care and that they have accessibility. We don't want to see that our policies and our programs are actually preventing providers—that we're losing providers and that they don't want to see Medicaid or Medicare beneficiaries anymore. So, we'll be very careful with policies so that we're not pushing providers out of the system, but that we're actually attracting providers to the program.”

    Verma replaces Acting Administrator Dr. Patrick Conway, who is also deputy administrator for Innovation and Quality.


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    03/17/2017
    Liz Beaulieu

    YARMOUTH, Maine – Outsourcing business functions may be on the upswing, but outsourcing them out of the country is still a rarity in the HME industry, according to a recent HME Newspoll.

    Seventy nine percent of respondents to the poll reported they don’t outsource any business functions out of the country, though they’re increasingly tempted to, due to razor-thin margins.

    “We chose not to outsource out of the country, although we have reviewed it several times,” commented one respondent. “For us to do so, when serving Medicare, especially did not seem right. That being said, because we did not, we were not able to participate in the latest rounds of bidding, which in our category, reimbursement is barely covering the cost of goods.”

    For the 21% that do outsource out of the country, the most common business functions to outsource are billing and collections, followed by insurance verification.

    The combination of steep reimbursement cuts with, in some states, a high minimum wage, means outsourcing out of the country is a necessity for some respondents.

    “Medicare reimbursement cuts + California $15 minimum wage = offshore labor,” commented one respondent, who outsources basic data entry, insurance verification, documentation, and billing and collections. “As of July 2016, we are actively replacing American workers with offshore labor. We anticipate replacing 20 jobs with 30 offshore jobs at over half the cost.”

    While there may be a stigma associated with outsourcing out of the country, one respondent said the quality of work is high and the cost is low.

    “We employ nurses with four-year degrees (BSN) to do insurance verification, billing and collections, clinical support and intake, because we can employ them very inexpensively,” said Pamela Bowen of Classic SleepCare in California.

    A number of respondents also noted that, while they don’t personally outsource out of the country, the billing and collections companies or software companies they use do. For one respondent, that was a deal-breaker.

    “I was unaware that our billing company outsourced our work,” commented the respondent. “We now use a company located in New York state.”


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    03/17/2017
    HME News Staff

    AMSTERDAM – Adults recognize that sleep is important, but they still prioritize other things in their lives over sleep, according to a new international survey published by Royal Philips on World Sleep Day.

    Ninety-two percent of 6,461 adults across five countries who were surveyed by Harris Poll said sleep is crucial to their overall health and wellbeing. They say even one bad night of sleep can result in looking tired, being less productive and feeling unmotivated.

    Yet 84% of adults say other things in their lives are more important than a good night’s sleep, including family time and job responsibilities.

    Twenty-eight percent of adults also say that, despite all the literature that screens should be turned off well before sleep, watching TV is the last thing they do before bed.

    “Sleep is vitally important to the ‘healthy lifestyle’ equation, but it is often cast aside as less important compared to the other fundamental elements such as eating well or exercising,” said Dr. Teofilo Lee-Chiong, sleep clinician and chief medical liaison, Philips. “We need to start thinking of health and wellness as a table with four legs, each of which representing proper nutrition, exercise, positive mental health and sleep—if we’re only focusing on diet and exercise, that table isn’t going to be balanced.”

    Philips aims to use the survey, “Unfiltered Sleep: A Global Prioritization Puzzle,” to start a conversation about the importance of sleep to overall health and wellbeing.

    ResMed highlights sleep research

    SAN DIEGO – ResMed has picked the top five research findings among more than 3,000 studies published last year in recognition of World Sleep Day.

    “Unnecessary hospital readmissions and inefficient practices are huge drivers of today’s exorbitant healthcare costs,” said Adam Benjafield, ResMed vice president of medical affairs. “Recognizing sleep apnea is associated with many other life-threatening conditions and knowing early detection makes a world of difference, treatment efficacy and efficiency have become even more paramount. The research we’ve highlighted today shows that we’re moving in the right direction.”

    Summaries of the research are:

    ·      There is a high prevalence of sleep-disordered breathing among stable chronic heart failure patients (Arzt M et al. JACC Heart Fail 2016).Of 6,876 stable chronic heart failure (CHF) patients across 138 German centers, the prevalence of moderate to severe sleep-disordered breathing (SDB) was 46%, with a significant difference seen between thesexes (36% in women vs. 49% in men). Risk factors included body mass index, left ventriculardysfunction, age, atrial fibrillation and male sex.

    ·      Early recognition of obstructive sleep apnea in patients hospitalized with COPD exacerbation isassociated with reduced readmission rates (Konikkara J et al. Hosp Pract 2016).Patients consulted for COPD exacerbation underwent a sleep test upon discharge and received positive airwaypressure (PAP) therapy as appropriate. The mean change in the number of clinical events six months prior tointervention compared to six months following intervention favored the group who used their PAP therapy,demonstrating early recognition and treatment of obstructive sleep apnea (OSA) in patients admitted withCOPD exacerbation may be associated with reduced hospital admission rates and emergency room visits.

    ·      CPAP significantly improves quality of life, sleepiness and cerebrovascular measures in patients with obstructive sleep apnea (McEvoy RD et al. N Engl J Med 2016).While results in the landmark SAVE trial were neutral on the primary endpoint of whether CPAP can reducemajor cardiovascular events in those with OSA and heart disease, the 2,700-patient study did show that CPAPcan significantly improve the quality of life for people with OSA, and—when used more than four hours pernight—may also lower the risk of stroke and other cerebral events.

    ·      Access to digital engagement tools improves patient compliance on CPAP therapy (Crocker M et al.CHEST (Suppl) 2016). A study of 128,000 sleep apnea patients found patients with access to digital engagement tools demonstratedimproved adherence to CPAP therapy over a three-month period. Nearly 90% of patients using a patientengagement tool in the study reached this important healthcare standard—a 24% relative increase overpatients who were only managed remotely by a provider.

    ·      A telehealth program for CPAP adherence reduces labor and yields similar adherence and efficacywhen compared to standard care (Munafo D et al. Sleep Breath 2016).A study evaluating the effectiveness and coaching labor requirements of a web-based automated telehealthmessaging program compared to standard care in newly diagnosed OSA patients found a significant reductionin the number of minutes coaching required per patient in the telehealth vs. standard of care group (23.9 vs.58.3). The majority of patients in this group stated the new approach met or exceeded their expectations.

    National specialty pharmacy providers merge

    LOUISVILLE, Ky. – PharMerica, a national provider of institutional and specialty pharmacy services, has acquired CareMed Specialty Pharmacy, a New Hyde Park, N.Y.-based national provider of specialty pharmacy services licensed in all 50 states. “The CareMed acquisition is in line with the company’s diversified business strategy and further bolsters our position in the rapidly growing specialty pharmacy market,” said Greg Weighar, CEO of PharMerica. Terms of the deal were not disclosed. PharMerica serves the long-term care, hospital pharmacy management services, specialty home infusion and oncology pharmacy markets. It operates 98 institutional pharmacies, 19 specialty home infusion pharmacies and four specialty oncology pharmacies in 45 states.

    Somnoware taps into Respironics’ EncoreAnywhere

    SANTA CLARA, Calif. – Somnoware says Philips Respironics has agreed to give it direct access to all CPAP usage data stored in the EncoreAnywhere patient management system with consent from the physician or health system. As a result, the data will be accessible to independent and network practices via Somnoware’s new care management module. By having access to this data, sleep physicians can use Somnoware’s module to set up their patients with CPAP devices faster and provide them with better long-term care, the company stated in a press release. The module allows physicians to monitor the progress of a CPAP device order and, once a patient is set up on the device, monitor their compliance by reviewing real-time updates. Somnoware says its sleep management platform is being used by one in five sleep physicians. It has two versions of the platform, one for sleep physicians and one for sleep centers.

    ACHC, SCMESA renew agreement

    CARY, N.C. – The Accreditation Commission for Health Care has renewed its partnership with South Carolina Medical Equipment Services Association. The agreement allows SCMESA members to receive significant discounts and savings on ACHC accreditation programs, as well as discounts on Accreditation University educational resources that help with accreditation. “Our partnership with ACHC is an important way SCMESA supports member goals of keeping their businesses compliant and competitive,” said Bobby Horton, executive director of SCMESA. “We are pleased to continue the relationship.”

    Registration opens for legislative conference

    WASHINGTON – Registration is now open for the AAHomecare Washington Legislative Conference, May 24-25 at the Washington Court Hotel. The association says the annual event provides an excellent opportunity to engage directly with lawmakers and their staff members on industry issues, including rural relief, competitive bidding, audits and complex rehab accessories. The event is open to both members and non-members. Early bird room reservations are available through April 28. Click here to register.

    Heartland Conference announces keynote

    WATERLOO, Iowa – Kevin Lacz, a former Navy Seal, will deliver the keynote address at this year’s VGM Heartland Conference, June 12-15. Lacz’s presentation, “A Morning with Kevin Lacz: Risk vs. Reward,” will take place June 1 at 8 a.m. Lacz will discuss the importance of identifying, mitigating and overcoming risks, using his own journey from student to decorated Navy Seal. Lacz is also the author of a New York Times bestselling memoir, “The Last Punisher.” Following the keynote address, Heartland attendees will have an opportunity to meet Lacz and to purchase his book during a book-signing event.  

    Women’s conference seeks speakers

    MINNEAPOLIS – Essentially Women is seeking speakers for its annual FOCUS conference, scheduled to take place here on Sept. 16. “We are actively seeking presenters on a variety of topics relevant to women’s health care providers,” said Christa Miehe, president of Essentially Women. “We offer our attendees a diverse selection of education sessions, including mastectomy, audits and compliance, marketing, professional and personal development, marketing and retail sales, to name a few.” Those who are interested should contact Miehe at christa.miehe@vgm.com by April 15. VGM acquired Oxford, Mich.-based Essentially Women in late 2015.

    U.S. Rehab’s Greg Packer among complex rehab honorees

    NASHVILLE, Tenn. – Greg Packer has been recognized for his work as an advocate for complex rehab technology by the University of Pittsburgh’s Department of Rehabilitation Science and Technology. Packer, president of U.S. Rehab, has been working with Mark Schmeler, director of the continuing education program and assistant professor of the Department of Rehabilitation Science and Technology at UPitt, on the Functional Mobility Assessment outcomes tool. The tool recently helped U.S. Rehab secure a Humana contract. Packer, along with several other complex rehab advocates, was awarded a medal during the Reach of RST Reception, held March 3 during the International Seating Symposium.

    SCA exec Janet Stephens recognized

    BOWLING GREEN, Ky. – Janet Stephens, director of planning & initiatives, SCA Global Hygiene Supply Personal Care Americas, has been named the recipient of the Women in Manufacturing STEP (Science, Technology, Engineering and Production) Ahead Award given by the Manufacturing Institute. The awards recognize women who have demonstrated excellence and leadership in their careers. Stephens has been with SCA for 28 years and has been instrumental in leading the company’s Bowling Green facility, which manufactures its TENA line of incontinence care products, to become one state-of-the-art and a benchmark in production efficiency.

    Binson’s makes Impact

    CENTER LINE, Mich. – Binson’s Medical Equipment and Supplies is a 2017 Michigan Works! Impact Award Winner. The award was established in 1987 to foster high-quality employment and training programs to provide support activities and a forum for information exchange for Michigan’s workforce development system. Since July 2014, nearly 50 on-the-job training contracts have been written with Binson’s. In February, the provider also received the 2017 Corporate Citizen Award from Macomb County.


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