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.

AUSTIN, Texas – Superior HealthPlan’s contract with the state of Texas could face scrutiny by a state ethics committee, according to local news reports.

Texas House Speaker Joe Straus has asked House members to investigate the Texas Health and Human Services Commission after an audit revealed it had mishandled its contract with the managed care plan.

Specifically, it found the state allowed Superior to report $29.6 million in bonus and incentive payments paid to medical providers' employees, even though such payments were not allowed under its contract with the state.

Superior Health Plan, part of Centene Corp., has contracted with Medline to serve as the “preferred provider” of DME and supplies to Medicaid recipients. The contract start date was delayed from Sept. 1 to Oct. 1, 2017, after a hearing in August in which lawmakers suggested that Superior HealthPlan amend its notice to patients to say they can “opt out” of using Medline.

WASHINGTON – AAHomecare and the American Thoracic Society will share the impacts of Medicare’s competitive bidding program on oxygen patients at a Feb. 14 congressional staff briefing.

Both organizations have conducted studies on the program and AAHomecare has used the results of those studies to bolster its arguments with lawmakers, as well as with CMS, the Department of Health and Human Services and the Office of Management and Budget.

But next week’s briefing, organized by Rep. Cathy McMorris-Rodgers, R-Wash., offers the organizations the opportunity to present findings to a broader segment of Hill staffers to build support for H.R. 4229.

The bill, which has 118 co-sponsors, would delay a second round of reimbursement cuts in non-bid areas from Jan. 1, 2017, to Dec. 31, 2018. Stakeholders believe if they can reach 150 co-sponsors, they’ll have a powerful case for leadership to move the bill.

Participants in the briefing will include Tom Ryan, president and CEO of AAHomecare, and Mike Calcaterra, Northern zone vice president for Norco in Spokane, Wash.

Stakeholders are asking providers to ask their contacts in the House and Senate to attend the briefing.

BOSTON – If HME providers have to deal with a preferred supplier for incontinence supplies, a new Medicaid contract in Massachusetts might be the way to go.

Because the upcoming contract between MassHealth and Geriatric Medical is a preferred supplier not a single-source contract, providers can still buy incontinence products from other distributors and manufacturers, points out Karyn Estrella, president and CEO of the Home Medical Equipment and Services Association of New England (HOMES).

“When it comes to bidding of any kind, this is the best-case scenario we could ask for,” she said.

The contract between MassHealth and Geriatric Medical, a Woburn, Mass.-based supplier of wholesale medical products, goes live March 1.

Other advantages of the contract include MassHealth’s selection of a local company and its insistence on keeping the provider network intact. Other states have allowed distributors to go direct to consumer, cutting out providers.

“We’re committed to working alongside the provider network to deliver better care at a lower cost to MassHealth members,” said Jeffrey Siegal, CEO of Geriatric Medical Supply.

While the general idea of the contract appears better than other alternatives, Estrella and other stakeholders still have a number of questions, including the implications, if any, of providers choosing to buy incontinence products from other distributors and manufacturers.

“What if they’re audited?” Estrella asked. “How do they prove that these other distributors have met the same quality standards that the preferred supplier, Geriatric Medical, has? There are still some unknowns.”

Also embedded in the contract are reimbursement cuts, but they’re not as bad as they could have been, Estrella says.

“The state worked with several of our members who shared the cost of providing incontinence products, and the state did not realize everything that is involved,” she said. “My understanding is that this had a positive impact on the reimbursement—that they came up from what they were originally thinking.”

WASHINGTON – AAHomecare and the American Thoracic Society will share the impacts of Medicare’s competitive bidding program on oxygen patients at a Feb. 14 congressional staff briefing.
Both organizations have conducted studies on the program and AAHomecare has used the results of those studies to bolster its arguments with lawmakers, as well as with CMS, the Department of Health and Human Services and the Office of Management and Budget.
But next week’s briefing, organized by Rep. Cathy McMorris-Rodgers, R-Wash., offers the organizations the opportunity to present findings to a broader segment of Hill staffers to build support for H.R. 4229.
The bill, which has 118 co-sponsors, would delay a second round of reimbursement cuts in non-bid areas from Jan. 1, 2017, to Dec. 31, 2018. Stakeholders believe if they can reach 150 co-sponsors, they’ll have a powerful case for leadership to move the bill.
Participants in the briefing will include Tom Ryan, president and CEO of AAHomecare, and Mike Calcaterra, Northern zone vice president for Norco in Spokane, Wash.
Stakeholders are asking providers to ask their contacts in the House and Senate to attend the briefing.
Spending bill includes DME-related provisions
WASHINGTON – Lawmakers passed a government spending bill early on Feb. 9 that contained several DME-related provisions.
The bill, which passed the House 240 to 186 and the Senate 71 to 28, contained a provision that would create a temporary transition payment for home infusion to address a payment gap created by a provision in the 21st Century Cures Act (see story). It also contained a provision that recognizes the clinical notes of orthotists and prosthetists as part of a patient’s official medical record to determine medical necessity; and a provision to remove the rental cap for speech-generating devices.
Hollister Inc. shifts away from wound care
LIBERTYVILLE, Ill. – Hollister Inc. on Feb. 2 announced its decision to divest portions of its wound care business.
Hollister, which manufactures products for not only the wound care market, but also the ostomy, continence and critical care markets, is in the process of transitioning its Hydrofera Blue and Endoform businesses to new owners, according to a press release.
The new owners, who plan to continue manufacturing and delivering the products, will be named in a “forthcoming” communication, the release says.
“For more than 95 years, our company’s mission has been ‘to make life more rewarding and dignified for people who use our products and services,’” said V. George Maliekel, president and CEO of Hollister. “We remain dedicated to our mission, and to serving our customers, the patients who rely on our products, and our employees around the world.”
The Hollister wound care product portfolio includes, among others, the brands Hydrofera Blue, Endoform, TRIACT and FastCast.
Hollister will continue to sell and distribute the other wound care products in its portfolio, according to the release.
A letter to customers, also dated Feb. 2, echoed much of the release, but added some color, including: “After extensive analysis and discussions, we have concluded that we will no longer pursue a path forward to build the wound care business.”
Hollister tells customers to continue ordering Hollister wound care products as they do today “until further notice.”
Advanced Home Care, Home I.V. merge
GREENSBORO, N.C. – Advanced Home Care now serves home infusion and enteral patients throughout Virginia, thanks to a merger with Home I.V. Care and Nutritional Services.
Advanced Home Care adds a branch in Waynesboro, Va., its eighth in the state, as a result of the merger with Home I.V. Care.
“Advanced Home Care will work closely with all patients, partners and employees to make the integration process as smooth as possible,” the company said in an announcement on its website. “The integration of both companies has already begun and will continue over the next few weeks. All patients will continue to receive the same high-quality care and service that they have come to expect.”
Advanced Home Care, a not-for-profit, hospital-affiliated company, operates 30 branches in North Carolina, Georgia, South Carolina, Tennessee and Virginia. It services more than 30,000 patients each day, making it one of the largest Medicare/Medicaid providers in the Southeast, according to its website.
The Braff Group, which originated the transaction and served as the exclusive M&A adviser to Home I.V. Care and Nutritional Services, says the deal is evidence of the continued consolidation of the home infusion market.
NTSB blames undiagnosed OSA for two accidents
WASHINGTON – The National Transportation Safety Board this week determined that two commuter railroad terminal accidents in the New York area were caused by engineer fatigue resulting from undiagnosed severe obstructive sleep apnea. The NTSB found the two accidents had “almost identical” probable causes and safety issues. The board also determined that these safety issues were not unique to these two properties, but exist throughout the country at many intercity passenger and commuter passenger train terminals. In August 2017 the NTSB expressed its “disappointment” with the withdrawal of a notice of proposed rulemaking by the Federal Railroad Administration and the Federal Motor Carrier Safety Administration that sought to require testing for certain commercial drivers and rail workers, stating “Obstructive sleep apnea has been the probable cause of 10 highway and rail accidents investigated by the NTSB in the past 17 years. Medical fitness and fatigue, two of the NTSB’s 10 Most Wanted List of Transportation Safety Improvements for 2017–2018, are tied to obstructive sleep apnea.” “The traveling public deserves alert operators,” said NTSB Chairman Robert L. Sumwalt this week. “That is not too much to ask.” The Sept. 29, 2016, accident on the New Jersey Transit railroad at Hoboken, N.J., killed one person, injured 110, and resulted in major damage to the station. The Jan. 4, 2017, accident on the Long Island Rail Road at the Atlantic Terminal in Brooklyn, N.Y., injured 108 people. Both accidents involved trains that struck end-of-track bumping posts and crashed into stations.
CMS plans to extend PMD demo
WASHINGTON – It looks like CMS plans to extend a demonstration project requiring prior authorizations for power mobility devices, according to a notice posted in the Federal Register on Feb. 7. The demo, in place in 19 states, is set to expire at the end of August. The Paperwork Reduction Act of 1995 requires federal agencies to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment. CMS has directed comments to be sent to the Office of Management and Budget by March 9. The demo kicked off in seven states in September 2012 and was expanded to 12 states in 2014, bringing the total to 19. In July 2015, CMS extended the demo through August 2018.
Stakeholders have told CMS they’d like to see the agency expand prior authorizations to the remaining states and also require them for complex rehab wheelchairs. CMS also started requiring prior authorizations for two complex rehab codes, K0856 and K0861, in 2017.
Texas lawmakers eye Superior HealthPlan contract
AUSTIN, Texas – Superior HealthPlan’s contract with the state of Texas could face scrutiny by a state ethics committee, according to local news reports.
Texas House Speaker Joe Straus has asked House members to investigate the Texas Health and Human Services Commission after an audit revealed it had mishandled its contract with the managed care plan.
Specifically, it found the state allowed Superior to report $29.6 million in bonus and incentive payments paid to medical providers' employees, even though such payments were not allowed under its contract with the state.
Superior Health Plan, part of Centene Corp., has contracted with Medline to serve as the “preferred provider” of DME and supplies to Medicaid recipients. The contract start date was delayed from Sept. 1 to Oct. 1, 2017, after a hearing in August in which lawmakers suggested that Superior HealthPlan amend its notice to patients to say they can “opt out” of using Medline.
SoClean adds new office
OXFORD, Mass. – SoClean, based here, is adding a new corporate office in Peterborough, N.H. The new office will serve as a call center and home base for top marketing and sales executives, while renovations take place to add other business functions. News of the new office comes as SoClean continues to expand with help from a recent investment from DW Healthcare Partners. “We chose Peterborough because of its experienced labor force, available commercial space, warehousing opportunities and business-oriented local community,” said Robert Wilkins, CEO. “The area has a talented employment pool and is a great place to conduct business. We are thrilled to be renovating a commercial space on Vose Farm Road, which will allow our brand to expand and scale globally.”
Invacare stages Medtrade Spring comeback
LAS VEGAS – Elyria, Ohio-based Invacare has signed a contract to exhibit at Medtrade Spring, March 27-29 in Las Vegas. “Invacare is a long-time exhibitor at Medtrade Spring and Medtrade, and we are pleased to have them back,” said Kevin Gaffney, group show director, Medtrade. Invacare says it wants providers to know that the company understands the challenges in the HME industry and that it’s committed to providing cost-effective products that help providers do business. “The market may be difficult, but efficient ways to run an HME business still exist, such as leveraging quality products like the Invacare Platinum Mobile Oxygen Concentrator with Connectivity that help satisfy clinical and patient needs with advancements such as integrated informatics or connectivity,” said Robert Hanley, manager, Corporate Account-HME, for Invacare. Register for Medtrade Spring here.
Retail workshops to provide ‘blueprint’
WATERLOO, Iowa – VGM Retail Services will hold 10 retail training workshops this year. The “Brick by Brick: Retail Learning Workshop” is designed to help providers manage and grow their retail operations. “We’re excited to take our retail team on the road to help providers strengthen their retail programs,” said Rob Baumhover, director of VGM Retail Services, a division of VGM Group, Inc. “Our workshops provide guidance and resources to help attendees strategize and create a customized blueprint for retail success.” Registration is open to all providers and includes a workbook, action items and lunch. For more information about the workshop or to register, visit www.brickbybrickretaillearningworkshop.eventbrite.com.
GEMCO, Brightree integrate
HUDSON, Ohio – GEMCO Medical has partnered with Brightree as an integrated electronic purchasing partner. GEMCO Medical customers will now be able to receive their products with the seamless electronic ordering power of the Brightree Integrated ePurchasing system. "Our focus has always been helping providers help their customers and this partnership provides a more efficient ordering system to do just that," says Richard Keirn, vice president of GEMCO Medical. "By removing extra steps in the current order process, we can save providers time and money so they can shift their focus."
Coloplast makes another buy
MINNEAPOLIS – Coloplast has acquired IncoCare Gunhild Vieler GmbH, a direct-to-consumer provider of continence supplies, it announced today. The German company will strengthen Coloplast’s presence in southeast Germany, according to a press release. “The acquisition of IncoCare is part of our strategy of pursuing inorganic opportunities to accelerate growth and to strengthen our service offering,” said Lars Rasmussen, Coloplast CEO. In December, Coloplast acquired SAS Lilial, a French company.
NHIA moves forward with data initiative
ALEXANDRIA, Va. – The National Home Infusion Association and Strategic Healthcare Programs (SHP), a healthcare data and technology services company, will collaborate on the collection of clinical and business performance data as part of an ongoing effort to develop national standards for home and specialty infusion therapy. SHP will work with NHIA to collect, aggregate, and report data using its web-based real time solution, according to a press release. NHIA in 2010 launched a multi-phase Industry Wide Data Initiative. “We are pleased to work with SHP to facilitate the creation of national quality standards while maintaining NHIA’s neutrality and ensuring the security and privacy for members who participate in our data activities,” said Connie Sullivan, NHIA vice president of research and innovation.
3B Medical debuts CPAP cleaner
WINTER HAVEN, Fla. – 3B Medical has launched 3B Lumin, a cleaner for CPAP masks and supplies, it announced today. Lumin has a disinfection cycle time of five minutes, releases no ozone, and is effective against bacteria, viruses, mold and fungus, according to a press release. "We wanted to develop a product that would not damage the CPAP machine itself, and had zero risk of exposing a respiratory patient to a lung irritant," said Dr. Jose Llana, national director of sales. Lumin will be available March 1.
States ramp up message: Florida, Maine
The Florida Alliance of Home Care Services recently joined forces with AAHomecare to discuss patient access issues and managed care concerns with state officials in Tallahassee. Stakeholders met with representatives from the governor’s office and the Agency for Health Care Administration. They also met with lawmakers, including Reps. Jose Oliva and Frank White. In a press release, FAHCS called the meetings “encouraging”…HOMES President and CEO Karyn Estrella and association members testified at a MaineCare public hearing on Jan. 29 regarding proposed changes to Medicaid regulations, including payment methodology. “We are concerned about the proposed implementation of the current Medicare fee schedule, since according to a recent study, these rates only cover approximately 88% of the provider’s cost,” Estrella said. “When MaineCare implemented these rates in July 2016, it led to an access problems and (the state) ultimately rescinded the rates. We have every reason to believe this will happen again.”
 

WASHINGTON – Home infusion and O&P providers are the big winners with the passage of a government spending bill early this morning.

The bill, which passed the House 240 to 186 and the Senate 71 to 28, contained several DME-related provisions, in particular, one that would create a temporary transition payment for home infusion to address a payment gap created by a provision in the 21st Century Cures Act.

“The legislation will allow Medicare beneficiaries, specifically those with heart failure and immunodeficiency diseases, to receive critical life-saving infusion therapies in their own home,” said NHIA President and CEO Tyler Wilson. 

The Cures Act requires Medicare to pay for services associated with providing Part B home infusion drugs, but not until 2021. The temporary payment, as laid out in the Medicare Home Infusion Therapy Access Act of 2017, will become effective Jan. 1, 2019.

The government spending bill also contains a provision that recognizes the clinical notes of orthotists and prosthetists as part of a patient’s official medical record to determine medical necessity. The provision comes from the Medicare Orthotics and Prosthetics Improvement Act of 2017.

Also in the bill: a provision to remove the rental cap for speech-generating devices.

WASHINGTON – The budget for the Department of Health and Human Services for fiscal year 2019 proposes two tweaks to Medicare’s competitive bidding program for DME.

First, HHS proposes eliminating the requirement that CMS pay a single payment amount based on the median bid amount and, instead, pay contract suppliers at their own bid amounts. Second, the agency proposes expanding the actual bidding process to all areas of the country, including rural areas.

“Expanding competitive bidding to rural areas will set prices for items and services in rural areas based on competitions in those areas rather than on competitions in urban areas,” the budget states.

HHS says in the event that less than two suppliers submit bids in a rural area, CMS will use a reference price from other, similar rural areas.

The agency says these changes will result in $6.5 billion in savings over 10 years.

The HHS budget also proposes eliminating what it calls the unnecessary requirement of a face-to-face provider visit for DME.

“Currently, physicians must document a beneficiary’s face-to-face encounter with a physician or non-physician practitioner as a condition for Medicare payment for a durable medical equipment order, which can be overly burdensome on providers and suppliers,” the budget states. “This proposal enables CMS not to impose this face-to-face requirement on all providers.”

WASHINGTON – Sen. Chuck Grassley, R-Iowa, has asked Office of Management and Budget Director Mick Mulvaney to tell him, in writing, the specific steps he would take to make sure the agency reviews and releases an interim final rule.

“This is important to me,” said Grassley during a Senate Budget Committee hearing this week.

The IFR, which has been stuck at the OMB since August, would provide relief from the competitive bidding program in rural areas.

Meanwhile, members of the Midwest Association of Medical Equipment Services asked House Speaker Paul Ryan to intervene in getting the IFR released during a Feb. 8 conference call with his deputy chief of staff, Allison Steil, according to a bulletin from the association.

During the call, MAMES members, led by provider Rick Adamich, the Wisconsin state chairman and president of Oxygen One in Waukesha, Wis., shared the impact of reimbursement reductions on patient access to care.

Steil told members that Ryan’s office is limited in what they can do, but they may be able to do something, according to MAMES.

WASHINGTON – AAHomecare and the American Thoracic Society held a well-attended Capitol Hill briefing on Feb. 14 to detail access problems for patients.

Al Dobson, president of Dobson DaVanzo & Associates and the lead on “Analysis on the Impact of Competitive Bidding on Medicare Beneficiary Access to Durable Medical Equipment,” a study commissioned by AAHomecare, detailed how 77% of case managers report difficulty discharging patients; and 52% of patients report difficulty accessing DME.

Those study findings are echoed by the ATS study, “Patient Perceptions of the Adequacy of Supplemental Oxygen Therapy,” which found that 51% of patients report problems with their oxygen service.

Giving the provider point of view, Mike Calcaterra, Northern Zone vice president for Norco and the Montana State Chair for Big Sky AMES, detailed how 20% of HME providers in Montana and 37% of providers in Idaho have closed their doors since 2013.

WASHINGTON – Industry stakeholders say they are as surprised as anyone by a proposal to expand Medicare’s competitive bidding program to rural areas.

“We don’t know who is proposing this or what evidence there is that this idea is prudent,” said Jay Witter, senior vice president of public policy for AAHomecare. “We are going to demand answers.”

The proposal is included in the budget for the Department of Health and Human Services for fiscal year 2019, which was released Feb. 12. The provision would also eliminate the requirement that CMS pay a single payment amount based on the median bid amount, and, instead, pay contract suppliers at their own bid amounts.

HHS says these changes will result in $6.5 billion in savings over 10 years.

“I am aghast that there’s belief in the budget that there’s $6.5 billion that can be take out of the DME benefit,” said Tom Ryan, president and CEO of AAHomecare. “We’ve already stripped the benefit and I don’t think there’s any more savings to be had.”

HHS says in the event that less than two suppliers submit bids in a rural area, CMS will use a reference price from other, similar rural areas. In many of those areas, there could very well be fewer than two suppliers bidding. At a well-attended Capitol Hill briefing Feb. 14, provider Mike Calcaterra, Northern Zone vice president for Norco and the Montana State Chair for Big Sky AMES, detailed how 20% of HME providers in Montana and 37% of providers in Idaho have closed their doors since 2013.

“There’s a real access issue,” said Ryan. “We have a solution. We need to get the interim final rule moved forward and we need support for H.R. 4229.”

Other DME-related provisions in the HHS budget include:

Eliminating the face-to-face requirement; testing whether using a benefit manager will result in fewer improper payments and lower utilization; and expanding prior authorizations to orthotics and prosthetics.

WASHINGTON – CMS has changed the guidelines for reporting a patient’s oxygen flow rate on a CMN, a move that will have two serious implications for providers, particularly those servicing the critically ill, says Andrea Stark.

First, through new modifiers laid out in a Feb. 15 joint DME MAC publication, CMS has instructed that for patients whose oxygen use differs between day and night, the average flow rate, not the highest flow rate, must be reported on question 5 of the CMN.

“They say this is going to simplify the process, but it makes things ten times more complicated,” said Stark, a reimbursement consultant for MiraVista LLC.

CMS has added three new modifiers, set to go into effect April 1: QA (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute); QB (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute and portable oxygen is prescribed); and QR (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute).

Second, by modifying existing modifiers QE, QF and QG, CMS has instructed that patients must now need more than 4 liters of oxygen per minute “at rest,” not at exertion, to qualify for a high-volume adjustment that increases reimbursement from $70.74 per month to about $106 per month.

“This will exclude patients who previously qualified for high-volume adjustments,” Stark said.

The reimbursement difference for a patient considered standard volume and high volume is about $20 to $30, a change that may be hardly worth the savings when you consider the upheaval to the documentation process and the possible threats to patients, Stark says.

“With the existing reimbursement cuts, this is just one more blow,” she said. “These high-liter-flow patients are the most expensive patients to take care of, and providers aren’t going to be paid nearly enough.”

WASHINGTON – Sen. Chuck Grassley, R-Iowa, has asked Office of Management and Budget Director Mick Mulvaney to tell him, in writing, the specific steps he would take to make sure the agency reviews and releases an interim final rule.

“This is important to me,” said Grassley during a Senate Budget Committee hearing this week.

The IFR, which has been stuck at the OMB since August, would provide relief from the competitive bidding program in rural areas.

Meanwhile, members of the Midwest Association of Medical Equipment Services asked House Speaker Paul Ryan to intervene in getting the IFR released during a Feb. 8 conference call with his deputy chief of staff, Allison Steil, according to a bulletin from the association.

During the call, MAMES members, led by provider Rick Adamich, the Wisconsin state chairman and president of Oxygen One in Waukesha, Wis., shared the impact of reimbursement reductions on patient access to care.

Steil told members that Ryan’s office is limited in what they can do, but they may be able to do something, according to MAMES.

Hill briefing: Associations tag team on access issues

WASHINGTON – AAHomecare and the American Thoracic Society held a well-attended Capitol Hill briefing on Feb. 14 to detail access problems for patients.

Al Dobson, president of Dobson DaVanzo & Associates and the lead on “Analysis on the Impact of Competitive Bidding on Medicare Beneficiary Access to Durable Medical Equipment,” a study commissioned by AAHomecare, detailed how 77% of case managers report difficulty discharging patients; and 52% of patients report difficulty accessing DME.

Those study findings are echoed by the ATS study, “Patient Perceptions of the Adequacy of Supplemental Oxygen Therapy,” which found that 51% of patients report problems with their oxygen service.

Giving the provider point of view, Mike Calcaterra, Northern Zone vice president for Norco and the Montana State Chair for Big Sky AMES, detailed how 20% of HME providers in Montana and 37% of providers in Idaho have closed their doors since 2013.

Health spending to hit 19.7% of GDP by 2026, report says

WASHINGTON – National health expenditure growth is expected to average 5.5% annually over 2017-2026, according to a report published last week by the Office of the Actuary at CMS.

Growth in national health spending is projected to be faster than projected growth in gross domestic product by 1% point during 2017-2026. As a result, health share of GDP is expected to rise from 17.9% in 2016 to 19.7% by 2026, the report says.

Drivers of growth: trends in disposable personal income, increases in prices for medical goods and services, and shifts in enrollment from private health insurance to Medicare that result from the continued aging of the baby-boom generation into Medicare eligibility.

For 2017, specifically, growth in national health spending is projected to have been 4.6%. For 2018, growth in national health spending is projected to be 5.3%.

Among the major payers for health care, Medicare is projected to experience the most rapid annual growth rate over 2017-2026 at 7.4%, largely driven by enrollment growth and faster growth in utilization from recent near-historically low rates.

Private health insurance is projected to experience the slowest growth rate at 4.7%, reflecting low enrollment growth and downward pressure on utilization influenced by, among other things, the increasing prevalence of high-deductible health plans.

Medicaid is projected to experience a growth rate of 5.8% over 2017-2026, slower than the 8.3% for 2014-2016.

Growth in personal health spending is projected to be 5.5% over 2017-2026.

KCI to lay off 68 employees

SAN ANTONIO – KCI USA, a subsidiary of Acelity, will lay off 68 workers in May, according to a notice filed with state labor regulators and reported by the San Antonio Express-News. No reason was given for the layoffs, and calls and emails to the company were not immediately returned, according to the newspaper. In 2016, Acelity, formerly Kinetic Concepts, said it was not awarded contracts for negative pressure wound therapy in the Round 2 re-compete of competitive bidding, due to a technicality.

Investment firm divests pediatric provider

HOUSTON – Main Street Capital has sold Marietta, Ga.-based SoftTouch Medical to a sponsor-backed strategic buyer, it announced Feb. 14. Main Street initially invested in SoftTouch, a provider of home medical equipment and services to pediatric patients in Georgia and Alabama, in 2014. SoftTouch’s product offerings include respiratory equipment, enteral nutrition, phototherapy and ventilators.

DASCO leverages Apacheta to gain efficiencies

WESTERVILLE, Ohio – DASCO Home Medical Equipment has added approximately 2,500 new confirmed orders each month, after tapping Apacheta’s mobile solution to gain more oversight of its delivery techs and streamline business operations. The provider has also reduced DSO by eight days, according to a press release. DASCO has implemented Apacheta’s Transport Manager, which enables managers and customers service reps to centrally plan, schedule and monitor field force activity via a cloud-based application; and Transport ACE, which streamlines mobile proof of delivery operations.

VMI launches accessible SUV

PHOENIX – Vantage Mobility International has launched the VMI Honda Pilot Northstar E, a spacious, accessible SUV. The SUV features VMI’s Access360 for expansive door opening width and height, 33.5 inches by 55.5 inches; an in-floor air ramp to keep dirt and debris out of the cabin; a 32-inch wide ramp to accommodate large power wheelchairs; and flexible seating to let the wheelchair user sit in the front passenger position of the mid row. “The introduction of the VMI Honda Pilot Northstar E accessible SUV with its innovative manual in-floor ramp offers the perfect combination of simplicity, space and style at a great price,” said VMI CEO Tim Barone in a press release.

Shield HealthCare expands into Arkansas

VALENCIA, Calif. – Shield HealthCare has expanded into Arkansas, demonstrating its commitment to the “ongoing growth of the company as a nationwide medical suppler leader,” it says. “We are excited to open up the Arkansas market,” said Roger Miller, chief marketing officer. “We believe that Arkansas customers using medical supplies need exactly what Shield offers.” Shield now operates in Arkansas, California, Colorado, Illinois, Texas and Washington. The company, which delivers incontinence, urological, ostomy, enteral nutrition, wound care and breastfeeding supplies, serves more than 180,000 patients. It offers home delivery, monthly order reminders, language translators and direct billing to insurance.

Invacare confirms move to France

ELYRIA, Ohio – Invacare will transfer production of Küschall manual wheelchairs from its facility in Witterswil, Switzerland, to its facility in Fondettes, France, by the end of the third quarter of this year. The move, which will allow the company to better optimize its facility in France, is expected to generate an incremental $1.7 million in annualized pre-tax savings in the Europe business segment. The front office of the Swiss facility will remain open, continuing to serve as Invacare’s European headquarters and research and development center, as well as its Swiss sales office. Invacare had made known its intention to relocate in a Form 8-K but it first had to complete a “consultation procedure” with potentially affected employees per Swiss law. Invacare has already shifted production of its Rea manual wheelchairs from its facility in Dïo, Sweden, to its facility in France.

ATS, ResMed award $100,000 grant for vent research

SAN DIEGO – Dr. Jeremy Orr of the University of California, San Diego, has been awarded the new ATS Foundation/ResMed Research Fellowship in Noninvasive Ventilation in COPD. Dr. Orr’s $100,000 award will support his research focused on the impact of NIV on cardiovascular biomarkers in COPD. “Noninvasive ventilation during sleep is one of the few treatments in COPD that improves survival, but we don’t really understand the underlying mechanisms,” Orr said. “This grant will facilitate my research into the potential systemic and extra-pulmonary benefits of NIV.” The American Thoracic Society aims to improve global health by advancing research, patient care and public health in respiratory disease, critical illness and sleep disorders. ResMed manufactures NIV devices for treating COPD in the home and hospital.

FODAC receives two grants worth $80K

STONE MOUNTAIN, Ga. – Friends of Disabled Adults and Children has been named the winner of two “2018 Collaborative Innovation Grants” totaling $80,000. FODAC will use the funds to create new partnerships with Children’s Healthcare of Atlanta and Goodwill Industries of North Georgia. The “Hospital to home support keeps children with disabilities moving” program with Children’s Healthcare will help to ensure that children hospitalized for a severe injury or illness can acquire the DME needed for home recovery. The “Expand recycling and access to home medical equipment” program with Goodwill will establish 10 new locations for collecting DME donations. The annual “Collaborative Innovation Grant” is an invite-only competition for nonprofits in the Building Community Network led by the Georgia Center for Nonprofits and The Home Depot Foundation. The network is a collective of nonprofit leadership, bringing together 200-plus Atlanta-area organizations.

WASHINGTON – National health expenditure growth is expected to average 5.5% annually over 2017-2026, according to a report published this week by the Office of the Actuary at CMS.

Growth in national health spending is projected to be faster than projected growth in gross domestic product by 1% point during 2017-2026. As a result, health share of GDP is expected to rise from 17.9% in 2016 to 19.7% by 2026, the report says.

Drivers of growth: trends in disposable personal income, increases in prices for medical goods and services, and shifts in enrollment from private health insurance to Medicare that result from the continued aging of the baby-boom generation into Medicare eligibility.

For 2017, specifically, growth in national health spending is projected to have been 4.6%. For 2018, growth in national health spending is projected to be 5.3%.

Among the major payers for health care, Medicare is projected to experience the most rapid annual growth rate over 2017-2026 at 7.4%, largely driven by enrollment growth and faster growth in utilization from recent near-historically low rates.

Private health insurance is projected to experience the slowest growth rate at 4.7%, reflecting low enrollment growth and downward pressure on utilization influenced by, among other things, the increasing prevalence of high-deductible health plans.

Medicaid is projected to experience a growth rate of 5.8% over 2017-2026, slower than the 8.3% for 2014-2016.

Growth in personal health spending is projected to be 5.5% over 2017-2026.

WASHINGTON – It’s becoming less and less likely that CMS will make its target implementation date for Round 2019, industry stakeholders say.

It has been a year since CMS put the brakes on Round 2019 of the competitive bidding program, and the agency still hasn’t provided an update on its plans for the next bid round.

“If I were a betting person, I’d say it’s certainly not going to happen on Jan. 1, 2019,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “At the end of the day, the Competitive Bidding and Implementation Contractor has a boatload of work to do, analyzing and vetting all of the bids.”

A week after CMS announced Round 2019 in February 2017, the agency said it would temporarily delay the program to give the new administration time to review it.

Since then, the Department of Health and Human Services has seen a shuffle in leadership, with Alex Azar taking the reins in January, replacing industry champion Tom Price, who resigned in September.

“There’s been a lot of consternation with this program, so maybe Azar wanted to take a fresh look at things,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

CMS has typically given the bidding process—from bid window opening to contract implementation—about 16 months. With the current Round 1 2017, Round 2 re-compete, and national mail-order program for diabetes set to end on Dec. 31, 2018, stakeholders say CMS could extend the current contracts by six months to buy itself more time.

“With that timing, they have a similar timeline (as past rounds), if they came out with something by the end of March or even into April,” said Bachenheimer. “But it seems unfeasible if they stick to business as usual.”

AAHomecare and other industry stakeholders have continued to make recommendations to CMS and HHS officials on how to improve the program, such as making the online bidding process more efficient.

“We like to be optimistic, but it’s impossible to say what’s happening—or not happening—behind the scenes,” Bachenheimer said.

However, a recent proposal to expand the competitive bidding process to rural areas and to pay providers based on their own bid amounts, not the median bid amount, gives stakeholders a peak into the agency’s thought process—and just how little it still seems to understand about the program.

“If they get rid of the median bid, would it be the bottom bid? Would you accept your own bid?” said John Gallagher, vice president of government relations for VGM. “How many bids would there be? It’s a bit dumbfounding.”

YARMOUTH, Maine – A little more than half of respondents to a recent HME Newspoll say President Donald Trump hasn’t had a positive impact on their businesses in his first year in office, largely because none of the changes he has made have anything to do with reforming Medicare’s competitive bidding program.

“I support this administration, but (the Department of Health and Human Services) needs to fix rural reimbursement,” wrote Bob Forbes of Advantage Home Oxygen in Dubois, Pa. “I’ve already watched one local (company) close and everyone else has downsized to the point of (threatening) patient safety.”

Fifty-one percent of respondents said the first year of a Trump administration has not had a positive impact on their businesses.

For the 49% respondents who reported Trump has had a positive impact, many credited tax reform.

“For the 2018 filling year, we should see a decrease to our taxes, in part due to the 20% deduction that will be allowed,” said one respondent. “This will help offset the low reimbursement we continue to deal with.”

Respondents also credited tax reform for everything from salary increases (“It may not have happened without it,” wrote Angela Fisher of Greene Respiratory Services in Milford, Ohio) to cash sale increases.

“The overall optimism in the economy has made it easier to sell the bigger-ticket items,” wrote one respondent.

But for the majority of respondents, it’s hard to see past the destruction caused by the bid program, something that could continue under Trump. A recently released HHS budget* for fiscal year 2019 proposes implementing an actual bid process in rural areas, a move that the agency says will save billions of dollars over 10 years.

“If they do not provide relief with the IFR or H.R. 4229, there will be a drastic loss of rural providers,” wrote one respondent. “I see where HHS now wants to conduct competitive bidding in rural areas—what a joke. As if there is $6.5 billion more to save. Our government is bent on destroying DME businesses and is doing a good job of that.”

Indeed, there may be some disappointment among the 64% of respondents to an HME Newspoll back in September 2016 who said they would vote for Trump, believing he would bring a business perspective to health care.

“I know that many people voted for Trump, believing that he was going to save the DME industry, but that hasn’t been the case,” wrote one respondent. “We have seen no appreciable change and don’t anticipate seeing one. Empty promises, as usual.”

http://www.hmenews.com/article/stakeholders-aghast-bid-proposal

http://www.hmenews.com/article/election-2016-hme-providers-cast-their-lot-trump

DARIEN, Ill. – Non-adherence to CPAP therapy is significantly associated with increased 30-day hospital readmissions, according to a study of patients with obstructive sleep apnea published in a recent issue of Journal of Clinical Sleep Medicine.
Non-adherent patients were three times more likely to be readmitted to the hospital within 30 days for any cause, the study shows.
"Until now no one has investigated the role of CPAP non-adherence in 30-day readmissions as an independent risk factor in all types of admissions," said principal investigator Dr. Behrouz Jafari, director of the sleep program at the Veterans Affairs Long Beach Healthcare System in Long Beach, California, and assistant professor of medicine in the section of pulmonary and critical care medicine at the University of California, Irvine. "This study carries important implications as it suggests that CPAP therapy may be an important, modifiable target for reducing hospital readmissions.”
The leading cardiovascular causes for readmission in these patients were atrial fibrillation, myocardial ischemia and congestive heart failure, all of which are linked to untreated sleep apnea, the study says.
The study involved 345 patients with obstructive sleep apnea who were hospitalized at a VA medical center from Jan. 1, 2007, to Dec. 31, 2015. Ninety-five percent of participants were men, and 72% were white. The 183 adherent patients had an average age of 66 years, and the 162 non-adherent patients had an average age of 62 years. Mean sleep apnea severity was severe in both groups.
Objective CPAP data were analyzed according to the Medicare definition of CPAP adherence, which is CPAP use for four or more hours per night on 70% of nights during a consecutive minimum period of 30 days. Results were adjusted for potential confounders such as age, sex, body mass index, living situation, race, comorbidities, and medication adherence.
Jafari noted that 30-day readmissions are touted as the key quality indicator for hospitals and a way to reduce healthcare costs.
"Improving CPAP adherence may have a cost-saving effect at local, state-based and national levels," he said.
CMS updates code list for Cures provision
WASHINGTON – AAHomecare has received an updated list of HCPCS codes that are affected by a provision in the 21st Century Cures Act that requires the federal government to limit its portion of Medicaid reimbursement to Medicare reimbursement. The association says 244 codes are now subject to the provision, with 13 codes removed and five codes added based on their Medicare spend in the 2017 calendar year. The five codes added are commode chair electric (E0170), enclosed pediatric crib hospital grade (E0300), therapeutic CGM receiver/monitor (K0554), POV Group 2 heavy duty for 301-450 pounds (K0807) and POV Group 2 very heavy duty for 451-600 pounds (K0808)
Walgreens eyes AmerisourceBergen
DEERFIELD, Ill. – Walgreens Boots Alliance is said to be in early talks to take over Valley Forge, Pa.-based AmerisourceBergen, according to news reports, though “no deal is imminent and there may not be one,” according to the Wall Street Journal. Walgreens already owns a 26% stake in the drug wholesale company. “For Walgreens, buying Amerisource would be an example of so-called vertical integration, in which a company acquires a link in its supply chain, enabling it to keep more of the margin in the products it sells,” the WSJ reported. In the same vein, CVS Health and Aetna announced plans to merge late last year. AmerisourceBergen was most recently in the news when it announced in November that it would purchase H.D. Smith for $815 million in cash.
Invacare promotes Leneghan to CFO
ELYRIA, Ohio – Invacare has appointed Kathleen Leneghan as senior vice president and CFO, replacing Rob Gudbranson, who resigned in November. “I look forward to partnering with Matt and progressing our transformation,” she said. “We have a significant opportunity to demonstrate sustained clinical value and generate profitable growth, and, in turn, create long-term shareholder value.” Leneghan had been serving as interim CFO since November. Prior to her promotion, she was vice president and corporate controller since 2003. Leneghan has been with Invacare for 27 years, serving in various financial roles in both North America and Europe. In other news, Invacare has declared a cash dividend of $.0125 per share on its common shares and $.011364 per share on its Class B common shares payable April 18, 2018, to shareholders of record on April 4, 2018.
Tandem Diabetes Care looks north   
SAN DIEGO – Tandem Diabetes Care, a manufacturer of touchscreen insulin pumps, has submitted a medical device license application to Health Canada to market its t:slim X2 Insulin Pump with Dexcom G5 Mobile continuous glucose monitoring integration. The company plans to launch the pump in Canada in the second half of 2018, subject to regulatory approvals. “This application is another important step toward achieving our strategic goal of bringing the benefits of the t:slim X2 Insulin Pump to people outside of the United States," said Kim Blickenstaff, president and CEO of Tandem Diabetes Care. The company anticipates that the t:slim X2 Insulin Pump offered in Canada will be capable of displaying both English and French, will offer a 24-hour clock, and will display glucose readings in millimoles per liter (mmol/L).
Insulet: ‘We are well on our way’
BILLERICA, Mass. – Insulet Corp. reported revenue of $130.5 million for the fourth quarter of 2017, an increase of 26% compared to the same period in 2016. U.S. revenue from the Omnipod was $76.5 million, an increase of 21%. Full-year revenue was $463.8 million and U.S. revenue from the Omnipod was $271.6 million. Among Insulet’s highlights for 2017: It received Medicare coverage under the prescription drug benefit for the Omnipod, paving the way to capturing an additional one-third of the U.S. market; it submitted Omnipod DASH, a mobile platform, for clearance by the U.S. Food and Drug Administration; and it broke ground on a new U.S. manufacturing facility. "Insulet had a very successful 2017 and our strong momentum this year gives us confidence for further improved performance in 2018," said Patrick Sullivan, chairman and CEO, in a release. “We are on a strong, sustainable growth trajectory and are well on our way to achieving our 2021 target of $1 billion in revenue.”
Viemed obtains $5 million line of credit
LAFAYETTE, La. – Viemed Healthcare has secured a two-year loan for $5 million from Whitney Bank, it announced Feb. 22. The loan provides Viemed, a provider of post-acute respiratory services, with “liquidity and flexibility, giving us quick access to non-dilutive capital should we need to bridge any working capital requirements during a period of significant growth for our company,” said Casey Hoyt, CEO, in a release. Viemed was split off from Patient Home Monitoring in late 2017.
Binson’s expands retail presence
CENTER LINE, Mich. – Binson’s Medical Equipment and Supplies has opened a new location in Ann Arbor, Mich. The 8-000 square-foot facility has dedicated retail space and will also serve as a distribution center to expand its delivery area to include Washtenaw, Livingston, Lewanne and Jackson counties. The facility will also allow Binson’s to establish better services for the University of Michigan Medical Center. “Binson’s looks forward to establishing a strong long-term relationship with the hospital and their patients,” said Nick Binson, vice president of retail operations. The family-owned company has opened six stores in the last five years as it ramps up its retail business. In late 2016, it acquired two H-Care stores in Flint and Saginaw.
Supreme Medical launches catalog
MOBILE, Ala. – Supreme Medical has launched a new Homecare & Post-Acute Catalog featuring more than 40,000 items from more than 700 manufacturers, it announced Feb. 21. The distributor of medical supplies and DME will use the catalog to build its homecare division servicing HME/DME providers, independent pharmacies, home health agencies and hospice providers, it said in a press release. “Homecare customers today want a one-stop shop experience,” said Colton Mason, senior vice president. “Launching this new catalog helps to showcase all we have to offer and lets homecare providers know that we can fulfill orders for the same breadth of products as the big guys, with the value added difference of not competing with their HME/DME.” Providers can request a free copy of the new catalog at https://www.suprememedical.com/request-catalog.
Convaid to support fun run
TORRANCE, Calif. – Convaid | R82 will support the 5K Oso Fit Run for Fun and Community Health Fair, sponsored by the Children’s Cerebral Palsy Movement, on March 3 in Mission Viejo, Calif. The event brings children living with CP together to participate in special track events, with shorter courses for participants who use braces, crutches, walkers or wheelchairs. Convaid | R82 running buddies will be on hand to assist. “In the case of CCPM, we recognize advancement has been made in different therapies that lead to better outcomes for children living with cerebral palsy,” said Ryan Williams, president, Etac NA. “Sometimes getting on a horse, being exposed to music and dance, can spark marked improvement in quality of life.”
Industry attorney Caesar dies
GREENVILLE, S.C. – Neil Caesar, an HME industry attorney and speaker, passed away Feb. 11. The president of the Health Law Center was 60. Caesar died from complications from a lengthy illness. He was a 20-year lung cancer survivor. A long-time and well-known presence at Medtrade events, Caesar was known in the industry for his healthcare experience, but he was also the president of South Carolina’s American Civil Liberties Union affiliate; an active Life Member of Mensa, the high-IQ society; and a hobbyist in the magical arts, according to an article in the Greenville News with the headline “Prominent Greenville healthcare attorney Neil Caesar dies at 60.”  Caesar is survived by his wife, Dr. Courtney Kyle Caesar, who he met through Mensa, and his son, Baer. A visitation has been scheduled for Feb. 24 at the Mackey Mortuary in Greenville from 12:30 p.m. to 1:45 p.m.
Lab Tactical launches online academy
ATLANTA – Lab Tactical Consulting has launched LabTac Academy, a collection of online courses for HME leaders. The courses draw on the Lab Tactical team’s experiences in the field with providers. The first bundle of courses offered through the academy is called HME Business Basics and comprises “Excel for HME,” “Net Revenue in HME,” and “Baseline Metrics in HME.” “This series of three courses will share no-nonsense insight into managing the revenue metrics of an HME business,” Lab Tactical says. The bundle also includes downloadable tools, including a NetRev calculator and a Baseline Metrics Worksheet.
People news: Rory Cooper
Rory Cooper, PhD, has been inducted as a fellow for the American Association for the Advancement of Science. Cooper, a University of Pittsburgh professor, School of Health and Rehabilitation Sciences associate dean for inclusion and Human Engineering Research Laboratories founding director, was elected a fellow “for distinguished contributions to the field of bioengineering and health and rehabilitation sciences, particularly for applications for people with disabilities.” AAAS is an international nonprofit organization with the stated goals of promoting cooperation among scientists, defending scientific freedom, encouraging scientific responsibility and supporting scientific education and outreach. It is also the publisher of the well-known scientific journal Science.

WASHINGTON – Rep. Cathy McMorris Rodgers, R-Wash., has released a congressional sign-on letter asking lawmakers to include H.R. 4229 in upcoming legislation to keep the government funded.

“Immediate action on this letter will enhance our opportunity for signatories, improve our prospects to include HME provisions in the coming legislation due March, and show strong support of Rep. Cathy McMorris Rodgers’ efforts on our behalf,” AAHomecare stated in bulletin to members late on Friday. “Our Hill sources have indicated that provisions in the omnibus legislation are expected to be finalized by March 14.”

The deadline for signatures is March 1 at 12 p.m. EST.

Industry stakeholders are asking providers to reach out to their representatives and demand they sign on to the letter. They suggest explaining how H.R. 4229 would partially roll back drastic Medicare reimbursement cuts in rural areas that have closed businesses and impacted access to care.

“These cuts fail to consider the unique attributes of health care in rural America, which have distinct cost difference from their urban counterparts and are stripping communities of DME resources,” Rodgers writes in the letter. “It’s estimated that over 40% of traditional DME companies nationwide have either closed or are no longer taking Medicare patients due to these unsustainable payment cuts.”

Currently, H.R. 4229, which would delay a second round of reimbursement cuts in non-bid areas from Jan. 1, 2017, to Jan. 1, 2019, has 122 co-sponsors.

Rodgers introduced H.R. 4229 on Nov. 2. She has previously spearheaded a sign-on letter to pressure the Office of Management and Budget to release an interim final rule that would provide relief from the bid program in rural areas.

YARMOUTH, Maine – It turns out, “What’s one thing you plan to do differently with your business in 2018,” isn’t a very popular question to ask HME providers.

Only two dozen people responded to our most recent HME Newspoll, and some of them responded with tongue and cheek.

“As of January 2018, the state of California passed legislation for the legalization of recreational marijuana,” commented Bruce Sandler of Wishing U Well Medical in Granada Hills, Calif. “So this year, we’re considering adding marijuana to our retail products. We’ll include free samples with every purchase. It would probably be a lot more fun.”

If there were a theme to the paltry number of responses to the poll, it would be marketing-related. Paul Reses of Lincoln Medical Supply in Pleastantville, N.J., says he plans to enhance his company’s web presence and continually update its content to keep it “fresh.” ATP Roger Lichty of Mobility Connections in Rockford, Ill., says he plans to focus his attention on “payers willing to pay a fair price” for his skills and products. And an anonymous respondent says he plans to “engage with more prospects through expanded use of the telephone, personal visits and social media.”

One likely reason for the lack of responses to the poll: With what seems like unending assaults to reimbursement for Medicare, and now Medicaid, a number of respondents feel they’re hamstrung.

“We’re closing our doors,” commented K.C. Martin of SEMO Medical Equipment and Supply in Cape Girardeau, Mo. “It’s truly sad for beneficiaries, but I have gone long enough without pay, and far enough dipping into savings and my kid’s college account. Good luck to the remaining providers.”

Other respondents say they’re not going that far but it won’t be business as usual.

“We’re preparing for 2019, when the Medicaid hammer comes down, and we start turning people away, because there is no such thing as a non-assigned claim for Medicaid,” commented Dave Anderson of Anderson’s Medical in Terre Haute, Ind.

Another anonymous respondent says he plans to keep a “credit card on file for all equipment.”

Other responses to the poll indicate plans to “outsource as much as I can,” including delivery and billing; to expand a service area for certain product categories; and to increase participation in advocacy efforts.

One respondent kept it short and sweet: “Make money, not lose it.”

ATLANTA – HME industry stakeholders have succeeded in steering Georgia away from basing its Medicaid reimbursement on competitive bidding-based Medicare reimbursement, AAHomecare reported this week.

Initially, the Georgia Department of Community Health indicated that it would just adopt Medicare reimbursement, because an aggregate pricing approach would create a $10 million shortfall. But after the Georgia Association for Medical Equipment Suppliers intervened and provided further analysis, the agency found that adopting the alternate approach wouldn’t cost the state anything.

“We appreciate DCH’s willingness to keep an open mind and work toward a solution that benefits both patients and Georgia taxpayers,” said Tyler Riddle, president of GAMES and vice president of MRS Homecare, in this week’s AAHomecare “Wednesday in Washington” bulletin.

State Medicaid programs across the country are grappling with how to comply with a provision in the 21st Century Cures Act that limits the federal government’s contribution to Medicaid reimbursement for certain DME to Medicare reimbursement.

Additionally, DCH has agreed to complete mass adjustments for providers that were originally reimbursed at Medicare reimbursement during the first part of 2018, before the agency decided to reverse course.

Stakeholders credit a positive, long-standing relationship with DCH for preventing the reimbursement cuts.

“It’s a great reminder that the work you put in building credibility with legislators and regulators over time can return important dividends in the long run,” said Teresa Tatum, executive director of GAMES, in the bulletin. “If we have more providers getting involved in advocacy efforts through their state associations and AAHomecare, I believe we’ll get even better public policy outcomes for our entire industry.”

WASHINGTON – More than 50 lawmakers signed on to a letter spearheaded by Cathy McMorris Rodgers, R-Wash., that calls on lawmakers to include H.R. 4229 in upcoming legislation to keep the government funded.

“This letter will enhance our prospects to include HME provisions in the coming legislation due March 23, and show strong support of Rep. Cathy McMorris Rodgers’ efforts on our behalf,” AAHomecare stated in a recent bulletin to members. “Our Hill sources have indicated that provisions in the omnibus legislation are expected to be finalized by March 14.”

Last week, industry stakeholders asked providers to reach out to their representatives and demand they sign on to the letter. They suggested explaining how H.R. 4229 would partially roll back drastic Medicare reimbursement cuts in rural areas that have closed businesses and impacted access to care.

“These cuts fail to consider the unique attributes of health care in rural America, which have distinct cost difference from their urban counterparts and are stripping communities of DME resources,” Rodgers writes in the letter. “It’s estimated that over 40% of traditional DME companies nationwide have either closed or are no longer taking Medicare patients due to these unsustainable payment cuts.”

Currently, H.R. 4229, which would delay a second round of reimbursement cuts in non-bid areas from Jan. 1, 2017, to Jan. 1, 2019, has 122 co-sponsors.

Rodgers introduced H.R. 4229 on Nov. 2. She has previously spearheaded a sign-on letter to pressure the Office of Management and Budget to release an interim final rule that would provide relief from the bid program in rural areas.

Cures update: Georgia Medicaid reverses course
ATLANTA – HME industry stakeholders have succeeded in steering Georgia away from basing its Medicaid reimbursement on competitive bidding-based Medicare reimbursement, AAHomecare reported last week.

Initially, the Georgia Department of Community Health indicated that it would just adopt Medicare reimbursement, because an aggregate pricing approach would create a $10 million shortfall. But after the Georgia Association for Medical Equipment Suppliers intervened and provided further analysis, the agency found that adopting the alternate approach wouldn’t cost the state anything.

“We appreciate DCH’s willingness to keep an open mind and work toward a solution that benefits both patients and Georgia taxpayers,” said Tyler Riddle, president of GAMES and vice president of MRS Homecare, in this week’s AAHomecare “Wednesday in Washington” bulletin.

State Medicaid programs across the country are grappling with how to comply with a provision in the 21st Century Cures Act that limits the federal government’s contribution to Medicaid reimbursement for certain DME to Medicare reimbursement.

Additionally, DCH has agreed to complete mass adjustments for providers that were originally reimbursed at Medicare reimbursement during the first part of 2018, before the agency decided to reverse course.

Stakeholders credit a positive, long-standing relationship with DCH for preventing the reimbursement cuts.

“It’s a great reminder that the work you put in building credibility with legislators and regulators over time can return important dividends in the long run,” said Teresa Tatum, executive director of GAMES, in the bulletin. “If we have more providers getting involved in advocacy efforts through their state associations and AAHomecare, I believe we’ll get even better public policy outcomes for our entire industry.”

MassHealth delays transition to preferred supplier
BOSTON – A preferred supplier contract for incontinence supplies between MassHealth and Geriatric Medical will now go live April 15, instead of March 1. “Based on HOMES and stakeholder input, Massachusetts Deputy Secretary Daniel Tsai has delayed implementation of the incontinence preferred supplier contract until April 15,” the state association tweeted on Feb. 18. “This will lead to a smoother transition.” Stakeholders and the state are still trying to work out details, including the implications, if any, of providers choosing to buy incontinence products from other distributors and manufacturers. “What if they’re audited?” Karyn Estrella, executive director of HOMES, has asked. Because the contract between MassHealth and Geriatric Medical is a preferred supplier not a single-source contract, providers can still buy incontinence products from other distributors and manufacturers.

Apria opens up e-prescribing platform
LAKE FOREST, Calif. – Apria Healthcare has re-launched DMEhub, an e-prescribing platform for all DME prescribers and providers. “Apria’s goal is to improve the overall experience for patients, prescribers and suppliers,” said Dan Starck, CEO of Apria. “By opening up the e-prescribing platform to the entire medical equipment industry, we aim to better serve all patients, regardless of their DME supplier.” Apria acquired DMEhub in June 2016. The intuitive platform uses “if/then” logic to gather the documentation needed to support each patient’s specific order and makes it easy for prescribers to electronically sign their orders, according to a press release. While not a requirement, there is an option to integrate the platform with any workflow management system or other healthcare software; additionally, it can be connected to any electronic medical record system, the release says. The overall goal, Apria says: improve order accuracy and compliance. “High error rates lead to delays in equipment delivery,” said Ian Worden, vice president, product development, Apria. “By creating a smoother and simpler process, hospitals can discharge their patients faster, and patients can start benefitting from life-changing therapies sooner.”

GCE Healthcare connects Zen-O with Clarity
KELLER, Texas – GCE Healthcare has launched Clarity, a secure online platform that allows providers to remotely monitor GCE’s Zen-O portable oxygen concentrators from any Internet-enabled device. The platform uses the cellular network and GPS to transmit data on everything from oxygen flow and purity, to device location and battery life. “With Clarity, home oxygen providers can see how their Zen-O devices are performing, giving them visibility of their POC fleet and the ability to act if need be,” said Donald Oleforo, GCE’s group product manager. “It helps predict maintenance and proactive patient visits. This will help providers reduce their operating costs by planning their time and resources. They can then deliver improved service levels to patients and even better levels of care.” Providers can also give their patients and their families access to the platform, giving them reassurance and confidence.

HomeTown Infusion expands service area
NEW ERA, Mich. – HomeTown Infusion has opened a new location in Rockford, Mich. The new location, which offers home and alternate site infusion services, will serve the greater Grand Rapids area, according to a press release. Hometown Infusion is a division of HomeTown Pharmacy, a multi-subsidiary, multi-specialty health and managed services provider. In addition to infusion services, HomeTown operates pharmacy, HME and supply locations throughout Michigan and Indiana.

Numotion partners with Travis Roy Foundation
BRENTWOOD, Tenn. – Numotion will serve as an adviser to the Travis Roy Foundation, offering guidance when assessing grants given by the foundation. The grants are used to purchase adaptive equipment for those who cannot do so through insurance, according to a press release. “Numotion is dedicated to helping people live active and independent lives,” said Mike Swinford, CEO, Numotion. “The Travis Roy Foundation is doing just that, and we’re looking forward to sharing our complex rehab technology expertise to further expand the tremendous impact of these life-changing technologies.” The Travis Roy Foundation was started after Travis Roy was paralyzed during his first hockey game for Boston University. The foundation is focused on empowering spinal cord injury survivors and funding research.

Sleep growth to slow down, according to survey
BOSTON – HME providers expect their sleep volume growth to increase over the next 12 months, but at a slower rate than previously reported, according to Needham’s “HME Sleep and Oxygen Survey” for the fourth quarter of 2017. Providers expect their sleep volume growth to increase 3% in the next 12 months, according to the latest survey, compared to 5.1%, according to a prior survey. Providers also reported that flow generator prices declined 3% in the last 12 months, compared to 1.8% in a prior survey, and mask prices declined 3% vs. 3.1%. Other findings from the survey, which was completed by 75 providers: Providers report only 3% of their patients purchased travel CPAP devices in the last 12 months; they expect 5% of patients to make purchases in the next 12 months; they expect portable oxygen concentrators to increase from 15.7% to 20.4% of the market over the next 12 months, with Applied Home Healthcare’s OxyGo and OxyGo Fit as the high-rated models; and they report 3.9% of their POCs have connectivity and remote monitoring features, a number they expect to increase to 7.1% in the next 12 months.

WHILL honored for innovation
SAN CARLOS, Calif. – WHILL was included in Fast Company’s annual ranking of the world’s Most Innovative Companies for 2018. The listing honors leading enterprises and rising newcomers that exemplify the best in business and innovation, according to a press release. WHILL earned a spot in the Top 10 Most Innovative Companies in Robotics. The company’s Model Ci personal electric vehicle features embedded Bluetooth for remote driving with an iPhone app, a mobile data network connection, and GPS, making it the smartest, connected, personal electric vehicle on the market, the company says. The Ci has also been recognized by CES 2018 “Best of Innovation Awards” in accessibility tech, and Engadget “Best of CES 2018” finalist.

Team@Work grows coaching staff
SPENCERVILLE, Ind. – Team@Work has appointed Mona Sabah Earnest as vice president-human resources organization development, and Jonathan Walters as vice president-leadership development and complex rehab technology coach. Earnest is an HR professional with 20-plus years of experience with both private and non-profit organizations, including Campbell Soup Company, Hewlett Packard and the Oklahoma Department of Human Services. She speaks three languages and is writing a book on cultural diversity. Walters has more than 20 years of experience leading and growing organizations. He specializes in personal leadership development, team engagement, strategic planning, content creation, process improvement and public speaking. Ty Bello is president and founder of Team@Work.

United Spinal exec named humanitarian of the year
NEW YORK – The president and CEO of the United Spinal Association has been named the 2018 “Peter Zarba Humanitarian of the Year” by the association’s New York City Chapter. Weisman has spent more than 35 years working to protect the rights of people with disabilities and to advocate for inclusion and accessibility. Prior to being named president and CEO, he was vice president and general counsel for the association. In all, Weisman has worked for the association, formerly Eastern Paralyzed Veterans Association, since 1979. He played a role in framing the American with Disabilities Act and participated in the signing ceremony.

Welch tapped to lead QS/1
SPARTANBURG, S.C. – J M Smith Corp. has named Kevin Welch president of QS/1 and Integra LTC Solutions. J M Smith named Welch chief technology officer in 2017, after it acquired the company he founded, Integra. J M Smith has named Saul Factor, who was president of QS/1, to lead its wholesale distribution units Smith Drug Co. and Burlington Drug Co.