WASHINGTON – With little time to make an informed decision, an increasing number of states, including Georgia, Indiana and Washington, are planning to adopt Medicare reimbursement for certain DME to comply with a provision in the 21st Century Cures Act.

CMS finally published a letter to state Medicaid directors on Dec. 27 with guidance on the provision—which requires CMS to cap its contribution to Medicaid reimbursement for certain DME at Medicare reimbursement—just three business days before its implementation on Jan. 1.

“We plan to go on the record with CMS and the administration about our concerns with not only the timeframe, but also the missing information,” said Laura Williard, vice president of payer relations for AAHomecare.

The letter outlined two options for states to demonstrate compliance with the provision: base Medicaid reimbursement on Medicare’s fee schedule or competitive bid rates, or a lesser percentage thereof; or conduct a “robust comparison” using both rate and unit utilization data to calculate what would have been the aggregate reimbursement under Medicare for those same items to demonstrate that Medicaid reimbursement is less than the allowable amount.

If they choose the first option, states must submit a plan amendment no later than March 31, 2018, with an effective date no later than Jan. 1, 2018; if they choose the second option, or an alternative approach, they must inform CMS by Dec. 31, 2017.

The problem with the second option, Williard says, is that state Medicaid directors don’t have all the information they need to conduct a “robust comparison.” The letter refers to a number of appendices with source data that were never provided. CMS has not even officially published a list of affected HCPCS codes.

“Without all of this, a state can’t make an informed decision,” she said. “Even with it, a little over two days is not enough time to analyze everything.”

While some states have chosen the first option—what CMS calls in the letter “the simplest way”—states like Alabama have delayed making a decision until they receive additional information. Alabama has run data and sent it to CMS for validation but has been told it won’t hear back until after Jan. 1, said Leigh Ann Matthews, the manager at Complete Care in Fort Payne, Ala., and the president of the Alabama Durable Medical Equipment Association.

“We have a good relationship with Medicaid and they understand the potential access issues if they go forward with this,” she said. “So they want to aggressively look at the data.”

While states where Medicaid programs are largely administered by managed care organizations are exempt from the provision, stakeholders know MCOs will be keeping a close eye on the changes to see how they play out in January and beyond.

“Will they follow suit?” said Karyn Estrella, executive director of the Home Medical Equipment and Services Association of New England. “Our understanding is it doesn’t affect those plans, but when have MCOs not followed Medicare?”

AAHomecare is keeping tabs on each state’s decision and has shared the letter with legal counsel, Williard says.

“We plan to put together some type of strategy,” she said. “We will continue to work, not only from a state perspective but also from a legal perspective. We want to impact this any way we can.”

MINNEAPOLIS – Coloplast, which has its U.S. headquarters here but is based in Denmark, announced this month that it has acquired SAS Lilial for a cash consideration of EUR 35.5m or DKK 264m.

Lilial is a privately owned French company that distributes catheter and ostomy supplies nationally. It provides patients with products from several different manufacturers, including Coloplast.

“The acquisition of SAS Lilial is part of our strategy of pursuing inorganic opportunities to accelerate growth and to strengthen our service offerings,” said Coloplast CEO Lars Rasmussen. “By acquiring Lilial we further strengthen our position in France and ensure our end users access to innovative products and services.”

Lilial has about 80 employees and is expected to record sales of about EUR 33m or DKK 246m for 2017.

Coloplast bought Comfort Medical, a Coral Springs, Fla.-based provider of ostomy, urology, continence and wound care supplies, for $160 million in cash in 2016.

Permobil adds power assist to portfolio

LEBANON, Tenn. – Permobil has acquired MAX Mobility, the Nashville, Tenn.-based manufacturer of the SmartDrive power assist device.

MAX Mobility’s most recent release, the SmartDrive MX2+ with PushTracker, works on virtually any manual wheelchair on the market.

“Almost three out of four manual wheelchair users have shoulder pain already,” said Mark Richter, Ph.D., CEO of MAX Mobility, who will join Permobil as senior group innovation advisor, working across the power, manual, and seating and positioning portfolios. “By becoming part of Permobil and adding power assist to the portfolio, we can expand our reach and reduce should pain for users globally.”

The SmartDrive device, which weighs just over 12 pounds, attaches to the back of the user’s manual wheelchair and uses a built-in battery to power the chair for miles on a single charge.

Larry Jackson, president of Permobil Business Region Americas, says SmartDrive “greatly expands our offering and will provide an independent mobility solution for our users globally.”

MAX Mobility is only the most recent of a number of acquisitions for Permobil in 2017, including Comfort Company in October.

Medline nearly triples footprint in Maryland

BALTIMORE – Medline is nearly tripling its footprint in Maryland with the construction of a 1.1 million-square-foot distribution center in the Principio Business Park in Perryville. The new center, which will replace the company’s current Havre de Grace facility, will be LEED-certified and is expected to create more than 200 new jobs over the next six years, according to a press release from the Maryland Department of Commerce. The center is one of 40 strategically located across the county, from which it distributes 350,000 medical devices. “A growing demand for Medline’s products and clinical solutions is driving their significant growth here in Maryland,” said Maryland Commerce Secretary Mike Gill.

Golden Technologies wins and gives

OLD FORGE, Pa. – Golden Technologies has been voted among the Best Places to Work in Northeastern Pennsylvania sponsored by the Times Leader Media Group. The reader contest is meant to highlight the best, most innovative places to work in the area. “This is a great honor to be recognized in the community,” said Rich Golden, CEO. “Awards like this are not possible without the hard work and dedication.” Members of the Golden team recently attended an event recognizing the winners of the contest at The Woodlands Inn…Employees of Golden Technologies raised $3,000 for the American Red Cross and its hurricane relief efforts. Golden matched employee contributions. Rich Golden recently presented the donations to Bill Goldsworthy, executive director of Red Cross Northeastern Pennsylvania.

GF to buy Intensa

ATLANTA – GF Health Products plans to acquire Intensa, a manufacturer of medical and laboratory furniture based in High Point, N.C. “This acquisition will expand our existing product line and customer base; is well-aligned with our growth strategies; and supports our objective to be a preferred global provider of healthcare equipment,” said Ken Spett, president and CEO of GF Health products. The transaction was scheduled to close on Dec. 31.

ATS oxygen study bolsters industry findings

WASHINGTON – A recent study from the American Thoracic Society correlates with the HME Patient Access Study sponsored by AAHomecare, the association says. Dobson DaVanzo & Associates has put together a summary of how the ATS study, “Patient Perceptions of the Adequacy of Supplemental Oxygen Therapy: Results of the American Thoracic Society Nursing Assembly Oxygen Working Group Survey,” reinforces findings of the patient access survey. In particular, both studies suggest that the financial pressure on the HME industry is impacting the lifestyle of oxygen patients, especially Medicare beneficiaries.

HHS to hold call on settlement option

WASHINGTON – The Department of Health and Human Services will host a call on the Low Volume Appeals Settlement Option on Jan. 9. The call will discuss the process and how to identify eligible appeals. CMS rolled out the new settlement option earlier this month. Providers with fewer than 500 appeals pending at the Office of Medicare Hearings and Appeals and the Medicare Appeals Council combined as of Nov. 3, 2017, with a total billed amount of $9,000 or less per appeal could be eligible, if certain other conditions are met. The call is scheduled for 1:30-2:30 p.m., EST. Register here.

OIG: Lincare mostly complied with neb-med policies

CLEARWATER, Fla. – Lincare Pharmacy Services generally complied with Medicare requirements when billing for inhalation drugs, according to a new report from the Office of Inspector General. Of 100 claim lines sampled, three did not comply because the beneficiaries medical records did not support medical necessity, resulting in $48 in overpayments. The OIG recommends that Lincare ensure that medical necessity is adequately supported in medical records before billing Medicare. Lincare concurred.

VGM rallies Congress

WATERLOO, Iowa – The government relations team at Waterloo, Iowa-based VGM will soon introduce a new tool to bring its members breaking news. “We will be using a program called Rally Congress to allow providers to quickly and easily message their members of Congress and state governments,” VGM stated in a bulletin this week. “This effective tool has resulted in many consistent supporters of the DMEPOS and CRT industries.” Members should receive an “introductory message” this week with further details.

UPitt’s Cooper named Health Hero

PITTSBURGH – Rory Cooper, PhD, has been named a Health Hero by O, The Oprah Magazine. Cooper, a University of Pittsburgh professor, School of Health and Rehabilitation Sciences associate dean for inclusion and Human Engineering Research Laboratories founding director, was one of 14 “changemakers” featured in the magazine’s January issue. Cooper was lauded for his work designing devices “with independence and dignity in mind.” Cooper also recently received the “Science and Environment Medal” as part of the 2017 Samuel J. Heyman Service to America Medals, known as the Sammies and the “Oscars” of government service.

ProMedica buys O.E. Meyer’s HME division

TOLEDO, Ohio – ProMedica Home Medical Equipment intends to buy out O.E. Meyer Co.’s HME division, according to the Sandusky Register. The division sells everything from aids to daily living to orthopedics to ramps to CPAP devices. ProMedica, an integrated health and wellness organization that serves counties in northwest Ohio and southeast Michigan, says the acquisition will allow the company to expand its offerings and serve consumers in new markets. It plans to keep O.E. Meyer’s five HME locations in Sandusky, Fremont, Tiffin, Walbridge and Lorain, and has offered positions to all HME employees, according to the newspaper. In addition to 12 hospitals, ProMedica has several divisions, including HME. O.E. Meyer will continue to operate industrial, wholesale health care, propane, and carbonic divisions at eight locations.

Sleep therapy system receives $58.5M in funding

MINNETONKA, Minn. – The makers of a transvenous implantable neurostimulation system for treating central sleep apnea have received $58.5 million in financing. The financing for Respicardia and its remedē System was led by ZOLL Medical Corp., a manufacturer of medical devices and related software solutions. "We believe the remedē System will soon become the treatment of choice for patients suffering from central sleep apnea," stated Bonnie Labosky, president and CEO of Respicardia. "Proceeds from the financing will be used to fund our U.S. commercialization efforts and support ongoing development of the system." The system received approval from the U.S. Food and Drug Administration in October 2017, paving the way for its market release in the United States. The system stimulates the phrenic nerve and engages the diaphragm to restore a normal breathing pattern during sleep. A trial published in Lancet show the system can significantly reduce the severity of central sleep apnea, and improve sleep, quality of life and patient satisfaction.

SpinLife recognized for customer commitment

OVERLAND PARK, Kan. – SpinLife, an online retailer of mobility scooters, has received a five-star rating from TopConsumerReviews.com. The provider offers a price match guarantee, free shipping and educational resources, as well as scholarships and gift cards for students using wheelchairs. “SpinLife impressed us with their commitment to customers," according to Brian Dolezal of TopConsumerReviews.com. SpinLife, which was founded in 1999, offers scooters, wheelchairs, walkers and lifts.

WASHINGTON – The confirmation hearing for Health and Human Services Secretary nominee Alex Azar will be held before the Senate Finance Committee Jan. 9.

President Trump nominated Azar, a former pharma exec and chairman and founder of Seraphim Strategies, which provides strategic consulting and counsel on biopharmaceutical and health insurance industries, in November.

In addition to the hearing, Azar has been meeting with committee members in their offices this week, according to The VGM Group, which urges HME providers with members on the Senate Finance Committee to contact them with questions for Azar, including:

whether he believes the competitive bidding program threatens the ability for Medicare beneficiaries to access medical equipment, and, if so, how would you address this issue if confirmed as HHS Secretary;

whether he would work with the Office of Management and Budget to get a competitive bidding relatedinterim final ruleapproved quickly and tell CMS to freeze reimbursement cuts for HME providers until beneficiary impact can be studied;

and what he would do address the broken Medicare audit system.

The hearing can be viewed live here starting at 10 a.m., ET. 

WASHINGTON – CMS has given state Medicaid directors more “open-ended guidance” for complying with a provision in the 21st Century Cures Act, AAHomecare reported on Friday afternoon.

In a Jan. 4 letter, CMS states: "States electing to submit an aggregate payment comparison, or an alternative approach to compliance as mentioned earlier in this letter, will work with CMS to determine the best approach to calculate the FFP limit for their state using expenditures for the period of January 1, 2018, through December 31, 2018."

The letter continues: “CMS is in the process of obtaining the required Office of Management and Budget (OMB) approval for these payment comparisons via the Paperwork Reduction Act (PRA) process. Only after CMS obtains a valid OMB control number will states be required to submit this information. Assuming PRA approval, the first comparative analysis must be submitted to CMS by March 31, 2019.”

In a Dec. 27 letter, CMS stated that states choosing this option must inform the agency by Dec. 31, 2017, giving them less than three business days to make a decision.

The previous letter outlined two options for states to demonstrate compliance with the provision: base Medicaid reimbursement on Medicare’s fee schedule or competitive bid rates, or a lesser percentage thereof; or conduct a “robust comparison” using both rate and unit utilization data to calculate what would have been the aggregate reimbursement under Medicare for those same items to demonstrate that Medicaid reimbursement is less than the allowable amount.

If states choose the first option, they must submit a plan amendment no later than March 31, 2018, with an effective date no later than Jan. 1, 2018.

The provision requires CMS to cap its contribution to Medicaid reimbursement for certain DME at Medicare reimbursement.

YARMOUTH, Maine – Subcontracting may be black and white on paper, but in the real world, it can be gray, even now that competitive bidding has been the law of the land in major cities for years.

By law, contract suppliers are responsible for coordinating care between referral sources and Medicare beneficiaries, for example, but subcontractors say that’s not always the case.

“It’s kind of like the dirty, little secret in the industry,” said a subcontractor for oxygen equipment and services. “They have virtually no contact with physicians—that’s left to the local providers like us.”

By law, contract suppliers must also furnish items and bill Medicare. The job of the subcontractors: deliver, instruct and repair.

Subcontractors are, in a way, enablers. They want to remain in contact with referral sources, because they still want their business for other product lines and other payers.

“We want to save face with referral sources,” said one subcontractor. “(The contract suppliers) are so bad at processing claims, because they’re so risk-averse, that we just do what needs to be done.”

One subcontractor says that one contract supplier has a policy of automatically canceling orders after three attempts to get documentation.

“We’ve started working with referral sources a little more closely, just calling them ahead of time to give them a heads up,” said the subcontractor, “to appease them and maintain the relationship.”

Adding insult to injury: While slow payments from contract suppliers haven’t been an issue for all subcontractors, one subcontractor has invoices into one contract supplier that are over 120 days old.

“We’re reconsidering subcontracting going forward,” the subcontractor said. “Referrals are becoming more comfortable with the fact that some HME companies can do some insurances but not others. We’re also hoping, even though Medicare is a loss-leader, that we’ll win more bids in the next round.”

Aeroflow, which has continually sought to increase its base of subcontractors to help grow its business, says it has 10 people dedicated to handling processing and payments for that side of its business. But the company acknowledges that the system can be slow.

“We find our largest challenge is receiving proof of delivery in a timely manner,” said Ryan Bullock, CIO. “This often leads to delays in subcontractor payment.”

At the end of the day, subcontrators say they’re the glue, not contract suppliers, that’s keeping the bid program together, for better or worse.

“This is why competitive bidding has succeeded in the eyes of Medicare, because the local providers are always stepping in,” said one subcontractor. “We’re just starting to say no. You can’t give away services for free.”

BANNOCKBURN, Ill. – Option Care has appointed John Rademacher as CEO and COO, effective immediately, the company announced Jan. 4. Rademacher had been serving as the interim CEO. Rademacher has more than 25 years of health care related experience, and has held executive positions including at Cardinal Health where he served as president and general Manager for both the Ambulatory Care Division and the Nuclear and Pharmacy Services Divisions, and at Cigna Corporation where he served as president of CareAllies and chief operating officer for the CIGNA Behavioral Health business. “I am honored and excited to be given the responsibility to lead Option Care,” said Rademacher in a press release. “We have such a proud heritage given all the great work over our 35-year history. With our national scale and highly qualified team, we are uniquely positioned as the market leader to continue to deliver high-quality, low-cost care to our patients and drive significant growth.”

Medical device tax goes back into effect

WASHINGTON – A 2.3% excise tax on medical device manufacturers went back into effect on Jan. 1 after a two-year hiatus, according to news reports. The tax initially went into effect in 2013 as a way to pay for expanded health insurance under the Affordable Care Act. The $150 billion medical device industry, representing everything from catheters to artificial joints, has fought the tax hard. Congress agreed to suspend the tax for 2016 and 2017, with an eye toward abolishing it before 2018, but several efforts to repeal the ACA have failed. Trade groups estimate that the tax will shave the industry by $20 billion over the next decade. Most, but not all, HME has been excluded from the tax.

TwelveStone, VirtueRN tackle fragmented post-acute care market

CHAPIN, S.C. – TwelveStone Health Partners and VirtueRN have joined forces to develop a post-acute care technology platform to address the fragmented market for medical equipment and medication services. The platform is expected to streamline workflow processes and increase the level of communication across the continuum of care. “Technology offers the opportunity to ensure that patients get what they need faster and more efficiently,” says Shane Reeves, CEO of TwelveStone Health Partners. “Our understanding of the players and shortcomings regarding post-acute medication service delivery, combined with VirtueRN’s technology prowess and knowledge of the post-acute care market, makes the combination a natural partnership opportunity.” TwelveStone says VirtueRN has a head start in creating the platform, allowing the two companies to get to market more rapidly and reduce overall project investment.

MobilityWorks hits 72 locations

RICHFIELD, Ohio – MobilityWorks, a provider of wheelchair accessible vans, has acquired Concord, N.C.-based Accessibility Mobility Center. The acquisition expands MobilityWorks’ presence in North Carolina, where it already has a van showroom and service center in Charlotte. Dan Plondke, the former owner of Accessibility Mobility Center, will oversee operations in Concord. “Becoming part of the MobilityWorks family will provide enhanced resources and increased opportunities to allow us to continue to find the best solutions for our customers,” he said. MobilityWorks now has 72 locations in 24 states. In addition to selling new and pre-owned modified vans for wheelchair accessibility, MobilityWorks and Accessible Mobility Center will also provide rental vans and adaptive equipment, such as hand controls, turning seats and scooter lifts.

Boas Surgical buys Wyoming Valley Prosthetics and Orthotics

BETHLEHEM, Pa. – Boas Surgical, a provider of prosthetics and orthotics, has acquired Wyoming Valley Prosthetics and Orthotics in Swoyersville, according to The Morning Call. Boas Surgical will continue to operate the Swoyersville location under the Boas Surgical name, adding six employees from Wyoming Valley Prosthetics and Orthotics to its roster, for a total of 38 employees, according to the newspaper. Boas Surgical, headquartered here, has a total of eight locations in Pennsylvania. It also has a location outside Phillipsburg in New Jersey.

Study: Hospitals can help diagnose sleep apnea

SAN DIEGO – A ResMed-funded study makes the case for hospitals screening patients for sleep apnea before they’re discharged to improve their chances of long-term survival. As part of the study, published in the American Journal of Medicine, more than 5,000 hospitalized patients were screened for sleep apnea and 18.7% were estimated to have the condition. Those who tested positive were placed on CPAP therapy post-discharge, and those who were adherent in the first three months improved their chance of survival over the next 20 months compared with those who were not adherent. “We have a profound opportunity to identify and help tens of thousands of hospitalized patients who don’t know they have a dangerous but treatable sleep condition,” said Sunil Sharma, the study’s principal investigator. “These results show just how important a hospital can be in addressing these issues.”

Zimmer steps down, Barranti steps up

FOSTER CITY, Calif. – Industry veteran Bernie Zimmer is retiring as president and CEO of CHME, a DME company based here. His successor: Lauren Barranti, who most recently served as the company’s executive vice president. “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 Zimmer of Barranti, who came to CHME from Apria Healthcare, where she was vice president of managed care. Zimmer will remain active in CHME as a member of the board of directors. Since joining CHMA, Barranti has implemented a number of operational initiatives with a focus on improving cash flow and profitability for the company, including a company wide contract optimization project.

Gov’t launches loan program for DME

SHERMAN, Texas – The Texacoma Council of Governments, a voluntary organization of local governments in Cooke, Fannin and Grayson counties, in collaboration with the Salvation Army of Grayson County, Areli Medical Supply and Grayson County Health Clinic, has launched a loan program for DME, according to the Herald Democrat. The program, which is funded by the Texas Department of Health and Human Services Commission, has two goals: collect and refurbish reusable DME; and loan it out to individuals in need. The program’s inventory includes wheelchairs, walkers, rollators, canes, portable commodes and shower chairs. To access the program, a referring agency and an individual’s doctor must complete referral and medical necessity forms.

WASHINGTON – Alex Azar, the nominee for secretary of the Department of Health and Human Serviecs, has verbally agreed to work with congressional leaders to address issues that are negatively impacting the HME industry.

During a Senate confirmation hearing on Jan. 9, Sen. John Thune, R-S.D., asked Azar if he would work with the Office of Management and Budget to “quickly approve” an interim final rule that would provide relief from Medicare’s competitive bidding program in non-bid areas. The rule has been sitting at the OMB since October.

“Yes, senator, I would be happy to work on those issues,” Azar told Thune.

The IFR would extend a delay to a second round of reimbursement cuts in non-bid areas to Aug. 1, 2017, through Dec. 31, 2018.

Thune, a member of the influential Finance Committee, has been a long-time champion for the industry’s efforts to provide relief to non-bid areas. Last year, he spearheaded a sign-on letter in the Senate asking then HHS Secretary Tom Price to use his regulatory authority to provide relief. It garnered 48 signatures.

During the hearing, Thune also asked Azar if he would also work to complete a report on beneficiary access required by the 21st Century Cures Act. He said HHS was supposed to complete the report by Jan. 12, 2017.

Editor’s note: In last week’s HME Newswire, we ran the story, “Subcontracting exacerbates problems with bid program.” This is a follow-up.
AMARILLO, Texas – Healthcare attorney Jeff Baird says no provider likes subcontracting agreements; nevertheless, there are a large number of them out there.
“Because reimbursement is so low, to take that reimbursement and split it between two companies doesn’t add up,” he said. “It’s a lose-lose.”
But contract suppliers want to make up for that low reimbursement with additional volume, and subcontractors want to hold on to their referral sources, so here we are.
Here’s what Baird had to say about how these agreements should be set up.
In a perfect world
“We have the contractor ABC and the subcontractor XYZ. ABC talks with the doctor; they get the order in; they make the decision as to whether or not the patient meets the medical necessity criteria. So ABC is the one that goes through the mental process. Then they call XYZ and say, ‘OK, you need to take care of Mrs. Smith,’ and XYZ does the heavy lifting. They deliver equipment; they educate Mrs. Smith and set her up; they handle repair and maintenance. ABC then bills Medicare, gets paid and pays XYZ.”
In reality
“XYZ doesn’t want to lose their referral sources for bid products and non-bid products, and doctors want one-stop shops. So the XYZs look at the CBIC website, see who the winners are and call them and say, ‘We see that you have a contract for this CBA; I want to be your subcontractor.’ Here’s the hook: They also say, ‘I’ll send you all kinds of patients.’ Doctors are loyal to XYZ, so they’re going to continue to refer to XYZ, and XYZ is going to send patients to ABC.”
Here’s where it gets dicey
“The CBIC wants the referrals to go through ABC, not XYZ. Well, the subcontractors fudge that a little bit and often referrals do flow through subcontractors to contract suppliers. If the CBIC determines that, they might come in and say, don’t do that.”
“The other area that’s a problem is if XYZ says to ABC, ‘Here’s everything; just bill for it.’ You can’t do that. If XYZ is doing everything, including the intake, and all ABC is doing is submitting a claim, that’s a sham. It’s critical that ABC has skin in the game.”
Gold standard
“The gold standard would be for ABC to pay a fixed annual fee to XYZ, say $4,000 a month or $48,000 a year, to perform subcontract services. The silver standard is to actually have a fee schedule, a set dollar amount for each service rendered. It’s not high risk, but it’s not as clean as the gold standard.”

WASHINGTON – Alex Azar, the nominee for secretary of the Department of Health and Human Services, has verbally agreed to work with congressional leaders to address issues that are negatively impacting the HME industry.

During a Senate confirmation hearing on Jan. 9, Sen. John Thune, R-S.D., asked Azar if he would work with the Office of Management and Budget to “quickly approve” an interim final rule that would provide relief from Medicare’s competitive bidding program in non-bid areas. The rule has been sitting at the OMB since October.

“Yes, senator, I would be happy to work on those issues,” Azar told Thune.

The IFR would extend a delay to a second round of reimbursement cuts in non-bid areas to Aug. 1, 2017, through Dec. 31, 2018.

Thune, a member of the influential Finance Committee, has been a long-time champion for the industry’s efforts to provide relief to non-bid areas. Last year, he spearheaded a sign-on letter in the Senate asking then HHS Secretary Tom Price to use his regulatory authority to provide relief. It garnered 48 signatures.

During the hearing, Thune also asked Azar if he would also work to complete a report on beneficiary access required by the 21st Century Cures Act. He said HHS was supposed to complete the report by Jan. 12, 2017.

Permobil further expands custom seating biz

LEBANON, Tenn. – Permobil will acquire the business assets of OBSS and NUTEC, Ottobock’s custom seating businesses, it announced Jan. 10.

The deal will further expand Permobil’s offering in the seating and positioning market in the U.S. and Canada, company officials say.

“We see tremendous potential in custom seating to improve health outcomes and achieve clinical objectives for individuals with complex needs,” says Tom Borcherding, president of Permobil Seating and Positioning.

Complementing the deal, Permobil has recently established a dedicated and clinically focused sales team in the U.S. to better support its seating and positioning business.

Permobil expects the deal to close by the end of the month.

This is the third acquisition Permobil has made in the seating and positioning market in the past few years. Most recently, in October, the company announced it had acquired Bozeman, Mont.-based Comfort Company. In 2015, Permobil acquired Belleville, Ill.-based The ROHO Group.

ResMed debuts Mobi

SAN FRANCISCO – ResMed has formally introduced its first portable oxygen concentrator to the market. The company says Mobi will be available to U.S. patients through their HME providers later this quarter, and it is pursuing clearance to sell in other countries in 2018. “We have focused decades of patient-centered ResMed technology and design innovation into this POC," said ResMed CEO Mick Farrell. "We've achieved great mobility, comfort and therapy quality in sleep apnea treatment with AirMini, the world's smallest PAP device. Mobi offers that same great balance to the many millions of people who rely on supplemental oxygen to enjoy their highest quality of life." ResMed technically entered the home oxygen therapy market in 2016 when it bought Austin, Texas-based Inova Technologies, the manufacturer of the LifeChoice Activox, an ultra-light POC, and the Activox DUO2, an integrated stationary and POC system.

Philips embeds telehealth services into solutions

AMSTERDAM and BOSTON – Royal Philips and American Well, a telehealth provider, have signed a new strategic partnership to jointly deliver virtual care solutions around the world. Through the partnership, the two companies will work to embed American Well’s mobile telehealth services into an array of Philips solutions, spanning personal health and wellness, population health management and clinical programs. “Philips brings great consumer professional devices and programs, coupled with powerful analytics,” said Ido Schoenberg, M.D., chairman and CEO of American Well. “With the addition of telehealth, they can now offer everything from data collection to care provision and clinical intervention.” The first Philips solution to have American Well’s mobile telehealth services embedded in it: the uGrow parenting app. American Well is the telehealth infrastructure behind the largest payers, hospitals and employers in the U.S., which collectively service more than 150 million Americans, Philips says. “American Well already collaborates with many of the largest insurers and healthcare providers in the U.S., offering great opportunities for joint business development with the aim to create a better patient experience in this important new area of digital healthcare delivery,” said Jeroen Tas, chief innovation & strategy officer at Philips.

Second CGM receives Medicare approval

ABBOTT PARK, Ill. – The FreeStyle Libre System is the second continuous glucose monitoring system approved for Medicare coverage. The Abbott-manufactured system requires no user calibration, reading glucose levels via a sensor worn on the upper arm. Users simply wave a reader over the sensor to get a reading. CMS in early 2017 approved certain CGMs as DME as long as they are approved by the Food and Drug Administration for use in place of a blood glucose monitor for making treatment decisions. The first such system approved: the Dexcom 5.

SoClean scales with investment backing

OXFORD, Mass. – SoClean, which makes CPAP sanitizing devices, has secured investment backing from DW Healthcare Partners. The funding will allow SoClean, which quadrupled sales in 2017, to scale the company, according to a press release. “DW Healthcare Partners is ideally suited to take us to the next level,” said Robert Wilkins, CEO of SoClean. “Their seasoned healthcare investment team is dedicated to accelerating SoClean's growth to maximize our value. We are confident that the best is yet to come for SoClean in 2018 and beyond.” Toronto-based DW Healthcare Partners is a healthcare-focused private equity firm that specializes in scaling mid-sized companies. “SoClean has revolutionized the way that CPAP machines are cleaned,” said Andrew Carragher, co-founder and managing partner of DW Healthcare Partners. “We are excited to back a product that provides such substantial value to its users.”

Invacare seeks another move to France

ELYRIA, Ohio – Invacare is considering relocating the production of Küschall manual wheelchairs from its facility in Witterswil, Switzerland, to its facility in Fondettes, France, according to a Form 8-K filed with the Securities and Exchange Commission on Jan. 11. Invacare hopes to complete the move, which it believes will allow it to better optimize the Fondettes facility, by mid-year 2018. By Swiss law, however, Invacare must first perform a “consultation procedure” with the potentially affected employees. That procedure is expected to last through Jan. 30. Invacare announced plans to shift production of its Invacare Rea manual wheelchairs from its facility in Dïo, Sweden, to its facility in Fondettes in July 2017.

Goalie Jim Craig joins Numotion’s team

BRENTWOOD, Tenn. – Numotion has announced a three-year partnership with U.S. Hockey “Miracle on Ice” goalie Jim Craig. The company is bringing in Craig to create motivational content for its website to inspire customers and employees, and to help create awareness for issues of those living with mobility disabilities. “In my years as a motivational speaker, I’ve learned that the power of dreaming, setting goals and having determination does indeed make a difference in a person’s outlook on life,” said Craig, a U.S. Hockey gold medalist. “There’s power in hope and I look forward to bringing just that to Numotion’s customers, employees and anyone faced with challenges.” Craig first became involved with Numotion when he was invited to speak at the company’s annual National Leadership Conference. Craig also accompanied Numotion leadership to Capitol Hill to help shine a light on the importance of complex rehab technology.

Ottobock to partner with para-athletes

LOUISVILLE, Ky. – Ottobock will provide equipment to para-athletes at the 2018 Winter Paralympics in Pyeongchang and the Gold Coast 2018 Commonwealth Games, it announced today. “Our team of experts incorporating orthotics and prosthetics professionals, wheelchair technicians and welders, will be available to repair and service prostheses, orthoses and wheelchairs so the athletes can concentrate fully on their performance in the competition,” said Thomas Much, Ottobock managing director, in a press release. Ottobock is the longest serving partner to the Paralympic Games.

NRRTS seeks nominations

LUBBOCK, Texas – NRRTS is accepting nominations for four awards: the Leadership Award, Distinguished Service Award, Consumer Advocate Award and Simon Margolis Award. “The NRRTS board of directors wish to recognize certain individuals and groups who have contributed to the advancement of CRT through leadership, advocacy or distinguished service,” the organization stated. NRRTS will accept nominations until midnight on Feb. 28 and will present the awards at the 2018 NRRTS/NCART Conference in Washington, D.C., on April 25. For more information, including award requirements, go here.

Short takes: BioScrip, Rotech

Denver-based BioScrip can now dispense and administer HEMLIBRA, a treatment for routine prophylaxis approved by the U.S. Food and Drug Administration. The drug helps to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients with hemophilia A with factor VIII inhibitors. “BioScrip continues to expand our therapy offering to better care for the patients that we support,” said Robert Roose, senior vice president and chief procurement officer. “Receiving the approval to dispense and administer HEMLIBRA underscores the fact that BioScrip is a destination of choice for our manufacturers.” BioScrip will provide HEMLIBRA in the patient’s home or in an infusion setting, depending on the patient’s care plan and conditions….Made4Net, a global provider of supply chain software solutions, has released a case study showing how Rotech Healthcare optimized its inventory levels and fulfillment process using WarehouseExpert WMS. Where Made4net made the biggest difference: inventory accuracy and visibility. Rotech’s previous manual reporting inserted delays and could lead to inaccurate counts. “It was all manual, so we didn’t have a way to see our current inventory in real time,” said Rotech’s inventory supervisor. “The best we could do was a day behind, and much of the time it wasn’t completely accurate, but we started cycle counting with the new system five months ago and we are now at 99.8% accuracy.”

People news: Merits Health, Philips Respiratory

Cape Coral, Fla.-based Merits Health Products has promoted Kevin Liu to president and Chris Blackmore to vice president of sales and business development. Liu has helped the company launch two new divisions, Avid Rehab for complex rehab and Pilot for home accessibility. He has also helped the company open new distribution centers and increase internal operating efficiencies. For his part, Blackmore has helped Merits increase sales by 300% in the past three years… Brent Shafer, CEO of North America operations for the Netherlands-based Royal Philips, will become CEO of Cerner on Feb. 1, according to news reports. In 12 years at Philips North America, Shafer helped “a mature and heavily diversified company develop and strengthen its healthcare focus,” said Cerner’s interim CEO and chairman Cliff Illig. Cerner, based in Kansas City, provides health information technologies to more than 27,000 provider facilities worldwide.

WASHINGTON – Industry stakeholders are casting a wider net for providers to build more support for a bill that would provide relief from Medicare’s competitive bidding program.

As of Friday, providers had helped to push the number of co-sponsors for H.R. 4229 to 110.

“We’ve got a core group of providers that have advocated all along and that’s terrific,” said Tom Ryan, president and CEO of AAHomecare. “But we’ve also got sideliners who have let others do it and we’ve got to get them engaged. It’s a call to arms.”

AAHomecare recently launched a Congressional Accountability Project to assign providers to serve as contacts for legislators in their states. These contacts are responsible for asking for support for legislation like H.R. 4229, educating lawmakers about industry issues and, basically, stepping up when there’s a call to action.

While providers in some states are actively engaged with lawmakers, that’s not the case in others, like Alaska, Delaware, Hawaii, Louisiana, New Mexico, Utah, Washington and the District of Columbia.

“I am reaching out to people I know in other states to say, ‘Hey, we need you or somebody you know to get assigned to these legislators,’” said Doug Coleman, chairman of the AAHomecare State Leaders Council and president of the Colorado Association for Medical Equipment Services. “This way we know that the vast majority of lawmakers are hearing the stories and the messaging so there’s a better chance (of getting H.R. 4229 passed).”

One obstacle to greater provider participation in lobbying efforts may be fear it will take too much time or they won’t know what to say, Coleman says.

“It doesn’t have to take much time and it’s not hard to tell a story and build a relationship,” he said. “We are going to try and come up with a webinar to do a little training.”

Even with Congress focused on a potential government shutdown last week, stakeholders continued their efforts to add more cosponsors to H.R. 4229 and get a bid-related interim final rule cleared by the Office of Management and Budget.

“The more support we get, that puts pressure on the Office of Management and Budget and CMS that we’ve got to fix this,” said Ryan.

WASHINGTON – The Senate Finance Committee has approved the nomination of Alex Azar as secretary of the Department of Health and Human Services by a 15-12 margin. The vote was split along party lines, with Democratic Sen. Tom Carper, D-Del., joining Republicans. At his Jan. 9 confirmation hearing, Azar told Sen. John Thune, R-S.D., he would work with congressional leaders to address issues negatively impacting the HME industry, including working with the Office of Management and Budget to approve an interim final rule that would provide relief from Medicare’s competitive bidding program in non-bid areas. The nomination now goes to the full Senate for final confirmation.

AASM recruits providers, patients
DARIEN, Ill. – The American Academy of Sleep Medicine has formed a new patient-focused membership organization, the American Alliance for Healthy Sleep, to improve the lives of sleep apnea sufferers through advocacy, education and support. AASM seeks healthcare providers and patients to become members of the new organization. “The American Academy of Sleep Medicine established the American Alliance for Healthy Sleep to bring health care providers and patients with sleep disorders together to promote healthy sleep for all,” said AASM President Dr. Ilene M. Rosen. The AAHS is a 501(c)(4) membership association that is led by a board of directors comprising both providers and patients. Its three-part mission is to: engage policymakers and the public to enhance understanding of and care for all sleep disorders; provide support services for patients with sleep disorders; and promote healthy sleep in all populations. Member dues are $25 for two years.

CPAP Store eyes 50 retail stores by 2020
LAS VEGAS – CPAP Store USA has opened its fifth retail store in Agoura Hills, Calif. It has also announced ambitious plans to open 45 more retail stores across the country by the end of 2020. "The growing CPAP-user community is expanding and becoming a great niche for those interested in franchising, helping us to expand our reach and help those in need,” said Marina BerBeryan, spokeswoman and ambassador of CPAP Store USA. “Sleep disorders, including sleep apnea, have become a significant health issue in the United States. It is estimated that 29.4 million American adults suffer from sleep apnea with 80% of the cases undiagnosed.” CPAP Store USA already has retail stores in Las Vegas (2), Los Angeles and Dallas-Forth Worth.

Permobil helps babies go
LEBANON, Tenn. – Permobil and the Permobil Foundation on Jan. 18 hosted and sponsored physical therapy and engineering students and researchers from Vanderbilt University, Belmont University and Power of Play to train children and families to use custom-fit toy cars. Permobil employees, students and engineers modified battery-powered ride-on cars to be custom fits for the children based on clinical assessments for their needs. The event was part of the Go Baby Go program to improve the day-to-day lifestyle of children with mobility impairments. Dr. Amanda Lowery, researcher and engineer at Vanderbilt and director of Go Baby Go Music City, along with Dr. Teresa Plummer, researcher and physical therapist from Belmont University, and Pete Capell, president of Power of Play, assisted throughout the event.

Precision Pulmonary Diagnostics rebrands
HOUSTON – Precision Pulmonary Diagnostics, a provider of sleep management services based here, has changed its name to Precision Sleep Solutions as part of a rebranding initiative. The company also plans to introduce a new corporate logo, color scheme and tagline, as well as launch a refreshed website. Company officials say the new name more accurately describes the core competence and value proposition of the company. “Our new name reflects how businesses addressing sleep apnea and fatigue in the workplace enjoy hard-dollar savings in employee health and safety expenditures,” said Dr. Mark Berger, president and CEO. Established in 2006, Precision Sleep Solutions provides comprehensive, cost-effective sleep apnea disease management solutions for the transportation Industry. Its patented process of sleep apnea testing and treatment delivery developed within a trucking company for the trucking industry has been recognized by organizations like the National Sleep Foundation and the American Sleep Apnea Association.

Comfort Mobility Medical broadens product portfolio
BOYNTON BEACH, Fla. – Comfort Mobility Medical has increased the number of lift chairs in its showroom to 24-30, all manufactured by Golden Technologies, the company has announced. Founder Patrick “Randall” Flack says he prides himself on knowing which lift chair is the best for each customer. “I personally test everything to understand how it works and who it will benefit the most, in terms of quality of life,” he said. Comfort Mobility Medical also carries other products, including Inogen One’s G3 portable oxygen concentrator. In 2018, the company has added a number of new products to its portfolio, including the Kalmia Therapeutic Sleep System by Parks Health Products.

Medtrade Spring heats up, Medtrade planning in progress
LAS VEGAS ¬– Early registration rates for Medtrade Spring end Jan. 31, show organizers have reminded providers. Early registration rates are $50 for the Expo pass and $199 for the conference pass. Those rates increase to $100 and $249, respectively, after Jan. 31. “Don’t let this value pass you by,” says Sarah Varner, marketing director for Medtrade. The Spring event is scheduled for March 27-29 at the Mandalay Bay Convention Center in Las Vegas…Show organizers have put out a call for presentations for Medtrade, Oct. 15-17 at the Georgia World Congress Center. They plan to emphasize panels again this year, but they will also select individual and co-presented sessions. Topics of interest include audits and compliance, competitive bidding, legal, retail/caretail, sales and marketing, strategic planning, business operations, executive leadership and Medicare updates.

Breast care event seeks speakers, exhibitors
NEW ORLEANS – The Global Breast Care Summit & Expo, hosted by the American Association of Breast Care Professionals, is calling for speakers and exhibitors. The event, scheduled for July 10-12 at Harrah’s Casino in New Orleans, provides individual attendees with the opportunity to network with mastectomy stakeholders, explore new products, and develop a professional edge through a broad range of educational opportunities and product demonstrations. Who should attend? Certified mastectomy fitters, healthcare providers, nurses, prosthetists and orthotists, wig/head wear fitters, and others.

Cure Medical sponsors Rollettes
LOS ANGELES – Cure Medical is now a sponsor of the Rollettes, a wheelchair dance team that seeks to empower women with disabilities through dance. "The Rollettes consistently embody our shared values of support, strength and grace within the community we serve,” said Lisa Wells, Cure Medical vice president of marketing. “Cure Medical is honored to financially support their educational and outreach programs that connect women in creative, collaborative and empowering ways.” Cure’s financial commitment includes sponsoring the Rollettes Experience National Camp in August.

Short takes: Brightree, Paragon Ventures
Brightree has extended its membership agreement with VGM & Associates through 2010. The agreement ensures VGM members will continue to save money through discounted access to Brightree’s core software solutions. Brightree and VGM have partnered since 2008…M&A advisory firm Paragon Ventures has a new managing director: Tony Marsallo. Marsallo, who co-founded Sleep Services of America, will focus on various healthcare businesses, including sleep medicine, home health, medical device and urgent care sectors…Netherlands-based NightBalance has received a “positive recommendation” from the Dutch National Health Care Institute to reimburse its Sleep Position Trainer for obstructive sleep apnea. The Dutch Ministry of Health, Welfare and Sport will formally approve the device for reimbursement following this recommendation. NightBalance says the approval is based on the company’s “strong data, demonstrating clinical efficacy,” including a clinical data set of more than 80,000 nights in peer-reviewed published research. Back in 2016, NightBalance said it would use a round of financing to bankroll a U.S. launch…Brookfield, Wis.-based OnCourse Learning has acquired Wound Care Education Institute, an internationally recognized wound care education provider for healthcare professionals. WCEI, founded by two nurses, conducts on-site and online courses, along with live and on-demand webinars. Its annual Wild On Wounds conference draws wound care clinicians from around the country. OnCourse Learning delivers licensure, regulatory and compliance education solutions throughout a number of industries, including health care, financial services and real estate…bflow has been named as one of the top three tech startups in Fresno by The Tech Tribune. To qualify, a company must be privately owned, less than 10 years old and a recipient of venture capital funding, according to a press release. bflow was recognized based on revenue potential, leadership, brand/product traction and its competitive landscape.

People news: Debra Bullock, Lou Silverman
Houston-based IMCO Home Care has named Debra Bullock as its full-time president. Bullock has serviced the medical device community for more than 40 years in sales, operations, management and member service development. For the last 21 years, IMCO, a separate company, has employed Bullock in various positions, most recently executive vice president of Long Term Care and Homecare. “I am thrilled about Deb coming on board full time at IHC,” said Pam Weadow, IMCO Home Care’s vice president and general manager. “Deb is an icon in our industry and has a great passion for helping people age in place. Both her knowledge and connections will help us take IMCO Home Care to the next level.” Established in 2012, IMCO Home Care, a group-purchasing organization, offers contracting solutions and resources that allow homecare providers to save time and money, and improve care…Durham, N.C.-based PatientPay, an end-to-end patient payment solution focused on specialty health care, has appointed Lou Silverman to its board of directors. Silverman is currently the CEO of Advanced ICU Care, where he has driven growth of the company for the past four years.

YARMOUTH, Maine – The big story in mobility for 2017 was CMS’s new prior authorization program for two complex rehab codes, K0856 and K0861.

Authorize this

Prior authorizations were the subject of two of the most read stories for 2017: “CMS announces first codes up for PA process” (No. 2) and “It’s a bumpy start for prior authorizations” (No. 4).

Mobility providers are no strangers to prior authorizations, which CMS already requires in 19 states for standard power wheelchairs as part of a demonstration project, but there are hiccups with any new program. In this case, stakeholders felt, at least initially, that providers didn’t have all the information they needed to comply with the program. It wasn’t until the last minute, for example, that they received an operational guide from CMS.

But by and large, stakeholders support this new program, as well as the demo. Complex rehab wheelchairs are costly to provide, and prior authorizations give providers a level of confidence that they’ll get paid for their work. Stakeholders have actually made the case for requiring prior authorizations for standard power wheelchairs in all states and for all complex rehab wheelchairs.

With the demo set to expire in August, CMS has the opportunity, stakeholders say, to do just that. Will 2018 be the year of widespread prior authorizations?

Accessible—and smart

Another subject that dominated the most read stories in 2017: home modifications. In the No. 1 story, “NSM sees ‘steady growth’ in home accessibility,” the national complex rehab provider provides an update on AccessNSM, which grew to 14 locations in 12 states in 2017.

Now that NSM and Numotion have consolidated much of the complex rehab market, they’re looking for additional ways to grow their businesses, and home modifications, which are needed by a similar customer base, fits the bill.

In the No. 3 story, “Group sets off movement for home modifications,” this niche business gets further play, with stakeholders organizing behind a bill in the House of Representatives that would give seniors a $30,000 tax credit for modifying their homes to help them age in place.

With the VGM Group also making a concerted push in this market (rebranding its Accessible Home Improvement of America to VGM Live at Home to expand its coverage to smart sensors and other home health technology), we’re also watching this space in 2018.

AMARILLO, Texas – Healthcare attorney Jeff Baird says no provider likes subcontracting agreements; nevertheless, there are a large number of them out there.

“Because reimbursement is so low, to take that reimbursement and split it between two companies doesn’t add up,” he said. “It’s a lose-lose.”

But contract suppliers want to make up for that low reimbursement with additional volume, and subcontractors want to hold on to their referral sources, so here we are.

Here’s what Baird had to say about how these agreements should be set up.

In a perfect world

“We have the contractor ABC and the subcontractor XYZ. ABC talks with the doctor; they get the order in; they make the decision as to whether or not the patient meets the medical necessity criteria. So ABC is the one that goes through the mental process. Then they call XYZ and say, ‘OK, you need to take care of Mrs. Smith,’ and XYZ does the heavy lifting. They deliver equipment; they educate Mrs. Smith and set her up; they handle repair and maintenance. ABC then bills Medicare, gets paid and pays XYZ.”

In reality

“XYZ doesn’t want to lose their referral sources for bid products and non-bid products, and doctors want one-stop shops. So the XYZs look at the CBIC website, see who the winners are and call them and say, ‘We see that you have a contract for this CBA; I want to be your subcontractor.’ Here’s the hook: They also say, ‘I’ll send you all kinds of patients.’ Doctors are loyal to XYZ, so they’re going to continue to refer to XYZ, and XYZ is going to send patients to ABC.”

Here’s where it gets dicey

“The CBIC wants the referrals to go through ABC, not XYZ. Well, the subcontractors fudge that a little bit and often referrals do flow through subcontractors to contract suppliers. If the CBIC determines that, they might come in and say, don’t do that.”

“The other area that’s a problem is if XYZ says to ABC, ‘Here’s everything; just bill for it.’ You can’t do that. If XYZ is doing everything, including the intake, and all ABC is doing is submitting a claim, that’s a sham. It’s critical that ABC has skin in the game.”

Gold standard

“The gold standard would be for ABC to pay a fixed annual fee to XYZ, say $4,000 a month or $48,000 a year, to perform subcontract services. The silver standard is to actually have a fee schedule, a set dollar amount for each service rendered. It’s not high risk, but it’s not as clean as the gold standard.”

WASHINGTON – The U.S. Department of Veterans Affairs, the Department of Health and Human Services and CMS are partnering to strengthen fraud prevention efforts.

The agencies will share data, analytics tools and best practices for identifying and preventing fraud, waste and abuse, according to a press release.

The VA plans to capitalize on the advancements CMS has made in this area, particularly the agency’s use of advanced technology, statistics and analytics to improve fraud detection and prevention efforts.

“We have a special obligation to keep America’s promise to those who have served our country and ensure that veterans receive high-quality and accessible health care,” said CMS Administrator Seema Verma. “CMS is sharing lessons learned and expertise to support VA to identify waste and fraud and eliminate these abuses of the public trust. Using state-of-the-art data analytics, CMS is partnering with VA to better detect and prevent wrongdoing in its programs.”

CMS estimates its program integrity efforts saved Medicare $17 billion in fiscal year 2015.

WASHINGTON – Alex Azar has been confirmed by the Senate as secretary of the Department of Health and Human Services by a 55-43 vote. At his Jan. 9 confirmation hearing, Azar told Sen. John Thune, R-S.D., he would work with congressional leaders to address issues negatively impacting the HME industry, including working with the Office of Management and Budget to approve an interim final rule that would provide relief from Medicare’s competitive bidding program in non-bid areas. Industry stakeholders plan to press Azar to keep that promise. “AAHomecare and the home medical equipment community look forward to working with Secretary Azar to make sure that our nation’s seniors, people with disabilities, and individuals with chronic conditions have access to HME products and services that can keep them at home with their families and principal caregivers,” said the association in a bulletin.

WASHINGTON – The ink is barely dry on his confirmation papers, but industry stakeholders are ready to work with new Health and Human Services Secretary Alex Azar.

“We look forward to working with Secretary Azar to produce a sustainable reimbursement environment for HME,” said Tom Ryan, president and CEO of AAHomecare. “We’re hopeful that he will work with the Office of Management and Budget to get the interim final rule, rolling back some of the cuts for rural providers, released soon. It’s also critical that HHS and CMS work on fixes for the competitive bidding program before the next bidding round goes into effect.”

The Senate confirmed Azar Jan. 24 by a 55-43 vote. At his Jan. 9 confirmation hearing, he told Sen. John Thune, R-S.D., he would be “happy” to work with the OMB to “quickly approve” an IFR that would provide relief from Medicare’s competitive bidding program in non-bid areas.

President Donald Trump nominated Azar in November after then-Secretary Tom Price resigned. While Price was an HME champion well versed in issues like competitive bidding, Azar, a pharmaceutical exec who worked most recently as chairman and founder of Seraphim Strategies, a consulting firm, doesn’t have much—if any—experience with DME. But that’s not necessarily a problem, say stakeholders.

“He doesn’t have a track record of negative or positive positions (on DME), which in and of itself is not a bad thing,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “As secretary, CMS is only one of the many agencies he’s responsible for and it’s unclear how closely he’ll be involved.”

Azar’s resume also includes a stint as president of Lilly USA, an affiliate of Eli Lilly, from January 2012 to January 2017; and a stint at HHS, from 2005-07, as a deputy secretary in the department, and from 2001-05, as general counsel.

As HHS secretary, Azar will be working at 10,000 feet, fighting the Affordable Care Act and other high-profile national healthcare issues, say stakeholders. As long as industry champions look over his shoulder on things like the IFR, they remain optimistic.

“We just want to him to remember to come back with his commitment to Thune to look into the IFR,” said John Gallagher, vice president of government relations for VGM.

WASHINGTON – The U.S. Department of Veterans Affairs, the Department of Health and Human Services and CMS are partnering to strengthen fraud prevention efforts.

The agencies will share data, analytics tools and best practices for identifying and preventing fraud, waste and abuse, according to a press release.

The VA plans to capitalize on the advancements CMS has made in this area, particularly the agency’s use of advanced technology, statistics and analytics to improve fraud detection and prevention efforts.

“We have a special obligation to keep America’s promise to those who have served our country and ensure that veterans receive high-quality and accessible health care,” said CMS Administrator Seema Verma. “CMS is sharing lessons learned and expertise to support VA to identify waste and fraud and eliminate these abuses of the public trust. Using state-of-the-art data analytics, CMS is partnering with VA to better detect and prevent wrongdoing in its programs.”

CMS estimates its program integrity efforts saved Medicare $17 billion in fiscal year 2015.

Beacon transitions HME biz to Alick’s

SOUTH BEND, Ind. – Beacon Home Care is transitioning its medical equipment and supplies business to Alick’s Home Medical Equipment by the end of the month, according to the South Bend Tribune. The companies, which are both based here, are calling the change a “joint venture,” the newspaper says. Beacon Home Care will retain its nursing, therapy, home health aide and other services. “We are focusing our energies on what Beacon does best,” Heidi Prescott, a spokeswoman for Beacon Home Care told the Tribune. “Home medical equipment is what Alick’s does best.” The 35 employees affected by the change have been offered positions at Alick’s, according to the newspaper. Alick’s also has locations in Elkhart, Plymouth, Michigan City and Mishawaka. The family owned business offers a full line of HME, including hospital beds, scooters, lift chairs and respiratory equipment.

Mediware expands portfolio

LENEXA, Kan. – Mediware Information Systems has acquired MEDTranDirect, a provider of software solutions for healthcare revenue cycle management and an approved network service vendor for Medicare. The move extends the capabilities in Mediware’s Kinnser Software, which it acquired in 2017. "At Mediware, we are transforming and empowering data-driven decision-making across the continuum of care to help providers determine the most cost-effective paths to improving patient outcomes,” said Bill Miller, CEO of Mediware. Mediware is a portfolio company of TPG Capital.

Drive DeVilbiss scores exclusive

PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare has become the exclusive distributor of the Uccello Kettle in the United States and Canada, the company announced Jan. 26. The kettle features a weighted base that arcs on a rotating axis, and a non-weight bearing, ergonomic handle for easy and safe pouring. “The Uccello Kettle is equipped with easy pouring technology,” said Jeanne Borgia, product manager, Personal Care and Bath Safety. “This gives individuals with limited dexterity and strength the ability to pour hot water safely and steadily.” Other features include a power light to indicate when the kettle is boiling and an auto shut off to protect it from overheating.

NSM notes: Contracts with payer, extends partnership with WHILL

NASHVILLE, Tenn. – National Seating & Mobility is now in-network with Geisinger Health Plan in Pennsylvania, the provider announced Jan. 23. “Our experienced assistive technology professionals and branch teams in Pennsylvania look forward to bringing customized rehab solutions to plan members with mobility challenges,” said Bill Mixon, NSM CEO, in a press release. NSM currently has branches in Harrisburg, Reading and Allentown, Pa. Geisinger serves 557,000 members in the state…NSM has extended its partnership with WHILL Inc. Per the partmership, NSM will serve as the national complex rehab distributor of the new Model Ci power mobility device. WHILL’s Model Ci has two motors, front omni-wheels, easy-to-use controllers and the ability to disassemble into three parts. NSM and WHILL previously announced an exclusive nationwide complex rehab agreement for the Model M power wheelchair in July 2017.

HME/RT Council has new leaders

WASHINGTON – Missy Cross, administrative director of ProMedica, has taken the reins as chairwoman of AAHomecare’s HME/RT Council, after two years of serving as vice chair. Al Neumann, co-owner of Corner Home Medical, will now serve as vice chair. Both Cross and Neumann have been actively involved in the industry. Cross, recipient of the inaugural Van Miller Homecare Champion Award in 2016, also sits on the board of directors of AAHomecare and the Ohio Association of Medical Equipment Services. Neumann is the secretary of the Midwest Association of Medical Equipment Services and also serves on its board. The council will convene in February to finalize its 2018 goals.

NHIA releases updated coding resource

ALEXANDRIA, Va. – The National Home Infusion Association has released the 2018 version of the NHIA National Coding Standard for Home Infusion Claims under HIPAA. The document presents HCPCS per diem "S" codes as a comprehensive coding system for home infusion therapy claims, and provides procedures for their use, information about what's included in the home infusion per diem, and detailed coding examples for both typical and unusual claims. The resource is available for free and can be downloaded here.

Study: ASV better for central apnea patients

SAN DIEGO – Patients with central sleep apnea who switch from positive airway pressure to adaptive servo ventilation therapy may be more adherent to therapy, according to a ResMed-funded study published in the Journal of Clinical Sleep Medicine. The study analyzed anonymous, aggregated data from the devices of 198,890 telemonitored patients with treatment-emergent central sleep apnea who started on PAP therapy. Researchers found 62.7% of patients were adherent on therapy while still on PAP; and 76.6% were adherent after switching to ASV therapy. “JCSM’s publication is a significant call for clinicians to monitor sleep apnea patients for central apneas and prescribe the therapy that best fits their needs,” said Carlos M. Nunez, M.D., ResMed’s chief medical officer.

RRI issues new product catalog

ST. LOUIS, Mo. – Responsive Respiratory has released its 2018 oxygen products catalog. The catalog features several new products and categories, including DOT-compliant multi-cylinder racks and an expanded line of home filling products. “We are continually monitoring the needs of providers to ensure we are meeting and exceeding the needs of our customers,” said Tom Bannon, president, in a press release. The full color catalog is available by request in both print and electronic format.

Aeroflow highlights success in 2017

ASHEVILLE, N.C. – Aeroflow Healthcare logged an annual sales growth rate of 146% in 2017, making it the company’s best year yet. “By actively seeking new markets, expanding through its competitive acquisition strategy, and moving from a brick-and-mortar model to a pack, pick and ship model, Aeroflow continued its expansion geographically and in product lines,” it stated in a press release. Other highlights from the year: Aeroflow saw a 17% increase in job growth in 2017, with plans to hire an additional 50 to 100 employees in 2018; and the company purchased and renovated a new distribution facility, The Hite Fulfillment Center, that spans 35,000 square feet, consolidates all inventory and improves logistical efficiency. Aeroflow also earned three recognitions in 2017, including being named to Inc. Magazine’s 5000 Fastest Growing Companies list, and being certified for the highly coveted Great Place to Work Award.

Early rates for Medtrade Spring set to expire

LAS VEGAS – Early registration rates for Medtrade Spring expire on Jan. 31, show organizers remind prospective attendees. “An expo pass gets you in front of hundreds of exhibitors and products, and a conference pass includes that plus access to education and experts,” said Sarah Varner, marketing director for Medtrade. “Don’t let this great value pass you by.” The show takes place March 27-29 at the Mandalay Bay Convention Center in Las Vegas.

WASHINGTON – Industry efforts to lobby lawmakers to pressure the Office of Management and Budget to release an interim final rule that would provide relief from Medicare’s competitive bidding program are moving the needle, stakeholders say.

A number of providers, including Patrick Naeger of Healthcare Equipment and Supply Co. in Perryville, Mo., have succeeded in getting their members of Congress to contact the OMB and its director, Mick Mulvaney, about the IFR in recent weeks.

“The pressure is mounting,” said John Gallagher, vice president of government relations for The VGM Group.

The IFR would extend a delay to a second round of reimbursement cuts in non-bid areas from Aug. 1, 2017, through Dec. 31, 2018.

The reports back from the members of Congress who have contacted the OMB: “They say they’re working on it,” Gallagher says.

“It’s a non-committal commitment, but to me that’s better than what we were getting, which was radio silence,” he said.

While stakeholders are simultaneously pushing both the release of the IFR and the passing of H.R. 4229, a bill that would provide similar relief, the IFR has taken precedence, at least in the short term. There are a number of pressing matters before Congress, like deadlines for funding the government and reforming immigration policies, that are making it difficult to get traction legislatively.

“The upshot is those issues may be opportunities for us to get our issues attached,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “But the environment right now is very distracting and resource-intensive for people on the Hill.”

At press time on Friday, H.R. 4229, which would delay a second round of reimbursement cuts in non-bid areas from Jan. 1, 2017, to Dec. 31, 2018, had 116 co-sponsors. Stakeholders believe if they can reach 150 co-sponsors, they’ll have a powerful case for leadership to move the bill.

“We’re trying to set up a meeting with Speaker of the House Paul Ryan, and if we could take that to him, that would be impactful,” Gallagher said.

Stakeholders believe having a secretary now in place at the Department of Health and Human Services is a piece of the puzzle now in place. Alex Azar said during his confirmation hearing that he would be willing to work with the OMB on releasing the IFR.

“Maybe that will help to move things along, as well,” Bachenheimer said.

WASHINGTON – HME issues took center stage at the inaugural meeting of a new CMS focus group aimed at putting “Patients Over Paperwork.”

The Provider Compliance Focus Group, which is expected to meet quarterly, discussed how reducing onerous regulations could help improve documentation compliance.

“You can imagine we probably spoke up more than anyone else in the room,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “It’s the same issues—we just bring them up over and over.”

Among those issues: CMS hasn’t published official guidance that the effective data stamp requirement has been removed; providers report difficulties complying with the proof of delivery requirement; and the industry’s pleas to bring back “common sense” clinical inference have so far fallen on mostly deaf ears.

With President Donald Trump’s pledge to reduce regulations on businesses, however, there’s definitely a change in the air, says Brummett.

“The political appointees at CMS now are engaged with us in a much more meaningful way,” she said. “I feel there’s more intention to make changes. There is pressure to make changes.”

That pressure to make changes—especially where it concerns HME—stems, in part, from the massive appeals backlog, much of which can be attributed to claims denied for documentation errors.

“When you have so many technical requirements, any auditor can sit there and look at a claim and find a reason to deny it,” said Wayne van Halem, president of the van Halem Group. “I’d like to see them focus on easing up on that. With that, and reinstating clinical judgment, I think we’d see a huge improvement.”

BOSTON – The Medicaid program in Massachusetts has entered into a preferred supplier agreement for incontinence supplies with Geriatric Medical & Surgical Supply, according to a recent administrative bulletin.

Geriatric Medical is a Woburn, Mass.-based supplier of wholesale medical products to long-term care, home care and nursing home facilities.

The state will hold a public hearing on Feb. 16 to review and discuss the proposed covered products and rates.

“(The state) is proposing this action to ensure that payments are consistent with efficiency, economy, and quality of care,” wrote the Massachusetts Executive Office of Health and Human Services in the bulletin. “EOHHS anticipates that annual aggregate MassHealth expenditures will decrease by approximately $3.7 million as result of this action.”

The agreement is expected to go live March 1.

The Home Medical Equipment and Services Association of New England plans to attend the hearing and testify. Additionally, HOMES and Geriatric Medical, one of the association’s associate members, are holding a webinar on Feb. 5 to discuss the agreement, as well as provide details on the status of the bid, the covered products, and the onboarding and implementation plan for MassHealth members.

Cooke & Burnell Orthopedic Supplies shuts down
PITTSFIELD, Mass. – Cooke & Burnell Orthopedic Supplies has closed, after an attempt to merge with another company failed, according to the Berkshire Eagle. Cooke & Burnell, which had four employees, stopped accepting new patients on Jan. 1, but it remained open for several weeks so that company officials could tie up loose ends. The merger was how they planned to renew their five-year license to sell orthopedic supplies, which expired at the end of 2017. Company officials decided to close the business, instead of searching for another license holder, because they didn’t have enough time, the newspaper reported. There’s a possibility that the closure will be temporary, but company officials told the newspaper of their prospects of finding another license holder: “We’re not banking on that.” In addition to braces, Cooke & Burnell provided a wide range of other HME, including electric scooters, lift chairs, hospital beds, diabetic shoes and bathroom accessories. The company has been providing customers with a list of six other firms in the Berkshires that provide similar equipment and supplies.

NY railway starts OSA program
GLENDALE, N.Y. – New York & Atlantic Railway launched an Obstructive Sleep Apnea program on Jan. 23, screening nearly 40 NYA locomotive engineers and conductors in New York City and Long Island, N.Y. If needed, they will receive treatment under the support and care of the railway’s medical team, according to a press release. “The detection and remediation of OSA will positively impact employee health and improve employee alertness for safety sensitive jobs,” said NYA President James Bonner. NYA is billing itself as the first short-line freight railroad in the United States to institute such an OSA program. It is working on the program with Rocky Mountain Sleep Disorders Center.

StateServ, Hospicelink merge
TEMPE, Ariz., and BIRMINGHAM, Ala. – StateServ Holdings and Hospicelink have combined to become the leader for DME benefit management solutions in the hospice and post-acute care markets, the two companies say. Together, StateServ and Hospicelink operate a national network of more than 1,300 DME provider locations and 21 company owned distribution centers that serve more than 100,000 patients daily. “This marks the beginning of a long-term strategy to expand our leadership in the core hospice market and position the combined business to add value across the post-acute continuum of care,” said Paul DiCosmo, CEO of StateServ. “This exciting partnership will enable substantial investments in technology and infrastructure for the benefit of our employees, customers and DME partners across the nation.” The combined company will be a portfolio company of Blue Wolf Capital Partners, a middle-market private equity fund. Paul DiCosmo, StateServ’s co-founder and CEO, has been named CEO of the combined company. Chad Trull, Hospicelink’s founder and CEO, has been named president. The combined company will retain both current headquarters in Tempe, Ariz., and Birmingham, Ala.

Navicure, ZirMed rebrand
ATLANTA – Navicure and ZirMed will operate under the name Waystar, after the two revenue cycle technology companies merged in November. Combined, they provide cloud-based technology to more than 440,000 providers, 21,000 healthcare organizations and 550 hospitals and health systems. “We’re proud and excited for all that our new company name represents,” said Matthew Hawkins, Waystar CEO in a press release. “We are pleased with the progress we are making integrating the companies’ cultures, growth strategies, and organizations to create a new standard for technology and service excellence for our partners and clients.” Waystar will maintain both the Navicure and ZirMed brands during the transition process.

VGM launches new playbook
WATERLOO, Iowa – The VGM Group has released its latest playbook, “Industry Snapshots: Forecasting 2018.” The free playbook includes articles on compliance, data and security, mega trends, tax bill implications and the economy. “In 2018 there is little debate there will continue to be change and uncertainty in the DMEPOS community,” said Clint Geffert, president of VGM & Associates, a division of VGM Group. “But, where there’s a threat, a great opportunity awaits. Our playbook will provide insight and tips to help providers improve performance and offset risks within their business.” VGM launched its first playbook in 2016. The latest playbook is available at playbook.vgm.com.

Aeroflow Breastpumps offers support directory
ASHEVILLE, N.C. – Aeroflow Breastpumps, a subsidiary of Aeroflow Healthcare, has launched a Lactation Support Directory, a national directory of more than 600 lactation consultants to help with breastfeeding questions. "Aeroflow Breastpumps' mission is to increase the instances of breastfeeding nationally," said Jennifer Jordan, Aeroflow director of Mom & Baby. "Part of that commitment goes beyond simply providing the best equipment and extends to providing resources, support and the education needed to help more moms successfully breastfeed.” The free directory is available at https://aeroflowbreastpumps.com/lactation-support-directory.

Primary care physicians can manage apnea care
MINNEAPOLIS – Some sleep apnea patients may be able to manage their conditions with primary care providers, rather than sleep specialists, according to new research review from the Minneapolis VA Healthcare System and the University of Minnesota School of Medicine. Apnea patients treated by primary care providers who received additional training in diagnosing and treating sleep disorders have similar outcomes to patients treated by specialists, the researchers found. As part of their review, which has been published in the Annals of Internal Medicine, researchers analyzed eight previously published studies covering 1,515 patients. Researchers did note that more studies are needed.