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    05/24/2017
    HME News Staff

    WASHINGTON – The House Small Business Committee is asking Health and Human Services Secretary Tom Price for relief for HME providers.

    Committee member Rep. Blaine Luetkemeyer, R-Mo., is circulating a letter addressed to both Price and CMS Administrator Seema Verma, expressing concern with a %38% reduction in suppliers since July 1, 2013.

    The letter seeks: additional resources to speed up fee schedule adjustments required by the 21st Century Cures Act; a delay in cuts implemented Jan. 1, 2017; and a restoration of the 2017 rural payments for oxygen concentrators based on adjusted fee schedules.

    “We must provide relief for durable medical equipment suppliers before they are no longer able to help patients across America,” says the letter.

    The letter is the result of grassroots efforts by Patrick Naeger, president of the Midwest Association for Medical Equipment Services.

    “I am grateful to my friend, Congressman Blaine Luetkemeyer, for recognizing the destruction small businesses like mine and thousands of others across the country are facing as a result of Medicare competitive bidding rural fee schedule cuts,” said Naeger, executive vice president of Healthcare Equipment & Supply in Perryville, Mo., in a press release.

    Last week, Rep. Cathy McMorris-Rodgers. R-Wash., began circulating a letter seeking changes to HME policy.


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    Industry stakeholders hit the Hill with letter to appeal for bid relief
    05/26/2017
    Liz Beaulieu

    WASHINGTON – The timing of AAHomecare’s Washington Legislative Conference couldn’t have been better, Tom Ryan told attendees on Wednesday, the day before their Capitol Hill meetings.

    The day before, on Tuesday, a “Dear Colleague” letter began circulating on the Hill appealing to Tom Price, secretary of the Department of Health and Human Services, and Seema Verma, CMS administrator, to intervene and provide relief from Medicare’s competitive bidding program.

    “There’s no score or procedure (required of this letter),” said Ryan, president and CEO of the association. “It’s a simple ask. Look (your representative) in the eye and ask them to sign this letter.”

    The letter, spearheaded by Rep. Cathy McMorris Rodgers, R-Wash., and five other representatives, asks Price and Verma to use their administrative authority to, among other things, freeze reimbursement in non-bid areas at the Jan. 1, 2016 rates.

    While providers may be frustrated by the lack of action thus far from Price, a long-time industry champion, Ryan reminded them that HHS is a large agency and that DME represents only 1.2% of its budget.

    “We are moving the needle at the top,” he said. “We are so close.”

    Ryan set as a goal getting at least 150 representatives to sign on to the letter following the week’s Hill meetings.

    “This letter is an opportunity to walk (bid relief) over the finish line,” he said.

    The timing of the letter and leveraging its momentum was so important that AAHomecare prioritized more time for meetings on the Hill on Wednesday afternoon, in lieu of booking congressional speakers.

    “This year it’s vital that we get you on the Hill, get out the ask and get signatures quick,” said Jay Witter, the senior vice president of public policy at AAHomecare.

    The letter also asks Price and Verma to consider more long-term fixes to make the competitive bidding program more “efficient and sustainable”; to permanently protect accessories for complex power wheelchairs from bid-related reimbursement cuts; and to reverse a recent “double-dip” cut to oxygen concentrators.

    “This is a letter (that contains) every issue we’ve been working on,” Ryan said.

    In addition to Rodgers, the original co-signers of the letter are Reps. Lee Zeldin, R-N.Y.; Dave Loebsack, D-Iowa; Diana DeGette, D-Colo.; Larry Bucshon, R-Ind.; and Marsha Blackburn, R-Tenn.

    “The fires are burning—our issues are upfront,” said Steve Ackerman, the new chairman of the board of directors at AAHomecare, and president and CEO of Spectrum Medical. “Now we have to fan those fires.”


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    05/26/2017
    Liz Beaulieu

    WASHINGTON – Forcing Medicare to better coordinate audits and improve the appeals process is one of the top priorities of the Senate Finance Committee this year, Kimberly Brandt told attendees at the AAHomecare Washington Legislative Conference on Wednesday.

    The committee plans to conduct a hearing for its AFIRM Act this summer, setting the stage for the bill to be re-introduced later this year, said Brandt, chief healthcare investigative counsel for the committee.

    “We hope to come out with finalized language no later than the fall,” she said.

    But the challenge this year, as it was in 2015, when the bill was first introduced, is cost. The Congressional Budget Office gave the Audit & Appeals Fairness, Integrity and Reforms in Medicare Act of 2015 a $1.4 billion price tag.

    Despite that challenge, the committee remains dedicated to reform—the problem is too big to ignore, Brandt says. The backlog at the administrative law judge level, the third level of appeal, is more than 700,000 cases deep, she pointed out, meaning if you submitted a case today, it would take more than 830 days to get a hearing.

    “That’s unacceptably long,” she said. “The ALJ can’t solve cases fast enough.”

    The committee also got reaffirmation recently, when a judge overseeing litigation related to audits and appeals between the Department of Health and Human Services and the American Hospital Association said the AFIRM Act would go a long way toward solving issues, Brandt said.

    “We were pleasantly surprised by that,” she said.

    While the specifics of the bill will likely be reworked this year, the overall goal is holding Medicare accountable for how it organizes and conducts audits, and oversees its auditors, Brandt said.

    “There aren’t even consistent standards that auditors are held to,” she said.

    While the committee does its work, the industry partnered with Rep. Marsha Blackburn, R-Tenn., in May to introduce a bill that would require prior authorization for certain high-cost DME. A provision in the bill would exempt approved claims from subsequent pre- and post-payments audits.

    “Prior authorizations are the way to go, in terms of a long-term fix,” said Jay Witter, senior director of government affairs for AAHomecare.

     

     


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    05/26/2017
    HME News Staff

    WASHINGTON – The House Small Business Committee is asking Health and Human Services Secretary Tom Price for relief for HME providers.

    Committee member Rep. Blaine Luetkemeyer, R-Mo., is circulating a letter addressed to both Price and CMS Administrator Seema Verma, expressing concern with a 38% reduction in the number of HME suppliers since July 1, 2013.

    The letter seeks: additional resources to speed up fee schedule adjustments required by the 21st Century Cures Act; a delay in cuts that went back into effect in non-bid areas on Jan. 1, 2017; and a restoration of payments for oxygen concentrators in rural areas based on adjusted fee schedules.

    “We must provide relief for durable medical equipment suppliers before they are no longer able to help patients across America,” says the letter.

    The letter is the result of grassroots efforts by Patrick Naeger, president of the Midwest Association for Medical Equipment Services.

    “I am grateful to my friend, Congressman Blaine Luetkemeyer for recognizing the destruction small businesses like mine and thousands of others across the country are facing as a result of Medicare competitive bidding rural fee schedule cuts,” said Naeger, executive vice president of Healthcare Equipment & Supply in Perryville, Mo., in a press release.

    Last week, Rep. Cathy McMorris-Rodgers, R-Wash., also began circulating a letter seeking changes to HME policy.

    CareCentrix, Performant specialize fraud efforts

    HARTFORD, Conn. – CareCentrix has teamed up with Performant Financial Corporation, the new national RAC for DME, home health and hospice, to deploy specialized analytics and algorithms to better identify and decrease waste and fraud, it announced May 23.

    “You only need to look at recent headlines to know that the problems of fraud, waste and abuse are only increasing,” said John Driscoll, CareCentrix CEO, in a press release. “CareCentrix is committed to bending the cost curve in health care by working with payers to guide care for their members to the home. We are thrilled to expand our capabilities in identifying and decreasing waste and fraud insurance claims in home health care and DME, and look forward to working with Performant to stay on the cutting edge of curbing this trend for our clients.”

    Home health and DME are known as high-risk areas for insurance abuse and error, representing more than $11.4 billion in improper payments each year for Medicare alone, according to the release.

    Because home health and DME claims are often high volume, but low unit cost, traditional approaches to detecting waste and fraud often fall short, CareCentrix says.

    “By leveraging their collective experience in home health care and cost-containment solutions, CareCentrix and Performant will deploy specialized analytics and algorithms to better detect the patterns that are often overlooked but add significant cost to health care payers,” the release states.

    Performant says DME and home health have become a growing concern for healthcare payers.

    “We are excited to leverage CareCentrix’s unmatched knowledge of home care management in pursuit of our mutual goal to curb improper payments,” said Simeon Kohl, senior vice president of healthcare at Performant, in the release.

    SBA, CMS to attend Heartland session

    WATERLOO, Iowa – Representatives from CMS and the Small Business Administration will participate in panel discussion at the VGM Heartland Conference in June. The discussion will focus on the future of the competitive bidding program, and provide an opportunity for audience members to ask questions and share feedback on the impacts to their businesses, according to a press release. “Providing platforms to share (provider) concerns and connecting VGM members with resources to navigate the regulatory environment helps strengthen and protect their businesses,” said John Gallagher, vice president of government relations for VGM. The SBA holds regular hearings across the country and HME providers have been making their case at every opportunity, including one held in Portland, Maine, in May 2016. The VGM Heartland Conference takes place June 12-15.

    Clinicians speak out on bid program

    WATERLOO, Iowa – People for Quality Care, the advocacy arm of The VGM Group, has released a video featuring damning testimony from clinicians on Medicare’s competitive bidding program. The clinicians provided the testimony at an annual conference recently hosted by Handi Medical Supply in Saint Paul, Minn. “Our goal is to empower the industry with the tools needed to continue the fight as we work together toward relief,” said Kelly Turner, executive director of PFQC. “This video reinforces the message shared by the industry and other stakeholders that the program is harming the very people it’s designed to protect and is in desperate need of reform.” Clinicians say the faulty program, combined with unsustainable reimbursement rates, has resulted in preventable hospital readmissions and reduced options. It has also resulted in patients either going without equipment or supplies, or paying for them out of pocket. “It may be great for Medicare; it’s not great for the patient,” says one clinician, who has been coordinating care for 45 years. “It is the worse thing that I’ve seen in my entire life.” PFQC encourages providers to share the video as part of their lobbying efforts.

    OIG pushes monthly rentals for all PMDs

    WASHINGTON – Medicare could save millions if it sought legislation to shift from a lump-sum purchase option to a monthly rental payment for all power mobility devices, according to a report from the Office of Inspector General (OIG) published in May. In January 2011, Medicare eliminated the lump-sum purchase option for standard power wheelchairs, a move that saved $86 million from 2011 to 2014, according to the OIG. If legislation were in place to also eliminate this option for scooters and complex power wheelchairs—what the OIG calls “nonstandard PMDs”—Medicare would have saved an additional $10.2 million from 2011 to 2014, according to the report. The OIG conducted an audit that covered Medicare payments totaling $264,376,368 for PMDs obtained by 85,761 beneficiaries choosing the lump-sum purchase option during 2011through 2014. The PMDs were new and used nonstandard devices provided to Medicare beneficiaries during the four-year period. The agency calculated the potential savings to the Medicare program by comparing the lump-sum purchase to what the rental payments would have been over a 13-month rental period.

    NHLBI introduces ‘COPD roadmap’

    BETHESDA, Md. – The National Heart, Lung, and Blood Institute has released a COPD National Action Plan to offer a roadmap for addressing the third leading cause of death in the United States. The plan has five goals: empower patients and caregivers to recognize and reduce the burden of COPD; equip healthcare professionals to provide comprehensive care to COPD patients; collect, analyze and share COPD data; increase COPD research; and turn COPD recommendations into research and public health care actions. The plan was developed with the input of COPD stakeholders, including patients, healthcare providers and academics. “The enthusiasm of members from the COPD community in sharing insights has been invaluable throughout this process,” said James P. Kiley, Ph.D., director of NHLBI’s Division of Lung Diseases, in a press release. “The different perspectives brought by those who live these issues every day contributed to making this a clear, coordinated way forward for all stakeholders.” To learn more about the plan go to copd.nih.gov. 

    What do Medicare beneficiaries spend for care?

    WASHINGTON – More than one-quarter of Medicare beneficiaries, or 15 million people, spend 20% or more of their incomes on premiums plus medical care, according to a new report from the Commonwealth Fund. Overall, beneficiaries spent an average of $3,024 on out-of-pocket costs. Of that, more than one-third was spent on cost-sharing for care, 25% on prescription drugs, and 39% on services not covered by Medicare, including dental and long-term care. The study also found that one-quarter of beneficiaries are underinsured, spending at least 10% of their total annual income on medical care, excluding premiums.

    Medicaid Fraud Control Units recover about $36 million from DME in 2016

    WASHINGTON – Medicaid Fraud Control Units made 29 criminal convictions and 56 civil settlements and judgments involving DMEPOS providers in fiscal year 2016, according to a report from the Office of Inspector General (OIG) published in May. On the criminal side, the units recovered more than $5 million; on the civil side, they recovered about $31 million. In all, the units reported 1,564 criminal convictions and 998 civil settlements and judgments, representing a total of almost $1.9 billion in recoveries. The OIG found that the units continued a trend of increasing the number of criminal convictions in 2016, and they hit a five-year high for the number of civil settlements and judgments. The OIG’s report was based on an analysis of 2012-2016 statistical data submitted by 50 units.

    F&P Healthcare grew homecare revenues by 4% in 2017

    AUCKLAND, New Zealand – Fisher & Paykel Healthcare reported net profit after tax of NZ$169.2 million for the fiscal year ended March 31, 2017, an increase of 18% over the previous year. Operating revenue was NZ$894.4 million, a 10% increase over the previous year, or 14% growth in constant currency. F&P says both were records for the company. By segment, the hospital product group grew revenues by 15% to NZ$500.4 million, or 19% growth in constant currency; and the homecare product group grew revenues 4% to NZ$381.5 million, or 8% growth in constant currency. “In the homecare product group, our masks continue to perform well, with 9% revenue growth or 13% in constant currency, compared to the previous year,” said CEO Lewis Gradon. “The new F&P Brevida nasal pillows mask, which was launched in August, is already showing great results in the markets where it is available. Our myAirvo home respiratory system is also growing strongly, building from our market-leading position in hospital humidification.” As part of its earnings, F&P also disclosed litigation-related expenses of $20.7 million in the 2017 fiscal year as part of its patent litigation proceedings* with ResMed. “We recognize that this is a significant cost and did not enter into litigation lightly,” Gradon said. “We have been providing unique solutions for patients for more than 45 years and we take pride in our proprietary technology. We also respect the valid intellectual property rights of others and we are confident in our position.”

    http://www.hmenews.com/also-noted/legal-wrangle-resmed-withdraws-complaint-plans-refile

    Soleo Health helps to ramp up home infusion advocacy

    MCKINNEY, Texas – Soleo Health, a national provider of specialty home and alternate-site infusion services, has joined Keep My Infusion Care at Home, an industry backed coalition that advocates for Medicare patients who are losing access to their treatment. Soleo Health has also authored a white paper that provides details on the impact of the 21st Century Cures Act on these patients. A provision in the act modifies the payment structure for certain infusion drugs under the Part B benefit, drastically reducing their reimbursement. The modification, which went into effect Jan. 1, essentially means that payments now cover only drug costs, not clinical services. “Home infusion has become a life-saving, cost-effective solution for more than 10 million Americans today,” said Drew Walk, CEO at Soleo Health. “Keeping care at home has sustained patients’ quality of life and better managed the costs associated with their respective conditions. With the new 21st Century Cures Act, these patients stand to be significantly compromised. Action must be taken immediately to help them remain at home, as this will benefit not only their health and wellbeing but our overall healthcare system, as well.” Another provision in the act provides payments for clinical services, but not until 2021, creating a four-year payment gap.

    ResMed studies connect the dots on central sleep apnea

    SAN DIEGO – People with treatment-emergent central sleep apnea (CSA) have a significantly greater risk of terminating CPAP therapy, according to a new ResMed-sponsored study presented on May 22 at the 2017 American Thoracic Society International Conference. Researchers found that 3.5% of patients had CSA during the first 90 days of therapy. ResMed says the study highlights the importance of regularly monitoring patients to support adherence to treatment, and diagnosing CSA early to minimize risk of therapy termination. The study builds on another study released earlier this year that showed patients with treatment-emergent CSA who switch treatment from CPAP therapy to adaptive servo-ventilation therapy use their therapy longer and have significantly fewer apneas during sleep. "This study provides the most robust view available on the prevalence of CSA in patients on PAP therapy,” said Dr. Carlos Nunez, ResMed’s chief medical officer. “The findings in this new research, combined with the research presented in April 2017, underscore the importance of keeping patients on therapy through regular monitoring, and rethinking the conventional wisdom on therapeutic options based on each patient's disease severity." Researchers found that patients with any form of CSA during CPAP therapy were at higher risk of terminating therapy in the first 90 days versus those who did not develop CSA, but patients with emergent CSA, whose condition only became apparent during therapy, were 1.7 times more likely to terminate their therapy than those without the condition. The study defined three groups among patients with CSA: emergency, persistent and transient.

    Survey: Home oxygen therapy inadequate, say patients

    BOSTON – Home oxygen patients say they are unable to access equipment to meet their needs, according to a new survey unveiled at ATS 2017 this week. The ATS Nursing Assembly Working Group surveyed 1,926 people and unearthed equipment issues like heaviness of tanks and portable oxygen concentrators that don’t meet their needs; and access issues like not being able to change suppliers, according to an article in RT Magazine. As a result, patients say they have lower quality of life. “Patients identify that they would benefit from equipment that is portable, lightweight and allows them to maintain activities of daily living,” said Kathleen Lindell, RN and Ph.D, of the University of Pittsburgh and lead study author. “Professional and patient organizations should develop processes to improve equipment supporting mobility and a better quality of life for oxygen dependent patients.” The American Thoracic Society has formed a workgroup to define optimal home oxygen therapy; identify barriers to therapy; and identify gaps and propose areas for future investigation and device development.

    Tactile Systems launches system to treat head and neck lymphedema

    MINNEAPOLIS – Tactile Systems Technology has launched Flexitouch, a pneumatic compression system to treat head and neck lymphedema at home. In a completed limited market release with more than 80 patients, 88% saw a reduction in head and neck swelling after an initial 32-minute session, according to a press release. “We are thrilled with these positive results demonstrating that the Flexitouch system can help head and neck lymphedema patients effectively reduce lymphedema swelling and improve their quality of life,” said Gerald Mattys, CEO of Tactile Medical.


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  • 06/02/17--09:07: CareCentrix bends cost curve
  • Partnership with Performant will decrease waste, create higher-performing networks, company says
    06/02/2017
    Liz Beaulieu

    HARTFORD, Conn. – HME providers may view CareCentrix’s recently announced partnership with Peformant as just another layer of scrutiny, but a company official says it will go a long way toward moving more care into the home.

    CareCentrix announced in late May that it will work with Performant, Medicare’s national RAC for DME, home health and hospice, to deploy specialized analytics and algorithms to better identify and decrease waste and fraud.

    “The intent here is not for this to be a negative experience,” said Stephen Wogen, the chief growth officer at CareCentrix. “I’m in a lot of conversations with a lot of payers and health systems, and DME is misunderstood. I think the industry is under siege because of historical bad practices, and a lot of that has been cleaned up, but it still needs to overcome a bad rap. We at CareCentrix believe the future of health care is in the home. But for that to be leveraged, home care needs to be accountable and reliable, and providers need to be trusted.”

    It’s hard to ignore DME and home health as high-risk areas for waste and fraud, Wogen says. Not when CMS says they represent more than $11.4 billion in improper payments each year for Medicare alone.

    CareCentrix already has analytics and compliance and special investigative teams in place to detect waste and fraud in its 10,000 provider locations. But the partnership allows the company to combine its existing efforts with Performant’s much larger data set, Wogen says.

    “We weed out players where we’re seeing patterns of fraud, so we believe we have high-performing networks,” he said. “But we believe we can have even higher performing networks.”

    The partnership also allows CareCentrix to broaden its existing efforts across post-acute care, Wogen says.

    “We can expand beyond the traditional silos of looking at just DME and looking just at home health, and look across settings,” he said. “We can look at post-acute care in its totality.”

    Wogen says one byproduct of the partnership with Performant and their combined data crunching may be more prospective vs. retrospective controls, something that an HME industry that’s lobbying for more widespread prior authorizations would no doubt welcome.

    “That could simplify how we all work,” he said. “We have a prior authorization process in place for a lot of our services today, but what if you were able to examine the process and take away some learnings and ascertain that automatic authorizations in some areas could streamline the process?”

    While CareCentrix is a firm believer in home care, it needs to toe the fine line between determining what’s necessary and what’s not, and the partnership with Performant better equips the company to do that heavy lifting.

    “A CPAP mask can keep a patient out of the ER and it can keep comorbidities under control, but does that mean a patient needs five masks a year—not necessarily,” he said. “Providers need to do everything they can to keep a patient compliant; at the same time, supplies continue to increase in cost. By getting the bad players out, it allows DME to be used for what it’s supposed to be used for. That’s how you bend the cost curve.”


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    06/02/2017
    HME News Staff

    WASHINGTON – Reps. Glenn “GT” Thompson, R-Pa., and Mike Thompson, D-Calif., have once again introduced a bill that calls on CMS to enforce a law that O&P providers be certified to receive payments under Medicare.

    Thompson and Thompson introduced H.R. 2599, the Medicare Orthotics and Prosthetics Improvement Act of 2017, last week. They have introduced similar bills in previous sessions of Congress.

    “Medicare beneficiaries in need of prosthetic and orthotic services deserve to know they’re getting the very best care,” said Mike Thompson in a press release. “Keeping fraudulent providers out of Medicare will ensure patients get the treatment they deserve, and has the added benefit of reducing costs.”

    The Benefits Improvement and Protection Act (BIPA), which was signed into law back in 2000, requires certification for O&P providers. CMS has failed to enforce the provision, however, resulting in an uptick in fraudulent payments to unlicensed providers, Thompson and Thompson say.

    The bill would also link eligibility for payment to the qualification of the providers and the complexity of the device; establish orthotists and prosthetists as Medicare providers, distinguishing them from DME providers; and clarify that notes taken by orthotists and prosthetists should be part of the patient’s medical record.

    Congress adjourned late last year without passing the Medicare Orthotics and Prosthetics Improvement Act of 2015.

    QMES secures more financing

    NEW YORK – HME platform company QMES has obtained a second round of financing from CIT Group.

    QMES, a DME provider in the Northeast, will use the $65 million secured senior credit facility to refinance legacy debt and support growth, according to a press release.

    “QMES’s active M&A growth strategy has led to the successful completion and integration of more than 15 acquisitions and they currently serve over 100,000 patients annually,” said William Douglass, managing director and group head of CIT’s Healthcare Finance business. “As a result, the firm has grown to become the largest DME provider in the Northeast.”

    QMES is a portfolio company of Quadrant Management, a New York-based private equity and restructuring firm that bought Landauer Metropolitan in 2013. An affiliate of Quadrant in May bought Braden Partners—better known as Pacific Pulmonary Services—and Associated Healthcare Systems from Teijin Limited.

    QMES received a $50 million senior secured credit facility from CIT in 2014.

    “Overall, the population is aging and we’re seeing growing rates of chronic diseases,” said Luke McGee, CEO of QMES in the release. “As a result, there’s a need for the type of equipment we distribute (i.e. CPAP machines, wheelchairs, ventilation equipment, etc.). CIT’s deep industry expertise and experience in financing middle market health care firms makes them a perfect financing partner for us and we’re excited to continue to build the business with them.”

    Mediware broadens reach in alternate care market

    LENEXA, Kan. – Mediware Information Systems has finalized an agreement to buy Kinnser Software, a provider of software solutions to 4,000 home health, hospice and private duty home care professionals, the company announced May 30.

    The acquisition allows Mediware to expand its portfolio in the home health and hospice space, creating an integrated, high-growth software provider for the alternate care market, according to a press release.

    “Kinnser’s intuitive platform provides Mediware with additional depth, expertise and capabilities to strengthen our platform in the home health and hospice space,” said Thomas Mann, CEO of Mediware, in the release. “This transaction marks our next step as we continue to expand our offering as the leading, integrated supplier of software solutions for alternate care providers.”

    Mediware is purchasing Kinnser from Insight Venture Partners, a global private equity and venture capital firm based in New York City. Insight invests in growth-stage technology, software and Internet businesses.

    TPG, which backed the deal, bought Mediware earlier this year.

    “As experienced investors in software and healthcare, we have witnessed the role that innovation can play in advancing the industry’s infrastructure,” said Nehal Raj and Jeff Rhodes, partners at TPG, in the release. “Alternate care providers are continuing to see growth in patient volumes and are relying on technology as a low-cost and efficient management solution. We partnered with Mediware because we saw a compelling opportunity to invest in a high-quality software provider that will continue to benefit from these trends. Kinnser fits well within this vision, and broadens our end-market breadth within alternate care settings.”

    Mediware has made a string of acquisitions in the past few years, including Definitive Homecare Solutions and its CPR+ platform; Fastrack; and CareCentric’s software solutions for the homecare market, including MestaMed.

    Philips buys maker of respiratory vest

    AMSTERDAM – Royal Philips has signed an agreement to acquire Respiratory Technologies, the maker of an airway clearance solution for patients with chronic respiratory conditions, like COPD and cystic fibrosis. Philips says the expansion of its respiratory care portfolio with RespirTech’s vest will further strengthen its solutions to manage care in the hospital and at home. “As healthcare continues to transform to a value-based care model, Philips is strengthening its respiratory care portfolio to enable its home care and hospital partners to better serve the care network,” the company stated in a press release. RespirTech’s portfolio also includes a robust clinical support program for managing respiratory patients in the home. The St. Paul, Minn.-based company was founded in 2004 and employs about 210 employees. Philips expects to complete the deal, announced May 22, in the coming months. It will not disclose financial details.

    People news: Sunrise Medical, VGM, Permobil, Drive

    FRESNO, Calif. – Thomas Rossnagel has resigned as president and CEO of Sunrise Medical, the manufacturer announced today.

    Johan Ek, chairman of the board of directors, has taken over as acting CEO, according to a press release.

    “After 20 years of service at Sunrise Medical, I would like to spend more time with my family,” said Rossnagel, who held the role since 2009. “For that reason, I have asked our owners, Nordic Capital, to find a new CEO for Sunrise Medical.”

    Sunrise Medical is a global manufacturer of complex rehab products, seating and positioning systems, scooters and geriatric product lines. Key brands include Quickie, Sopur, RGK, JAY, Breezy, Sterling and Gemino.

    Douglas moves into new position at VGM

    WATERLOO, Iowa – VGM & Associates has named Craig Douglas to the newly created position of vice president of payer and member relations.

    Douglas will be tasked with navigating payer relationships and addressing concerns that are impacting VGM members.

    “Adding Craig’s expertise will serve as a huge benefit to our membership community,” said Clint Geffert, VGM & Associates president, in a press release. “He brings 18 years of experience working with payer sources and providers and has vast knowledge of the HME industry.”

    Douglas previously served as vice president of payer relations for VGM’s Homelink division, where he was responsible for provider onboarding; oversight of network adequacy for the payer partners and patients for whom care was coordinated; and building and fostering effective, goal-driven relationships with payers and providers. 

    Mick joins Permobil

    LEBANON, Tenn. – Permobil has tapped WB Mick as its new general manager of the TiLite Business Unit Manual.

    Mick, who will start June 12, previously worked as Numotion’s vice president of business development. Larry Jackson, president of Permobil’s Business Region Americas, will remain involved as president of the business unit, according to a press release.

    “I always respected Larry’s vision and leadership and I am excited to work for him at world’s most innovative manual wheelchair manufacturer,” said Mick.  “Larry will continue to be a guiding force for me and Business Unit Manual.” 

    Permobil acquired ROHO in 2015 and TiLite in 2014.

    Lewarski elected to ARCF board

    PORT WASHINGTON, N.Y. – Joe Lewarski has been elected to the board of directors of the American Respiratory Care Foundation. Lewarski, vice president of global respiratory and sleep for Drive DeVilbiss Healthcare, is a registered respiratory therapist and fellow of the American Association for Respiratory Care. He has also served multiple terms on the AAHomecare board of directors and he was awarded the association’s Homecare Champion Award in 2011. Lewarski was also awarded the Invacare Award for Excellence in Home Respiratory Care by the ARCF in 2001.

    AAH elects new leaders

    WASHINGTON – AAHomecare elected new leadership during its annual membership meeting at the Washington Legislative Conference in May. Steve Ackerman, CEO, Spectrum Medical, is chairman of the board of directors; Bill Guidetti, executive vice president, East Zone, Apria Healthcare, is vice chairman; and Jeff Hall, president of Reliable Medical Supply, is treasurer. Laura McIlvaine a board member with Shield Healthcare, has joined the board; and Doug Coleman, CEO of Rocky Mountain Medical Equipment, Major Medical Supply & UCH Home Medical Supply, has joined the board and executive committee.

    Consumer groups join the cause

    WASHINGTON – More than two dozen national consumer advocacy groups have joined with the ITEM Coalition in urging lawmakers to sign on to a letter asking Health and Human Services Secretary Tom Price and CMS Administrator Seema Verma to use their regulatory authority to make changes to protect the HME benefit. “Over the past several years, CMS has made significant policy and regulatory changes to the Medicare DME benefit,” the letter states. “Many of these changes have been intended to save taxpayer money; however, they have had a substantial negative impact on beneficiary access to vital devices and services that improve health and function.”Among the consumer groups signing the letter: the Amputee Coalition, the Clinician Task Force, Paralyzed Veterans of America and the United Spinal Association.

    Inogen gets international clearance

    GOLETA, Calif. – Inogen has obtained the EC Certificate for its Inogen One G4 portable oxygen concentrator and will now make the device available for sale in certain countries. “We are thrilled to launch the Inogen One G4 internationally and look forward to working with our international partners to increase freedom and independence for oxygen users with this product around the world as we have done in the United States,” said Scott Wilkinson, president and CEO, in a press release. The Inogen One G4 launched in the U.S. in May 2016.

    Short takes: D.W. McMillan, BOC, Insulet

    D.W. McMillan Home Medical Equipmenthas a new location at 1108 Douglas Avenue in Brewton, Ala., right beside Regions Bank. “Our goal is to help people keep life on track and being more visible in our new location will hopefully help,” Larry Rambach, manager, told the Brewton Standard. D.W. McMillan is a full-service HME provider…Claudia Zacharias, president and CEO of the Board of Certification/Accreditation (BOC), has been recognized as a top 50 women-led business leader by the Commonwealth Institute of South Florida. She accepted the award at the group’s luncheon on May 18. TCI of South Florida partnered with Kaufman Rossin, a CPA and advisory firm, to survey more than 10,000 women-led businesses…Insulet Corp. has appointed Bret Christensen as chief commercial officer. He will run the company’s commercial operations, including sales, marketing, customer care, market access and advocacy. Christensen joins Insulet from Myriad Genetics, where he most recently served as general manager of the Preventive Care business unit.

     


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    06/08/2017
    HME News Staff

    WASHINGTON – Eighty-four members of Congress and counting have signed a letter asking HHS Secretary Tom Price to make significant changes to HME policy.

    Time is running out, however: The goal is at least 150, and the deadline is Friday, June 9.

    AAHomecare reports another 20 members have sought additional information on the letter, which is spearheaded by Rep. Cathy McMorriss Rogers, R-Wash., and five other representatives.

    The uptick in commitments comes after AAHomecare’s Washington Legislative Conference, May 26-27.

    AAHomecare, VGM and state associations are rallying their members to contact their representatives and urge them to sign the letter.

    “If you haven’t yet contacted your representative in the House on this issue, please do so as soon as possible to help us finish with a strong showing on the letter,” said AAHomecare in its weekly bulletin on Wednesday.

    VGM reports that its VGM Action Center has been used to send more than 1,000 letters to members of Congress in the past two weeks, urging them to sign the letter.


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    Also, Secretary Price finally goes on record about access issues
    06/09/2017
    Liz Beaulieu

    WASHINGTON – When HHS Secretary Tom Price took to Twitter last week to post several videos of small business owners speaking on the negative impact of Obamacare, one in particular caught the eye of social media-savvy HME providers.

    Dudley Hoskins Bostic, owner of Hoskins Drug Store in Clinton, Tenn., said, “There is an access issue. It’s not available—it is actually not available to the residents and the citizens of Tennessee. And it’s narrowing as we speak.”

    The video, only a few seconds long, had providers wondering whether Bostic was talking about Obamacare—or Medicare’s competitive bidding program.

    “My daughter just pulled it up and my mouth fell open,” said Bostic, who hadn’t seen the video until provider Tyler Riddle called her to tell her it was on Twitter. “I know that (Price) is an advocate for us, and I’ve always liked him, even more now, since I’ve met him. He’s such a smart man. But it was DME bidding and rates that I was talking about. They must have chopped that out.”

    Bostic says she was part of a recent roundtable discussion in Tennessee hosted by Price and CMS Administrator Seema Verma. While she was fully aware that the focus of the meeting was the Affordable Care Act, she went off script because it’s competitive bidding that has had the most significant impact on her 87-year-old business.

    For Hoskins Drug, one of the biggest impacts of the program has been how it limits the ability of the company, which was awarded contracts for several but not all items, to fully take care of beneficiaries.

    “They don’t want multiple providers in and out of their homes—it’s supposed to be a calming time for them, not a revolving door,” she said. “They need everything. I can do beds and support surfaces, but I can’t do oxygen. What goes with oxygen, but a bed? It makes no good sense.”

    More ominously, Bostic notes that with 40% of HME companies choosing to close their doors, competitive bidding is wreaking havoc on small businesses—and small town America.

    “Every community that is thriving has a corner store and a pharmacy,” she said.

    During the roundtable discussion that preceded the video taping, Bostic says she told Price and Verma that Hoskins Drug’s two priorities are getting pharmacists recognized as healthcare providers and securing the reimbursement that goes along with that; and repealing and replacing the competitive bidding program.

    “He pointed his finger at me and said, ‘Yes ma’am,’” she said.

    And therein lies the rub for providers like Riddle. While providers have been assured repeatedly in private that Price and Verma are working on competitive bidding reform, they have yet to acknowledge on the record, since taking office, that there are issues with the program.

    That acknowledgement came on June 8, however, when, during a hearing on the fiscal 2018 budget by the Senate Finance Committee, Price said HHS is “looking very seriously” at the access issues created by the bid program, especially in rural areas, according to news reports.

    In what turned out to be a big week for DME, providers are latching on to Bostic’s video and this acknowledgement.

    “(Bid reform) is very much on (HHS’s) radar,” agreed Riddle, vice president of MRS Homecare in Tifton, Ga. “But what that doesn’t do is motivate a provider that’s barely hanging on. What that doesn’t do is put CMS on public notice. What that doesn’t do is say to third-party payers that they’re applying rates based on a flawed program. We get it; it’s on their radar. But a public statement that says, ‘This program is screwed up,’ is more beneficial.”

    When Price’s acknowledgement began circulating on Twitter on Friday, provider Gary Sheehan tweeted: “This is all I wanted, public acknowledgement of serious issues. My sincerest thanks @SecPriceMD—now let’s get about a fix!”


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    06/09/2017
    HME News Staff

    WASHINGTON – Industry stakeholders spent Friday pushing to get as many signatures as possible on a letter asking HHS Secretary Tom Price to make significant changes to HME policy.

    The goal is at least 150: at press time, there were 112.

    The letter is spearheaded by Rep. Cathy McMorriss Rogers, R-Wash., and five other representatives.

    The uptick in commitments comes after AAHomecare’s Washington Legislative Conference, May 26-27.

    Throughout the day on Friday, AAHomecare and HME providers took to Twitter to post updates and rally the troops, so to speak.

    “Make the call or email, let’s make the final push for signatures,” the association tweeted.

    VGM reports that its VGM Action Center has been used to send more than 1,000 letters to members of Congress in the past two weeks, urging them to sign the letter.

    OIG: Bid program did not impede access

    WASHINGTON – Most Medicare beneficiaries continued to have access to CPAP/RAD devices after Round 2 of the competitive bidding program began, according to a new report from the Office of Inspector General.

    For CPAP/RAD supplies, however, Medicare payments stopped for 46% of beneficiaries in Round 2 CBAs, compared to 33% in non-bid areas.

    “The decline may or may not indicate disruptions in receiving needed supplies,” the OIG stated. “For example, the decline may indicate that the program reduced the provision of unnecessary supplies, as CMS determined to be the case with Round 1 of the program.”

    The OIG conducted the study in response to a 2014 letter in which members of Congress expressed concerns about the program’s impact on access to DME.

    The OIG says its findings are consistent with CMS’s conclusion that the bidding program is not impeding access to CPAP/RAD devices.

    Round 2 of competitive bidding kicked off July 1, 2013.

    Brightree buys Conduit Technology

    ‘The next logical area in need of automation is the intake process,’ says CEO Matt Mellott

    ATLANTA – Brightree has acquired Conduit Technology, a provider of documentation and workflow solutions.

    Conduit Technology’s flagship product, Conduit Office, is the engine behind Brightree’s MyForms.

    “Historically, HMEs have used automation tools in their back-end operations to achieve greater operational efficiencies, typically around the billing process,” said Matt Mellott, president and CEO of Brightree. “The next logical area in need of automation is the intake process, and MyForms will play a significant role in Brightree delivering a robust and comprehensive intake solution.”

    The acquisition will allow Brightree to enhance MyForms to give HME providers greater access to workflow and automation technology to eliminate paper forms, reduce claim denials, improve audit outcomes and create process integrity, especially in the order intake process.

    Brightree introduced providers to MyForms in 2014, when it formed a strategic partnership with Conduit Technology. Now more than 200 providers with nearly 7,000 users leverage the solution to cut order-processing times, accelerate the time to submit claims, and reduce errors during order creation and confirmation, the company says.

    “MyForms has reshaped the intake process for many of our customers,” said Bobby Shoshal, COO of Brightree.

    Using MyForms, providers can create custom forms based on provider- and payer-specific business rules. Once forms are created, documents are automatically populated with patient and order data from the Brightree system.

    Terms of the deal will not be disclosed.

    Two large providers in Iowa merge

    CONRAD, Iowa – NuCara Pharmacy & Home Medical, headquartered here, has acquired Hammer Medical Supply, headquartered in Des Moines, Iowa, according to the Times Republican. Per the deal, Hammer Medical Supply will continue operating its nine locations under its own name. Three of the four owners of Hammer Medical Supply—Rick Johnson, Kurt Johnson and Mark Johnson—will retire, and the remaining owner, Terry Flatt, will stay on as a stockholder and Hammer’s CEO. “The Johnsons were ready to retire, and we didn’t want the company to dissolve,” Flatt told the newspaper. Together, NuCara and Hammer Medical Supply now have more than 30 locations in five states and employ more than 400 people. NuCara, which stated as a small pharmacy, entered the HME and supply industry in 1981.

    Inogen nails down Cleveland facility

    GOLETA, Calif. – Inogen has secured an additional facility in the Cleveland area to help grow its direct-to-consumer business, it announced June 2. The facility will allow the company to recruit employees from the Northeast to grow its sales force for that business, the company says. “We are planning on adding additional headcount of approximately 240 people in the Cleveland area location over the next three years,” said Scott Wilkinson, president and CEO. “We look forward to having a sales and service support location in the Eastern time zone, which we think will allow us to better serve our customers.” As of Dec. 31, 2016, Inogen’s sales force for the direct-to-consumer business comprised 177 sales representatives located in the company’s Goleta, Calif., and Richardson, Texas, facilities. The Cleveland area facility will also include customer service and support functions. Inogen has secured tax benefits from state and local governments of up to $1.9 million over the next three years based on forecasted headcount additions and tenant improvement costs for the facility.

    Golden beefs up exec team

    OLD FORGE, Pa. – Golden Technologies has made three key hires to lead growth for the company, including two newly created positions. Cy Corgan will serve as vice president of national accounts. Corgan has more than 25 years of experience in HME, and most recently served as national sales manager with EZ-Access. Jack Byrne will serve as CFO. He previously served as CFO at EXTOL, a privately owned software company, in Pottsville, Pa. Chris Carroll will serve as director of marketing. Caroll has more than 20 years of experience in public relations and marketing, most recently as the director of annual giving & alumni relations at The Commonwealth Medical College in Scranton.

    Invacare proposes $100M raise

    ELYRIA, Ohio – Invacare intends to offer $100 million aggregate principal amount of convertible senior notes due 2022 in a private offering to qualified institutional buyers, the company announced June 7. In connection with the offering, Invacare expects to grant the initial purchaser an option to purchase up to an additional $15 million aggregate principal amount of notes that will be delivered within a 13-day period beginning on the date the company first issues the notes. Final terms of the notes, including the initial conversion price, interest rate and certain other terms of the notes, will be determined at the time of pricing. The notes will bear interest semi-annually and will mature on June 1, 2022, unless repurchased or converted. Invacare intends to use a portion of the net proceeds from this offering to pay the cost of the convertible note hedge transaction. It also intends to use any remaining net proceeds for working capital and general corporate purposes, which may include funding portions of its ongoing turnaround.

    Medtrade offers discount for early registration

    ATLANTA – Early registration for Medtrade opens Monday, June 12. This year’s show takes place Oct. 23-25 at the Georgia World Congress Center. In May, show organizers announced that they were shortening the show from four days to three, with extended hours for the show floor. Registering early saves up to $75 on the expo and more than $200 on the conference, according to a press release. “Demand for HME will continue to skyrocket, and Medtrade can help providers by giving them the tools they need,” said Kevin Gaffney, show director. “The motivation, inspiration, and product ideas from Medtrade can truly set the stage for future success.” Register here.

    Supply company owner accused of $1M in Medicaid fraud

    NEW YORK – The owner of Monack Medical Supply has been indicted on charges of Medicaid fraud, according to a press release from the New York Attorney General’s Office. Kester Atumonyogo allegedly billed Medicaid and Healthfirst, a Medicaid managed care organization, $1 million for an expensive nutritional formula while supplying patients with a lower-priced formula. According to the indictment, Atumonyogo used a fraudulent social security number to enroll Monack Medical Supply in the Medicaid program, and has a history of identity and welfare fraud. “New Yorkers pay into Medicaid to meet the healthcare needs of the most vulnerable in our communities,” said Attorney General Eric Schneiderman.“They deserve to know their dollars are going to help people, not profit unscrupulous business owners.” If convicted, Atumonyogo could face four to 25 years in prison.

    VGM’s longtime COO retires

    WATERLOO, Iowa – Jim Phillips, president and COO of the VGM Group, has retired, VGM announced June 1. Phillips has spent 25 years at the company, the last nine as COO. He was appointed president in January of 2016. “Jim has been a big part of VGM, and he will be greatly missed,” said Mike Mallaro, VGM’s CEO. “Jim remains a VGM Group board member, valued adviser and friend to so many of us in the VGM extended family.” Phillips joined VGM in 1991, when the company’s founder, the late Van G. Miller, recruited him to start an equipment leasing division. Phillips grew the division, known as VGM Financial Services, from one associate to more than 40 associates managing financing for the home health care and golf industries. VGM will not replace Phillips “at this time,” the company stated in an email to HME News. “Responsibilities previously held by the COO will be distributed among members of VGM’s senior leadership team,” it stated.

    Hospital wholesaler buys DME company

    CROSSVILLE, Tenn. – Professional Health Solutions, a DME company based here, has been acquired by ASP Global, a wholesaler of hospice medical supplies. Professional Health’s main business is fulfilling prescriptions for disposable wound care dressings direct to patient homes. “Adding Professional Health Solutions to the ASP Global family of companies expands our distribution to ‘the last mile’—the patient,” said Lorne Tritt, CEO of ASP Global. “It advances our mission of supporting the full continuum of care: hospitals, IDNs, home health, hospice and group practices.” Professional Health execs Pennie Wicks-Pelfrey and Jannetta Miller-Barger are staying on to run the company within ASP Global.

    Diplomat Specialty Infusion expands into parenteral nutrition

    URBANDALE, Iowa – Diplomat Specialty Infusion Group, a home infusion pharmacy, has added a sterile compounding environment to its Iowa location, paving the way for it to provide parenteral nutrition therapies. Diplomat’s location in Urbandale now features an ISO 7 cleanroom, the standard needed to compound IV nutrition formulations. A cleanroom is a controlled environment with a low level of pollutants. ThriveRx, the nutrition division, focuses on home parenteral and enteral nutrition. Diplomat Specialty Infusion Group is a brand of Diplomat Pharmacy, a large independent provider of specialty pharmacy services in all 50 states.

    United Spinal names award winners

    NEW YORK – United Spinal Association will host a Congressional Awards Reception on June 13 as part of its Roll on Capitol Hill to recognize members of Congress for their outstanding service to people with disabilities and veterans. The association will recognize Sen. Elizabeth Warren, D-Mass., with its James J. Peters Disability Rights Champion Award; Rep. Phil Roe, R-Tenn., with its VetsFirst Congressional Bronze Star Award; and Rep. Lee Zeldin, R-N.Y., with its Junius A. Kellogg Congressional Outstanding Leadership Award. United Spinal will also honor disability advocates who have shown leadership and dedication to, and success in, state and/or federal policy issues impacting the broader disability community. This year, Frances M. Ozur Cole, the president of United Spinal's New Mexico Chapter, will receive the 2017 Finn Bullers Advocate of the Year Award. Jenn Wolff, formerly United Spinal's advocacy alliance manager, will receive the 2017 Grassroots Advocacy Award. Roll on Capitol Hill, in its sixth year, takes place June 11-14.

    Legislation seeks to ease air travel for disabled passengers

    WASHINGTON – Sen. Tammy Baldwin, D-Wis., has introduced the Air Carrier Access Amendments Act to protect the rights of disabled passengers and the close service gaps they face. More than 30,000 airplane passengers last year filed disability-related complaints. “To keep America’s promise of full equality for all, we must work to break down the barriers that individuals with disabilities and our veterans face when they travel,” said Baldwin in a press release. “Equal access to air travel ensures individuals with disabilities are able to participate in today’s economy and enjoy their travel opportunities.” Joining Baldwin on the bill: Democratic Sens. Richard Blumenthal, Conn., Tammy Duckworth, Ill., Maggie Hassan, N.H., and Ed Markey, Mass.

    Short takes: BOC, Shield Healthcare, Sunrise Medical

    The Board of Certification/Accreditation (BOC) is now accepting nominations for its board of directors. Directors serve four-year terms and must participate in four board meetings annually. For more information, or to obtain a nomination form, go to bocusa.org/boc-board-directors…Shield Healthcare is pushing its OstomyLife program nationwide as part of its renewed commitment toMedicare ostomy patients. …Sunrise Medical celebrated World Environment Day June 5. The manufacturer is committed to using sustainable practices in its facilities, embracing processes to conserve natural resources, avoiding pollution and reusing materials and recycling.

     


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    06/09/2017
    HME News Staff

    WASHINGTON – Most Medicare beneficiaries continued to have access to CPAP/RAD devices after Round 2 of the competitive bidding program began, according to a new report from the Office of Inspector General.

    For CPAP/RAD supplies, however, Medicare payments stopped for 46% of beneficiaries in Round 2 CBAs, compared to 33% in non-bid areas.

    “The decline may or may not indicate disruptions in receiving needed supplies,” the OIG stated. “For example, the decline may indicate that the program reduced the provision of unnecessary supplies, as CMS determined to be the case with Round 1 of the program.”

    The OIG conducted the study in response to a 2014 letter in which members of Congress expressed concerns about the program’s impact on access to DME.

    The OIG says its findings are consistent with CMS’s conclusion that the bidding program is not impeding access to CPAP/RAD devices.

    Round 2 of competitive bidding kicked off July 1, 2013.


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    06/13/2017
    HME News Staff

    WASHINGTON – The HME industry has met its goal of at least 150 co-signers for a letter calling on Health and Human Services Secretary Tom Price to provide relief from Medicare’s competitive bidding program.

    Thanks to a few late additions, stakeholders were able to secure 154 co-signers for the letter, spearheaded by Reps. Cathy McMorris Rodgers, R-Wash., Dave Loebsack, D-Iowa, Lee Zeldin, R-N.Y., and Diana DeGette, D-Colo.

    “This is an impressive number considering only two weeks were given to gain supporters and much of that time was when Congress was out of session,” VGM stated in a bulletin to members.

    AAHomecare President and CEO Tom Ryan had called on stakeholders to secure at least 150 co-signers for the letter at the Washington Legislative Conference on May 24-25. The letter remained open through June 9.

    The letter asks Price, along with CMS Administrator Seema Verma, to consider more long-term fixes to the competitive bidding program; to permanently protect accessories for complex wheelchairs from bid-related reimbursement cuts; and to reverse a recent “double dip” cut to oxygen concentrators.

    A similar letter spearheaded by the House Small Business Committee and Rep Blaine Luetkemeyer, R-Miss., a committee member, has received support from four other members. That letter will remain open until this Friday, June 16.

    Both letters will be sent to Price and Verma, sending a clear message that they need to make DME policy reform a priority, stakeholders say.

    VGM gave a shout-out to stakeholders in Alabama, Iowa, North Dakota, South Dakota, Maine, Vermont, Wyoming and Rhode Island, who were able to get all of their representatives to sign on to the Rodgers letter. Stakeholders in Missouri, Kentucky, Tennessee, Utah, Idaho, Minnesota, Mississippi, New Hampshire, Wisconsin, West Virginia, Colorado, Connecticut and Massachusetts were able to secure all but one or two of their representatives.


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    06/14/2017
    HME News Staff

    WASHINGTON – Senior Medicare Patrol projects achieved $163,904 in cost avoidance on behalf of Medicare and Medicaid in 2016, up from $21,533 in 2015, according to a study from the Office of Inspector General.

    Savings to beneficiaries and others totaled $53,559, up from $35,059, the OIG says.

    In 2016, 53 projects had a total of 6,126 active team members who conducted a total of 26,220 group outreach and education events, reaching an estimated 1.5 million people. The projects also had 195,386 individual interactions with, or on behalf of, a beneficiary, according to the OIG.

    “We note that the projects may not be receiving full credit for recoveries, savings, and cost avoidance attributable to their work,” the report states. “It is not always possible to track referrals to Medicare contractors or law enforcement from beneficiaries who have learned to detect fraud, waste, and abuse from the projects. In addition, the projects are unable to track the potentially substantial savings derived from a sentinel effect, whereby Medicare beneficiaries' scrutiny of their bills reduces fraud and errors.”

    Senior Medicare Patrol projects receive grants from the Administration for Community Living to recruit and train retired professionals and other senior citizens to recognize and report instances or patterns of healthcare fraud. The OIG has collected performance data on the projects since 1997.


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    06/15/2017
    HME News Staff

    WASHINGTON – While most states experienced faster growth in healthcare spending in 2014 due to Medicaid expansion and Health Insurance Exchange enrollment, per capita spending in Medicaid expansion and non-expansion states grew at similar rates, according to a CMS analysis of data from 1991-2014.

    The data also shows that the most recent economic recession, which ended in 2009, and the modest recovery since then has had a sustained impact on healthcare spending and health insurance coverage. Every state experienced slower growth in per capita personal healthcare spending from 2010-13 vs. 2004-09, CMS says.

    “Recent economic and health sector factors have had clear impacts by state, both by payer and in the rates of overall per capita personal healthcare expenditure growth; however, during the 2009-14 period, the variation in spending between the lowest and highest states was virtually unchanged,” said David Lassman, the lead author of a report on the data, published in Health Affairs.

    Topline findings from the report include:

    Considerable regional variation on personal health care spending

    ·      In 2014, the New England and Mideast regions had the highest levels of total per capita personal health care spending ($10,119 and $9,370, respectively), or 26% and 16% higher than the national average ($8,045).

    ·      In contrast, the Rocky Mountain and Southwest regions had the lowest levels of total personal health care spending per capita in 2014 ($6,814 and $6,978, respectively) with average spending roughly 15% lower than the national average. 

    Similar growth in Medicaid expansion and non-expansion states

    ·      While most states experienced faster growth in 2014 compared to 2013 due to Medicaid expansion and enrollment in Health Insurance Exchange plans, per capita health spending in Medicaid expansion and non-expansion states grew at similar rates, 4.4% and 4.5% respectively. The similar growth in per capita spending for expansion and non-expansion states was due largely to two effects: Faster growth in the use of healthcare goods and services in expansion states relative to non-expansion states due to a larger increase in the percent of people insured in those states; and faster growth in spending per insured person in non-expansion states relative to expansion states.

    Impact of recent economic recession and recovery

    ·      The most recent economic recession, which ended in 2009, and modest recovery since then, had a sustained impact on health spending and health insurance coverage.

    ·      For 2010-13, per capita personal health spending grew at a rate of 2.8 % per year on average, substantially slower than during 2004-09, when spending averaged 5.2% growth per year.

    ·      During 2010-13, every state experienced slower growth in per capita personal health care spending with an average deceleration of just over two percentage points compared to the 2004-09 period. 

    Three major payers

    ·      Medicare: States with above average per enrollee Medicare spending were generally located in the eastern United States while states with the lowest spending were generally in the western United States. The state with the highest per enrollee Medicare spending in 2014 was New Jersey ($12,614) with spending levels roughly 15% above the national average ($10,986). In 2014, Montana was the state with the lowest per enrollee Medicare spending, at $8,238 per enrollee (25% below the national average per enrollee).

    ·      Medicaid: The recent trends in per enrollee spending were driven by the Medicaid coverage expansion, which increased the share of relatively less expensive enrollees relative to the previous Medicaid beneficiary population mix in expansion states. Total Medicaid spending increased 12.3% from 2013 to 2014 for states that expanded Medicaid, compared with 6.2% for states that did not expand Medicaid. However, on a per enrollee basis Medicaid spending declined considerably for the expansion states (-5.1%) in 2014, because of the enrollment of relatively less expensive enrollees, whereas per enrollee Medicaid spending in the non-expansion states increased 5.1%. 

    ·      Private Health Insurance: Per enrollee private health insurance spending was $4,551 in 2014, an average annual increase of 3.3% since 2009 ($3,872). Total private health insurance spending grew more rapidly in states that did not expand Medicaid eligibility by 2014 than in states that did expand eligibility, at rates of 6.8% and 4.6%, respectively.


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    ‘(These letters) give HHS Secretary Price a club to hit career staffers with’
    06/16/2017
    Theresa Flaherty

    WATERLOO, Iowa – Fresh on the heels of a successful letter in the House of Representatives seeking competitive bidding relief, industry stakeholders say they now have their sights on a Senate version.

    “We hope to have Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D, come up with a letter in the next couple of weeks,” John Gallagher, vice president of government relations for The VGM Group, told attendees at the Heartland Conference last week. “(These letters) give HHS Secretary Tom Price ‘a club’ to hit career CMS staffers with.”

    The letter asks Price and CMS Administrator Seema Verma to use their authority to, among other things, freeze Medicare reimbursement in non-bid areas at the Jan. 1, 2016, rates.

    Stakeholders lauded Rep. Cathy McMorris Rodgers, R-Wash., for spearheading the letter in the House, calling her the industry’s newest champion.

    “She gets (HME),” said Gallagher. “We asked her to be our champion and she said ‘yes.’”

    While chaos in Washington, D.C., has slowed things down considerably—leading to much frustration for HME providers—things are starting to fall into place, say stakeholders. Price has now brought on many of his own staffers who are familiar with HME issues and aren’t stubbornly welded to the flawed bid program.

    “Career staffers have been working against us for 30 years,” Jay Witter, senior vice president of public policy for AAHomecare, told attendees.

    Stakeholders, who argue that Congress intended for CMS to reset rates in non-bid area for the second half of 2016 to match those of the first half of the year, say they’d like to see CMS’s own tactics turned against them.

    “CMS has set a broad authority for the secretary with all the shenanigans of the last 10 years,” said Witter. “Our hope is now that we have Price and his staff, they can interpret these laws their way.”

    Still, despite optimism in the air, the industry’s to-do list remains long and complex. In the short term, quick action is needed to permanently stave off Medicare’s plans to apply bid-related pricing to accessories for complex wheelchairs on July 1.

    “We’re looking to get this fixed by the end of the month,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “It will be a pretty intense two weeks.”


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    06/16/2017
    Theresa Flaherty

    WATERLOO, Iowa – On the battlefield that is Medicare, HME providers can either retreat or fight back—either way there is risk, keynote Kevin Lacz told Heartland Conference attendees Tuesday morning.

    “There are risks you take everywhere you go,” Lacz, a former Navy Seal and best-selling author, who co-starred in the movie, American Sniper. “The reward is on the other side. You need to learn to read and react, and always reassess.”

    The 16th Annual VGM Heartland Conference, which was held June 12-15, featured more than 70 exhibitors and a full slate of sessions covering 10 tracks, from billing and reimbursement to big ideas.

    With providers battling audits, competitive bidding and onerous regulations every day, Lacz’s metaphor resonates.

    Fortunately, there are bright spots. Wayne van Halem, president of The van Halem Group, told attendees during the session “2017 Mid-Year Audit Update” that he finally feels like “CMS is sort of loosening up.”

    “They have a huge appeals backlog they have to resolve by 2021,” he said. “In the past, if they were on the fence, (they would deny the claim), and they are now saying pay the claim.”

    van Halem said stakeholders have been trying to persuade CMS to expand the “wildly successful” settlement conference facilitation pilot to all four Medicare jurisdictions. The pilot has looked at more than 30,000 claims so far, with an 82% overturn rate.

    The frustration level with the audit process was evident during another session, the “SBA/CMS Panel Discussion.”

    “The process is so tremendous,” said provider Ben Rachel. “The claims process, the audit process, the appeals process. What are we not giving you that you need to see?”

    Tangita Daramola, the CMS competitive acquisition ombudsman, said she wants to hear from providers.

    “What are the problem-solving opportunities to make sure beneficiaries get what they need and you get paid,” she said. “Please don’t hesitate to contact us. You do a tremendous job in the field working with seniors and the disabled.”

    Get out your notepad

    Provider Rick Wyche has attended Heartland for several years, largely for the networking opportunities.

    “We like the opportunity to put a face to a name and learn what are providers are doing to success,” said Wyche, director of business development for After the Fall in Woodbridge, Va.

    James Rogers said he met lots of “brilliant” providers, even chasing one down after a session.

    “She’s on the West Coast and I am on the East Coast,” said Rogers, CEO of Chattanooga, Tenn.-based Phoenix Rehab & Mobility and PPS Orthotic and Prosthetic Services. “She had all kinds of great ideas—I got out my notepad.”


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    ‘In these decreased reimbursement days, we try to save money any way we can,’ says one respondent
    06/16/2017
    Liz Beaulieu

    ATLANTA – The decision by show organizers to shorten Medtrade from four to three days is spot on, say the large majority of respondents to a recent HME Newspoll.

    Citing Medtrade’s shrinking exhibit hall, 85% of respondents said they think it makes sense to shave off a day from the show.

    “Twenty years ago, it used to take four days to visit all the exhibitors at Medtrade,” wrote David Beshoar of MedServe Equipment in Palatine and Urbana, Ill. “Now you can likely visit all of them in two days. It’s very reflective of how our industry has changed.”

    Show organizers announced in May that this year’s Medtrade, Oct. 23-25 at the Georgia World Congress Center, would end on Wednesday night, instead of Thursday afternoon. They also announced an additional hour of exhibit time on Tuesday and Wednesday, extending show floor hours to 5 p.m.

    Organizers appear to have hit the sweet spot with a three-day show. The largest majority of respondents (41%) said that’s how long they have attended Medtrade in past years. Thirty percent and 26% of respondents said they have attended the show for four days and two days, respectively.

    A shorter Medtrade also helps attendees reduce travel costs and minimize time out of the office, respondents say.

    “I usually attend the pre-show education on Monday, then head over to the show floor on Tuesday for some quick looks at specific items, then hopefully I’m on a plane on Tuesday night and back to work on Wednesday,” wrote one respondent. “In these decreased reimbursement days, we try to save money any way we can.”

    Although this year’s show will be shorter, respondents said there’s still a lot to get done. They want to get updates on the latest legislative and regulatory issues; they want to learn about new business processes; they want to see new and updated products; and they want to rub elbows with their peers.

    “I go for the education and to see what other companies are doing,” wrote James Long of Littleton Respiratory Homecare in Wilmington, Ohio. “If I learn one thing, it can make a huge difference to my business. It really is one of the few chances I have all year to work on the business, instead of working in it.”

    One challenge that remains for attendees, respondents say: balancing time in the educational sessions and in the exhibit hall, which often overlap.

    “We want to learn more about cash/retail opportunities and see retail products,” wrote Randy Ford of TMD in Phoenix, Ariz. “The challenge is going to seminars and covering the exhibit hall at the same time.”

    A number of respondents said they’re open to additional changes to the show’s format, such as condensing the educational sessions in the mornings, leaving the afternoons and early evenings for the exhibit hall.

    “We used to go more to the classes, but in recent years, it has been more about looking for new products, meeting with major suppliers for Medtrade deals and learning from the exhibitors about changes, offerings and new information,” said Charles Satterfield of Archer’s Total Home Healthcare in Sweetwater, Tenn. “I would prefer larger meetings in the mornings from 8 a.m. until 12 p.m., with multiple subjects and speakers and float in and out of those rooms. Networking and sharing ideas, problems and issues is always important.”


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    06/16/2017
    HME News Staff

    WASHINGTON – The HME industry has met its goal of at least 150 co-signers for a letter calling on Health and Human Services Secretary Tom Price to provide relief from Medicare’s competitive bidding program.

    Thanks to a few late additions, stakeholders were able to secure 154 co-signers for the letter, spearheaded by Reps. Cathy McMorris Rodgers, R-Wash., Dave Loebsack, D-Iowa, Lee Zeldin, R-N.Y., and Diana DeGette, D-Colo.

    “This is an impressive number considering only two weeks were given to gain supporters and much of that time was when Congress was out of session,” VGM stated in a bulletin to members.

    AAHomecare President and CEO Tom Ryan had called on stakeholders to secure at least 150 co-signers for the letter at the Washington Legislative Conference on May 24-25. The letter remained open through June 9.

    The letter asks Price, along with CMS Administrator Seema Verma, to consider more long-term fixes to the competitive bidding program; to permanently protect accessories for complex wheelchairs from bid-related reimbursement cuts; and to reverse a recent “double dip” cut to oxygen concentrators.

    A similar letter spearheaded by the House Small Business Committee and Rep Blaine Luetkemeyer, R-Miss., a committee member, has received support from four other members. That letter was to remain open until last Friday, June 16.

    Both letters will be sent to Price and Verma, sending a clear message that they need to make DME policy reform a priority, stakeholders say.

    VGM gave a shout-out to stakeholders in Alabama, Iowa, North Dakota, South Dakota, Maine, Vermont, Wyoming and Rhode Island, who were able to get all of their representatives to sign on to the Rodgers letter. Stakeholders in Missouri, Kentucky, Tennessee, Utah, Idaho, Minnesota, Mississippi, New Hampshire, Wisconsin, West Virginia, Colorado, Connecticut and Massachusetts were able to secure all but one or two of their representatives.

    CMS details healthcare spending by state

    WASHINGTON – While most states experienced faster growth in healthcare spending in 2014 due to Medicaid expansion and Health Insurance Exchange enrollment, per capita spending in Medicaid expansion and non-expansion states grew at similar rates, according to a CMS analysis of data from 1991-2014.

    The data also shows that the most recent economic recession, which ended in 2009, and the modest recovery since then has had a sustained impact on healthcare spending and health insurance coverage. Every state experienced slower growth in per capita personal healthcare spending from 2010-13 vs. 2004-09, CMS says.

    “Recent economic and health sector factors have had clear impacts by state, both by payer and in the rates of overall per capita personal healthcare expenditure growth; however, during the 2009-14 period, the variation in spending between the lowest and highest states was virtually unchanged,” said David Lassman, the lead author of a report on the data, published in Health Affairs.

    Topline findings from the report include:

    Considerable regional variation on personal health care spending

    ·      In 2014, the New England and Mideast regions had the highest levels of total per capita personal health care spending ($10,119 and $9,370, respectively), or 26% and 16% higher than the national average ($8,045).

    ·      In contrast, the Rocky Mountain and Southwest regions had the lowest levels of total personal health care spending per capita in 2014 ($6,814 and $6,978, respectively) with average spending roughly 15% lower than the national average. 

    Similar growth in Medicaid expansion and non-expansion states

    ·      While most states experienced faster growth in 2014 compared to 2013 due to Medicaid expansion and enrollment in Health Insurance Exchange plans, per capita health spending in Medicaid expansion and non-expansion states grew at similar rates, 4.4% and 4.5% respectively. The similar growth in per capita spending for expansion and non-expansion states was due largely to two effects: Faster growth in the use of healthcare goods and services in expansion states relative to non-expansion states due to a larger increase in the percent of people insured in those states; and faster growth in spending per insured person in non-expansion states relative to expansion states.

    Impact of recent economic recession and recovery

    ·      The most recent economic recession, which ended in 2009, and modest recovery since then, had a sustained impact on health spending and health insurance coverage.

    ·      For 2010-13, per capita personal health spending grew at a rate of 2.8 % per year on average, substantially slower than during 2004-09, when spending averaged 5.2% growth per year.

    ·      During 2010-13, every state experienced slower growth in per capita personal health care spending with an average deceleration of just over two percentage points compared to the 2004-09 period. 

    Three major payers

    ·      Medicare: States with above average per enrollee Medicare spending were generally located in the eastern United States while states with the lowest spending were generally in the western United States. The state with the highest per enrollee Medicare spending in 2014 was New Jersey ($12,614) with spending levels roughly 15% above the national average ($10,986). In 2014, Montana was the state with the lowest per enrollee Medicare spending, at $8,238 per enrollee (25% below the national average per enrollee).

    ·      Medicaid: The recent trends in per enrollee spending were driven by the Medicaid coverage expansion, which increased the share of relatively less expensive enrollees relative to the previous Medicaid beneficiary population mix in expansion states. Total Medicaid spending increased 12.3% from 2013 to 2014 for states that expanded Medicaid, compared with 6.2% for states that did not expand Medicaid. However, on a per enrollee basis Medicaid spending declined considerably for the expansion states (-5.1%) in 2014, because of the enrollment of relatively less expensive enrollees, whereas per enrollee Medicaid spending in the non-expansion states increased 5.1%. 

    ·      Private Health Insurance: Per enrollee private health insurance spending was $4,551 in 2014, an average annual increase of 3.3% since 2009 ($3,872). Total private health insurance spending grew more rapidly in states that did not expand Medicaid eligibility by 2014 than in states that did expand eligibility, at rates of 6.8% and 4.6%, respectively.

    CPAP withdrawal: It may foster diabetes, heart disease, study says

    YARMOUTH, Maine – Not using CPAP therapy could have grave repercussions for patients with sleep apnea, according to a study published this month in the Journal of Clinical Endocrinology & Metabolism.

    “OSA recurrence during CPAP withdrawal increases plasma free fatty acids (FFA) and glucose during sleep, associated with sympathetic and adrenocortical activation,” researchers concluded. “Recurring exposure to these metabolic changes may foster diabetes and cardiovascular disease.”

    Researchers based their findings on a randomized crossover trail of CPAP vs. CPAP withdrawal. They used 31 patients with moderate to severe OSA acclimated to CPAP.

    To conduct the study, patients underwent polysomnography while sleeping with CPAP or after CPAP withdrawal, in random order. Venous blood was sampled at about 20 minute intervals on both nights. In 11 patients, researchers assessed glucose kinetics with an infusion of 6,6-[2H2]glucose.

    Researchers found CPAP withdrawal caused recurrence of OSA associated with hypoxemia, sleep disruption, and heart rate elevation. CPAP withdrawal dynamically increased nocturnal FFA (p = 0.007), glucose (p = 0.028), and cortisol (p = 0.037), in proportion to respiratory event frequency, heart rate elevation, or sleep fragmentation.

    CPAP withdrawal also increased systolic blood pressure (p = 0.017) and augmentation index (p = 0.008), but did not affect insulin, triglycerides, glucose production, oral glucose tolerance, cholesterol, or hsCRP.

    OIG finds savings increase from Senior Medicare Patrols

    WASHINGTON – Senior Medicare Patrol projects achieved $163,904 in cost avoidance on behalf of Medicare and Medicaid in 2016, up from $21,533 in 2015, according to a study from the Office of Inspector General.

    Savings to beneficiaries and others totaled $53,559, up from $35,059, the OIG says.

    In 2016, 53 projects had a total of 6,126 active team members who conducted a total of 26,220 group outreach and education events, reaching an estimated 1.5 million people. The projects also had 195,386 individual interactions with, or on behalf of, a beneficiary, according to the OIG.

    “We note that the projects may not be receiving full credit for recoveries, savings, and cost avoidance attributable to their work,” the report states. “It is not always possible to track referrals to Medicare contractors or law enforcement from beneficiaries who have learned to detect fraud, waste, and abuse from the projects. In addition, the projects are unable to track the potentially substantial savings derived from a sentinel effect, whereby Medicare beneficiaries' scrutiny of their bills reduces fraud and errors.”

    Senior Medicare Patrol projects receive grants from the Administration for Community Living to recruit and train retired professionals and other senior citizens to recognize and report instances or patterns of healthcare fraud. The OIG has collected performance data on the projects since 1997.

    OIG releases final report on test strip market share

    WASHINGTON – Suppliers in Medicare’s national mail-order program provided 19 types of diabetes test strips to beneficiaries from October through December 2016, according to a new study from the Office of Inspector General. The top two strip types accounted for 53% of the Medicare mail-order market, and the top 10 strip types accounted for 97.5% of the market, the study says. To conduct the study, the OIG sampled 1,210 claims from a total population of 438,872 claims for diabetes test strips. The Medicare Improvements for Patients and Providers Act (MIPPA) requires the OIG to determine the market shares of the types of diabetes test strips before each round of competitive bidding. MIPPA prohibits CMS from awarding a contract to a supplier of diabetes test strips if the supplier’s bid does not cover at least 50%, by volume, of all types of diabetes test strips on the market, known as the “MIPPA 50 percent rule.” This is the third of three reports by the OIG. The agency released the results of a second study in February, and a first study in December.

    MSD buys Attentus Medical

    STOUGHTON, Mass. – MSD, a provider of products, distribution and biomedical services and technology solutions to the home infusion, HME and oncology markets, has completed its acquisition of Attentus Medical Sales, a distributor of medical, packaging and compliance products for the home infusion and specialty pharmacy markets. The acquisition allows the two companies to align complementary products and technologies to address the expanding needs of the post-acute care market, and leverage MSD’s nationwide infrastructure, according to a press release. “The combination will create a highly differentiated distribution, medical device and technology solutions company uniquely positioned to improve both the delivery and efficiency of care for healthcare providers and patients,” the release states.

    Nunn’s HME boosts coverage in Syracuse

    ROME, N.Y. – Nunn’s Home Medical Equipment has acquired Tri-County Home Care’s assets, excluding its Veterans Affairs customers, the company announced June 1. With a location in Syracuse, N.Y., the acquisition of Tri-County Home Care expands Nunn’s presence in the central New York region. “Acquiring Tri-County Home Care’s assets is another step forward for Nunn’s, as we expand and grow in the central New York region,” said Shawn Weiman, vice president. “Our geographic region now covers 22 counties.” Nunn’s will service Tri-County Home Care customers out of either its Rome or Syracuse location, depending on their home zip codes. The acquisition will also allow Nunn’s to expand its core business of respiratory products and services, including home oxygen and sleep therapy, into the Syracuse area and beyond, the company says. Nunn’s, which has been in business since 1942, celebrates its 75th anniversary this year. It is currently owned and operated by its original founder’s daughter and granddaughter, Sheila Nunn Murphy and Erin Weiman, as well as son-in-law Weiman.

    Drive DeVilbiss steps up support for AAH

    WASHINGTON – Drive DeVilbiss Healthcare has become a platinum level partner of AAHomecare, the highest corporate category. “Providing AAHomecare with additional resources is an investment that I am confident will pay significant dividends for our company, as well as the suppliers we serve,” said Harvey Diamond, CEO of Drive DeVilbiss. While AAHomecare’s budget is largely derived from membership dues, additional financial commitments from corporate sponsors allow the association to increase its work in areas like payer relations, value-based reimbursement models, and legislative and regulatory affairs. Drive DeVilbiss joins Medtrade at the platinum level. Other companies in leading corporate categories include Apria Healthcare, Brightree, Inogen, Lincare, Pride Mobility Products, ResMed and The VGM Group at the gold level; and Byram Healthcare, Philips Home Healthcare Solutions and Sunovion Pharmaceuticals at the silver level.

    Tonka Medical Supplies chases federal contracts

    MINNEAPOLIS – Tonka Medical Supplies, an HME and supplies provider, plans to expand sales by applying for a GSA Schedule and actively pursuing federal contracts, it announced June 12. “The opportunity to service government accounts, specifically Veterans Affairs, opens up significantly more markets throughout the region as our goal continues to be expanded sales of our home care medical supplies,” stated Barbara Platten, general manager. “Getting our company on a GSA schedule will expand our reach not only to the federal level, but also to numerous state and county agencies throughout the region as they will be able to take advantage of our home care products at a set government pricing.” Tonka Medical Supplies, founded in 1995, carries a full line of DME and supplies. It also specializes in herbs, natural remedies, dietary supplements and natural cosmetics.

    Bill seeks to clarify compounding provisions

    ALEXANDRIA, Va. – Reps. Morgan Griffith, R-Va., and Henry Cuellar, D-Texas, have introduced a bill in the House of Representatives that would clarify congressional intent on several compounding provisions included in the Drug Quality and Security Act of 2013. Since the passage of DQSA, there has been a lack of understanding as to where federal regulatory oversight of traditional compounding pharmacies begins and ends, according to the National Home Infusion Association. Specifically, there are questions regarding the dispensing of compounded products across state lines, inspection standards, and several other DQSA provisions, the association says. In explaining the need for the bill, the NHIA stated in a press release: “It is important for home and specialty infusion providers to have clarification on application of a provision in the DQSA that calls for a Memorandum of Understanding (MOU) between the U.S. Food and Drug Administration (FDA) and states, specifically regarding the distribution of compounded products across state lines. NHIA has long maintained that dispensing a compounded product to an individual patient pursuant to a prescription is not commonly considered distribution of the product under state or federal law. The FDA, in its draft MOU released in 2015, included dispensing as an act of distribution and imposed strict limits that could negatively affect access to medications for a patient whose provider is based in another state. This would have serious implications, since the common business practice of dispensing medications for administration in a patient’s home can occur across a state line from the physical site where the drug is compounded.”

    United Spinal logs 200 congressional visits with ROCH

    WASHINGTON – United Spinal Association and more than 150 wheelchair users, clinicians, partners and disability advocates from 35 states gathered in Washington, D.C., June 11-14 for the 6th annual Roll on Capitol Hill to discuss improving disability policies with key congressional leaders. During the event, attendees took part in more than 200 congressional office visits, meeting face to face with their representatives and other key contacts to discuss their unique challenges living with a disability and to advocate for a number of issues, including improved access to the complex rehab technology that wheelchair users rely on to live active and healthy lifestyles. Among the speakers at the event was Don Clayback, executive director of NCART, who, along with Jose Hernandez, a program specialist with the association, and Rick Hayden, president of the association’s California chapter, provided an update on legislation to create a separate benefit for complex rehab technology.

    VGM kicks off nominations for HME Woman of the Year

    WATERLOO, Iowa – VGM is now accepting nominations for the 2017 HME Woman of the Year Award. The announcement was made during the “Women and Wine” event at VGM’s Heartland Conference last week. The event included a session on how to apply Sheryl Sandberg’s “Lean In” concepts and a moderated discussion on work-life balance. Also at the event, a video was shown promoting the award. Last year’s winner was Dr. Kirsten Davin, who has used the award as a platform to network with other women in the industry and share successes and obstacles that impact their businesses. Davin and the other finalists for last year’s award are not eligible for this year’s award, but they encourage their peers to nominate a deserving woman who has impacted the industry. Women are also encouraged to nominate themselves. “I would encourage everyone to take a minute to really think about what they do, what they’ve done, and who they’ve touched,” Davin said. “By really sitting down and reviewing your career, we often find out that we have a greater impact than we think we do.” Nominations are due Aug. 14.

    NCD Homecare beefs up exec team in wake of acquisition

    NASHVILLE – NDC Homecare, a division of NDC, has added Eugene Keane as director of category management. In this new role, Keane will work closely with NDC’s homecare distributor and manufacturer partners to build success in the homecare space. “I am looking forward to having Eugene join our homecare team,” said Doug Harper, president of NDC Homecare. “His experience and knowledge will be pivotal to analyzing competitive products and market profitability for homecare distribution and assisting us in becoming the partner of choice for the homecare provider.” Keane has more than 25 years of experience in home health care, including director of a regional independent pharmacy chain in New England, and territory manager for Sunrise Medical. NDC announced in May that it had acquired Dedicated Distribution. NDC stated at that time that it plans to use Dedicated Distribution, a wholesale supplier of HME and supplies, as a platform for its Home Care Division.

    Software vendors in the news: Brightree, QS/1, Mediware, Encore Healthcare

    Brightreehas released its new Patient Financial Services solution, providing HME providers with enhanced live-call resources to streamline their patient payment process, including payment plan options, progress reporting and enrollment opportunities. The solution allows providers to, among other things, remind patients of balances owed and use live-call agents to procure one-time or incremental payments, and enroll patients in Brightree Patient Collections automated payment services, eliminating manual processes and delays…QS/1 has added another certification through Elavon to process transactions for Europay, MasterCard and Visa compliant cars. “Being certified by Elavon allows QS/1 to process EMV payments through its system,” said Sonny Anderson, vice president of systems and technology…Mediware has added FreshAire CPAP & Supplies to its roster of HME providers using CareTend software to manage operations, improving their productivity and compliance…Encore Healthcare has released a new respiratory patient management software for non-invasive ventilation and oxygen patients. Nexus Home Silver is an application that fuses a software-based ventilation and oxygen therapy equipment setup/maintenance protocol with its clinical risk assessments and plan of care protocols. The web-based application can be used on a smartphone, tablet or PC, guiding respiratory therapists through a comprehensive ventilation and/or oxygen therapy protocol and enabling them to document initial setup, home safety and vent check visits.

    People in the news: Sarah Hanna, Greg Boucher, Lena Jouran, Dr. Jose Llana

    Sarah Hanna, CEO of ECS North, has been nominated by an employee for a Patriot Award. To make a nomination, an employee must serve in the National Guard or Reserve, or have a spouse who is a guard or reserve member. The award reflects the efforts made to support members through a wide-range of measures, including flexible schedules, time off prior to and after deployment, caring for families and granting leaves of absence if needed. Award winners receive a certificate and accompanying lapel pin…The Braff Group has announced that Greg Boucher has joined the firm as managing director of health care information technology in its Washington, D.C., office. Boucher has extensive experience working with middle-market businesses in M&A advisory, strategic planning, and business development. Prior to joining The Braff Group, he was a managing director at Bengur Bryan and The McLean Group, two highly regarded mid-Atlantic investment banks…Smith Drug Company has named Lena Jouran divisional vice president, finance. She will support both Smith Drug Company and Burlington Drug Company in her new role. Jouran replaces Kyle Waltz, who has accepted the position of vice president corporate controller at J M Smith. Jouran comes to Smith Drug Company from Walgreens, where she was finance director of pharmacy procurement, supply chain and Rx insights…3B Medical has named Dr. Jose Llana national director of sales. Previously, he was a territory manager for Philips Healthcare, where he regularly received “Territory Manager of the Year.” Dr. Llana left private practice to enter the medical device and pharmaceutical industry.

    Short takes: ROVI, Convaid | R82

    Carson, Calif.-based ROVI Mobility Products has named Jacob Titus, a junior at Burlington County Institute of Technology in Medford and Westampton, N.J., as the recipient of its 2017 Design Innovation Award Scholarship. Titus won the award based on his concept for an elevator built into an existing staircase. He will receive $1,500 to put toward continuing his education. ROVI’s connection to BCIT goes back to 2015, when students at the school helped the manufacturer create a test track for a launch party for its ROVI X3 power mobility system…Convaid | R82 will return to the Cure SMA National Conference as a platinum exhibitor. Charles Larose, western region sales manager, and Steve Ricker, eastern region sales manager, will join Matt Abrahams, business development representative, to attend the event, June 29-July 2 at Disneyworld in Orlando, Fla. They will highlight the Convaid Carrot car seat, Convaid Trekker, the R82 Flamingo High-Low and the R82 Stingray. Last year, Convaid | R82 expanded its program of planned giving to Cure SMA by donating Convaid Trekkers to the organization’s Chicago-based loaner pool. The companies have also participated in Cure Walk-n-Rolls throughout the United States.


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    ResMed, Philips flow generators are neck and neck
    06/20/2017
    HME News Staff

    NEW YORK – Sleep patient volume grew 4.4% in the last 12 months and is expected to grow 5.1% in the next 12 months, according to respondents to the second quarter 2017 HME Sleep and Oxygen Survey conducted by Needham and HME News.

    That’s up significantly from 0.8% and 2.5%, respectively, in a prior survey.

    Flow generator prices declined 1.8% in the last 12 months (vs. a decline of 3.8% in a prior survey), and mask prices declined 3.1% (vs. 4.4%), according to respondents.

    “This represents a reversal of the worsening price declines seen in our prior two surveys that followed the 2016 Medicare reimbursement cuts and seems to indicate that pricing declines are returning to the historical range,” Mike Matson of Needham wrote in his report highlights.

    Respondents indicated that interest in travel CPAPs is on the rise: They reported 5.5% of their sleep patients purchased travel CPAPs in the last 12 months and 10.6% are expected to purchase the devices in the next 12 months.

    ResMed’s and Philips Respironics’ flow generators were rated equal by respondents, while ResMed’s masks were rated highest, with Respironics’ very close behind, according to the survey.

    Respondents expect ResMed’s share of flow generator purchases to decrease 2.3% and its share of mask purchases to decrease 3.6% in the next 12 months. They expect Respironics’ share of flow generator purchases to decrease 1.1% and its share of mask purchases to increase 2%.

    On the oxygen side of the market, respondents expect portable oxygen concentrators to increase from 16.6% of the ambulatory oxygen market to 21.4% over the next 12 months, which implies 29% growth, down from 45% in a prior survey. They rated a private label POC from Inogen highest.


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    06/21/2017
    HME News Staff

    MURFREESBORO, Tenn. – TwelveStone Health Partners, a provider of pharmacy, infusion and enteral, respiratory and DME services, has secured $3.35 million in funding from Nashville, Tenn.-based private-equity firm Claritas Capital.

    “We have been wanting to accelerate our expansion plans for some time, and Claritas Capital offers the smart money, speed to market and accountability we had been looking for,” said Shane Reeves, CEO of TwelveStone.

    TwelveStone plans to use the funds to expand from its primary base in middle Tennessee into Chattanooga, where it plans to open a pharmacy and infusion center. The company also plans to add an infusion center to its company headquarters here.

    Additionally, TwelveStone plans to take its MEDIpack packaged medication offering nationwide and to invest in an end-to-end tech platform to support post-acute chronic care management. “TwelveStone understands the post-acute care market like no other, and it’s where the growth of healthcare is heading,” says John Chadwick, a partner and founder at Claritas, which represents more than 50 companies and oversees $6 billion in aggregate financing.

    TwelveStone was formed in 2016 when Reeves-Sain retail pharmacy and Entrust, its specialty pharmacy, were purchased for $66 million by Fred’s, a rural retail pharmacy organization. TwelveStone emerged from the remainder of the Reeves-Sain businesses.

    ARI sells to PE firm for $140M

    MILWAUKEE – ARI Network Services has entered into a definitive agreement to be acquired by an affiliate of True Wind Capital Management, a San Francisco-based private equity firm that focuses on investing in tech companies.

    ARI provides website solutions and digital marketing services to dealers in a number of markets, including HME.

    “The investment by True Wind positions ARI to accelerate our pace of innovation and better positions ARI to capitalize on future growth opportunities,” said Roy Olivier, president and CEO of ARI.

    Under the terms of the agreement, ARI shareholders will receive $7.10 in cash for each share of ARI common stock they own. The purchase price represents a premium of about 33% to ARI’s average closing price for the period of 60 trading days ending June 20. The all-cash transaction represents an enterprise value of about $140 million and has been unanimously approved by ARI’s board of directors.

    The deal is expected to close in the third calendar quarter of 2017.


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    CMS, DME MACs must be up and running in July
    06/23/2017
    Liz Beaulieu

    YARMOUTH, Maine – HME stakeholders are cheering a hard-fought win for a remark code that will allow providers to identify when claims have been adjusted due to a retroactive delay to reimbursement cuts in non-competitive bidding areas.

    The DME MACs agreed with the need for the code, found one that was appropriate and forwarded the request to CMS. But initially, they were told no, stakeholders say.

    “There was push back, because of the additional programming time it might require,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “CMS said, ‘We don’t want to hold up the adjustments,’ and we don’t want to, either, but we need a code. The industry shared its concerns and, lo and behold, they were able to program the code.”

    The adjustments are mandated by the 20th Century Cures Act. A provision in the act delays a second round of reimbursement cuts in non-bid areas from July 1, 2016, to Jan. 1, 2017, allowing providers to recoup a portion of six months worth of payments.

    The remark code—N689—will not only give providers a way to parse out Cures adjustments from other reprocessed claims, but also, theoretically, give software vendors a data point for creating customized reports, stakeholders say.

    “That way providers know how many claims have been adjusted, how much money they’ve collected, and, just in general, how things are moving through,” said Andrea Stark, a reimbursement consultant for MiraVista, who hosted a webcast recently on how providers should be preparing for the adjustments.

    Stakeholders breathed a sigh of relief when providers started receiving adjustments in May, but it turns out the MACs were just running two test batches. The MACs, which are still processing their normal load of claims, wanted to see how much additional work processing the adjustments will be, they say.

    “They watched to see how many of them suspended for manual customer service intervention and will require people power,” Stark said. “They did notice some issues, including recoupments that were requested after an overpayment had already been paid, and recoupments that were initiated for skilled nursing facility visits where the data may have changed after the fact.”

    While stakeholders have argued the adjustments are taking too long, they acknowledge it’s a huge undertaking, with the MACs expected to process 140,000 claims per day across the four jurisdictions once they’re running full bore in July.

    “I think it’s been a big issue for suppliers and the MACs, because of the volume and how it needs to be handled,” said Ronda Buhrmester, a reimbursement specialist for the VGM Group. “We’re hoping once they work out some of the kinks it will go quicker.”


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