WASHINGTON – The heat wave blanketing the East Coast last week had nothing on the heat the HME industry applied to lawmakers as part of a virtual fly-in July 18.

“We notified every representative in the state and got a lot of good feedback,” said Paula Hardison, office manager for New Bern, N.C.-based Carolina Diabetic Supply. “We’ve shared our representatives’ email addresses with employees and customers, as well as the complaint line and the number to (the Capitol Hill switchboard).”

The virtual fly-in was a coordinated effort among AAHomecare, The VGM Group, The MED Group and state associations. The goal: to encourage not only providers, but also beneficiaries and referral sources, to contact lawmakers and describe the problems they’ve encountered under Round 2 of competitive bidding since July 1.

In addition to phone calls, more than 2,500 letters were sent to lawmakers last week, according to AAHomecare.

Right now, some of the loudest messages come from hospitals and discharge planners, say stakeholders.

“Bid winners 600 or 700 miles are telling them it will be weeks before they can send a walker,” said John Gallagher, vice president of government relations for The VGM Group. “When you are talking about, say, the Mayo Clinic, that’s not going to fly. That gets members of Congress saying, ’Wait a minute.’”

Although there is no way to gauge the number of calls made, a July 17 webinar to prep providers for the virtual fly-in drew 1,000 callers, with many additional callers, including Rep. Glenn Thompson, R-Pa., unable to get through. That bode well for the fly-in, Thompson told callers when he was eventually patched in.

“The fact that you are burning up the phones today is impressive and I am thankful for that,” he said. “That intensity is what we need. I am not going to be satisfied until we get competitive bidding stopped.”

Thompson is the lead co-sponsor on H.R. 1717, a bill to repeal and replace competitive bidding with a market-pricing program (MPP). Although the bill, which has 137 co-sponsors, is still the industry’s best chance for relief, stakeholders say they aren’t putting all their eggs in that basket.

“If (Congress) thinks there’s an emergency, they have ways of fixing things,” said Jay Witter, vice president of government affairs for AAHomecare. “Our job is to get support for our legislation and be ready for any opportunity that develops.”

WASHINGTON – The word on the street is that CMS won’t release the single payment amounts for the Round 1 re-compete until this fall, leaving more than one HME provider on standby.

CMS had planned to announce the amounts in the spring.

“It’s not fair,” said Chris Rice, CEO of Diamond Respiratory Care in Riverside, Calif., which submitted bids. “But nothing with this program is going to surprise me.”

CMS also plans to release the names of the contract suppliers in the fall and kick off the Round 1 re-compete on Jan. 1, 2014.

Providers like Frank Trammell say they can’t begin any new major initiatives until they know where they stand with the program.

“We’re blindfolded and handcuffed—it’s crazy,” said Trammell, president of Carolinas Home Medical Equipment in Matthews, N.C., which submitted bids. “I was expecting to hear something the last day in June.”

Speculation on the reason for the delay is rampant: Was the recent roll out of the program in 91 cities as part of Round 2 a much bigger job than CMS expected? Has all of the recent push back against the program given the agency pause?

“I’m sure they’ve gotten so much flack on Round 2 that they’re taking a break until the bullets stop flying,” said Mark Ehlers, owner of Ehlers Health Supply in Stockton, Calif., a Round 2 bid area. “The thinking, here, is that we’re not even hitting the iceberg in terms of the problems.”

While providers suspect CMS likely doesn’t think the delay is a big deal—it’s the second go-around in these nine cities, after all—they beg to differ.

“If a provider is not an existing contract supplier, then I would expect they’d need more ramp up time than they’re going to get,” said Bob Lichtenstein, president of Hollywood Medical Supply in Hollywood, Fla., which submitted bids.

Providers also point out that the nine areas may be the same for the Round 1 re-compete, but the product categories are vastly different. CMS has added new products like home infusion pumps, and lumped together products like oxygen concentrators and CPAP devices.

“If I’m going to do low-air mattresses as I have been, I also have to do beds, which I haven’t been,” Trammell said. “The last thing I want to do is deliver beds and lose money, but I have to in order to do low-air loss mattresses. That’s probably one of the most intelligent things that Medicare has done for itself.”

The delay adds fuel to the industry’s argument that CMS hasn’t been transparent enough throughout this process, says John Shirvinsky, who heads up the state HME association for Pennsylvania. Pittsburgh was one of the bid areas in the Round 1 re-compete.

“The problem we’ve always had is one of transparency,” he said. “That turns on a couple of different things, but one of those things is we don’t know who the winners are until they release the amounts, and usually there’s a two-month lag in between those two things. They’re going to have to turn things around pretty quickly.”

CMS officials would not comment on the record for this story.

WASHINGTON – In the wake of the industry’s recent virtual fly-in, H.R. 1717 has picked up an additional seven co-sponsors, bringing the current total to 144. The bill, which was introduced April 24 by Rep. Tom Price, R-Ga., would repeal the competitive bidding program and replace it with a market-pricing program (MPP). “Shoring up that support is important,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Feeding lawmakers information about the beneficiary impacts—that’s all the focus right now.” The virtual fly-in, held July 18, garnered 3,350 emails, and likely, thousands of phone calls.

ResMed takes new action against BMC Medical/3B Medical

SAN DIEGO – ResMed has filed new legal action in the International Trade Commission (ITC) and an amended complaint in U.S. federal court to stop the alleged infringement of its patents by BMC Medical and 3B Products, according to a press release. BMC Medical is a Chinese medical device manufacturer and 3B Products is its U.S. sales subsidiary. ResMed asserts patents for the following products have been infringed upon: the RESmart CPAP and RESmart Auto CPAP devices, and the Willow nasal pillows patient interface and the iVolve nasal mask. ResMed is asking the ITC to stop BMC Medical and 3B Products from importing and selling these products in the United States. ResMed has also amended a pending action in the U.S. federal court to assert alleged additional patent infringement by BMC Medical and 3B Products. ResMed is asking the court to stop the infringement and to award damages against BMC Medical and 3B Products.

Drive Medical agrees to hold back two masks

PORT WASHINGTON, N.Y. – Drive Medical announced July 23 that it has agreed to stop importing and selling certain CPAP masks as part of a consent order approved July 19 by the International Trade Commission (ITC). Drive Medical has agreed to stop importing and selling the Freedom 210 and Freedom 220 CPAP masks, two products that ResMed argues infringe on patents. “Drive respects the intellectual property rights of all third parties and is conducting an investigation as to the patent claims asserted by ResMed as part of a separate lawsuit pending in California,” the company stated in a press release. “Drive is continuing to offer a wide variety of CPAP masks to its customer base.”

Brightree, Strategic AR integrate solutions

ATLANTA and OVERLAND PARK, Kan. – Brightree has formed a relationship with Strategic AR to facilitate a more streamlined patient collection and payment posting experience, according to a press release. Strategic AR is a software and services company focused on helping HME providers automate patient billing workflows and collections using not only traditional mail, but also voice response and online technologies. As part of the relationship, Brightree and Strategic AR will integrate their solutions, allowing users to “easily and accurately identify patients who need to be contacted, reduce staff time associated with posting payments and provide a seamless experience for patients online,” according to the release. The two companies will also work together on joint marketing and product development initiatives.

DHS expands into two bid areas

HARRISBURG, Pa. – Dynamic Healthcare Services (DHS) announced July 25 that it was awarded contracts to service oxygen patients in the northern New Jersey and Huntington-Ashland (WV-KY-OH) competitive bidding areas as part of Round 2 of the program. DHS is pursuing new oxygen subcontracts and various acquisition opportunities in these two bid areas. “With these new competitive bid contracts, we will expand our focus into northern New Jersey and the Huntington-Ashland markets and continue to explore new HME sales, subcontracting and acquisition opportunities,” stated Michael Holloway, president of GMH Ventures, the parent company of DHS, in a press release.

Stakeholders donate to fund to stop bidding

WASHINGTON – Eleven stakeholders have contributed to AAHomecare’s “STOP Competitive Bidding Fund,” the association reported in a July 24 bulletin. The donors are: Barnes Healthcare Services, Brown & Fortunato, First Choice Medical, Home Medical Express, Invacare, MK Battery, PhilCare Home Medical Equipment, Respicare of Central Florida, The MED Group, Vistacare Health Services and Smith & Nephew. Stakeholders that contribute $200 or more, if they choose to, are included in a list of donors on AAHomecare’s website. The association expects to spend in excess of $180,000 on a legal challenge to stop competitive bidding. The fund will help to cover these legal costs.

Margolis to retire from NRRTS

LUBBOCK, Texas – NRRTS Executive Director Simon Margolis will retire Aug. 30, the registry announced July 24. He will stay on as a part-time consultant through the end of the year. Weesie Walker, past-president of NRRTS, will take on the position of interim executive director. “Simon’s vision for our organization in its infancy and leadership over the past seven years has shaped NRRTS as it is today,” stated Michele Gunn, NRRTS president, in a release. “He will be missed more than he knows but needs now to care for himself as he has done for our industry for the past 35 years. We will carry on, and I can think of no one better than Weesie Walker to help us continue our mission.”

CMS announces improvements to PECOS system

WASHIINGTON – Various improvements, including validation checks, have been implemented to the Internet-based PECOS system, according to a CMS announcement. The checks for DMEPOS applications include minimum and maximum date ranges, and dollar amount values when entering surety bond information. This feature ensures the accuracy of the surety bond information entered, CMS stated. Providers and suppliers can also now use the system to manage the collection of required signatures for electronic documentation or documents requiring their signature prior to submission. 

MetroStar launches social media presence

NEW YORK, N.Y. – MetroStar Home Health Products now has Facebook and Twitter pages that give customers another way to communicate with the company. MetroStar plans to post daily health tips and facts on social media. "Social networks have become an important tool for business these days," stated COO Isaac Newman in a press release. “We hope that, in addition to being a resource for our customers, they can get a glimpse of who we are as people.”

ABC Home Medical invests $1M to expand

EXTON, Pa. – ABC Home Medical has relocated its national headquarters and customer service center to a 13,000-square-foot office complex in Exton, Pa., according to an article in Area Development Online. The company, which provides urological supplies and other medical products, needed to lease a bigger space to accommodate anticipated growth. As part of the move, it generated a capital investment of $1 million, including a $75,000 grant from the Pennsylvania First Program, $175,000 from Job Creation Tax Credits and a $38,700 grant from Guaranteed Free Training, according to the publication.

OIG identifies $6M in prostheses that don’t meet requirements

WASHINGTON – CGS Administrators paid $6 million for 4,260 lines of service for lower limb prostheses in 2010 and 2011 that did not meet local coverage determination (LCD) requirements, according to a report from the Office of Inspector General. At the time CGS paid for these lines of service, it did not have edits in place to evaluate whether or not they met all the LCD requirements. In 2012, CMS directed CGS and the other DME MACs to put in place edits for all requirements in the LCD for lower limb prosthetics. The OIG recommends that CGS recover $6 million in identified overpayments for lines of service for lower limb prostheses that did not meet the requirements in 2010 and 2011; and monitor the edits it has developed since 2012 to make sure they’re working correctly. CGS concurred with the recommendations and plans to take corrective actions. FMI: http://go.usa.gov/jWGH.

Senior Medicare Patrol saves $6M

WASHINGTON – The Office of Inspector General’s (OIG’s) Senior Medicare Patrol project was responsible for recovering $6 million in funds in 2012, according to a new report. The project was also responsible for $133,977 in savings to Medicare beneficiaries, up from $13,657 in 2011. Additionally, the project provided information to federal prosecutors for a case that eventually resulted in a $12.9 million settlement. The project recruits and trains retired professionals and other senior citizens to recognize and report instances or patterns of healthcare fraud. In 2012, there were 5,137 active volunteers, a 9% decrease from 2011. These volunteers conducted 113,457 one-on-one counseling sessions and 14,748 group education sessions, a 71% and 33% increase, respectively, from 2011.

CMS backpedals on overpayments

BALTIMORE – CMS has backed off collecting overpayments for beneficiaries who may have received items or services while they were incarcerated, either in a facility or on supervised release. CMS had identified previously paid claims that contain dates of service that partially or fully overlap a period when the beneficiary was incarcerated based on information from the Social Security Administration (SSA). CMS has since learned that the information related to these periods of incarcerations was, in some cases, incomplete for its purposes. CMS will review the data to improve its processes for identifying periods of incarceration. In the meantime, providers should no longer encourage beneficiaries to contact their local SSA office to have their records updated. Also, they should no longer fax info to CMS’s regional offices. CMS is currently working to develop processes to resolve this issue.

NSG to review nebulizers

WASHINGTON – National Government Services, the Jurisdiction B DME MAC, will initiate a widespread prepayment review of nebulizers (E0570), related drugs, accessories and dispensing fees, it announced in a recent message. Providers that receive an additional documentation request should provide, within 45 days, the following: a copy of a signed and dated detailed written order; a copy of the dispensing order, if applicable; a copy of medical records supporting medical necessity; and proof of delivery. The review is an expansion of documentation compliance reviews currently being conducted on oxygen equipment and glucose supplies. Click here to view the local coverage determination.

Provider warns of security breach

SAN JOSE, Calif. – The new owner of San Jose Medical Supply has begun notifying current and former customers that their personal information was breached in 2011, according to local news reports. Jesille Kuizon, who acquired the company in August 2012, discovered in June 2013 that information, including birth dates, Social Security numbers, Medi-Cal ID numbers and health information, had been disclosed to competitors Front Medical Supplies and/or Living Medical Equipment. San Jose Medical is advising customers to register a fraud alert with the three major credit bureaus.

People news

MK Battery has promoted Wayne Merdinger to executive vice president & general manager. Merdinger joined the company in 2006 and most recently served as vice president of business development & international sales. He brings more than 35 years of healthcare-related sales, marketing and general management experience to his new position…A/R Allegiance Group has partnered with Dave Bargmann, co-founder of Homecare Collection Service, which he sold to Invacare in 2008. Bargmann will work with A/R Allegiance on sales/marketing and other strategic initiatives that add value and enhance the patient billing experiences of the company’s provider customers...Philip Alkana of Attleboro, Mass., a respiratory therapist with 30 years of experience, has joined the staff of Reliable Respiratory in Norwood, Mass. He will serve as a clinical care specialist. His previous positions have included director of respiratory care at New England Sinai Hospital and Franciscan Children’s Hospital…Integra Partners, a healthcare network manager that connects DME and O&P providers with health plans, has appointed Richard McMullen controller. He will be responsible for overseeing the company’s financial planning and analysis, treasury audit, accounts payables, accounts receiveables, and tax functions. Previously, McMullen was vice president of finance for Wilhelmina Models.

WASHINGTON. – AMEPA will merge with AAHomecare on Aug. 1, adding 150 members to the association’s rolls for a total of about 850.

Rob Brant, president of AMEPA, will become director of industry relations at AAHomcare. He will focus on growing membership, fostering relationships with state associations, and developing grassroots advocates across the country.

“I am excited to welcome AMEPA’s members and Rob Brant to AAHomecare,” stated Robert Steedley, president of Barnes Healthcare Services in Valdosta, Ga., and chairman of AAHomecare’s board of directors, in a press release. “Rob’s energy, devotion and passion for this industry will be a wonderful addition to our team.”

Brant helped to form AMEPA in 2008, after widespread reports by providers in Round 1 competitive bidding areas that they were wrongly disqualified.

Since then, AMEPA has worked on a host of industry issues, often in conjunction with AAHomecare.

“We had a single goal of stopping Medicare’s flawed bidding program, and we are more committed than ever to achieving that goal with AAHomecare,” stated Brant in the release. “But as a durable medical equipment company owner, I know that there were more threats to homecare businesses than just the bidding program, and that is why AMEPA is joining forces with AAHomecare.”

NAIMES merged with AAHomecare* in May, adding about 140 members to the association’s rolls.

http://hmenews.com/article/leading-industry-associations-join-forces

BALTIMORE – Talk about a clawback. Some recent letters rescinding certain audits were sent in error, say stakeholders.

What happened? Some providers apparently received letters from the DME MACs rescinding certain audits on power wheelchairs, support surfaces and prosthetics. 

Unfortunately, that was only partially correct.

“The intent was that they meant to send out rescinds on certain power mobility, but they accidentally sent it on O&P and some other stuff,” said Wayne van Halem, president of the van Halem Group, a consulting firm. 

van Halem reached out to CMS after getting numerous calls from clients asking about the letters.

Essentially, CMS limited the look-back period on power mobility claims to the last 12 months. The change was made so that the timeframe for mobility claims in non-demo states being reviewed parallels that of claims being reviewed in the seven states included in the power mobility demonstration project. The demonstration launched in September of 2012.

It’s disappointing that CMS didn’t limit the look-back period across-the-board, say stakeholders.

“We think that all audits related to claims with a date of service prior to August 2011 should be cancelled,” said Tom Fise, executive director of the American Orthotics and Prosthetics Association.

At any rate, with pretty much all home medical equipment undergoing intense audit scrutiny, industry stakeholders are working to address the issue. AAHomecare recently resurrected its Audit Task Force, and The VGM Group in July launched Speak4DME.com, an initiative to collect written and video testimony from providers about the impact audits have on patient care.

“Our goal is to create a national report of audit problems, based on stories we are receiving from members, to be presented to key congressional committee leadership and CMS later this year,” said Ryan Ball, director of state policy for VGM & Associates.

WASHINGTON – Industry stakeholders recommend that HME providers learn the ins and outs of the face-to-face rule well before CMS starts enforcement on Oct. 1.

Stakeholders remind providers that the rule has not one, but two major requirements: a face-to-face exam and a detailed written order. 

“Providers are still surprised at how much detailed information they need to have—all before they can deliver any equipment,” said Asela Cuervo, a private practice attorney in Washington, D.C. “They’re going to have to do a great deal of heavy lifting.”

CMS announced on June 27, one business day before implementation, that it would not enforce the rule until Oct. 1. The reason: “concerns that some providers needed additional time to establish operational protocols necessary to comply” with the rule.

Meeting the two major requirements shouldn’t be too much of a stretch for most providers, stakeholders say.

“Most providers are going ahead and getting the clinical documentation, they just need to start getting those written orders before delivery,” said Kim Brummett, senior director for regulatory affairs at AAHomecare.

Other important-to-know details of the rule, stakeholders say: A physician assistant, nurse practitioner or clinical nurse specialist may conduct the face-to-face exam, but the physician still needs to sign off on it; and the physician must include his or her signature and NPI number on the detailed written order. Also, the rule applies only to equipment, not to supplies, they say. 

“People have gotten caught up on this applying to every piece of DME,” Brummett said.

While that much stakeholders are sure of, there are still many gray areas surrounding the rule. AAHomecare has prepared and shared with CMS a draft FAQ that it would like to see the agency distribute, but the document has been hung up in a clearance process, stakeholders say. 

“They need to put some guidance out there,” Brummett said. “They said we needed more time to get prepared, but it’s more about us needing more from them.”

The rule, once it’s enforced, will be more than something just providers have to get used to, stakeholders say.

“Beneficiaries have to understand, too, that they may not get equipment when they want it,” Cuervo said.

WASHINGTON. – AMEPA merged with AAHomecare on Aug. 1, adding 150 members to the association’s rolls for a total of about 850. Rob Brant, president of AMEPA, will become director of industry relations at AAHomecare. He will focus on growing membership, fostering relationships with state associations, and developing grassroots advocates across the country. Brant helped to form AMEPA in 2008, after widespread reports by providers in Round 1 competitive bidding areas that they were wrongly disqualified. Since then, AMEPA has worked on a host of industry issues, often in conjunction with AAHomecare. “As a durable medical equipment company owner, I know that there are more threats to homecare businesses than just the bidding program, and that is why AMEPA is joining forces with AAHomecare,” stated Brant in a press release. NAIMES merged with AAHomecare in May, adding about 140 members to the association’s rolls.

Scooter Store: Auction postponed, buyer still sought

NEW BRAUNFELS, Texas – The Scooter Store’s bankruptcy auction, originally set for Aug. 6, will now be held Sept. 23, according to Law360. A Delaware bankruptcy judge on July 31 gave The Scooter Store permission to use its cash collateral to fund its own case in Chapter 11, rather than using a $10 million debtor-in-possession package. The move is intended to save The Scooter Store money and buy additional time to line up a buyer, Law360 reported. The new timeline establishes a Sept. 19 bid deadline and a Sept. 24 sale hearing.

Record quarter, year for ResMed

SAN DIEGO – ResMed this week reported revenue of $414.6 million for the quarter ended June 30, 2013, an 11% increase over the same quarter last year. GAAP net income for the quarter was $73 million or $.50 cents per share. Revenue for the year ended June 30, 2013, was $1.5 billion, an increase of 11% over last year. “In the fourth quarter of fiscal 2013 we showed strong year-over-year growth on both top and bottom lines,” said CEO Mick Farrell in a release. “Revenue in the Americas increased by 11% over the prior year’s quarter.”

Roscoe Medical under new private equity ownership

STRONGSVILLE, Ohio – Roscoe Medical has finalized a recapitalization with Tenex Capital Management, a private equity investment group in New York, the manufacturer and distributor announced July 30. Roscoe Medical’s current management team, led by President and CEO Paul Guth, will remain in place. “This is a great fit for Roscoe Medical, and another chapter in the growth story of the company,” he stated in a press release. Currently, Roscoe Medical serves more than 3,100 customers with 89 full-time employees in four locations. It manufactures and distributes everything from respiratory therapy to HME to pain management products. Tenex Capital Management invests in middle-market companies experiencing significant change in their markets, operations or capital structure, according to the group’s web site. Previously, Roscoe Medical was owned by River Associates, a private equity investment group in Chattanooga, Tenn.

Rep. Welch introduces diabetes bill

WASHINGTON – Rep. Peter Welch, D-Vt., on July 26 introduced H.R. 2845, a bill that would allow community pharmacies to deliver diabetes supplies to Medicare beneficiaries. As of July 1, when the national mail-order program started, only contract suppliers can ship or deliver supplies to beneficiaries. In May, Welch, who has championed community pharmacy in the past, sent a letter to CMS Administrator Marilyn Tavenner expressing concerns about the impact of the program on beneficiaries in rural areas. That letter was signed by 42 other representatives.

AAHomecare reestablishes audit task force

WASHINGTON – AAHomecare’s Regulatory Council has resurrected its audit task force, the association said in a recent newsletter. Task force members represent “a broad cross-section of association members,” stated AAHomecare. During its first conference call, the task force redrafted a strategic plan for tackling audit issues. AAHomecare members will be able to download the finalized plan from the Regulatory Council page on the AAHomecare website by mid-August. The task force is also in the process of completing checklists for providers to use internally to track audits. 

MACs join forces to reduce denials

WASHINGTON – The Part A and Part B Medicare Administrative Contractors have formed a task force to educate on national issues of concern regarding improper payment errors, they have announced. The Comprehensive Error Rate Testing (CERT) A/B Contractor Task Force will hold its first teleconference Aug. 20. The task force affords providers the benefit of a “collaborative, consistent voice to reduce costly claim denials, as well as the CERT error rate,” according to a bulletin. The task force will enhance, not replace, the ongoing educational activities by CMS, the Medicare Learning Network and the MACs in their jurisdictions. It will select one to four national CERT “hot topics” each year that may focus on provider or facility types, or on certain specialties. It will then publish scenario-driven articles with tips on avoiding specific errors. The task force’s campaign kicks off with the call on Aug. 20 from 2 p.m. to 3 p.m. EST. Register here.

CMS posts FAQ regarding incarcerated beneficiaries

BALTIMORE – CMS expects to resolve issues with denials associated with incarcerations after October, according to a Frequently Asked Questions document issued July 31. Earlier this summer, CMS identified overpayments for beneficiaries who may have been incarcerated when they received items or services. On July 23, the agency issued a bulletin, backpedalling on the recoupments, citing incomplete information. The FAQ addresses the resulting confusion, including sections on appeals and recoupments.

Cristia Medical Supply expands into incontinence

WEST PALM BEACH, Fla. – Cristia Medical Supply plans to add a variety of incontinence products, including absorbent pads and pull-ups to its HME offerings, the provider announced July 31. The provider says the number of individuals who need incontinence supplies has grown in recent years. “It is not just about expanding our product offering,” stated Jonathan Anderson, customer service manager, in a release. “It is also about providing products that enhance the quality of life for our customers.”

Mobility123 launches rental program on Jersey Shore

ABSECON, N.J. – Mobility123 now rents beach wheelchairs to visitors to the Jersey Shore, the provider announced July 19. The durable, stainless steel wheelchairs, available for rental periods ranging from one day to one month, are specially designed to roll across sand. Mobility123 offers free delivery and pickup of the wheelchairs. The provider also carries bath safety items, scooters and stair lifts.

Pre-show schedule now includes online marketing seminar

ORLANDO – There’s a new pre-show seminar scheduled for Medtrade: Marketing consultants Lisa Wells and Anna McDevitt will present “Keeping your business ahead of the digital curve” on Oct. 7 from 1 p.m. to 5 p.m. Wells, president of Get Social Consulting, and McDevitt, president of Laboratory Marketing, will take attendees through scalable marketing principles using entertaining stories, in-class activities, videos and real-world examples. Other pre-show seminars cover business management (Kathy Quehl of Brightree), sales management revenue growth (Mike Sperduti of Emerge Sales) diversification (Mike Mallaro of The VGM Group) operational efficiencies (Miriam Lieber of Lieber Consulting) and audits (Mary Ellen Conway of Capital Healthcare Group). FMI: http://www.medtrade.com/conference/seminars-workshops-webinars.shtml.

Time’s running out to throw your name in the speaker ring

LAS VEGAS – The deadline to submit a proposal to Medtrade’s Educational Advisory Board (EAB) for Medtrade Spring 2014 is Friday, Aug. 9. The EAB will evaluate proposals based on timeliness of topic, overall content, audience interest, creativity, prior speaking expertise, knowledge of subject matter, prior speaker evaluation results and speaker references. Sales presentations and incomplete submissions will not be considered. For more information, contact Toni Ward at antoinette.ward@emeraldexpo.com or 770-291-5441. Medtrade Spring takes place March 10–12 at the Mandalay Bay in Las Vegas.

Short takes: Invacare, Brightree, BioScrip

Invacarehas laid off an additional 25 workers at its Taylor Street manufacturing facility. It’s the third layoff at the facility … Brightree has completed the transition of CareAnyware into its brand, changing the name of CareAnyware EMR software to Home Health and Hospice solution. Brightree acquired CareAnyware in December 2012 … BioScrip has secured a $75 million revolving credit facility. A portion of it will be used toward the $223 million purchase of Cincinnati-based CarePoint Partners…

People news: Karen Collishaw, Michael Clark, Darrell Burnette

The board of directors of the Community Health Accreditation Program (CHAP) has selected Karen Collishaw as president and CEO. She will direct CHAP as “it embarks on a new strategic direction to advance the highest quality in community-based care,” according to a press release. Collishaw is the former deputy executive director of the American Academy of Dermatology…The CPAP Horizon Project has appointed Michael Clark, vice president of sales and business development at Signature Sleep Services (d/b/a Sleep960), to its board of directors. Clark, along with other yet-to-be-named board members, will serve in an advisory role and will help establish the strategic direction of the organization, according to a press release…RESNA recently certified Darrell Burnette, Mobility Solutions sales representative for Ottobock, as an Assistive Technology Professional (ATP), Ottobock announced in a press release.

BEDFORD, Mass. – Insulin pump maker Insulet reported revenues of $60.1 million for the second quarter ended June 30, 2013, an 18% increase compared to the same period last year. Gross profit was $26.8 million, compared to $22.3 million. Operating losses decreased to $5.8 million, compared to $10.5 million. The company cited the launch of its new, smaller OmniPod during the first quarter of 2013 as key to growth. "With a greater than 50% year-over-year increase, we shipped a record-setting level of initial orders of the OmniPod in the second quarter,” stated Duane Desisto, president and CEO, in a release. “This robust demand drove strong financial results, and we generated positive quarterly cash flow for the first time in Insulet's history.” 

Liberator reports earnings

STUART, Fla. – Liberator Medical posted sales of nearly $17.5 million for its fiscal third quarter ended June 30, 2013. That’s an increase of 16.9% compared to the same period last year, the company stated in an earnings report released Aug. 9. Net income for the quarter was $2 million, an increase of 197.9% over the same period the previous year. Liberator also noted that it has repurchased 195,000 shares since it announced a buyback program June 13.

KCI buys U.K.-based wound care company

SAN ANTONIO – Kinetic Concepts, Inc. (KCI) has signed a definitive agreement to acquire Systagenix, a provider of wound care products based in the U.K., for $485 million. The deal represents a major step in KCI’s strategy toward increased revenue diversification and geographic expansion, according to a press release. Systagenix’s products focus on moist wound healing dressings, including Promograin Prisma, a collagen dressing; Tielle (foam) and Adaptic (non-adherent contact layers). It distributes more than 20 million dressings each month to more than 100 countries. Formerly part of Johnson & Johnson, Systagenix has about 800 employees worldwide. Also as part of the deal, One Equity Partners will spin off an early stage diagnostics business from Systagenix and operate it as a standalone business. KCI will enter into a long-term strategic relationship with the business for the distribution of Woundcheck protease status.

Mail-order program forces Roche to cut jobs

INDIANAPOLIS – Roche, which has its North American headquarters here, will cut jobs in the next several months due to a 14% decline in revenues for the first six months of this year for its diabetes care business, according to an article in the Indianapolis Business Journal. “The U.S. diabetes care market is rapidly evolving, and Roche’s diabetes care business in the U.S. is responding by making changes to its customer service and manufacturing operations, which includes the elimination of some jobs,” spokesman Todd Siesky wrote in a prepared statement to the journal. A national mail-order program for diabetes supplies went into effect July 1, cutting Medicare reimbursement by, on average, 72%. Roche will cut jobs in customer service in Fishers and in manufacturing in Indianapolis. Between the two sites, Roche employs more than 900 in the area, according to the journal. Reuters reported earlier this year that the company is trying to sell its diabetes care business.

3B/BMC asks for investigation of ResMed

LAKE WALES, Fla. – 3B Medical/BMC Medical, a manufacturer of sleep diagnostics and therapy devices, has requested that the International Trade Commission investigate whether ResMed's action to exclude imports of CPAP devices and interfaces is contrary to the public interest in lowering healthcare costs, according to an Aug. 7 press release. "Because of the economic pressures to reduce healthcare costs, we believe that 3B/BMC plays an important and vital role in bringing lower costs to the sleep disordered breathing market," stated Alex Lucio, vice president, 3B Medical, in the release. "In our view, the litigation by ResMed has little to do with any legitimate intellectual property issues and has more to do with using litigation costs to try and limit competition.” The request is the latest development in the 3B Medical/ResMed patent infringement dispute.

A/R, Universal form relationship

OVERLAND PARK, Kan. – A/R Allegiance Group announced Aug. 9 that it has entered into a joint development agreement with Universal Software Solutions. Their goal: a seamless, automated solution. A/R offers an automated patient billing workflow and collections solution, whereas Universal offers a practice management solution. “Our combined solutions will create noticeable savings to the HME or home infusion provider at a time when they need it most,” stated Christopher Dobiesz, president of Universal, in a press release.

No stop to prepay review for certain power wheelchairs

INDIANAPOLIS – National Government Services (NGS), the DME MAC for Jurisdiction B, has reported a claims error rate for power wheelchair bases with options and accessories of 64% between April 1, 2013, and June 30, 2013. NGS examined 754 claims that were developed for additional documentation and it paid in full only 234 claims. The most common reason for denials: The physical and functional findings that were documented in the medical records failed to clearly establish medical necessity for power mobility. Additionally, NGS reported providers failed to respond to requests for additional documentation to support medical necessity 57 times. The DME MAC will continue to conduct a widespread prepayment medical review for all Group 2 power wheelchairs that do not possess the capability of adding a power seating option (K0820-K0829).

Apria sticks with collections contract

LAKE FOREST, Calif. – Apria Healthcare has extended its contract with Waltham, Mass.-based Connance after the company helped it increase patient pay cash collections. Connance provides predictive analytic technologies that improve financial performance in healthcare enterprises. Connance started to manage Apria’s collection agency network in 2011, streamlining communication efforts, and standardizing reporting and activity management.

Short takes

Cardinal Health’sretail pharmacy customers can now use Independence Medical as a resource for more than 40,000 home medical products, Cardinal announced Aug. 8 at its annual Retail Business Conference…Ottobock Mobility Solutions has snagged exclusive distribution rights in North America for three products by Krabat AS, a developer of aids for children and youth, Ottobock announced Aug. 8. The products: Krabat Pirat, a floating aid that helps a child be independent in the water; Krabat Pilot, an aid that facilitates crawling; and Krabat Jockey Plus, an active children's chair that provides mobility and variation…The American Association of Breast Care Professionals has asked Noridian, the Jurisdiction D DME MAC, for a meeting to discuss numerous and ongoing audits in the region. Noridian is currently conducting a complex medical review of silicone breast forms (L8030)…Vantage Mobility International (VMI) has given away a 2013 Honda Odyssey Touring Edition with VMI Northstar Conversion to Steve Herbst, one of three winners of the 2013 Local Heroes Contest, the company stated in an Aug. 6 press release…ApniCure has announced that positive results from the ATLAST clinical trials of its Winx sleep therapy system to treat obstructive sleep apnea have been published in Sleep Medicine. The trial results show significant improvements in both apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) on the first night of treatment and following 28 days of using the Winx…Pinnacle Medsource has expanded into Texas with a new distribution center in northern Houston, according to a press release. Pinnacle Medsource, which uses a “hybrid manufacturer/distributor bundling model,” carries products from more than 60 manufacturers.

People news

Quantum Rehab and Pride Mobility Products have promoted Chuck Finn to COO and hired Douglas Cummins as chief technology officer.

YARMOUTH, Maine – Industry stakeholders are trying to organize numerous press calls in August about the negative impact of competitive bidding as another way to get the attention of lawmakers, who are in their home districts for the whole month.

Stakeholders say press calls are in the works in Minneapolis and Philadelphia, two areas included in Round 2 of the program, with other states targeted.

“We’re trying to get as much information to lawmakers as possible, and this is another tool to do that,” said Kelly Turner, executive director of People for Quality Care (PFQC), the advocacy arm of The VGM Group.

The PFQC organized the first of these press calls in South Carolina in July. The group is also trying to organize calls in states that are represented by lawmakers on key committees, like Illinois, Ohio, Georgia, Michigan and Wisconsin.

Rose Schafhauser, executive director of the Midwest Association for Medical Equipment Services, says the press calls are a good way to share the horror stories that she’s been receiving from not only providers, but also Medicare beneficiaries and referral sources.

“A major hospital system in the area had a situation where there was a referral for a scooter that went awry and the patient ended up getting harmed,” she said. “We have to get these stories out.”

With the complaint hotline run by the PFQC about to hit 1,500, there are stories to go around in nearly every bid area, despite CMS’s claims of few problems, stakeholders say. 

“Congress is saying, ‘We’re not hearing enough from beneficiaries and referral sources,’” said Seth Johnson, vice president of government affairs for Pride Mobility Products, who is involved in organizing the press call in Philadelphia. “So what we really need to do to compel Congress to take action is make sure they’re well aware that beneficiaries are being harmed and they are complaining.”

WASHINGTON – A new auditor that’s in the works has the potential to streamline the process, but it will likely mean more activity, as well, industry stakeholders say.

“Anytime there’s a new contractor, they tend to be more active,” said Wayne van Halem, president of the Atlanta-based van Halem Group.

CMS this month announced plans to create a new program integrity contractor for Medicare and Medicaid called a Unified Program Integrity Contractor (UPIC). The agency plans to fold the existing ZPICs and the Medicaid program integrity contractors into the UPICs. 

A likely result of the shake-up will be an increase in audits for Medicaid, stakeholders say.

“This is a little worrisome, since right now, everyone just has to deal with Medicare audits,” said Kelly Wolfe, president of Regency Billing and Consulting. “Plus, every state has different rules for Medicaid, and I don’t know how the UPIC is going to deal with that. The last thing we need is people who don’t interpret the rules the right way.”

Still, the UPICs could be a positive development for the industry, stakeholders say. The new auditor will rely on predictive modeling, data mining, software algorithms and analytic tools. It will also have the ability to better collaborate and share information among payers and other contractors. This preemptive, unified approach could mean a more streamlined process and fewer duplicate requests, they say.

That would be a real benefit for providers, says Sylvia Toscano, owner of Professional Medical Administrators. 

“We are currently experiencing duplicate requests from RACs, SMRCs, MACs, and ZPIC and CERT contractors on claims already reviewed,” she said.

Stakeholders don’t expect the UPICs to be on the scene anytime soon. Awarding million-dollar contracts takes time, they say.

“ZPICs were announced four or five years ago, and they’re still not transitioned in every jurisdiction,” van Halem said. 

YARMOUTH, Maine – When it comes to product pricing, competitive bidding has changed the playing field between select vendors and providers, according to the latest HME NewsPoll.

Only 37% percent of the 67 respondents to the poll reported getting discounts from vendors as a result of competitive bidding. Of those, the largest majority, 38%, reported getting discounts of 6% to 10%.

“Most have approached us with discounts, knowing that there are manufacturing competitors that are also knocking on our door,” one respondent commented. “We are pushing for national discounts.”

Another respondent said: “We’re seeing across-the-board cuts from every vendor to gain our business.”

The largest majority of respondents, 33%, reported getting discounts for mobility products.

Respondents reported that vendors are frequently tying discounts to volume and package purchases. They also report vendors are offering discounts only on certain products.

“The manufacturers are promoting less expensive ‘competitive bidding equipment,’ but our normal line has either stayed the same price or has increased a little,” said Brent Bradshaw, president of Durable Medical Equipment, Inc., in Austin, Texas.

Sixty-three percent of respondents, however, reported they’re not getting discounts from vendors. To boot: Some vendors are reducing their payment terms for products purchased, they say.

“We have always gotten good discounts and not much has changed with the advent of competitive bidding,” said Rick Perrotta, president of Network Medical Supply in Charlotte, N.C. “Although, one of our major vendors changed our billing terms from 90 days to 60 days. I suspect they want to limit their exposure to losses from companies going out of business.”

Another respondent reported a vendor reducing payment terms to 45 days.

One respondent reported that competitive bidding has resulted in more office visits and calls from vendors that offer lower-cost products.

“I have seen more of the ‘inexpensive manufacturers’ more often,” the respondent said.

COCONUT CREEK, Fla. – InnoMed Technologies will no longer distribute its respiratory products exclusively through DeVilbiss Healthcare, the company announced Aug. 12.

“With competitive bidding and declining reimbursement rates, demands are being placed on manufacturers to reduce prices and in order to remain competitive with companies such as ResMed, Fisher & Paykel Healthcare and Philips Respironics, we believe moving toward a direct sales model is the right thing to do,” stated CEO Ron Richard in a press release. “DeVilbiss was a good partner for many years, but InnoMed has to plan for the future and create a solid business model for our customers and investors.”

The transition began Aug. 12.

By bringing its sales efforts in-house, InnoMed believes it will be able to broaden the reach of its product mix and renew its focus on customer care and educational support for patients and clinicians.

InnoMed’s flagship product line is the Nasal-Aire nasal interface, which debuted in 2001. It also manages and distributes the Hybrid oral nasal interface and the Aloha nasal pillow interface, among other products.

A sister company, Mergenet Medical, plans to launch a High Flow Therapy System in 2014.

Thomas Ryan named president and CEO of AAHomecare
WASHINGTON – AAHomecare named Thomas Ryan its new president and CEO Aug. 14. Ryan began as a respiratory therapist and has spent the last 25 years as president and CEO of Farmingdale, N.Y.-based Homecare Concepts, which provides home oxygen therapy, sleep apnea therapy and traditional durable medical equipment. AAHomecare in March announced the departure of former president and CEO Tyler Wilson, effective in September. “Tom Ryan emerged as the clear choice to lead our association in the future,” stated Robert Steedley, chairman of AAHomecare’s board of directors in a release. “His real-life, practical experience as a homecare provider and entrepreneur enables him to relate to our members in a way that few association CEOs can.”

Rotech has proof of insolvency, company says
ORLANDO, Fla. – Rotech Healthcare hopes a summary judgment in bankruptcy court will prove there isn’t enough value in the company to pay creditors, Dow Jones reported Aug. 14.

If the judge agrees with papers filed Aug. 13 with the U.S. Bankruptcy Court in Wilmington, Del., the summary judgment could shut down a planned two-day trial pitting the company and its creditor supporters against the official committee representing shareholders.

The disagreement is the latest between shareholders and the company* since Rotech filed for Chapter 11 April 8. Rotech has also asked that an official committee representing shareholders be disbanded.

Shareholder opposition prompted Rotech to drop a planned recovery for equity stakeholders of 10 cents a share. Rotech has said that the company is unable to pay its debts, so a long court process would be pointless, Dow Jones reported.

Now, Rotech lawyers contend, the evidence mustered by shareholders supports the company's arguments: The expert for the official creditors' committee puts Rotech's value at $540 million or less. According to Rotech, it will take at least $647.5 million to cover the bills, Dow Jones reports.

Invacare announces quarterly dividend
ELYRIA, Ohio – Invacare’s board of directors has announced a cash dividend of $0.0125 per share on common shares and $0.011364 per share on Class B common shares, payable Oct. 11 to shareholders of record on Oct 3. Headquartered in Elyria, Ohio, Invacare is the largest manufacturer of home and long-term care medical products.

Study: CPAP reduces risk of death from COPD, sleep apnea
DARIEN, Ill. – Researchers have found that continuous positive airway pressure (CPAP) therapy reduces the mortality rate of those with both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA), referred to as overlap syndrome. The study can be found in the Aug. 15 issue of the Journal of Clinical Sleep Medicine, published by the American Academy of Sleep Medicine.

“We have shown that more time on CPAP in patients with the overlap syndrome was associated with a reduced risk of death, after controlling for common risk factors,” said lead study author Michael Stanchina, M.D., clinical assistant professor of medicine at the Alpert Medical School of Brown University, and a physician at Rhode Island Hospital in Providence, R.I, in a press release.

Study results showed patients using CPAP have a significantly higher survival rate than those not using the therapy, with benefits realized from even minimal use of CPAP.

“We were most surprised to find that any level of CPAP use in this cohort, over no use, was associated with some mortality benefit,” Stanchina said.

Texas counties say bankrupt Scooter Store owes tax liens
NEW BRAUNFELS, Texas  - Three Texas counties want a bankruptcy judge in Delaware to reject The Scooter Store’s request for final relief orders because they say the company owes them $35,000 in unpaid tax liens, Law360 reports.

Dallas, Harris and Nueces counties objected to the struggling company’s bid for final orders authorizing cash collateral and instead want the court to give priority to the debts they are owed.

In an objection, the counties wrote, “The debtors are preferring one secured creditor at the expense of another, which is not how a proper fiduciary acting to benefit all creditors of the estate should act.”

According to Law360, the Texas counties want Peter J. Walsh, U.S. bankruptcy judge, to reject The Scooter Store’s request unless the company protects the interests of the liens and the counties in proceeds from the sale of the company’s collateral.

Portable concentrators shake up oxygen industry
DUBLIN – Transformative innovations in portable-oxygen concentrator technology are revolutionizing the industry, moving it beyond large, stationary concentrators and cumbersome portables toward smaller machines, according to Wintergreen Research, Inc. The market for oxygen concentrators—at $242.5 million in 2012—are expected to reach $1.9 billion by 2019, it said. That growth is due to new competitors and increased demand for the new smaller, lighter concentrators, which are also becoming less expensive, the research firm noted. The cost of home delivery of oxygen cylinders combined with falling reimbursements further support a move by oxygen providers to a non-delivery model, the company said in a report.

Can CPAP therapy help asthma patients?
WASHINGTON – The American Lung Association is recruiting asthma patients for a study examining whether CPAP therapy can also improve asthma control. “If CPAP is to be found effective, this will introduce an entirely new way to treat asthma without medication,” stated Robert Wise, MD, director of the association’s Asthma Clinical Research Centers (ACRC), in a press release. “If we can reduce the number of inhalers and the frequency of inhaled rescue medication with this new treatment, it will not only relieve the burden of asthma but improve quality of life.” In 2011, it was estimated that 25.9 million Americans had asthma, including 7.1 million children. Asthma is the cause of nearly 11 million ambulatory physician encounters and 440,000 hospitalizations annually, according to the release. The ACRC is recruiting non-smokers between the ages of 15-60 with a history of asthma for its four-month study.

BioScrip to sell 6.8M shares in public offering
ELMSFORD, N.Y. – BioScrip, a provider of infusion and homecare services, has upped the ante on its public offering. The company announced Aug. 14 that it will offer 6,895,873 shares instead of 6,800,000, all of which are being sold by existing stockholders. The underwriter of the offering, Morgan Stanley, has 30 days to purchase up to an additional 1,020,000 shares from selling stockholders. BioScrip will not receive any of the proceeds from the initial sale of the shares. The offering is expected to close Aug. 19.

CareGiver Partnership receives ‘excellent’ rating
NEENAH, Wis. – The CareGiver Partnership, a national retailer of incontinence supplies and other home healthcare products, has earned an “excellent” rating from STELLAService, an independent company that rates the customer service performance of online businesses. “I’m pleased to say we’re often referred to as the Zappos of home healthcare products, meaning our customer satisfaction rating sets us apart, and STELLAService rates us as highly as Amazon and Walmart,” stated Lynn Wilson, founder, in a press release. In addition to an overall rating of “excellent,” the CareGiver Partnership also received designation for telephone and email support, shipping speed, product fit and quality, and ease of returns and speed of refunds.

Aeroflow sees spike in pediatric-related biz
CHARLOTTE, N.C. – Aeroflow Healthcare’s sales of pediatric nebulizers jumped from approximately 1,700 in its first year to more than 7,500 in its second year in the Charlotte and Piedmont, N.C. areas, the company announced Aug. 13. Aeroflow has also added apnea monitors and bili-blankets to its portfolio of pediatric products, as well as breast pumps. The Affordable Care Act requires that insurance companies pay for pumps, creating new demand. Aeroflow has nine offices in the Southeast and ships products nationwide.

Braun to move production from Michigan to Indiana
WINAMAC, Ind. – The Braun Corp. announced Aug. 13 that it will spend about $7.5 million to modify a production line at its Winamac, Ind., facility so workers can install rear-entry wheelchair lifts on minivans there. The move shifts production from Kalamazoo, Mich. The new line is expected to be operational by late next year. The Indiana Economic Development Corp. offered Braun up to $500,000 in tax credits and $100,000 in training grants. The move will create 70 jobs in Indiana.

Nonin receives award for quality
MOUNTAIN VIEW, Calif. – Global consulting firm Frost & Sullivan announced Aug. 13 that it has awarded Nonin Medical the 2013 North American Pulse Oximetry Devices Product Quality Leadership Award. The award is based on product performance, product design and perceived value in the marketplace. "We are pleased that Frost & Sullivan recognizes Nonin Medical's commitment to quality in an extremely price-sensitive market," stated Steve Bucholz, president and chief operating officer of Nonin Medical, in a press release.

New grant program helps with DME
DALLAS – The Patient Advocate Foundation and Susan G. Komen have launched a grant program for breast cancer patients to help with expenses, including durable medical equipment, lymphedema care and supplies, prosthesis and wigs. The one-time $300 grant is available to those who have been diagnosed and are in active treatment for breast cancer and fall within 250% or less of the federal poverty limits. More information is available at www.patientadvocate.org/gethelp.

Invacare HCS exec joins Brightree
ATLANTA – Lynda Bell, director of the Invacare HCS billing and collections business, will join Brightree in September as director of strategic accounts for its billing services organization, according to a press release. Bell will work with providers to help improve billing and collection practices. “I have worked with Lynda for several years and have always been impressed with her drive to improve the customer experience while managing a team of professionals,” stated Dave Cormack, president and CEO of Brightree, in the release. “We are pleased to have her join our team as we continue to expand our AR management services to meet the growing demand from our customers as they seek to off set the decline in reimbursement rates.”

CareCentrix appoints new CEO
HARTFORD, Conn. – CareCentrix, a home healthcare benefit management company, has appointed John Driscoll as CEO, according to a press release. Driscoll joins CareCentrix from Castlight Health, a healthcare technology company, and replaces Eric Reimer. “I am honored to lead CareCentrix through its next phase of growth," stated Driscoll in the release. "Our efforts will be focused squarely on delivering exceptional service to health plans, patients and providers; driving innovative care delivery in the home; and empowering our associates to take on larger roles as CareCentrix expands to serve more customers."

WASHINGTON – Tom Ryan is not a new name or face—he has been advocating for the HME industry through AAHomecare and his company, Farmingdale, N.Y.-based Homecare Concepts, for years. Ryan, the new president and CEO of AAHomecare, spoke with HME News recently about why he’s so engaged and where he sees HME’s future. 

HME News: How will being a provider affect your leadership of AAHomecare?

Tom Ryan: I know the effects of poor public policy. I’ve been in business 25 years. We bid for 35 contracts and won one. We went from being a major player to trying to get through this alive. Now I’m coming out of a harried, hectic market upturned by competitive bidding and I have a chip on my shoulder, a sense of urgency.

HME: Are you still hopeful that competitive bidding will be replaced by a market-pricing program (MPP)?

Ryan: It’s going to be a difficult process, but we’re making gains on a daily basis. H.R. 1717 is continuing to gain co-sponsors, and the program is starting to have quality issues, discharge delay issues. I know New York is a chaotic mess.

HME: What are your other goals for the association?

Ryan: We need a stronger voice in Washington, D.C., and a more robust membership. People who’ve sat on the sidelines in the past—we need to get them engaged. The demographics for this industry are very, very good. If we can come together to get through this storm, I see very smooth sailing ahead.

HME: What does the industry need to do to get through the storm?

Ryan: We need to become part of the solution. Healthcare providers are starting to be paid based on quality outcomes and patient satisfaction. We need to be part of that discussion. It cannot just be about price compression. It has to be value-based. Home care is something the patients prefer, and it costs less. Why aren’t we at the table?

COLUMBUS, Ohio – HME providers are “high risk,” and therefore should be required to get surety bonds if they want to participate in Ohio’s Medicaid program, according to a recent audit report. 

That may or may not be a big deal, stakeholders say.

“As Medicare providers, a lot of our members already have that,” said Kam Yuricich, executive director of the Ohio Association of Medical Equipment Services (OAMES). “The big question is if this will be a separate bond, or the same one a lot of providers already have.”

As part of a performance audit of the Ohio Department of Job and Family Services (ODJFS), which oversees the state Medicaid program, the Ohio Auditor of State recommended surety bonds for “high risk” providers, including home health care providers, ambulance/ambulette services and durable medical equipment providers. The requirement would increase fraud debt collections by at least $10 million each year, the auditor stated.

It’s up to ODJFS to decide if and how to act on the auditor’s findings. The agency has a year to implement suggestions before reporting its decisions and actions back to the legislature. 

Only three states currently require surety bonds for Medicaid providers: Florida, Arkansas and Texas. Those bonds are in addition to the surety bonds Medicare requires, says insurance expert Bill McMahon.

“They have completely different stipulations,” said McMahon, an account executive for Cailor Fleming Insurance in Youngstown, Ohio. “They can’t intertwine—both agencies want their money.”

Ohio providers say if the state requires additional bonds, it will mean increased complexity in doing business.

“Most providers are in favor of doing what we can to keep the market clear of bad players,” said Joe Petrolla, president of Boardman, Ohio-based Seeley Medical. “(However), I’m not sure why this is necessary. It would just be another layer of bureaucracy.”

RALEIGH, N.C. – A new system meant to streamline billing for Medicaid is, in a word, a mess, say providers here.

“We expected glitches, but nothing like this,” said Beth Bowen, executive director of the North Carolina Association of Medical Equipment Services.

The new system, called NC Tracks, was implemented July 1. Since then, HME providers have experienced many technical issues with the system, which uses different product codes than the old system and is, in many cases, not compatible with common billing software used by providers.

“I tried to submit batch claims and they got rejected,” said Kim Lynn, HME operations manager for Carolina Apothecary in Reidsville. “We are hand entering claims patient by patient.”

That’s a time consuming and expensive proposition, especially for providers who lost Medicare business in Round 2 competitive bidding areas July 1, they say.

“We are running half staff now and may have to lay off more people,” said Paula Hardison, office manager for Carolina Diabetic in New Bern. “We are taking it one week at a time.”

Providers also report difficulty getting through to the Medicaid call center, and difficulty getting paid.

“We get on the line and it takes an hour to get the answer,” said Clark Robichaux, president of Oxy Care Equipment in Wilmington. “We haven’t received any payments since they turned over to the new system. We’ll probably end up suspending Medicaid patients.”

NCAMES has been in constant contact with Medicaid to try and get issues resolved, says Bowen, who has been providing near-daily updates to her members.

“I think what’s really frustrating for providers is that NC Tracks is touting (how great) their system is,” she said. “It’s not a rosy picture at all.”

SAINT PAUL, Minn. – With the pricing for Round 2 of competitive bidding sending reverberations throughout various payer circles, nowhere is the threat possibly more powerful than one state Medicaid program.

While most states have some flexibility, in Minnesota, the pricing for Medicaid is “locked in” to the pricing for Medicare. So when the pricing for Medicare was reduced, on average, 45%, on July 1 as part of the program, the hands of state officials were pretty much tied, says Rose Schafhauser, executive director of the Midwest Association for Medical Equipment Services (MAMES).

“They have no choice but to use the new Medicare rates,” she said.

But in the 11th hour, during the last week of the legislative session in late May, stakeholders succeeded in getting an amendment passed as part of an omnibus bill that delays the implementation of competitive bidding pricing for one year, until July 1, 2014.

While this is good news, the pricing between Medicaid and Medicare is still locked and stakeholders must now sit down with state officials to negotiate what will happen next year. During previous negotiations, officials, realizing that providers can’t eat a 45% cut, have floated the idea of a 20% cut, Schafhauser says.

“We can’t afford a 20% cut, either,” she said.

At the same time, it’s no secret that states aren’t in any position to pass up potential savings. Earlier this year, the Office of Inspector General (OIG) scolded CMS for failing to collect $225.6 million in Medicaid overpayments.

WATERLOO, Iowa – On the new web site Speak4DME.com, providers have a new platform to discuss audit issues. Lisa Ziehl’s take: Audits aren’t a bad thing—if they’re done the right way.

“There’s so much opportunity to do audits the right way, before the claim is paid,” said Ziehl, operations manager for Willmar, Minn.-based Rice Home Medical. “Right now they’re coming in four or five years after the fact, sometimes on the same claims that have already been audited. It becomes unrealistic and difficult to manage.”

Ziehl is taking her experience and her opinions to the web, joining nearly two dozen other providers that have agreed to share their stories on Speak4DME.com, which The VGM Group launched in July. VGM helps providers create and edit videos of providers talking about audits and their impact on patients. 

VGM President Ron Bendell says the site will help convince lawmakers that there needs to be more oversight of CMS’s independent audit contractors. 

“Congress is the only thing that can help with these audits, but lawmakers are being told by CMS that there are no problems, just successes,” he said. “We need to bring these stories to lawmakers, and show them the real people and emotions behind them.”

The site is similar to VGM’s Speak4OandP.com, an orthotics and prosthetics-focused site launched in February. Bendell said the success of that site, combined with requests from lawmakers for personal stories from their constituents, inspired Speak4DME.com.

Bendell’s goal for Speak4DME.com is 250 providers representing all 50 states sharing their stories.

Many providers have expressed support for the site, but are nervous about filming themselves—they shouldn’t be, Bendell said.

“Everyone looks good on camera when they’re being truthful about how important this issue is for their business and patients,” he said.

WASHINGTON – Two legal efforts to stop competitive bidding are still in play but face significant obstacles, say industry stakeholders.

AAHomecare last week learned that the Department of Health and Human Services (HHS) has filed a motion to dismiss the association’s lawsuit, which argues that CMS violated the rules governing the bid program by awarding contracts to providers without proper state and local licenses.

“Our executive committee is looking at this, and we have to decide what our resources allow us to do and what our next step is,” said Tyler Wilson, outgoing president and CEO of AAHomecare. “We feel strongly about the correctness of our position, but justice doesn’t always prevail in the courts.”

If it choses to move forward, AAHomecare, which filed the lawsuit in June with Havre de Grace, Md.-based Home Mediservice, must file a response in September.

Another stakeholder, Shoreview, Minn.-based Key Medical Supply, has decided to move forward with its lawsuit, which argues that the bid program will cripple its business and jeopardize patient access. It filed an appeal in June and the Midwest Association for Medical Equipment Services (MAMES) filed an amicus brief in August.

“One of the things the judge said as part of his ruling was, ‘How come there aren’t hundreds of companies involved?” said Rose Schafhauser, executive director of MAMES. “This was the perfect opportunity to show the court that we have four bid areas in our territory and this is impacting our entire membership.”

Both lawsuits have faced this big obstacle: To date, the courts have agreed with the government that they don’t have jurisdiction to rule on the bid program.

“I’m not sure there’s a reason to think the judicial bar will be any weaker going forward,” said Dan Leyton, a partner at Kravitz Talamo & Leyton, which has been involved in past lawsuits. “But maybe there’s room for some creative lawyering.”

So what’s pushing stakeholders forward? In the Key Medical Supply case, at least, the judge granted the government’s request for dismissal, but he also strongly criticized* HHS and the bid program.

“We need to show we’re doing everything in our power to stop this,” Schafhauser said. “Even if there’s a slim chance, there’s a slim chance.”

WASHINGTON – Tom Ryan is not a new name or face—he has been advocating for the HME industry through AAHomecare and his company, Farmingdale, N.Y.-based Homecare Concepts, for years. Ryan, the new president and CEO of AAHomecare, spoke with HME News recently about why he’s so engaged and where he sees HME’s future. 

HME News: How will being a provider affect your leadership of AAHomecare?

Tom Ryan: I know the effects of poor public policy. I’ve been in business 25 years. We bid for 35 contracts and won one. We went from being a major player to trying to get through this alive. Now I’m coming out of a harried, hectic market upturned by competitive bidding and I have a chip on my shoulder, a sense of urgency.

HME: Are you still hopeful that competitive bidding will be replaced by a market-pricing program (MPP)?

Ryan: It’s going to be a difficult process, but we’re making gains on a daily basis. H.R. 1717 is continuing to gain co-sponsors, and the program is starting to have quality issues, discharge delay issues. I know New York is a chaotic mess.

HME: What are your other goals for the association?

Ryan: We need a stronger voice in Washington, D.C., and a more robust membership. People who’ve sat on the sidelines in the past—we need to get them engaged. The demographics for this industry are very, very good. If we can come together to get through this storm, I see very smooth sailing ahead.

HME: What does the industry need to do to get through the storm?

Ryan: We need to become part of the solution. Healthcare providers are starting to be paid based on quality outcomes and patient satisfaction. We need to be part of that discussion. It cannot just be about price compression. It has to be value-based. Home care is something the patients prefer, and it costs less. Why aren’t we at the table?

BALTIMORE – CMS looks to be slowly working toward the Jan. 1 implementation date for the Round 1 re-compete. HME News has learned that some providers last week received bona fide letters asking them to provide supporting documentation to substantiate their bid amounts. CMS had planned to release the single payment amounts sometime in the spring and the names of the contract suppliers this fall. Meanwhile, stakeholders continue to lobby for H.R. 1717, which would replace competitive bidding with a market-pricing program. The bill currently has 150 co-sponsors, a number that is expected to rise once lawmakers return to Washington, D.C., the second week of September.

CMS addresses providers going out of business

WASHINGTON – CMS has announced that, effective immediately, it will allow the replacement of oxygen equipment when suppliers exit the business. In a bulletin this week, CMS stated that, under such circumstances, it will now consider the equipment lost and start a new 36-month rental period for the new supplier on the date the equipment is furnished. CMS noted that suppliers exiting the business without transferring patients to new suppliers are in violation of statutory and regulatory requirements.

Sleep vendors continue legal wrangle

SAN DIEGO – ResMed has announced that the International Trade Commission (ITC) has agreed to investigate BMC Medical, a Chinese medical device manufacturer, and its U.S.-based distributors, 3B Medical and 3B Products, for patent infringement. ResMed requested the investigation. It also filed a lawsuit against BMC in federal court in May. "We're encouraged by the ITC's action to investigate this case against BMC," stated ResMed Global General Counsel and Chief Administrative Officer David Pendarvis. "We invest over $100 million in research and development each year to fuel these advances and other companies should not be allowed to infringe ResMed's intellectual property by using our technology." ResMed filed a similar lawsuit against Apex Medical, a Taiwanese manufacturer, earlier this year. That action resulted in Apex consenting to an order barring it from bringing infringing products into the U.S. market. Apex, however, is fighting back. On Aug. 20, the company announced that it will challenge six of the seven patents involved in the lawsuit. It is doing so under a law that allows re-examination of patents if there is substantial invalidity evidence. 

HME companies make Inc. list

NEW YORK – A number of HME companies have made the Inc. 500/5000, an annual ranking of the nation’s fastest-growing private companies. Companies in the health category include Carolina’s Home Medical Equipment, A/R Allegiance, Roscoe Medical, Keen Healthcare, RemitData, Sunset Healthcare Solutions, Blue Dot Medical and Strategic AR. To view all the companies in the health category, go to http://www.inc.com/inc5000/search/2013/x/x/x/x/10/x/.

Home Health Depot sees Texas as ‘smart growth opportunity’

INDIANAPOLIS – Home Health Depot has opened a new branch location in Austin, Texas, expanding its reach to a total of six states. Initially, the new branch will focus on providing complex rehab equipment to patients in the greater Austin and San Antonio markets, according to a press release. “We continue to look for smart growth opportunities as the delivery of healthcare is quickly changing due to today’s economic realities,” stated President Nathan Feltman in the release. In addition to Texas, Home Health Depot has a presence in Georgia, Illinois, Indiana, Iowa and Michigan. Last year, Home Health Depot acquired Advanced Rehab Technologies in Iowa, the respiratory assets of RCS Management in Indiana, Medical Mobility in Indiana, and Genesis Healthcare Services in Atlanta. Home Health Depot offers a full line of products designed to meet the specific medical and functional needs of people with disabilities. 

Contract suppliers must be enrolled in Medicaid

WASHINGTON – Contract suppliers in competitive bidding areas can’t bill dual-eligible beneficiaries for co-pays if they’re not enrolled in the Medicaid program in the relevant state, AAHomecare has notified members in a bulletin. This extends to Medicaid managed care organizations. The association had sought clarification from CMS on the issue. Additionally, the prohibitions against billing dual-eligible beneficiaries for Medicare cost-sharing (i.e. deductible and co-insurance) apply under the program. The Medicaid statute considers payments from Medicare and Medicaid as payments-in-full for items provided to dual-eligible beneficiaries, according to AAHomecare. Beneficiaries are under no legal obligation to make further payment to providers. Providers who charge dual-eligible beneficiaries for cost-sharing could face penalties, the association says. States must pay providers for any Medicare cost-sharing for dual-eligible beneficiaries. To be paid, providers must be enrolled with Medicaid in each state in their service area.

Noridian reports overpayments on PMD rentals

FARGO, N.D. – Noridian Administrative Services has reported overpayments on some power mobility devices in Round 2 competitive bidding areas. Noridian says the problem stems from a system issue that led to DME MACs paying a higher rate than allowed under the program. Claims that meet the following criteria have been overpaid: processed on or after July 1, 2013, billed with the KJ modifier and submitted under a certain code. Noridian says it will adjust these claims to the correct payment amount and send suppliers overpayment notifications. 

Hasco Medical reports increased revenue

ADDISON, Texas – Hasco Medical, Inc. reported in a shareholder update on Aug. 20 that net revenue for the first half of the year increased $5.5 million compared to the same period last year. The company is in the process of purchasing Auto Mobility Sales, Inc., and has completed the liquidation and closure of Southern Medical and Mobility, Inc., a business not in alignment with its auto-division strategy. Hasco also reported that it has launched www.WeDeliverFreedom.com, a resource that connects those who need wheelchair-accessible transportation with crowdfunding financing options, and named Rick Fountain as vice president of service. The company sells, rents and provides parts for handicap-accessible vans in 16 locations from Maine to Florida. It also sells medical equipment and supplies in Florida. 

Medtrade highlights retail

ORLANDO, Fla. – Medtrade will go to new lengths to highlight retail-oriented products at this year’s event, Oct. 8-10. A panel of experts will select five products that will be featured in a conference session called “The Best New HME Retail/Cash Opportunities,” Oct. 9 from 1:30-2:30. During the session, which will be moderated by Jim Greatorex, owner of Black Bear Medical, manufacturers will have five to seven minutes to discuss their products. The products will also be featured in a window display in the Retail Design Center on the show floor. “I, and many others, go to Medtrade looking for the next great cash opportunity,” stated Greatorex in a press release. “This year, providers will have a chance to expand their business and in some situations be one of the first to promote a product.”

Len Serafino: ‘Keep Breathing’

YARMOUTH, Maine – Former homecare exec Len Serafino has released his second novel, “Keep Breathing,” the story of a road trip along the I-95 corridor taken by a man with idiopathic pulmonary fibrosis and his friend. Serafino will donate 20% of proceeds from the book, which is available on Amazon.com, to the Pulmonary Fibrosis Foundation. Serafino spent 16 years working in the HME industry for companies like Drive Medical, Chad Therapeutics and American HomePatient. He is also the author of the novel “Back to Newark” and a book on effective communications skills, “Sales Talk.”

CMS releases off-the-shelf codes

BALTIMORE – At long last, CMS has finalized its list of off-the-shelf (OTS) orthotics codes. In February 2012, the agency released an initial list and sought public comment. Federal law defines OTS as items that require “minimal self-adjustment.” At that time, industry stakeholders expressed concerns that the list included some items that should be considered custom devices not OTS, and therefore should only be provided by certified fitters or orthotists. View the finalized list of codes here: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSc....

Up for review: catheters

NASHVILLE, Tenn. – CGS, the Jurisdiction C DME MAC, will conduct a service-specific review of certain intermittent catheters (A4351, A4352 and A4353), it announced Aug. 20. Providers who receive letters requesting additional documentation may be asked to provide the following: Preliminary dispensing order (if items were dispensed prior to obtaining a detailed written order); detailed written order; medical records that support medically necessary to perform intermittent catheterization; request for refill; delivery documentation; any other pertinent records; and copy of advance beneficiary notice if one was obtained. The review is being done because of high payment error rates.

Demand for enteral feeding to grow

YARMOUTH, Maine – The global market for enteral feeding devices is expected to reach $2.45 billion by 2018 up from $1.64 billion in 2011, according to a new report released Aug. 18 by Transparency Market Research. Enteral feeding pumps accounted for 61% of total revenues in 2011 and are expected to grow at a CAGR of 6.1% from 2011 to 2018. North America and Europe are the biggest markets, accounting for 67% of total revenues in 2012. Dominant players in the market include Abbott Nutrition, Danone and Fresenius-Kabi, according to the report.

UN gives RESNA special status

WASHINGTON – RESNA has received special consultative status from the United Nations, allowing the organization to increase its international presence, says President Alex Mihailidis. RESNA now may actively work with the UN Economic and Social Council, adding items to its provisional agendas, submitting statements and attending meetings. The status also allows RESNA to send official representatives to UN events, conferences and activities, and to consult with the council on items of mutual interest. “We look forward to forging new relationships with other non-governmental organizations and entities within the United Nations that share our common interest of improving access to technology for people with disabilities,” stated Mihailidis in a prepared statement.

App could reduce COPD hospital readmissions, developer says

PHILADELPHIA – The use of an app called SmartScope could cut hospital readmissions of COPD patients by up to 40%, says its developer. By asking patients eight questions about their symptoms each day and reporting the answers to doctors, SmartScope could help physicians predict and prevent attacks of COPD up to a week in advance, says Futura mHealth, the Philadelphia company that developed the program along with Temple University. David Gulian, Futura mHealth CEO, told MobiHealthNews that each COPD episode can shave up to three years off a patient’s expected life span.

Short takes

3B Medical has hired Joe Toth to lead its sales team as national sales director. Toth will draw on 20 years with Puritan-Bennett and seven years as the co-owner of a sales and consulting company in the homecare industry…101 Mobility now has a corporate-owned location in Virginia Beach, Va. The location offers a full range of mobility products and installation services to the state’s Tidal Creek areas, including Norfolk, Hampton Roads, Newport News and Chesapeake Bay… Numotion, a provider of complex rehabilitation technology and products, announced the launch of its new website Aug. 19. The new website, http://www.numotion.com, features industry, advocacy and company news.