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In brief: Sleep providers report volume increases, Essity lists on Nasdaq

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06/23/2017
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.

New company Essity lists on Nasdaq

PHILADELPHIA – Essity, a global hygiene and health company, listed on the Nasdaq Stockholm on June 15. The listing follows SCA Group’s decision to split into two independently listed companies: forest products company SCA, and Essity. Essity says it plans to continue to expand on the market growth of the Tork, TENA and JOBST brands. “With the launch of Essity we have a new name and an even stronger sense of purpose—improving well-being by providing leading hygiene and health solutions,” said Don Lewis, president, Professional Hygiene, said. “Our hygiene and health focus will allow us to bring new innovations to market while offering our customers and consumers the insights, knowledge and best practices that can only come from one of the world's leading hygiene companies.” Essity says it will begin phasing out the Tork and TENA brands over the next two years, replacing them with new Essity branding.

Upstep launches orthotics service

NEW YORK – Upstep is launching an online custom orthotics service in the U.S., the company announced in a press release. Customers simply place an order online and receive a footprint kit at home. The customer then follows instructions to make a foot imprint and send it back to the company. Upstep uses 3D technology to scan the footprint and create a customized orthotic based on that customer’s particular needs.

USS streamlines A/R

DAVISON, Mich. – Universal Software Solutions has added a Collections & Denials Module to its Healthcare Data Management Software, the company announced in a press release. The automated software will streamline accounts receivables by generating prioritized work lists sorted by criteria into an electronic grid. “This module enables HME billers to be far more efficient and focused on their high value billing claims and denials,” says Christopher Dobiesz, president. “It also allows for a shared cooperative work space between billing staff and managers.”

Court sides with Fairview HME

ST. LOUIS – The U.S. Court of Appeals for the Eighth Circuit has upheld the dismissal of a class action lawsuit filed against Fairview Health Services alleging its HME division made unauthorized telemarketing calls in violation of the Telephone Consumer Protection Act. The court ruled that Samuel Zean, who filed the complaint in Minnesota, had given prior express written consent to receive calls. The TCPA prohibits any person from making “any call using an automatic telephone dialing system or an artificial or prerecorded voice to any telephone number assigned to a cellular telephone service.” Fairview provided documents with Zean’s signature, giving the company permission to contact him by phone, including by cell phone. Fairview Health Services is a nonprofit corporation that operates hospitals and clinics in Minnesota and sells HME under the name Fairview Home Medical Equipment.

Celebrations: Orchid Medical, Peritech Home Health, RRI

Orchid Medicalin Orlando, Fla., is celebrating its 15-year anniversary. The company was established in 2002 as a regional DME provider to the workers’ compensation market. Among the company’s achievements in the past 15 years are a new DME retrospective repricing program, and an expansion beyond DME into ancillary services, including home and vehicle modifications…Peritech Home Health in Wyomissing and DuBois, Pa., is celebrating its 25-year anniversary. The company started as a DME provider that serviced pregnant women with high-risk diagnosis of pre-term labor. From there it has evolved into a full-service maternal child home health agency that services pregnant women, women after delivery and children…Responsive Respiratory, Inc. celebrates 15 years in business as a manufacturer and distributor of high-pressure home oxygen equipment and supplies this year. Over the last decade and a half, RRI has grown from a regional startup to a national manufacturer and distributor.

Convaid names new ambassadors

TORRANCE, Calif. – Convaid | R82 has added two new ambassadors to represent its growing population of product enthusiasts. Joining ambassadors Cesar, Emerson and Andrew are Jax and Z’Mya. The ambassadors are community volunteers who serve one-year terms representing Convaid at community events, engaging online and participating in other activities. "The Ambassador Program is an important part of our community outreach. Not only are our ambassadors faithful brand fans, they are the Convaid | R82 eyes and ears on the ground,” said Nanneke Dinklo, director of marketing. “They contribute valuable product and community insights, which we use for research and development to deliver improvements and new products.” Jax and Z’Mya will make special appearances at Abilities Expos in their respective regions, write blog posts, share videos, contribute to product case studies and engage on an ongoing basis with the Convaid | R82 online community.  Convaid established the ambassador program in 2015.

Convaid | R82 align discounts

TORRANCE, Calif. – Convaid | R82 now have the same primary discount, 30%, according to a press release. Secondary discounts will change accordingly, to reflect the same or slightly different total discount customers used to receive on R82 products. For more information, customers should contact their sales rep or call 844-876-6245. Convaid and R82 have slowly been combining functions since Convaid was sold to Etac in 2015.

Short takes: Golden Technologies, Mediware, Home Care Medical

Rich Golden, CEO of Golden Technologies, was recently honored by Junior Achievement of Northeastern Pennsylvania with the Entrepreneur of the Year Award at the annual Business Hall of Fame Dinner & Awards Ceremony. Golden launched the company in 1985 in a one-care garage. Today, it encompasses a large facility dedicated to manufacturing lift chairs. “I attribute the tremendous growth and success of Golden Technologies to the continued hard work and determination of our employees, many of whom have been with us for a very long time,” Golden said. “We’re just in a bigger garage.” Junior Achievement provides programs to students teaching work readiness, entrepreneurship and financial literacy…Mediware has announced that Biologic Infusion Pharmacy has chosen Mediware Reimbursement Services for fullly outsourced billing and collections services. Biologic Infusion Pharmacy was founded in 2013 and specializes in infusion therapy for patients throughout southern California. After recent staffing changes in its reimbursement department, the company’s president began evaluating billing and collections options, looking for ways to get the job done without the hassle of hiring and training new staff…Home Care Medical has reaccredited by the Joint Commission. The New Berlin, Wis.-based provider became the state’s first accredited HME provider in 1990. Serving southeastern Wisconsin since 1974, Home Care Medicare provides enteral nutrition, rehab technology, respiratory services, HME and bracing.


Senators circulate sign-on letter

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06/29/2017
HME News Staff

WASHINGTON – A letter urging HHS Secretary Tom Price to use regulatory authority to provide bid relief in non-bid areas is now circulating in the United States Senate.

The letter, which is spearheaded by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., and also addressed to CMS Administrator Seema Verma, states: “We are concerned that CMS did not fully consider the costs of providing DME in non-competitively bid areas or the length of time needed by providers to adjust to the change.”

A House letter, spearheaded by Reps. Cathy McMorris Rodgers, R-Wash., Dave Loebsack, D-Iowa, Lee Zeldin, R-N.Y., and Diana DeGette, D-Colo., collected 154 co-signers earlier this month. That letter also asked the secretary to permanently protect accessories for complex wheelchairs from bid-related reimbursement cuts and CMS on June 23 announced it would preserve reimbursement for accessories for Group 3 or higher complex rehab power wheelchairs.

“Providers are seeing a much more receptive HHS and CMS that are willing to listen to the concerns of providers and industry stakeholders,” said John Gallagher, vice president of government relations for The VGM Group, said in a bulletin. “This new dialogue has led to quick action with CRT, and now providers have to keep the wheels turning for DME.”

Providers are urged to contact their senators and ask them to sign the letter which is available through the July 4 recess.

 

Cures adjustments require planning

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‘This is not a Publishers Clearing House prize, where they show up at the door and give you a cardboard check’
06/30/2017
Liz Beaulieu

YARMOUTH, Maine – Sure, getting the money they’re owed will be great, but are HME providers ready to process adjusted claims?

“There are, surprisingly, a lot of internal process considerations,” said Andrea Stark, a reimbursement consultant for MiraVista. “These are going to be some of the more complex claims in your system.”

N689, a recently announced remark code that will allow providers to identify adjustments will help, but other process considerations include how providers handle other payers and patient co-pays.

Other payers

“In North Carolina, for example, Medicaid has an allowable that was above the July 1 rates, but now they’re below the Cures adjusted rate—that will result in Medicaid recoveries,” Stark said. “Now Medicaid has overpaid for a couple of services. I don’t know how materially that will be felt, but these are the kind of scenarios providers have to figure out.”

Patient co-pays

“Do you go back to patients and ask for the portion of co-pays you’re owed?” Staked said. “There’s no right or wrong answer, but each has its consequences. If you pursue it, prepare to have confused and angry patients asking you, ‘Why are you collecting on this?’ You also have to ask yourself how much you’re going to spend trying to collect 20% of a 20% adjustment. But you are entitled to that money.”

Get out the ‘elbow grease’

Stark advised providers to take time in June and even July, before the DME MACs start processing adjustments on a daily basis, to put a plan in place.

“They need to make sure they’ve thought through all the angles,” she said. “This is not a Publishers Clearing House prize, where they show up at the door and give you a cardboard check. It’s going to take some elbow grease.”

In brief: Senators circulate letter, Liberty looks to sell

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06/30/2017
HME News Staff

WASHINGTON – A letter urging HHS Secretary Tom Price to use regulatory authority to provide bid relief in non-bid areas is now circulating in the United States Senate.

The letter, which is spearheaded by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., and also addressed to CMS Administrator Seema Verma, states: “We are concerned that CMS did not fully consider the costs of providing DME in non-competitively bid areas or the length of time needed by providers to adjust to the change.”

A House letter, spearheaded by Reps. Cathy McMorris Rodgers, R-Wash., Dave Loebsack, D-Iowa, Lee Zeldin, R-N.Y., and Diana DeGette, D-Colo., collected 154 co-signers earlier this month. That letter also asked the secretary to permanently protect accessories for complex wheelchairs from bid-related reimbursement cuts and CMS on June 23 announced it would preserve reimbursement for accessories for Group 3 or higher complex rehab power wheelchairs.

“Providers are seeing a much more receptive HHS and CMS that are willing to listen to the concerns of providers and industry stakeholders,” said John Gallagher, vice president of government relations for The VGM Group, said in a bulletin. “This new dialogue has led to quick action with CRT, and now providers have to keep the wheels turning for DME.”

Providers are urged to contact their senators and ask them to sign the letter, which is available through the July 4 recess.

Lincare settles claims allegations

CLEARWATER, Fla. – Lincare has agreed to pay $20 million to settle allegations that it fraudulently billed for oxygen equipment and services.

The company admits no wrongdoing, according to news reports.

According to a whistleblower lawsuit, Lincare billed Medicare and other government health programs for unnecessary oxygen equipment and tanks, fabricated orders and improperly waived co-pays and deductibles.

The lawsuit also alleges Lincare paid kickbacks to physicians and their families by providing oxygen and supplies for free.

In court documents, Lincare said it followed regulations and blamed “garden variety” errors, according to an article on Reuters.com.

The lawsuit was originally filed as two separate suits in 2009 and 2010, by former employees SallyJo Robbins and Kathleen Dunlap in New York, and Germano Lima and Roberto Rabassa in Massachusetts. They will receive $6 million of the judgment; the government will receive $9 million.

In November 2016, a whistleblower lawsuit filed against Lincare by a former employee was dropped in response to a request by the employee, Rebecca Saiff. That lawsuit accused Lincare of, among other things: improperly billing Medicare for equipment that was not reimbursable, failing to provide services, and retaining overpayments to which it knew it was not entitled.

Liberty Medical looks to sell

PORT ST. LUCIE, Fla. – Mail-order supplier Liberty Medical may close on deal next month to sell the majority of its assets.

If the deal closes, the company will lay off 263 employees Aug. 27, according to a local news report. Among the affected positions: president, chief financial officer and director of human resources.

Liberty has undergone much turmoil over the past few years. In December 2012, a group of Liberty executives bought the company from its parent company, Express Scripts. Two months later, in February 2013, it filed for Chapter 11 bankruptcy. It cited a dispute with Express Scripts over tax liabilities and a significant recoupment by Medicare among its liabilities.

Liberty settled with Medicare in October 2014, paying $32 million. That same month, a bankruptcy judge approved a stalking horse bid for Liberty’s assets. It was acquired for $68.5 million by Palm Beach Capitol.

Invacare closes China factory

ELYRIA, Ohio – Invacare has closed its Suzhou, China manufacturing facility it announced June 26. The change is in line with the company’s strategic plan to leverage its infrastructure and improve efficiencies. The closure is expected to generate $4 million in pre-tax savings annually. “We are focused on having the right number of facilities in the right locations to better meet the needs of our customers,” said Matthew Monaghan, chairman, president and CEO in a release. Since taking the helm in 2015, Monaghan has worked to turn around the North America HME business. Since 2012, Invacare has been under a consent decree with the U.S. Food and Drug Administration that has limited its ability to make and sell certain products from its corporate headquarters and Taylor Street manufacturing facility. The company announced recently that the FDA has now approved three certification reports from its third-party auditor and it is now waiting for the agency to re-inspect its facilities.

Sunset Healthcare to distribute BellaMa products

WALNUT, Calif. – BellaMa, a manufacturer of breast pumps and breastfeeding accessories, has partnered with Sunset Healthcare Solutions to distribute its line of breast bumps to the home medical equipment market. Sunset is a manufacturer and distributor of CPAP, oxygen and other homecare products. “We have had great success adding value to the home healthcare industry through our dedication to service and providing quality medical supplies,” said Greg Wood, chief development officer for Sunset. “We look to expand on that with the addition of these high-quality breast pumps.” BellaMa will continue to serve the retail market through Amazon, Walmart, Sears and Bed Bath and Beyond.

Supreme Medical partners with IMCO

HOUSTON – Supreme Medical Fulfillment, wholesale distributor of DME and medical supplies, has partnered with IMCO Home Care, a national member service organization of HME providers, pharmacies, VNAs, hospice care and group homes, to offer its purchasing power to members. “IMCO Home Care members will be able to place orders that can be shipped directly to their patient’s front doorstep from our warehouse,” said Colton Mason, senior vice president of Supreme Medical, in a press release. Supreme Medical offers a full range of medical supplies, including ostomy, wound care, enteral nutrition, diabetes, respiratory therapy and DME. IMCO Home Care contracts with leading branded manufacturers and resource companies to deliver a robust product portfolio to members.

VGM Fulfillment, Brightree integrate technologies

WATERLOO, Iowa –VGM Fulfillment has partnered with Brightree to integrate technologies that will enable Brightree customers to automate the ordering process, enabling drop-shipping from VGM Fulfillment’s warehouse, according to a press release. “Automating the order process allows Brightree customers to push orders directly to us,” said Shalini Douglas, implementation manager for VGM Fulfillment. “It saves time and gets the orders delivered to patients faster and more efficiently. Our team is currently shipping nearly 6,000 orders per day while maintaining a fill rate of 99%.” VGM Fulfillment has been shipping CPAP supply orders directly to patients since 2009.

Active Body secures patent, seeks investors

ATLANTA – Active Body has received a patent for its wheelchair-rollator hybrid design, the startup announced June 27. The product concept features a robotic lift that allows a wheelchair user to transition to a standing position where waking is facilitated in a supportive frame. “Health benefits from continued ambulation are significant and well documented.,” said Charles Wike, president, in a release. “With the dramatic increase in the elderly population and the continued decline in the cost of robotic lift mechanisms, we believe that this concept will represent a significant market niche.” Active Body is seeking to license its technology to medical device manufacturers. For more information, visit: www.activebodyinc.com.

QS/1 names new leader

SPARTANBURG, S.C. –Saul Factor has been tapped as the new president of QS/1, it was announced today. Factor will take over for Tammy Devine who in May announced she would retire. Factor is a pharmacist who eventually moved into sales and brand management with PCA, Eli Lilly and RxAmerica, where he was charged with improving customer experience. During his tenure there as COO, the company’s revenues double to $1B. “Saul has a track record of success—he has built teams that have deployed both operational and commercial excellence programs focused on delivering a better customer experience while driving incremental shareholder value,” said Alan Turfe, CEO and Chairman of the Board at JM Smith Corporation, parent company of QS/1, in a press release.

Harmar recognized as ‘hero’

SARASOTA, Fla. – Harmar Mobility received the “Hero of Freedom Award” at the Wheelchairs 4 Kids Heroes Appreciation Lunch June 21. Harmar has supported Wheelchairs 4 Kids by significantly reducing the cost of providing vehicle wheelchair lifts and installation services, assisting with product expertise, sponsoring events and participating in fundraising. “Harmar was very touched to receive this recognition from Wheelchairs 4 Kids,” said David Baxter, vice president of marketing for Harmar, in a press release. “These kids, their families and the crew at Wheelchairs for Kids are the real ‘heroes’ and we hope our little part helps them enjoy life just a little bit more.”

Patient engagement ‘crux’ of COPD management

YARMOUTH, Maine – COPD patients are more likely to be active and participate in pulmonary rehab if they have social support, according to a report published in the Annals of the American Thoracic Society. Researchers looked at the association between healthy behaviors and two kinds of social support: structural, the type of social network a person has such as being married or living with a partner or caregiver, and functional, the support a person perceives his/her social network provides. They found that participants who: lived with others took 903 more steps each day; had a spouse or partners were 11 times more likely to participate in rehab; and were more likely to receive a pneumococcal vaccine and slightly less likely to smoke. “Patient engagement in self-care is the crux of COPD management,” said senior study author Huong Q. Nguyen, PhD, RN, a research scientist at Kaiser Permanente Southern California and an affiliate associate professor at the University of Washington. “Our goal with this study was to identify factors associated with self-care activities, including physical activity, quitting smoking, participating in a pulmonary rehabilitation program, adherence to medications, and getting influenza and pneumococcal vaccinations.”

Brightree plans summit

ATLANTA – Brightree will host another Brightree Summit at Medtrade in Atlanta. The one-day summit takes place Oct. 23, from 8 a.m. to 5 p.m. followed by a networking event from 5:30 to 7:30 at the Omni Hotel. The event features three educational tracks (training, executive and operations), and will include providers who are using Brightree successfully. “Brightree customers will share their expertise and reveal their best practices in how to maximize results and be profitable,” said Mark Blount, vice president of marketing for Brightree. Medtrade takes place Oct. 23–25 at the Georgia World Congress Center. Show organizers in May announced they would shorten the show by one day. 

People: United Spinal, InfuSystem, CHAP

Lisa Wells has been named to United Spinal Association’s Board of Directors. Wells, vice president of market at Cure Medical, has more than 20 years of experience in public relations and marketing communications for medical device, medical supply and health technology companies and has created two social media communities for wheelchairs users…Darrell Montgomery and Christopher Sansone have been elected to InfuSystem’s Board of Directors. Montgomery has nearly 30 years experience in operational management, technology sales and consulting experience. Sansone has extensive investment experience as both a managing partner and founder of an investment partnership…Barbara McCann, current chairwoman, has been appointed as interim president and CEO of Community Health Accreditation Partner (CHAP). She replaces Karen Collishaw, who has announced her resignation as CEO after a three-year tenure.

 

Tricare will make payment adjustments

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07/07/2017
HME News Staff

WASHINGTON – Tricare, the healthcare program for uniformed services members and their families, will also adjust payments from June through December 2016 per a provision in the 21st Century Cures Act, according to AAHomecare.

The provision in the Cures Act requires Medicare to retroactively delay 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.

In a letter responding to HME providers who inquired about whether Tricare, which bases its payments on Medicare’s payments, would also make adjustments, Tricare stated: “You are correct TRICARE uses Medicare’s DMEPOS fee schedule, Medicare reduced their rates in the second half of 2016, and a subsequent resolution (the 21st Century Cures Act) delayed that reduction, and retained the original, higher rates for claims with dates of service between July 1 and December 31, 2016.  TRICARE followed suit and we suggest you resubmit any claims adjudicated under the reduced rates to the Managed Care Support Contractor (MCSC) in your region for reprocessing.”

In response to the news, Laura Williard, vice president of payer relations for AAHomecare, advises providers to submit a small batch of claims to ensure they are processed correctly before submitting all claims.

Williard also advises providers who have not already done so to submit similar letters inquiring about the adjustments in case they are questioned by the contractors administering Tricare contracts.

The news culminates six months of work by Williard and AAHomecare on this issue. They reached out to Tricare and its contractors, marshaled providers to pressure the program, and even secured legal opinions confirming that Tricare was obligated to follow the Cures provision.

In brief: Senate letter approaches deadline, Brightree beefs up resupply management solution

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07/07/2017
HME News Staff

WASHINGTON – HME stakeholders have until Tuesday, July 11, to collect signatures for a letter from Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., asking HHS Secretary Tom Price to use his regulatory authority to provide relief from competitive bidding in rural areas. At press time on Friday, 14 senators had signed the letter. A similar letter in the House of Representatives drew 154 signatures. As proof that the letters have an impact, CMS announced June 23 that it would no longer apply bid-related pricing to accessories for complex power wheelchairs, an “ask” in the House letter. “This letter from the U.S. Senate sends a strong and united voice from Congress to HHS and CMS saying DME policy issues need to be made a priority,” VGM stated in a bulletin to members last week. “The remaining senators will not sign unless they hear from their constituents.”

Brightree beefs up resupply management solution

ATLANTA – Brightree announced last week that it has bought AllCall Connect, a Joliet, Ill.-based provider of live-calling solutions for CPAP patient resupply, its second acquisition in as many months.

Brightree says its acquisition of AllCall Connect will allow it to enhance Brightree Connect, its resupply patient contact management solution, with a “turnkey live-call center service with trained experts and proven processes,” according to a press release.

“Data has shown us that interactive voice response systems are effective at managing patient outbound calls,” said Matt Mellott, president and CEO of Brightree. “Live outbound calling, combined with Brightree Connect’s IntelligentQ technology, is far more impactful in optimizing an HME’s CPAP resupply program and providing a better patient experience.”

In another move to boost its resupply management solution, Brightree announced in June that it has integrated its technology with VGM Fulfillment’s technology, allowing its provider customers to drop-ship supplies directly from VGM Fulfillment’s warehouse.

Brightree believes resupplies are an important part of compliance to sleep therapy. Research indicates more than 50% of patients that order resupplies on a regular basis sleep more than seven hours per night and more than 80% of them use their therapy seven nights per week, it says.

Brightree announced in June that it had bought Conduit Technology, a provider of document and workflow solutions. Conduit Technology’s flagship product, Conduit Office, is the engine behind Brightree’s MyForms.

Last year, Brightree sold to ResMed for $800 million.

Airway Oxygen hit by ransomware attack

WYOMING, Mich. – Airway Oxygen has experienced a ransomware attack affecting 500,000 individuals, according to the breach portal of the Office for Civil Rights of the Department of Health and Human Services. In a notice to customers, Airway Oxygen said it learned that an unidentified criminal(s) had gained access to its technical infrastructure and installed ransomware to deny the company access to its own data. “We have no indication that any of your protected health information stored on the computer network was accessed and acquired,” it stated in the notice. “Nevertheless, we wanted to provide notice to you so that you would be aware of the situation.” Airway Oxygen said the types of protected health information involved in the breach include full name, home address, birth date, telephone number, diagnosis, type of services provided and health insurance policy numbers. It said no bank account numbers or debit or credit card numbers were exposed in the breach. Since learning of the incident, Airway Oxygen said it has taken steps to secure its internal systems against further intrusion, including scanning the entire internal system; changing passwords for users, vendor accounts and applications; conducting a firewall review; updating and deploying security tools; and installing software to monitor and issue alerts as to suspicious firewall log activity. “We have hired a cyber-security firm to assist in conducting an investigation to assess the case and impact of the breach,” it stated. “In addition, we are identifying further actions to reduce the risk of this situation recurring.”

Graham-Field uses grant to increase exposure

ATLANTA – Graham-Field has received a $5,000 grant and been named a semi-finalist in the Atlanta Metro Export Challenge, a competition sponsored by JPMorgan Chase, UPS and Partnership Gwinnett. Twenty-eight companies were selected as semi-finalists and each receives a grant to apply toward expenses related to building capacity and activities, according to a press release. “It is an honor to be a winner of the annual Atlanta Metro Export Challenge”, said Ken Spett, president & CEO. “The grant will enable Graham-Field to further expand our international trade show participation to reach new customers.” Graham-Field’s Hausted Stretcher and Chair Patient Handling and Lumex Clinical Care Recliner lines are manufactured in the USA.

PHS ranks among best workplaces

ST. PAUL, Minn. – Pediatric Home Service has been recognized as one of the 2017 Top 150 Minnesota Workplaces for the seventh year in a row. The Star Tribune ranked PHS second out of 109 mid-sized companies, according to a press release. The awards recognize the most progressive companies based on a confidential employee survey measuring benefits, pay, work/life balance and employee engagement. “We want PHS to be an environment that makes employees want to come and stay,” said Mark Hamman, president. “We want them to stay for their entire career, and many of our employees have.”

Ottobock backs Invictus Games

AUSTIN, Texas – Ottobock Healthcare will support the Invictus Games for the third year in a row, the mobility solutions supplier announced in a press release. Founded by Prince Harry, the games are the only international adaptive sporting event for injured military service members. Events at the games, to be held Sept. 23-30 in Toronto, include archery, indoor rowing, powerlifting, cycling swimming and wheelchair basketball and rugby. Ottobock will provide prosthetic and orthotic technical services for the athletes. “Ottobock has a long history of partnering with international sporting competitions that support athletes with physical challenges reach their goals,” said Matt Swiggum, regional president and CEO for Ottobock North America. “We welcome the opportunity to assist these brave men and women as they compete through sport at the Invictus Games again this year.”

Circadiance joins VGM’s network

PITTSBURGH – Circadiance has joined VGM’s network of vendors, increasing the company’s access to more than 5,000 independent HME providers. “The partnership between Circadiance and VGM allows Circadiance to reach a large number of HME providers with innovative sleep and respiratory monitoring products,” said David Groll, CEO of Circadiance. As part of the partnership, Circadiance will offer VGM members “an economical ordering advantage,” the company says. Circadiance’s brands include the SleepWeaver soft cloth CPAP mask, the NeoPAP high flow respiratory support system, and the SmartMonitor infant apnea monitor.

Providers in the news: Keeler’s Medical Supply files for bankruptcy, Medicine Shoppe Pharmacy becomes Haag Pharmacy

Keeler’s Medical Supplyin Yakima, Wash., plans to stay open despite recently filing for bankruptcy, according to the Yakima Herald. Changes in Medicare and Medicaid reimbursement and audits forced the company to file for bankruptcy on June 15, President Chuck Vetsch told the newspaper. Vetsch hopes that filing for bankruptcy will allow the company to negotiate payment plans with its creditors, the newspaper reported. Keeler’s sales feel from just under $10 million in 2010 to a little more than $1.6 million in 2016, according to court documents. As of June 1, the company had about $785,000 in assets…The Medicine Shoppe Pharmacy in Emporia, Kan., is now operating under the name Haag Pharmacy, according to the Emporia Gazette. “Anyone in this business has to be willing to change with it,” Amber Haag, owner, told the newspaper. “We feel now is the time to make this change to better prepare us for future opportunities for growth, and to continue to provide exceptional care and services to our patients.” The pharmacy began operating as the Medicine Shoppe in 1993, when owner Don Hill joined the national franchise.

People in the news: Laura Williard, Lauren Barranti

AAHomecare has promoted Laura Williard to vice president of payer relations. In a bulletin to members, the association credited Williard for “stemming the tide and in some cases reversing further cuts with the help of state associations, utilizing a multi-pronged approach.” AAHomecare says Williard will continue to push and reach out to the Defense Health Agency and contractors to get a CURES fix implemented for Tricare, and will continue to work with state leaders to educate payers like BCBS in a number of states on the impact of using Medicare’s competitive bid rates…CHME, a Foster City, Calif.-based HME provider, has named Lauren Barranti executive vice president. Barranti was most recently vice president of managed care at Apria Healthcare. She has more than 20 years of experience working with medical providers, insurers and government agencies to support the healthcare needs of patients across the country. “Lauren very much appreciates the business model that CHME has created and understands our market approach and is excited to help our company continue to expand our business and service even more patients in need,” said Bernie Zimmer, CHME’s founder and CEO.

Short takes: BOC, QS/1

The Board of Certification/Accreditation has named Harry “J.R.” Brandt as the inaugural recipient of the Jim Newberry Award for Extraordinary Services. BOC says Brandt is a highly respected practitioner and orthotics and prosthetics advocate who played a significant role in BOC’s growth and success. A former member and chairman of BOC’s board of directors, Brandt was instrumental in developing BOC’s accreditation process. The award, launched in 2016 in honor of James Newberry, who passed away that year, recognizes outstanding individuals who perform extraordinary service to BOC and its stakeholders…QS/1 has partnered with Updox to offer Pharmacy Connect, a web-based care coordination suite that helps pharmacies securely exchange patient information with healthcare providers and engage patients. With Pharmacy Connect, a pharmacist can receive clinical files from a physician’s electronic health record system and send the patient a secure notification to access an online appointment  system for medication therapy management (MTM). Once the MTM is completed, the pharmacist can send a secure message with results back to the physician.

Price now has letters from both Senate, House

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07/12/2017
HME News Staff

WASHINGTON – HME stakeholders collected 46 signatures for a letter from Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., asking HHS Secretary Tom Price to use his regulatory authority to provide relief from competitive bidding in rural areas, VGM reported this morning.

Stakeholders rallied in the last hour, lifting the number of signatures for the letter from 14 on Friday to 46 on Tuesday, the deadline.

Now Price and CMS Administrator Seema Verma have received letters from both the House of Representatives and Senate. The House letter drew 154 signatures.

“These letters detail much needed reform within the competitive bidding program and act as continued pressure for the governing agencies to fix the highly flawed program,” VGM wrote in a bulletin.

Stakeholders in 13 states—Alabama, Colorado, Florida, Hawaii, Iowa, Kansas, Mississippi, North Carolina, North Dakota, Ohio, South Dakota, West Virginia and Wyoming—were all to get all of their senators to sign on to the letter, VGM reported.

As proof that the letters have an impact, CMS announced June 23 that it would no longer apply bid-related pricing to accessories for complex power wheelchairs, an “ask” in the House letter.

Stakeholders apply steady pressure for bid relief

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Recent data analysis by AAHomecare shows 42% reduction in number of providers from 2013 to 2017
07/14/2017
Theresa Flaherty

WASHINGTON – Industry stakeholders say they’re primed to build further support for bid relief after a post-July 4th recess surge resulted in a total of 48 signatures for a Senate sign-on letter.

The letter, spearheaded by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., asks HHS Secretary Tom Price to use his regulatory authority to provide bid relief in rural areas. A similar letter in the House secured 154 signatures in June and helped to preserve reimbursement for accessories for complex power wheelchairs.

“It makes it easier for the administration to make those improvements when they know there’s significant support for doing it,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

There’s significant urgency to get something done. A recent review of the Medicare Supplier Directory by AAHomecare showed the number of traditional DME suppliers is steadily decreasing, with roughly 6,086 unique suppliers and 9,810 locations nationally as of July of this year—a decrease of 42% since 2013.

“Every month that goes by, we are losing critical mass,” said Tom Ryan, president and CEO of AAHomecare. “For every business that closes, there is going to be a patient access issue.”

Case in point: The recent decision by LifeCare Solutions to pull out of California means 30,000 patients need to find new providers. But CMS doesn’t get it, say stakeholders.

“CMS uses their metric of participation rate, which doesn’t change,” said Ryan. “We don’t think that does a deep enough dive to determine other costs to other parts of the healthcare system. They strictly look at DMEPOS and that’s an issue.”

Still, stakeholders say they are encouraged by some positive signs. The agency recently released its proposed 2018 changes to the End-Stage Renal Disease Prospective Payment System, and it contained no DME-related provisions.

“There’s speculation that there is work going on for a separate regulation that would make improvements to the bidding program,” said Bachenheimer. “I don’t have any idea how quickly we will see either an interim final rule or a proposed rules or some other indication they are moving forward. It could be days, weeks or months.”

While stakeholders are currently pressing for a regulatory fix, they are prepared to go the legislative route if necessary, they say.

“We are growing short of time for the announcement of the next round of bidding,” said Jay Witter, senior vice president of public policy. “We continue to work with our champions and they are poised to do something legislatively whenever the time is right.”


In brief: Tricare will make payment adjustments; Hospital HME, DASCO form partnership

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07/14/2017
HME News Staff

WASHINGTON – Tricare, the healthcare program for uniformed services members and their families, will also adjust payments from June through December 2016 per a provision in the 21st Century Cures Act, according to AAHomecare.

The provision in the Cures Act requires Medicare to retroactively delay 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.

In a letter responding to HME providers who inquired about whether Tricare, which bases its payments on Medicare’s payments, would also make adjustments, Tricare stated: “You are correct TRICARE uses Medicare’s DMEPOS fee schedule, Medicare reduced their rates in the second half of 2016, and a subsequent resolution (the 21st Century Cures Act) delayed that reduction, and retained the original, higher rates for claims with dates of service between July 1 and December 31, 2016.  TRICARE followed suit and we suggest you resubmit any claims adjudicated under the reduced rates to the Managed Care Support Contractor (MCSC) in your region for reprocessing.”

In response to the news, Laura Williard, vice president of payer relations for AAHomecare, advises providers to submit a small batch of claims to ensure they are processed correctly before submitting all claims.

Williard also advises providers who have not already done so to submit similar letters inquiring about the adjustments in case they are questioned by the contractors administering Tricare contracts.

The news culminates six months of work by Williard and AAHomecare on this issue. They reached out to Tricare and its contractors, marshaled providers to pressure the program, and even secured legal opinions confirming that Tricare was obligated to follow the Cures provision.

Hospital HME, DASCO form partnership

POINT PLEASANT, Ohio – Pleasant Valley Hospital’s HME division has entered into a joint venture with DASCO Home Medical Equipment, the Gallipolis Daily Tribune reports. It will now do business as DASCO-Pleasant Valley Home Medical Equipment and will be jointly owned by the two organizations, the newspaper says. “This partnership will allow DASCO to provide increased access to highly specialized respiratory equipment like home oxygen, non-invasive vent systems and CPAP equipment, while continuing to provide specialty care medical products and equipment to the families in this community,” Rachel Mazur, DASCO CEO, told the newspaper. The staffs of the two organizations are working together to install state-of-the-art business and communication technology to identify and serve the needs of customers. They are also working to further identify, define and implement best practices for clinical and business operations to allow for improved patient outcomes, the newspaper reports. DASCO’s home office is in Westerville, Ohio; it has several branches throughout the state, as well as West Virginia, Kentucky and Indiana.

SleepQuest buys Grove Medical

SAN CARLOS, Calif. – SleepQuest, a national provider of care management services for obstructive sleep apnea, has acquired Grove Medical Equipment in Anaheim, Calif. SleepQuest closed on the transaction on June 30 and began serving Grove Medical’s customers on July 1. The acquisition expands SleepQuest’s service base in the Oakland and East Bay areas, and gives OSA patients there access to telehealth- and on-site based services. “This business fits well with our business model and information technology platform,” said Robert Koenigsberg, founder and CEO of SleepQuest. In addition to its main location here, SleepQuest has patient service centers in San Francisco, San Jose and Fresno.

Lifeway Mobility buys Total Access of New England

HARTFORD, Conn. – Lifeway Mobility, an accessibility solutions company based here, has acquired Total Access of New England. Total Access will operate as Lifeway Mobility from a new office near Westborough, Mass., and continue to serve the Greater Boston area. Dan Martin, owner of Total Access, will join Lifeway as vice president and will be responsible for the Massachusetts operation. Martin, a certified aging in place specialist, founded Total Access seven years ago in response to requests for access solutions for homes and businesses. Lifeway Mobility serves Connecticut, Massachusetts and Rhode Island. It was formed by Paul Bergantino, formerly of Numotion.

Aeroflow Breastpumps launches insurance-friendly site

ASHEVILLE, N.C. – Aeroflow Breastpumps has launched a new website that combines ecommerce with insurance processing, the company said in a press release. Users must fill out a “Qualify through Insurance Form” before being eligible to shop for breast pumps that are covered by their specific insurance plan.The site features breast pumps from top brands like Medela, Spectra, Lansinoh and Evenflo, and offers instructional videos and other resources. “Aeroflow is dedicated to making the transition into motherhood as enjoyable and stress-free as possible for women across the country,” said Jennifer Jordan, Aeroflow’s director of Mom and Baby. “Our new website’s simplified and intuitive design makes shopping for a breast pump easier than ever, without compromising on what we at Aeroflow Breastpumps do best: getting moms access to the medical products they need, both easily and at no extra charge.”

HME Woman of the Year committee named

WATERLOO, Iowa – VGM Group has announced the five members of its 2017 HME Woman of the Year Honorary Selection Committee. They are Dr. Kristen Davin, the inaugural HME Woman of the Year, and president and owner of Precision Seating Solutions; Rose Schafhauser, president and owner of Association Management and executive director of MAMES and SWMESA; Quinton Hart, mayor of Waterloo, Iowa; Rick Rector, executive vice president of United Publications, Inc., and publisher of HME News and Home Health Technology News; and Joan Eliasek, president of Extended Care Sales at McKesson Medical-Surgical. The selection committee will review all of the nominations and each submit three semifinalists. Upon reviewing the semifinalists, VGM will select three finalists to attend the awards ceremony on October 24 at Medtrade, where the 2017 HME Woman of the Year will be announced. Nominations are due Aug. 14. www.vgm.com/hmewomanoftheyear.

AAHomecare, VGM want your data

The next submission round for AAHomecare’s HME Audit Key opens July 17. Even if you haven't previously participated or have skipped rounds, you can still take part in this round, says the association. The latest results, running through the first quarter of 2017, showed overturn rates of 68% of repository products; 77% for ostomy, urological, wound care and diabetes supplies; and 81% for NPWT devices and supplies. “Please help fight back against a broken audit and appeal system,” says AAHomecare. Registration and participation is free and open to all suppliers at hmeauditkey.org…With HME providers starting to receive Cures payment adjustments from both Noridian and CGS, VGM is asking them to share any issues, including issues with posting in their billing software. FMI: Ronda Buhrmester, ronda.buhrmester@vgm.com, Dan Fedor, dan.fedor@vgm.com.

Home infusion: Studies highlight benefit of education, inotropic therapy

Patients have better outcomes when they receive home infusion education before they are discharged from the hospital, according to Option Care data. These patients were less likely to experience disruptions in therapy, go to the emergency room or be readmitted to the hospital, according to a presented by the company at the National Home Infusion Association Annual Conference & Exposition in May. The study compared outcomes of 60 patients who received pre-discharge education vs. 37 patients who did not and found outcomes improved by 20% for the first group. Education included proper handwashing, appropriate care of medication, and how to monitor for signs of infection…Advanced heart failure patients who received home infusion of inotropic therapy have a better quality of life, according to another study from Option Care and presented at the NHIA conference. The study included 88 adult heart failure patients who filled out the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before the start of inotropic infusion and three months after therapy. There was an 8.65% improvement among all patients. Additionally, there were improvements in shortness of breath (17.13%), hospital stays (17.65%) and medical care costs (20.78%).

US power soccer team takes second place in World Cup

KISSIMEE, Fla. – Team USA has taken second place in the 2017 Fédération Internationale of Powerchair Football Association (FIPFA) World Cup in Kissimee, Fla. Team USA was going for its third consecutive World Cup win. “It was a thriller of a game, with the score tied 2-2 until France broke away in the final minutes,” said Wayne Merdinger, executive vice president and general manager of MK Battery, the primary sponsor and official battery of the US Power Soccer Association and TEAM USA. England took third place, defeating Australia. Medtrade attendees had the opportunity to see Team USA in action at last year’s show. “When we saw the team last year at Medtrade 2016, it was obvious that they were an incredibly skilled group,” says Kevin Gaffney, group show director, Medtrade. “We at Medtrade are thrilled that Team USA has once again done so well in the World Cup. We offer our sincere congratulations.” 

CPAP helps keep COPD patients out of hospitals, study shows

TUCSON, Ariz. – Although PAP therapy is associated with a reduction in hospitalization for COPD patients, more than 92% of patients are not receiving the therapy, according to a recently published study funded by Royal Philips. The retrospective study, led by Dr. Sairam Parthasarathy, professor of medicine and interim chief of Division of Pulmonary, Allergy, Critical Care and Sleep Medicine at the University of Arizona College of Medicine, revealed that only 7.5% of the more than 1.8 million COPD patients analyzed were receiving any form of PAP therapy. Data from the reviewed administrative claims suggest that individuals receiving either BiPAP, CPAP or non-invasive positive pressure ventilation therapy experienced lower hospitalization risk than before therapy initiation, as well as lower hospital risk than those who did not receive any positive airway pressure therapy at all. “Frequent readmissions of COPD patients not only disrupt their quality of life, but are costing our health systems billions,” says Parthasarathy. “This analysis revealed that there is a solution already accessible within our toolbox that can keep patients out of the hospital, but it is significantly underutilized. With improved awareness and implementation of PAP therapy as a treatment for COPD, we can lower the cost burden for health systems while allowing patients to recover in the comfort of their own homes.”

States move to single-source more and more DME

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‘They’re commoditizing this portion of health care, and it’s scary to think about how far they’ll take it’
07/21/2017
Liz Beaulieu

YARMOUTH, Maine – Distributors have been picking up Medicaid contracts for incontinence supplies in a number of states for years. Now the stakes have been raised.

In Indiana, for example, Medline has won a single-source contract to provide all DME and supplies to Medicaid patients under Managed Health Systems, a managed care company that’s administering part of the state’s program. Medline plans to drop ship aides, soft goods and supplies, and has set up a network that includes Apria Healthcare to provide “hard DME,” says George Kucka, president and CEO of Fairmeadows Home Health Center in Schererville, Ind.,

“This is completely changing the paradigm,” said Kucka, who is also the HME/Respiratory Therapy Council Chair for AAHomecare. “It’s starting to spread, and it’s not good. This points to the fact that no one respects that there’s a service aspect to this.”

Kucka got word of the contract via a letter in February. His contract with MHS will be terminated—he serves about 150 patients under the plan—and the new contract with Medline will start on Sept. 1.

Down in Texas, Medline has won a single-source contract to provide supplies—the list includes 244 codes—to Medicaid patients under Superior HealthPlan, a managed care company that’s administering part of that state’s program. That contract also starts Sept. 1.

“How is Medline going to know what to dispense to the patient?” said Victoria Peterson, an administrator for Respiratory & Medical Homecare in El Paso, Texas, which serves about 125 patients under Superior HealthPlan, representing about $75,000 in revenues per month. “When they get a script that says PediaSure, what kind are they going to provide, because there are 25 different kinds. The doc doesn’t know—we go back to the nutritionist to find the best fit. Same thing with trachs—there are six different types of tubes.”

Respiratory & Medical Homecare has filed four complaints with three difference offices of the Texas Health and Human Services Commission, as well as Superior HealthPlan. Another provider, Alliance Medical Supply, enlisted the legal team at Brown & Fortunato to also file a complaint.

“All the DME providers that have been providing services in a fabulous way for decades—now all of a sudden, they would be eviscerated,” said Pam Colbert, a member of the firm’s Health Care Group.

In a response to a request for an interview, a media relations specialist at Medline said no one was available at the moment.

“It’s a very new deal,” she said, referring to the contract in Texas. “But we may have more details to share in the coming months.”

Providers like Ben Hertz don’t begrudge Medline and other distributors like TwinMed for earning a living, but this trend is another major shift in the HME industry toward larger companies and less personal care.

“They’re all trying to maximize their own revenues, but it’s like, health care is so personal,” said Hertz, the store manager for Elmora Healthcare in Elizabeth, N.J., where the state has contracted with Medline to provide incontinence supplies to all Medicaid patients under Horizon N.J. Health. “You go to the doctor that your family has been going to for 50 years. You got to the hospital, and your nurse is your neighbor. They’re commoditizing this portion of health care, and it’s scary to think about how far they’ll take it.”

Kucka says he’s not going down without a fight, and depending on how the contract plays out, he’ll likely have Medicaid patients on his side.

“If there are service issues that creep up, the Medicaid population is more vociferous than the Medicare population,” he said. “They’re going to scream.”

‘What shift?’ HME industry divided over role of young professionals

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07/21/2017
Liz Beaulieu

YARMOUTH, Maine – The VGM Group gave a nod to young professionals when it hosted a meet-up for the HME Young Professionals Group at the Heartland Conference in June, but it turns out the HME industry is still very much gray.

The majority of the respondents to a recent HME Newspoll (54%) say they’re not experiencing a shift to a younger workforce.

“We have more over 65 than under 40,” wrote one respondent. “What shift?”

The majority of respondents (46%) to the poll say they only have one to five employees under 40. Five percent say they have none.

Young professionals, who are more likely not to have experience in the HME industry, can detract or add to a business, depending on the respondent, according to the poll.

“Unfortunately, we can’t afford to spend time training inexperienced staff,” wrote on respondent. “There is way too much to learn. I myself started at a young age with no experience, but that was a different time.”

On the other hand, “While experience is valuable, there are so many changes to the way we do things from five years ago that we are finding it easier to train someone with no experience,” wrote another respondent.

For the 38% percent of respondents who say they have 10 or more employees under 40, that inexperience means a fresh perspective.

“We look forward to hiring young team members,” wrote one respondent. “Most of them are not aware of what’s happened over the past 10 years in the HME industry and, therefore, they bring a welcomed attitude to our workforce.”

Other benefits of a younger workforce, respondents say: more affordable health insurance for those companies that offer it to their employees, and a higher level of tech-savviness. Detriments: less work ethic and more turnover, they say.

“Average length of employment for the younger population is two years or less,” wrote one respondent.

At some point, however, as a big portion of the workforce retires, HME companies will increasingly have to look to younger professionals. That will be a sad day, one respondent says.

“I feel that we are losing a lot of knowledge from our more senior employee base,” wrote the respondent.

 

In brief: ConvaTec adds distribution business, Compass Health launches new product line

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07/21/2017
HME News Staff

READING, United Kingdom – ConvaTec, a global medical products company, has agreed to pay nearly $121 million for Woodbury Holdings, a distributor of incontinence and catheter supplies.

The Floral Park, N.Y.-based Woodbury offers a portfolio of more than 500 incontinence and 650 catheter products, and a wide array of nutritional, enteral feeding and vascular compression products through subsidiaries Woodbury Health Products and Wilmington Medical Supply.

"ConvaTec and Woodbury share a common commitment to improving the lives of people with continence issues and a dedication to providing quality products, together with distinctive service and personal support,” said Paul Moraviec, CEO of ConvaTec, in a press release. “We look forward to working with our Woodbury colleagues to bring our comprehensive end-to-end suite of services to even more customers."

With this acquisition, ConvaTec Americas will create a new distribution unit for catheter- and incontinence-related products, comprising the U.S. distribution companies of 180 Medical, Symbius Medical, South Shore Medical Supply, Wilmington Medical Supply and Woodbury Health Products.

The deal is the latest in a recent string of manufacturers acquiring disposable medical supplies companies. In 2016, Coloplast paid $160 million for Comfort Medical; and Domtar acquired Home Delivery Incontinence Supplies for $45 million.

In October 2016, ConvaTec raised nearly $1.8 billion in an initial public offering, according to news reports. ConvaTec is owned by private equity firms Nordic Capital and Avista Capital Partners, which acquired the company in 2008 for $4.1 billion.

GAO: Cover disposable devices as substitutes for DME

Health and Human Services calls move ‘premature’

WASHINGTON – The Government Accountability Office has recommended that the Department of Health and Human Services evaluates the possible costs and savings of using disposable devices as substitutes for DME and, if appropriate, seek legislative authority to cover them.

While Medicare generally doesn’t cover disposable devices, the GAO identified eight such devices that could potentially substitute for DME devices that are covered. These disposable devices fall into existing Medicare DME categories: infusion pumps, including insulin pumps; blood glucose monitors; sleep apnea devices; and nebulizers.

The GAO’s recommendation is the result of a report examining (1) potential disposable DME substitutes and their possible benefits and limitations; (2) the incentives and disincentives stakeholders identified for developing these substitutes, including the possible influence of health insurance coverage; and (3) issues related to benefit category designation, including legal authority and potential payment methodologies if Medicare coverage were expanded to include disposable DME substitutes.

In addressing issues related to benefit category designation, the GAO identified three possible options for covering disposable devices: an expansion of the current DME benefit, an expansion of the current home health benefit, or the establishment of a new benefit category.

Under the current DME benefit, disposable devices are not covered because they don’t meet CMS’s regulatory definition for “durable”: able to withstand repeated use, with an expected lifetime of at least three years.

To conduct the report, the GAO reviewed agency documents and literature on disposable DME substitutes and Medicare payment policy; interviewed CMS officials; and interviewed various stakeholders, including representatives of device manufacturers, beneficiary advocates, healthcare providers and insurers for their perspectives.
In response to the report, HHS said it was premature to evaluate disposable devices as substitutes for DME.

Ascensia, Dexcom bundle diabetes products

PARSIPPANY, N.J. – Ascensia Diabetes Care and Dexcom have hammered out a commercial agreement that they expect to increase access to the Dexcom G5 continuous glucose monitoring system. Per the agreement, Ascensia’s ContourNext One blood glucose monitoring system will be provided in the bundle of supplies for the Dexcom G5. The role of the ContourNext: to provide highly accurate readings for CGM calibration, something people who use the G5 do on a regular basis to verify sensor readings are on track. This “complete bundle” will be available to people with diabetes who are covered by Medicare and qualify for “therapeutic” CGM, according to a press release. “With this agreement, we are pleased to begin offering a complete bundle to Medicare-eligible patients, enabling access to the Dexcom G5 as efficiently as possible,” said Rick Doubleday, chief commercial officer at Dexcom. Earlier this year, CMS decided to classify certain CGMs as DME, if, among other criteria, they’re “therapeutic” and approved by the U.S. Food and Drug Administration for use in place of blood glucose monitors for making diabetes treatment decisions.

Agreement increases access to OxyGo POCs

COSTA MESA, Calif. – CareCredit will provide financing options for the oxygen patients of nearly 20,000 providers across the country under a new, multi-year agreement with OxyGo. This marks CareCredit’s first foray into the HME industry. “Entering this new market with a well-regarded partner aligns perfectly with our goal of helping people pay for the care they need when they need it,” said Greg Pierce, senior vice president and general manager of CareCredit. “Our agreement with OxyGo gives their providers a way to help people finance the equipment they need—with convenient, monthly payments.” CareCredit is a health, wellness and personal care credit card accepted through a national network of more than 200,000 healthcare provider locations and select health-focused retailers. The agreement will increase access to the OxyGo family of portable oxygen concentrators, says Dave Marquard, CEO and founder of the company, which is part of Cleveland-based Applied Home Healthcare Equipment. “This new partnership will help patients live more independent and healthier lives,” he said. “Having the freedom to be on the go while you’re on oxygen can make a big difference. Now more patients will be able to get an OxyGo and/or OxyGo FIT portable oxygen concentrator, giving them greater independence.”

Compass Health launches first product under AccuRelief line

QUINCY, Mass. – Compass Health Brands has unveiled its new AccuRelief 3-in-1 Wireless Pain Device and Bluetooth-connected mobile app, its first product under the company’s AccuRelief 2.0 line. The device, which is small enough to fit in your pocket, combines TENS, EMS and massage with the convenience of mobile technology. Additionally, the mobile app features diagrams of muscle groups, an electrode placement guide, satisfaction tracking and more. The device features 14 pre-set programs with up to 60 levels of adjustable intensity for 12 treatment zones, including the back, knee, neck, and shoulders. As an alternative to the mobile app, the device also includes a hand-held remote control.

Invacare backs vets at Wheelchair Games

ELYRIA, Ohio – Invacare is a national sponsor of this week’s 37th Annual National Veterans Wheelchair Games. The games, which run from July 17-22 in Cincinnati, feature a multitude of sporting events, including basketball, handcycling, track and table tennis. “The pure talent, tenacity and devotion to the sport demonstrated by these veteran athletes makes us honored to continue to show our support,” said Dean Childers, senior vice president and general manager of Invacare North America. Invacare associates started their supporting role on Sunday, when they met athletes at the airport to help ensure their wheelchairs were unloaded and assembled properly. Throughout the week, they’re also offering repairs and replacements. Additionally, during the event’s expo day, Invacare will display several products, including its new küschall custom manual wheelchairs; and its Invacare TDX SP2 power wheelchair with LiNX technology, which is set to launch in the third quarter of this year.

FODAC receives ‘green’ recognition

STONE MOUNTAIN, Ga. – Friends of Disabled Adults and Children was recognized by the Atlanta Better Buildings Challenge for its continuing energy consumption reduction, it announced in a press release. “We are grateful for the recognition of FODAC’s longstanding green initiative by the ABBC,” said Chris Brand, president and CEO of FODAC. “Our repurposing and recycling program has always supplied much of our inventory to supply the needs of our clients, and keeps almost 300 tons of equipment and related parts out of landfills.” FODAC is a nonprofit that has provided more than $10 million in DME and supplies to people with injuries and disabilities.

Video makes patients more likely to stick with CPAP

DENVER – Sleep apnea patients were more likely to use their CPAP machines after watching video of themselves struggling to breathe, according to a new study led by Mark Aloia, Ph.D., a sleep expert at National Jewish Health in Denver. Twenty-four patients newly diagnosed with moderate to severe OSA received education with a personalized video (PVD), education with a non-personalized video (NPV) or treatment as usual (TAU). The PVD group used CPAP devices more than two hours per night (6.5)—more than the NPV group (4.1) or the TAU group (3.5). “Sleep apnea is one of those disorders you never really notice in yourself,” say Aloia in an article in Sleep Review Magazine. “I mean, you’re asleep; you’re consciously not aware of what’s happening to you.”

TheraSkin expands VA offerings

NEWPORT NEWS, Va. – TheraSkin will now be available in all four sizes to veterans through 110 Veterans Affairs Medical Centers and 800 Community Based Outpatient Centers nationwide, distributor Soluble Systems announced July 18. "We are especially proud to offer two additional sizes of TheraSkin to the doctors and nurses treating our nation's veterans suffering with chronic wounds at the VA hospitals and outpatient centers," said Allan Staley, CEO. "Whether the wound is large or small, clinicians and veterans can know that they have more options available to them with proven clinical evidence to back it up." In the United States alone, chronic lower extremity ulcers affect an estimated 2.4 million to 4.5 million people at an estimated cost of $4,000 per month and $16,000 per episode, according to a press release.

Medtrade: 100 days and counting

ATLANTA – Advance registration rates remain in effect until Aug. 26 for Medtrade, which takes place Oct. 23-25 at the Georgia World Congress Center in Atlanta. The conference pass allows admission to educational sessions.“It’s a wise investment, because the motivation, inspiration, and product ideas from Medtrade can set the stage for future success,” said Show Director Kevin Gaffney. Show floor passes can be obtained for free from exhibitors. Show organizers announced in May that this year’s show would be shortened from four days to three. To register, go here.

NCPA names finalists for business plan competition

ALEXANDRIA, Va. – The National Community Pharmacists Association has named three teams of pharmacy students as finalists for the 2017 GoodNeighbor Pharmacy NCPA Pruitt-Schutte Student Business Plan Competition. The students hail from the University of Arkansas for Medical Sciences, the University of Pacific Thomas J. Long School of Pharmacy and Health Sciences, and the University of Southern California School of Pharmacy. They will present their business plans in a live competition on Oct. 14 at NCPA’s annual convention in Orland, Fla. They’re competing for first ($3,000 to the NCPA student chapter and $3,000 contributed to the school in the dean's name to promote independent pharmacy), second ($2,000 to the NCPA student chapter and $2,000 contributed to the school in the dean's name to promote independent pharmacy) and third place  (Third Place: $1,000 to the NCPA student chapter and $1,000 contributed to the school in the dean's name to promote independent pharmacy).

Sports clinic brings DME in house

VAIL, Colo. – The Steadman Clinic, which offers sports medicine and orthopedic surgery, has added a DME service. In the past, the clinic used third-party vendors to produce and sell DME, whether it’s braces, crutches or boots, but it wanted more influence over what its patients use to recover from their injuries, says Nick Eaton, DME manager at The Steadman Clinic. “By bringing DME in house, we can recommend products that pertain to each provider’s protocol on a patient-specific basis,” he said. The clinic’s patients often need assistance and protection before and after a procedure; others need braces to enable them to have the mobility for normal activity in their lifestyle and to help prevent further injury.

New impact survey seeks ‘street level’ view

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07/27/2017
HME News Staff

WASHINGTON – AAHomecare is developing a new survey with Dobson DaVanzo & Associates to determine the impact of competitive bidding on patient access to home medical equipment nationwide.

The survey will seek input from HME providers, beneficiaries, caregivers and hospital discharge planners. Dobson DaVanzo, a leading healthcare research group, will create a report based on the survey results.

Although industry stakeholders have met with regulatory agencies to discuss improvements to the bid program, more anecdotes are needed, particularly from beneficiaries and caregivers, says AAHomecare.

“A better understanding of the experience we have every day working with beneficiaries and discharge planners to secure needed equipment in a timely manner will help policymakers come up with solutions that help providers and patients alike,” said Steve Ackerman, AAHomecare chairman in a weekly bulletin. “This independent evaluation of what is actually going on at the street level, trying to get patients home, is long overdue."
AAHomecare has formed a steering committee for the survey that includes: John Gallagher, VGM Group; George Kucka, Fairmeadows Home Health Center; and Gary Sheehan, Cape Medical Supply.  

Stakeholders grease wheels for possible action in September

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07/28/2017
Theresa Flaherty

WASHINGTON – Industry stakeholders have legislative language being vetted that would freeze payment rates at the current amounts and fix the so-called “double-dip” for oxygen payments.

The news comes on the eve of the August recess, a time when HME providers need to turn up the heat on lawmakers while they’re back in their home districts.

“Then we can say, ‘Here’s your August meeting agenda,’” said Tom Ryan, president and CEO of AAHomecare. “Get them to understand this language so when the House of Representatives comes back in September the legislation can be dropped with bi-partisan support.”

Rep. Cathy McMorris-Rodgers, R-Wash., has agreed to sponsor the legislation. Stakeholders are working to get a Democratic co-sponsor.

Providers in New England will be doing their part to get the word out. The state association representing HME providers in six states has already lined up nearly a dozen appointments—many with the representatives themselves.

“I have never seen as many meetings where we are meeting with the representatives,” said Karyn Estrella, executive director of the Home Medical Equipment and Services Association of New England or HOMES. “I would hope that—we’ve been reaching out to these folks for a good 10 or 12 years—they are really starting to hear about the problems.”

Those problems have snowballed in the last few years, said Estrella.

“We are sharing with them how many companies have gone out of business,” she said. “In some states, there are 50% fewer companies in three short years. It’s mind-boggling.”

Despite the noise surrounding the Senate’s efforts to reform health care, stakeholders remain optimistic they will be heard. John Gallagher was in Montana recently, visiting lawmakers’ offices with providers, including that of Sen. Jon Tester, D-Mont.

“They are looking to get past this and move onto other things,” said Gallagher, vice president of government relations for The VGM Group. “They are ready start working on things that are important for rural health care.”

The fight against the bid program has been a protracted one, but now’s not the time to slow down, stakeholders say.

“I know it sounds like the same old, same old, but it’s still really important for folks to keep those channels of communication open,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

 

AAH launches survey to dig deeper into access issues

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07/28/2017
Theresa Flaherty

WASHINGTON – Industry stakeholders are reaching past the ranks of HME providers to gauge the impact of competitive bidding, as they continue to push for reforms to the program.

AAHomecare is working with Dobson DaVanzo & Associates, a well-respected healthcare research group, on a new surveythat will seek input from not only HME providers but also Medicare beneficiaries, caregivers and other healthcare professionals like hospital discharge planners.

“We’ve made headway at CMS, certainly, with Tom Price, but there continues to be (pushback) from some career folks that do not believe there’s an access issue,” said Tom Ryan, president and CEO of the association. “We believe it would be beneficial to get a third-party group like Dobson DaVanzo to do a non-biased survey, reaching out to discharge planners and others who have patients affected by bidding.”

AAHomecare has created a survey steering committee: Members held an initial call last week, and plan to hold weekly calls going forward. The committee is currently developing a matrix of providers who have already signed up to participate and working on question sets.

Discharge planners are uniquely situated to see firsthand the problems caused by competitive bidding, says provider Gary Sheehan, a committee member.

“I do think there is real value in that it’s a systems issue for discharge planners that they are dealing with every single day,” said Sheehan, CEO of Sandwich, Mass.-based Cape Medical Supply. “The discharge planner can cite case after case after case of having real problems getting basic medical equipment to discharge patients back into the community into a lower cost environment.”

The survey will also look at both urban and rural markets.

“I think what will come out of it is a really comprehensive look at the access issues, where they are and also some of the cost that the system is incurring because of these access issues,” said Sheehan.

AAHomecare hopes to have the survey live in the next two or three weeks, with a report from Dobson DaVanzo in three months.

“We’re doing our best to get this going as quickly as possible, because timing is everything,” Ryan said.


In brief: Temporary payment for home infusion passes House, Stratice partners with athenahealth

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07/28/2017
HME News Staff

WASHINGTON – A bill that reforms several Medicare benefits, including home infusion and O&P, sailed through the House of Representatives last week.

H.R. 3178, the “Medicare Part B Improvement Act of 2017,” includes a provision that would create a temporary payment for home infusion therapy to close a gap created by another bill, the 21st Century Cures Act. The Cures Act requires Medicare to pay for services associated with providing Part B drugs, but not until 2021. Meanwhile, a second provision in the act cut payments for those drugs on Jan. 1.

The provision, originally introduced by Reps. Pat Tiberi, R-Ohio, and Bill Pascrell, D-N.J., as H.R. 3163, would put a temporary payment in place for 2019 and 2020.

H.R. 3178 also includes a provision that would allow the documentation produced by an O&P practitioner to be considered part of a patient’s medical record for purposes of determining medical necessity. The provision was originally introduced by Reps. Mike Bishop, R-Mich., and Mike Thompson, D-Calif., as H.R. 3171.

The bill has moved with lightning speed: It was introduced on July 11 by Rep. Kevin Brady, R-Texas, chairman of the House Ways and Means Committee, Rep. Richard Neal, D-Mass., and nine co-sponsors.

The bill does not include a provision that would strengthen protections requiring mail-order contract suppliers to include at least 50% of the types of diabetes testing supplies that were available before the implementation of the program. That provision, which also would prevent suppliers from encouraging beneficiaries to switch brands, still exists as a standalone bill, H.R. 3271.

NSM tapped to distribute WHILL wheelchair

NASHVILLE, Tenn. – National Seating & Mobility will be the exclusive national distributor for WHILL’s Model M power wheelchair, the companies announced July 24. NSM’s national distribution channel and expert clinical field team “vastly increase” the Model M’s service area in the complex rehab and access industries, according to a press release. “We’re excited to have NSM’s clinical experts providing product evaluations on the Model M, ensuring the chair fits and meets the versatile needs of their clients,” said WHILL CEO Satoshi Sugie in the release. The Model M will be available through NSM and AccessNSM branches nationwide. WHILL received clearance from the U.S. Food and Drug Administration for the Model M last year, paving the way for doctors to prescribe the wheelchair as a medical device. WHILL also offers the Model A for cash sale. Model M keeps the four-wheel drive, patented all-direction wheels and sleek design of the Model A, but also offers customizable features like arm and back supports, and ankle huggers.

Stratice partners with athenahealth

CARMEL, Ind. – Stratice Healthcare, vendor of an EHR integrated e-prescribing platform connecting medical professionals with their suppliers, has partnered with athenahealth and its “More Disruption Please” program. The goal of the program: to make athenahealth’s eOrdersPlus application available to its growing network of 100,000 healthcare providers. eOrdersPlus users can access an efficient platform while eliminating phone calls, faxes and manual processes to receive detailed written orders with electronic integration to the prescriber’s EHR platform.athenahealth offers medical record, revenue cycle, patient engagement, care coordination and population health management services.

DarioHealth enters strategic agreement with Byram

CAESAREA, Israel, and NEW YORK – DarioHealth has expanded its insurance coverage provider network by entering into a strategic agreement with Byram Healthcare, the two companies announced July 25. DarioHealth, which makes the Dario Blood Glucose Monitoring System all-in-one blood glucose meter and native smartphone app, recently expanded its third-party insurance coverage option for consumers in the U.S. who want their products reimbursed by insurance. “DarioHealth initiated the provider network approach earlier in the year and it has been met with much success,” said Erez Raphael, chairman and CEO of Dario Health, in a press release. “By partnering with only the most reputable third-party providers, our team is fully committed to help consumers take control of their self-diabetes management.” With the addition of Byram, DarioHealth expects to cover 30% of consumers in the U.S. diabetes market, according to the release.

Miller takes reins at Mediware

LENEXA, Kan. – Bill Miller has been name CEO of Mediware Information Systems, the software company announced July 27. He succeeds Kelly Mann, who has served as CEO since 2007. Miller has more than 20 years of healthcare and technology experience, most recently as CEO of OptumInsight at Optum, a subsidiary of UnitedHealth Group. Prior to OptumInsight, Miller served as vice president of technologies at Cerner Corporation. “Having spent my entire career in the healthcare and technology industries, I have known Mediware as an industry leader with a deep understanding of the marketplace and an ongoing commitment to quality and client service,” said Miller in a press release. “I am excited about their strong position in the expanding markets they serve, and look forward to working with TPG and the Mediware team to build on the momentum that the company has achieved to-date.”

Invacare to relocate wheelchair production

ELYRIA, Ohio – Invacare said it plans to shift production of its Invacare Rea manual wheelchairs from its facility in Dïo, Sweden, to its wheelchair manufacturing facility in Fondettes, France. The move will allow the company to better optimize its wheelchair manufacturing facility in Fondettes, while enabling its Dïo facility to focus on its production of beds for the Nordic market, along with being the distribution center for lifestyle products, the company said in a press release. “As we continue to make progress in Phase Two of our strategic transformation, we will continue to leverage our existing global infrastructure and further increase efficiencies,” said CEO Matthew Monaghan in the release. “By transferring wheelchair production from Dïo to Fondettes, we are able to create a European wheelchair center of excellence that is centrally located to our European customers.” The move is expected to be completed in January 2018.

Philips shifts workers

MURRYSVILLE, Pa. – Royal Philips has relocated more than 100 employees to a new 14,000-square-foot space in Pittsburgh’s Oakland neighborhood, where they are closer to universities, medical centers, research partners and innovation leaders, the company announced in a press release. “Working in close proximity to hospitals, universities, and start-ups alike will enable us to incubate our regional research partnerships and, ultimately, accelerate our ability to develop new solutions to drive the future of health technology,” said John Frank, CEO of Philips’ sleep and respiratory business. Philips, which acquired Respironics in 2008, has in the past two years established new professional and distribution facilities in Murrysville and New Kensington, and completed construction of a brand new, state-of-the-art distribution and service facility in Mount Pleasant.

Aetrex re-launches website with tech focus

TEANECK, N.J. – Aetrex Worldwide has re-launched Foot.com. The website, originally launched in 2009, now highlights “the intrinsic benefits of foot scanning,” according to a press release. Aetrex recently rolled out its next gen foot-scanning technology, Albert, and it continues to invest in the development of new software that elevates what customers can learn from their feet. “Users of the Albert scanning technology have the option to explore foot care, health and wellness topics as part of their foot scanning experience, which really drives the in-store experience home,” said Melissa Libner, vice president of marketing for Aetrex’s Technology & Orthotics division. Aetrex says more than 40,000 users visit the website each week.

Home Because connects consumers with providers

PORT ORANGE, Fla. – Home Because has launched a new website to connect consumers and caregivers with local providers online. “We realized how many consumers and caregivers were turning to online resources for purchase decisions on HME and in-home services, but they could make much better decisions with local, in-person provider support,” said Carol Lockett, creator of HomeBecause.com. “Our website bridges that gap.” The key to HomeBecause.com is its “provider search” feature: A consumer can select a product or service category, research the topic, then click the search feature to point them to a local provider. Providers can sign up to be listed on the website, including premium listings within their geographic areas.

AASM adds app to telemedicine platform

DARIEN, Ill. ­– The American Academy of Sleep Medicine has launched the SleepTM app to directly connect patients to sleep medicine professionals and accredited sleep centers through its SleepTM telemedicine platform. The app provides patients with convenient access to sleep medicine services on their mobile devices, AASM says. “The AASM SleepTM app promotes affordable, convenient, patient-centered care by eliminating common health care obstacles such as distance, travel costs and wait times,” said Steve Van Hout, AASM SleepTM’s chief architect. “This app will significantly enhance the ability of sleep specialists to meet the growing demand for sleep care, while reducing costs and improving efficiency.” Through the app, patients request a live video visit with a sleep medicine provider who is licensed in the state where they live or the state in which they are traveling. The app works on Wi-Fi, 3G, 4G and LTE connections, and it is currently available in the App Store for iOS devices (iPhone and iPad). An Android-compatible app is scheduled to be released on Google Play in August 2017.

SoClean surveys users

OXFORD, Mass. – CPAP sanitizing device company SoClean recently polled more than 300 customers about their experience with sleep apnea and CPAP. Since starting CPAP therapy, 43% of SoClean users said they have noticed results almost immediately and 93% said that they have been sleeping better. The survey also showed that: 77% of SoClean’s customers are male; 48% are between the ages of 56 and 70; and 57% have high blood pressure and 38% were able to decrease their high blood pressure since starting CPAP therapy.

Short takes: WVU HME, Vertess

WVU Home Medical Equipment held a ribbon cutting ceremony this week for its new store in Bridgeport, West Va. The store gives WVU HME, part of St. Joseph’s Hospital, a central location to provide everything from chair lifts to wrist splints to customers in north central West Virginia…New York-based Vertess continues its national expansion with the addition of Tucson, Ariz.-based Hilsman Knight as managing director. “I am very excited to join the Vertess team and hope my strong healthcare M&A background will help us expand, especially in the Western U.S.,” he said. Knight recently facilitated the sale of the largest Miracle Ear franchise in Arizona to a West Coast private equity group.

 

 

In brief: NSM makes big play in Michigan, Health Complex rebrands

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08/04/2017
HME News Staff

NASHVILLE, Tenn. – National Seating & Mobility has acquired the mobility division of Wright & Filippis, positioning the company as the leading provider of complex rehab solutions in Michigan, it says.

“Wright & Filippis is one of the country’s most respected providers of prosthetics, orthotics, custom mobility products and accessibility solutions,” said Bill Mixon, CEO of NSM. “This acquisition allows both companies to focus on our areas of expertise to better serve clients in Michigan.”

NSM will take over Wright & Filippis’ complex rehab operations in metro Detroit and Lansing. Wright & Filippis’ mobility division in Flint will merge with an existing NSM branch in Freeland. NSM also operates a branch in Troy.

Eighteen Wright & Filippis employees, including seven ATPs, will make the transition to NSM.

Wright & Filippis has been shedding different divisions in the past few years to zero in on its prosthetics and orthotics business. It sold its diabetes supply business in 2013, and its HME and respiratory businesses in 2014, leaving O&P and complex rehab and accessibility.

In June, NSM also picked up Mobility Healthcare, with locations in Carrollton and Lewisville, Texas.

Numotion expands North Carolina presence

BRENTWOOD, Tenn. – Numotion has acquired the rehab division of CVC Home Medical in Wilmington, N.C., it announced today. The move allows Numotion to expand its reach in the eastern part of the state. CVC has served the Wilmington and Morehead City area for more than 20 years, according to a press release. “We are excited about expanding in North Carolina,” said Mike Swinford, CEO, Numotion. “We are always looking for ways to better serve customers and provide them with innovative mobility solutions. This acquisition will provide the disabled community in eastern North Carolina with greater access to mobility resources, products and services.” CVC’s rehab employees will be integrated into Numotion’s Wilmington location. In April, Numotion acquired Horn’s Medical Supply in Athens, Texas.

Health Complex: Where patients are ‘All Taken Care Of’

WATERBURY, Conn. – Health Complex Medical has launched a new brand to showcase its expanded solutions for sleep therapy, the company announced Aug. 1. After collaborating with employees, having discussions with physicians and patients, and analyzing competitive positioning, the company has developed a new logo, tagline, collateral system and outreach materials. “Each audience told us that they place more value in ‘the solution’ than just the service, the equipment or the supplies,” said Jack Hogan, president and CEO. “It became clear that Health Complex was seen as an extremely valuable partner that removes the difficulties associated with sleep and respiratory care. So when people turn to us, they know it’s all taken care of.” “All Taken Care Of” is the company’s new tagline. The new logo features four repeated symbols in varying shades of green and yellow to form a check mark. The symbols represent an “abstraction of both a medical icon and stars at night,” the company says. Health Complex, which has locations in Waterbury, Danbury and Wethersfield, offers a full range of sleep therapy and respiratory products. The company has an in-house customer service center, on-site acclimation rooms and trained sleep therapists on staff.

HME provider closes due to cuts

REDDING, Calif. – Northern Rehab Equipment & Respiratory is closing its doors after 19 years in business, according to a local newspaper. The HME provider served customers all over the North State, specializing in products for the elderly like beds, wheelchairs, walkers, oxygen concentrators, diabetic shoes and more. Owner Stephanie Schwartz told the newspaper that her company maintained a steady clientele but decreases in Medicare reimbursement made the business too difficult. New West Medical, also in Redding, bought some of Northern Rehab’s inventory and took on some of its customers, according to the newspaper. Unlike Northern Rehab, which focused on Medicare, New West Medical has a diversified book of business, mixing Medicare with private insurance and Medi-Cal, the state’s Medicaid program.

Philips helps providers ‘break cycle’ with connected vent

AMSTERDAM – Royal Philips has made its wirelessly connected Trilogy family of portable ventilators commercially available in North America. The Bluetooth-enabled devices, which connect to Care Orchestrator, deliver data directly to mobile devices or the desktops of healthcare providers multiple times per day, allowing them to make clinical decisions more proactively, according to a press release. Care Orchestrator is a cloud-based software application that enables data, clinical management workflow, informatics and intelligence capabilities for providers, payers and patients in a single platform. “To have a meaningful impact on patient outcomes, we need to work closely with care providers and develop technologies that can help them break the cycle of reactive care,” said Eli Diacopoulos, Respiratory Care Business Leader, Philips.

Medforce, DME Data Solutions fill in gaps

SUFFERN, N.Y., and SAN DIEGO – Medforce Technologies and DME Data Solutions have formed a strategic partnership to deliver providers an end-to-end solution for business management that improves efficiency, increases productivity and boosts profitability, the two companies say. Medforce is a provider of process and document management software; DME Data Solutions is a provider of productivity software. Together, the two companies offer more than a dozen software modules focused on minimizing manual efforts, improving automation and freeing up resources to focus on strategic activities, according to a press release. “We each fill in gaps in each other’s portfolio and together can deliver a full suite of software and services for the benefit of DME providers,” said Ken Ravazzolo, founder of DME Data Solutions. DME Data Solutions’ flagship product, IMS, is an inventory, patient management and billing system that uses barcode technology and emphasizes par-level reordering and resupply. IMS is currently installed in hundreds of locations throughout the U.S. and Canada, the release states.

Annual ‘Get out’ contest now live

PHOENIX – Sports ‘n Spokes, the sports and recreation magazine of the Paralyzed Veterans of America, has teamed up with the Spina Bifida Association and Cure Medical, a manufacturer of intermittent catheters, to host this year’s “Get Out & Enjoy Life” event. Now in its seventh year, the GOEL event kicks off today, Aug. 1, with a photo contest. As part of the contest, the social media pages of Sports ‘n Spokes, the Spina Bifida Association and Cure Medical will feature a daily listing of accessible vacation spots, outdoor programs and other events. This year’s theme is “travel everywhere your heart desires to go regardless of your paralysis,” and highlights activities like adaptive sports, accessible amusement parks, inclusive vacation spots and other unique travel outing across the United States. Participants can submit their photos for the contest here. The first place winner will receive a custom-built Razorback wheelchair courtesy of Colours Wheelchair, a GOEL summer tour T-shirt and the cover of the November issue of Sports ‘n Spokes.

People in the news: BOC, UPitt

The Board of Certification/Accreditation has added three employees: Judi Knott, chief marketing officer; Cecelia Huffman, marketing communications manager; and Tyrone Vines, business development specialist. “BOC is thrilled to welcome these three highly experienced employees to our team,” said President and CEO Claudia Zacharias. “As we expand our service offerings, we continue to focus on hiring professionals who enable us to carry out our mission, while continuing to deliver the customer service our credential-holders have come to expect”…Dr. Rory Cooper is stepping down as chairman of the Department of Rehabilitation Science & Technology at the University of Pittsburgh to devote more time to directing the Human Engineering Research Laboratories (HERL) and serving as associate dean for inclusion in the School of Health and Rehabilitation Sciences (SHRS). Cooper will remain chairman for a few months while the university evaluates and reorganizes the current structure of the Department of Rehabilitation Science & Technology, and its diverse programs and academic offerings.

In brief: Apria settles with MassHealth, Trump stalls sleep reg

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08/11/2017
HME News Staff

LAKE FOREST, Calif. – Apria Healthcare has agreed to pay more than $750,000 to settle allegations that it billed Massachusetts residents for services already covered by MassHealth, the state’s Medicaid program.

Under the settlement announced Aug. 9, Apria has agreed to pay $99,008 in restitution and $665,934 in penalties to settle allegations that the company improperly billed consumers between December 2011 and April 2017, according to Massachusetts Attorney General Maura Healey.

Despite the settlement, Apria denies it violated any state laws.

“We are pleased to have resolved this matter with the Massachusetts Attorney General,” said Raoul Smyth, Apria’s executive vice president and general counsel, in a statement. “Although Apria denies that it has violated any Massachusetts laws, this resolution reflects Apria’s desire to put this matter behind it so that it can continue to focus on the needs of patients.”

Apria says it addressed the processes that were the focus of the Attorney General’s investigation long before this settlement was reached.

Study: Bid program puts Medicare more in line with commercial insurers

BETHESDA, Md. – A comparison of the prices Medicare paid for certain DME under its competitive bidding program in 2010 and the average prices that commercial insurers paid that same year supports the conclusion that CMS overpaid for DME, according to a new study conducted by the Health Care Cost Institute and published this month in Health Affairs. On average, the Round 1 Rebid prices for the seven items included in the study were 34.7% lower than the prices in the Medicare fee schedule for 2010. On average, commercial payers paid 28.7% less than Medicare for the same items in 2010. “This suggests that in the nine program MSAs, the program resulted in prices that were generally comparable to but lower than the prices obtained by large commercial insurers,” the study’s authors say. Because the bid program has better lined up prices from Medicare with those of commercial insurers, the study’s authors argue it is an “effective mechanism for achieving savings,” with one caveat. “If the concerns about the program’s long-term sustainability can be resolved, competitive bidding for DME and similar items may be an effective mechanism for achieving savings in Medicare, relative to historic fee schedule prices,” they say. The Health Care Cost Institute is a non-partisan, non-profit organization that aims to provide complete, accurate, unbiased information about healthcare utilization and costs to better understand the U.S. healthcare system, according to its website.

Trump stalls sleep reg for drivers, rail workers

WASHINGTON – President Donald Trump, who has pledged to drastically slash federal regulations, has sounded the death knell for a regulation to require sleep apnea screening for commercial drivers and rail workers, according to news reports. The Federal Railroad Administration and the Federal Motor Carrier Safety Administration said late last week that they are scraping the regulation, arguing that it should be up to trucking and railroad companies to decide whether or not to screen their employees. Last year, however, the agencies announced a proposal to require screening for commercial drivers and railroad workers, and sought public input. Deadly rail crashes in New York City and New Jersey, as well as several highway crashes, have brought the issue to the forefront. In the Metro-North train crash in 2013, the engineer fell asleep at the controls because he had a severe, undiagnosed case of sleep apnea. In the New Jersey Transit train crash in September, the engineer also suffered from undiagnosed sleep apnea.

New Apria program helps reduce readmissions

LAKE FOREST, Calif. – Apria Healthcare has launched a new program for patients on non-invasive ventilation that it says significantly reduces hospital admissions.

As part of the Apria Clinical Evidence (ACE) program, respiratory therapists perform regularly scheduled home visits to help patients maintain compliance with therapy and intervene as needed to get patients back on track. During the visits, RTs monitor each patient’s progress and record their responses to a number of quality of life indicators, as well as document emergency department visits and unplanned hospital admissions.

“Apria is uniquely positioned to help these patients reduce hospital admissions by providing them with the tools and support they need for success,” said Dan Starck, CEO of Apria Healthcare. “Through the ACE program, we have seen tremendous success in reducing hospital admissions when comparing the six months prior to initiating therapy with the six months post therapy, particularly for patients diagnosed with COPD.”

Initial results from the ACE program are comparable to a recent study published in the Journal of Clinical Sleep Medicine, which demonstrated that multifaceted COPD intervention—including non-invasive ventilation, RT-led respiratory care and patient education—resulted in an 88% reduction in hospital admissions, according to Apria.

Apria is offering the ACE program nationwide through its locations in Springfield and Wilmington, Mass.

Inspired by Drive launches online community

SANTA FE SPRINGS, Calif. – Inspired by Drive has launched “Live Inspired,” an online community for special needs families. It features a weekly guest blog and other resources, and offers families a place to connect. “Our commitment to special needs families goes beyond our products,” said Matt Lawrence, vice president and general manager. “The Live Inspired community is an extension of our mission to enhance the quality of life of the people we touch and our commitment to families.”

AccessNSM taps new vice president

NASHVILLE, Tenn. – AccessNSM, the accessibility division of National Seating & Mobility, has named Kalen McKenzie vice president. McKenzie previously served as regional account manager at Dornier MedTech and vice president of national accounts at Invacare. “Kalen’s experience and expertise will be extremely valuable to AccessNSM,” said Bill Mixon, NSM CEO, in a press release. “His leadership will play an integral role in the continued strategic growth of the company.” As vice president, McKenzie will focus on integrations and organic growth for AccessNSM.

Pedors launches footwear program

ROSWELL, Ga. – Pedors Shoes has introduced a Geriatric Footwear Program that provides PTs and OTs with a discount code they can share with their patients to help offset the cost of therapeutic footwear. Pedors believes the program can help to address Medicare’s broken audit system and the emergence of e-commerce, which it says have driven orthotics fitters and pedorthists out of the market and made it harder for patients to find footwear. “The objective of the program is to keep the cost of orthopedic footwear on par with what a patient might expect to pay for a pair of sneakers,” said Stephen O’Hare, president.

AAH seeks nominations for homecare champion

WASHINGTON – AAHomecare is accepting nominations for the 2017 Van Miller Homecare Champion Award. The award, which was established in 2016 when the association renamed the AAHomecare Champion Award, recognizes a member who has made exceptional contributions to home care. Nominations can be submitted to Sue Mairena at suem@aahomecare.org until Sept. 8. The award will be presented during the Stand Up for Homecare reception at Medtrade on Tuesday, Oct. 24. Missy Cross, vice president of the homecare division of O.E. Meyer Co., received the inaugural award last year.

Aeroflow donates breast pump kits

ASHEVILLE, N.C. – Aeroflow and Ameda, a breast pump manufacturer, are partnering with Grady Memorial Hospital in Atlanta to provide breast pump kits for new mothers to use at Dekalb Detention Center. The program gives the mothers, most of whom will be in Dekalb for short periods of time, the opportunity to initiate and maintain lactation so they can continue to feed their baby breast milk once they’re reunited at home. "Many women at Dekalb believe they are not allowed to breastfeed, even in the hospital, but I encourage them to consider doing so, even if it's only for a short period of time," said Kelly Webb, the Lactation Program Coordinator at Grady Memorial Hospital. "Access to a breast pump allows a new mother to maintain supply and remain emotionally connected to her infant." Aeroflow Breastpumps, a subsidiary of Aeroflow Healthcare, is a DME provider specializing in helping pregnant and nursing women qualify for their breast pumps through their insurance and the Affordable Care Act.

Last call for HME Woman of the Year nominations

WATERLOO, Iowa – The nomination period for the HME Woman of the Year award closes Monday, Aug. 14. To nominate a woman for the award, all you have to do is complete four questions stating how the woman has made an impact on the industry. Women are also encouraged to nominate themselves. Last year’s recipient, Dr. Kirsten Davis, has used the award as a platform for networking with other women in the industry, and sharing successes and obstacles that impact their businesses. “I would encourage everyone to take a minute to really think about what they do, what they've done, and who they've touched,” said Davin. “By really sitting down and reviewing your career, we often find out that we have a greater impact than we think we do.”  The winner of the award will be announced at Medtrade in October.

QS/1 boasts QIR-certified installers

SPARTANBURG, S.C. – QS/1 has met the stringent guidelines of the Qualified Integrators and Resellers (QIR) Program, giving its pharmacy and provider customers assurance that they meet regulatory requirements to protect consumer credit card data. This Payment Card Industry Data Security Standard (PCI DSS) qualification details the procedures for a secure installation and continued maintenance of payment application systems. QS/1 integrators are PCI-certified under the QIR program to install, configure and maintain payments systems, like the company’s Point-of-Sale. “QS/1 has a history of leading the way in point-of-sale technology,” said Saul Factor, QS/1 president. “With network breaches at an all-time high last year, we want to ensure we stay ahead by taking every step possible to protect our customers and those they serve by reducing the risk of a security breach.”

EZ-Access makes improvements

ALGONA, Wash. – EZ-Access has updated its website, www.ezaccess.com, and strengthened its sales team. The company, which makes accessibility solutions, worked with VGM Forbin to update its website to improve the experience for current and prospective customers who are searching for products. The website, which was built to perform well on all devices, features products segmented by categories, a dealer contact form, a live chat and stronger security. EZ-Access has also added Scott Haisch as West Region Business Manager, reporting directly to David Heinz, director of sales for the company’s Residential Access division. Previously, Haisch was managing director of an international sales and marketing consulting company.

 

Superior HealthPlan to make changes to Medline contract

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0
08/15/2017
HME News Staff

AUSTIN, Texas – Superior HealthPlan, a managed care company that’s administering part of the state’s Medicaid program, has decided to delay a contract with Medline until Oct. 1, according to the San Antonio Express-News.

The contract, which includes 244 codes for DME and supplies, was set to start Sept. 1.

Superior Health Plan, part of Centene Corp., also plans to recast the contract as “preferred provider” vs. “single source,” making it clearer that Medicaid recipients will still have their choice of provider, the newspaper reported.

The changes to the contract come on the heels of a hearing before the state’s Committee on Human Services in the House of Representatives on Aug. 9. During the hearing, lawmakers suggested that Superior HealthPlan amend its notice to patients to say they can “opt out for any reason or no reason at all,” the newspaper reported.

Prior to the hearing, a number of providers, including Respiratory & Medical Homecare and Alliance Medical Supply, had sent letters of protest to different offices of the Texas Health and Human Services Commission, as well as Superior HealthPlan.

Superior HealthPlan’s contract in Texas is only one of many such contracts between managed care companies and distributors spreading nationwide.

CMS revamps claims review process

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0
08/16/2017
HME News Staff

WASHINGTON – Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.

As part of an expanding “Targeted Probe and Educate” program, the Medicare Administrative Contractors will identify these providers through data analysis.

“TPE claim selection is different from that of previous probe and educate programs,” the agency stated in an Aug. 14 announcement on its website. “Whereas previously the first round of reviews were of all providers for a specific service, the TPE claim selection is provider/supplier specific from the onset. This eliminates burden to providers who, based on data analysis, are already submitting claims that are compliant with Medicare policy.”

Per the program, the MACs will review 20 to 40 claims per provider, per item or service, per round, for a total of up to three rounds of review. After each round, providers will be offered individualized education based on the results of their reviews.

Providers with moderate and high error rates in the first round of reviews, will continue on to a second round of 20-40 reviews, followed by additional education. Providers with high error rates after the second round will continue to a third and final round of reviews and education.

Providers with continued high error rates after three rounds of review may be referred to CMS for additional action, which may include 100% pre-pay review, extrapolation, referral to a Recovery Auditor Contractor, or other action.

Providers may be removed from the review process after any of the three rounds of review, if they demonstrate low error rates or sufficient improvement in error rates, as determined by CMS.

The program began as a pilot project in one MAC jurisdiction in June 2016 and was expanded to three additional jurisdictions in July 2017. CMS will expand the program to all jurisdictions later this year.

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