WASHINGTON – A letter asking lawmakers to include H.R. 4229 in an upcoming spending bill has drawn 57 co-signers, according to the VGM Group.

The letter, spearheaded by Rep. Cathy McMorris Rodgers, R-Wash., will now go to a House Appropriations Committee for possible inclusion in a spending bill that Congress must pass by March 23 to keep the government funded.

Lawmakers were said to be finalizing provisions for the spending bill by March 14.

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 128 co-sponsors.

AUSTIN, Texas – Providers in Texas have staved off reimbursement cuts proposed by Superior HealthPlan, a managed care company that oversees part of the state’s Medicaid program.

Providers were notified in February that Superior was reducing rates for certain product categories from 85% of Texas Medicaid rates to 60%, with a few providers receiving a reduction of 65% to 70%, effective May 1. Providers were given 30 days to accept or reject the plan.

In response, VGM Group organized a conference call with providers, encouraging them to voice their concerns with Superior, the Texas Health and Human Services Commission and state lawmakers.

“Providers stepped up and answered the call for action by engaging with public officials to display their opposition to these egregious cuts,” said Collin Brecher of VGM Government Relations. “While states are looking to trim their budgets, these proposed cuts are going to continue to appear, and providers in all states must remain proactive by building relationships at the state level to prevent these types of harmful cuts from being implemented.”

In an online notification on Feb. 26, Superior stated it was suspending the reimbursement changes at this time.

“We will be working with the Texas Health and Human Services Commission (HHSC) to address DME costs as directed by the 85th Legislature in potentially a different type of provider based initiative at a later date,” it stated.

Superior has come under fire in recent months for its plan to contract with Medline to serve as the “preferred provider” of DME and supplies to Medicaid beneficiaries.

WASHINGTON – With it “increasingly possible” that a competitive bidding-related interim final rule may never be finalized by the Office of Management and Budget, AAHomecare is stepping on the gas on H.R. 4229.

“While this realization is a difficult pill to swallow, it also underscores the importance of our legislative efforts,” wrote Tom Ryan, CEO and president of AAHomecare, in the association’s weekly bulletin to members on Wednesday.

Those legislative efforts got a boost this week when a letter signed by 56 members of the House of Representatives was sent to leaders of the Appropriations Committee, asking them to include provisions from H.R. 4229 in upcoming budget legislation. The number of co-sponsors for H.R. 4229 also hit 128 this week.

AAHomecare acknowledges that including provisions from H.R. 4229 into the budget legislation will be an uphill battle, with hundreds of competing interests looking to influence or be part of the budget legislation.

“But we have one important factor in our favor: Thanks to your strong advocacy efforts, 20 members of the House Appropriations Committee are H.R. 4229 co-sponsors,” Ryan said.

AAHomecare encourages stakeholders to now target decision makers on both the House and Senate Appropriations Committees to reinforce the message of the recent sign-on letter, which was spearheaded by Cathy McMorris Rodgers, R-Wash., who also introduced H.R. 4229.

“Let’s build on this foundation and make a strong impression on these targets this week and next week,” Ryan wrote. “We’ve come too far to let this opportunity clip by without giving it our all.”

WASHINGTON – With it “increasingly possible” that a competitive bidding-related interim final rule may never be finalized by the Office of Management and Budget, AAHomecare is stepping on the gas on H.R. 4229.

“While this realization is a difficult pill to swallow, it also underscores the importance of our legislative efforts,” wrote Tom Ryan, CEO and president of AAHomecare, in the association’s weekly bulletin to members on Wednesday.

Those legislative efforts got a boost this week when a letter signed by 56 members of the House of Representatives was sent to leaders of the Appropriations Committee, asking them to include provisions from H.R. 4229 in upcoming budget legislation. The number of co-sponsors for H.R. 4229 also hit 128 this week.

AAHomecare acknowledges that including provisions from H.R. 4229 into the budget legislation will be an uphill battle, with hundreds of competing interests looking to influence or be part of the budget legislation.

“But we have one important factor in our favor: Thanks to your strong advocacy efforts, 20 members of the House Appropriations Committee are H.R. 4229 co-sponsors,” Ryan said.

AAHomecare encourages stakeholders to now target decision makers on both the House and Senate Appropriations Committees to reinforce the message of the recent sign-on letter, which was spearheaded by Cathy McMorris Rodgers, R-Wash., who also introduced H.R. 4229.

“Let’s build on this foundation and make a strong impression on these targets this week and next week,” Ryan wrote. “We’ve come too far to let this opportunity clip by without giving it our all.”

Cigna, Express Scripts plan merger

BLOOMFIELD, Conn. – Health insurance giant Cigna Corporation plans to acquire Express Scripts for $67 billion, it announced Thursday.

Express Scripts is the largest pharmacy benefits manager in the United States, covering more than 80 million lives, according to news reports.

“Cigna’s acquisition of Express Scripts brings together two complementary customer-centric services companies, well-positioned to drive greater quality and affordability for customers,” said David M. Cordani, president and CEO of Cigna in a press release. “This combination accelerates Cigna’s enterprise mission of improving the health, well-being and sense of security of those we serve, and in turn, expanding the breadth of services for our customers, partners, clients, health plans and communities.”

Cordani will assume the role of president and CEO of the combined company; Tim Wentworth, president and CEO of Express Scripts, will assume the role of president of Express Scripts.

While both organizations say the move will expand consumer choice and create better value, others disagree.

“We’re still assessing the implications of a Cigna-Express Scripts merger, but one thing is clear: Consolidation among health care giants leads to fewer choices for patients and plan sponsors,” said Douglas Hoey, CEO of the National Community Pharmacists Association, in a press release. “In addition, companies make claims of cost savings that will benefit patients and health plan sponsors, but the available evidence from previous consolidations suggests otherwise.”

The deal is the latest sign of upheaval in the market. In December, CVS Health announced a planned merger with Aetna. In January, Amazon announced it would partner with Berkshire Hathaway.

The deal is expected to be finalized in December 2018, subject to shareholder and regulatory approval.

QMES secures $175M in financing

NEW YORK – QMES has locked in a $157 million senior secured credit facility from CIT Group’s consumer finance business. QMES, a portfolio company of Quadrant Management, a private investment firm based in New York City, will use the new credit facility to refinance legacy debt, support growth and make strategic investments, according to a press release. “This new credit facility will enable us to expand beyond our core markets and further solidify our position in our current markets,” said Luke McGee, CEO of QMES, which serves 500,000 patients in the Mid-Atlantic and Northeastern states. “It will also allow us to continue to invest in our best-in-class technology solutions which continue to innovate our service offerings to providers and patients.” Last year, QMES secured a $65 million secured senior credit facility from CIT, and in 2014, it secured a $50 million credit facility.

Permobil launches consumer app

LEBANON, Tenn. – Permobil has launched the My Permobil consumer app as part of its Permobil Connect platform. The free app provides enhanced performance and usage data to help consumers get the most out of their connected wheelchairs. “In a world where everything is connected, it just makes sense for our wheelchairs to be, as well,” said Larry Jackson, president of Permobil Americas. “Our consumers want to be able to live their lives and not worry about things like battery levels, actuators or mechanical issues.” With the app, users can view data on everything from battery charge and status level to travel distance and seat function. Service technicians already use the Permobil Connect platform to perform remote diagnostics, allowing them to potentially diagnose an issue before it even occurs.

Connecticut providers face steep cuts

HARTFORD – The Connecticut Department of Social Services has published a bulletin outlining its plans to reduce reimbursement rates for HME, supplies, O&P and complex rehab by 50% to 60% on April 1, according to the Home Medical Equipment and Services Association of New England. HOMES, in collaboration with AAHomecare and NCART, is planning a multi-pronged approach to fighting the cuts, first with a survey of providers in the state. The provider survey, which closed March 9, asks for information about their participation in the Medicaid program, how the cuts would affect the products and related services they provide, and what business/operational changes would be made. HOMES plans to keep individual results confidential but share combined results with state officials. The association says to “stay tuned” for other efforts to fight the cuts.

Texas providers beat back rate cuts

AUSTIN, Texas – Providers in Texas have staved off reimbursement cuts proposed by Superior HealthPlan, a managed care company that oversees part of the state’s Medicaid program.

Providers were notified in February that Superior was reducing rates for certain product categories from 85% of Texas Medicaid rates to 60%, with a few providers receiving a reduction of 65% to 70%, effective May 1. Providers were given 30 days to accept or reject the plan.

In response, VGM Group organized a conference call with providers, encouraging them to voice their concerns with Superior, the Texas Health and Human Services Commission and state lawmakers.

“Providers stepped up and answered the call for action by engaging with public officials to display their opposition to these egregious cuts,” said Collin Brecher of VGM Government Relations. “While states are looking to trim their budgets, these proposed cuts are going to continue to appear, and providers in all states must remain proactive by building relationships at the state level to prevent these types of harmful cuts from being implemented.”

In an online notification on Feb. 26, Superior stated it was suspending the reimbursement changes at this time.

“We will be working with the Texas Health and Human Services Commission (HHSC) to address DME costs as directed by the 85th Legislature in potentially a different type of provider based initiative at a later date,” it stated.

Superior has come under fire in recent months for its plan to contract with Medline to serve as the “preferred provider” of DME and supplies to Medicaid beneficiaries.

Medicare announces electronic initiative

WASHINGTON – CMS has announced a new initiative, MyHealthEData, to give patients control of their healthcare data. Under the initiative, patients would have access to their entire health record electronically and be able to share the data with whomever they want to make informed decisions about their care. CMS Administrator Seema Verma also announced the launch of Medicare’s Blue Button 2.0, which allows beneficiaries to access and share their health data and connect their claims data to secure applications, providers, services and research programs. Additionally, CMS plans to overhaul its Electronic Health Record Incentive Programs to refocus on interoperability, and to reduce the time and cost required of providers to comply with requirements.

NCART, UPitt launch CRT survey

PITTSBURGH – The University of Pittsburgh’s Department of Rehabilitation Science and Technology has partnered with NCART to survey complex rehab professionals. The online survey will assess the current industry and personnel landscape, and address future planning needs. “There is a big shift toward aging in place and keeping people out of hospitals or long-term care facilities,” said Mark Schmeler, associate professor at the UPitt and study co-investigator. “CRT and providers play a critical role in this shift alongside other healthcare professions. But we need to assess the current and future capacities of CRT professionals.” All ATP-certified supplier and manufacturer representatives are invited to complete the anonymous survey by April 15. Respondents will have the opportunity to enter a random drawing for one of 10 free unlimited access passes to the RSTCE library of CEU accredited webinars for one full year.

Sleep apnea grows in rural areas 

NEW YORK – Private insurance claims for sleep apnea increased by 911% between 2011 and 2014 in rural America, according to FAIR Health, a national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information. Claims in urban areas increased by 839% and, nationally, claims for sleep apnea increased 850%, according to a press release. "Sleep apnea is a public health issue of increasing interest and concern," said FAIR Health President Robin Gelburd. "FAIR Health is ready to contribute its data resources and analytical capabilities to help researchers, policy makers and others address this issue."

Show organizers, exhibitors offer free passes
LAS VEGAS – Advance rates for the upcoming Medtrade Spring show are in effect until March 18, show organizers have announced. Advance rates are $100 for an expo pass and $249 for a conference pass. Expo passes are available for free, however, by contacting any Medtrade Spring exhibitor, show organizers say. Medtrade Spring is scheduled for March 27-29 at the Mandalay Bay Convention Center in Las Vegas. Register here

WASHINGTON – Industry stakeholders are pushing to get HME-related provisions into an omnibus spending bill.

On Tuesday, Jason Orr, president of the Kentucky Medical Equipment Suppliers Association, and Thad Connally, former KMESA president, met with every office of Kentucky’s delegation, including Senate Majority leader Mitch McConnell, to ask the Senator to support the H.R. 4229 provisions in the final package. They were joined by Tom Ryan and Jay Witter of AAHomecare.

“We’ve got an uphill fight to get our provisions into the upcoming spending package, but powerful advocacy work like this impromptu fly-in, coupled with tremendous co-sponsor support the HME community has generated for HR 4229, increases our chances for success,” said Ryan, in a bulletin.

And, on Monday, the ITEM Coalition sent a letter asking House and Senate leaders to include HME-related provisions in the omnibus bill on behalf of the group’s 75 member organizations.

Specifically, the coalition asked to include language from H.R. 3730, which seeks to exclude manual CRT products from bid-derived pricing; and asked to include language from the Medicare O&P Improvement Act, including a clarification of the definition of off-the-shelf-orthotics.

WASHINGTON – Stakeholders met with Senate Majority Leader Mitch McConnell, R-Ky., and other key lawmakers last week to make their case for including language from H.R. 4229 in an omnibus spending bill.

“We met with McConnell and laid out all the issues,” said Tom Ryan, president and CEO of AAHomecare, who attended the meeting—one of several with the Kentucky congressional delegation last week—along with Jason Orr, president of the Kentucky Medical Equipment Suppliers Association, and Thad Connally, former KMESA president. “The Kentucky folks have got a lot of good contacts—it’s all about politics being local and they’ve been working that relationship with McConnell over a long period of time.”

In meetings held with lawmakers in Washington State last week, staffers were tuned in to the issues, said John Gallagher.

“The staff has been hearing from a lot of patients that have access issues and they are hearing from hospitals that have discharge issues, so the temperature is rising,” said Gallagher, vice president of government relations for VGM.

With everything from immigration to funding for Planned Parenthood on the table, getting into the omnibus bill— scheduled for a vote March 23—is a heavy lift, says Ryan.

“Getting into an omnibus is a challenge so I don’t want to be overly optimistic, but we’re not giving up the fight,” he said. “There’s not going to be many other vehicles to get this done.”

Focusing on H.R. 4229, which currently has 135 co-sponsors, is a shift in gears for the industry, which has spent the past several months pressing for the Office of Management and Budget to release a competitive bidding-related interim final rule.

That’s looking “increasingly unlikely” to happen, say stakeholders.

“I don’t think the IFR is dead by any means but nobody knows what’s in it or where it is,” said Gallagher. “I think it’s appropriate (that focus has shifted) because we’ve got such a short window of time on the omnibus bill.”

http://www.hmenews.com/article/stakeholders-press-inclusion-spending-pac...

http://www.hmenews.com/article/stakeholders-unrelenting-ifr

YARMOUTH, Maine – The majority of respondents to a recent HME Newspoll (67%) agree that 2018 will be a “hot” year for mergers and acquisitions in the HME industry.

But the drivers of that activity are representative of an industry in distress, especially for smaller providers, respondents say.

“With the huge vendor pricing difference for mom-and-pop providers vs. nationals and the low reimbursement rates, there will be little choice for ‘hometown’ DMEs but to sell,” wrote one respondent. “I have seen three providers in my area close or sell last year alone. The only competition we have left is the nationals.”

An even percentage of respondents (30%) say they are either in the buyer’s or seller’s seat.

The nationals may be doing the bulk of the buying, but there are other providers that are throwing their hats in the ring, saying they have no choice in the current climate.

“Based on survival in this crazy industry, it’s either you expand and buy companies that make sense, or you will become extinct,” wrote Michael McCartney, the CEO and owner of an HME company in the Buffalo, Rochester, N.Y., area.

While a consolidated industry is widely seen as a negative, it improves the odds of the providers who are left, including the non-nationals.

“I purchased a DME and may expand,” wrote one respondent. “People ask me, ‘Why would you get in that business if 40%-plus of providers have gone out of business?’ I say, ‘Because there is 40% less competition.’”

Indeed, despite the staggering consolidation that has already occurred since 2011, when Medicare kicked off its competitive bidding program in nine cities, the industry may not have hit rock bottom yet, respondents say.

“Medicare rate cuts have made it nearly impossible for the smaller and even some of the mid-sized DME providers to stay in business,” wrote one respondent. “I fully expect the number of providers to continue to shrink dramatically in 2018.”

NASHVILLE, Tenn. – National Seating & Mobility has opened a branch in Bangor, Maine—its first in the state, it announced last week. The provider also plans to open a branch in Portland this spring. “We are proud to add these new locations and experienced professionals to the NSM family and look forward to partnering with healthcare providers to serve clients in these communities,” said CEO Bill Mixon. In December, NSM opened a branch in Anchorage, Alaska.

Compass Health completes major sales reorg
CLEVELAND – Compass Health Brands has reorganized its sales team and more than doubled its field presence to better serve the needs of its customer base, the company announced March 13. Additionally, Compass has expanded its team to include a customer and sales support representative to provide “a personalized concierge-level of customer service to its customer base.” To lead the company going forward, Compass has added Gregory Zenko, Todd Blockinger, Michael Scarsella and Peter Kaplan. Zenko, who will serve as senior vice president of the HME division, has more than 20 years of experience in the medical device and capital medical equipment industry. He will lead the company’s strategy, development and position in the U.S. and global markets. Blockinger, who will serve as vice president of strategic accounts, was previously vice president of sales for the MED Group. Scarsella, who will serve as national sales director, was previously Northeast regional vice president at Golden Technologies. Kaplan will serve as vice president of product management. The reorg was necessary, Compass says, after acquiring four major health businesses in a little more than one year. Compass was formed when Carex Health Brands and Roscoe Medical merged. Its core offerings are the ProBasics, Roscoe, Meridian and Carex brands.

Cure Medical heads north of the border
NEWPORT BEACH, Calif. – Cure Medical has expanded into Canada with its Ultra Ready-to-Use Catheters. “We continuously receive requests from Canadian sales partners and end users who are looking for a quality-made, affordable intermittent catheter that is not made with known carcinogens like DEHP or BPA,” said John Anderson, CEO, in a press release. The Cure Ultra line includes straight and coude options for men and a ready-to-use straight catheter for women.

Sunset expands beyond respiratory
CHICAGO – Sunset Healthcare Solutions plans to add TENS units to its product offerings, it announced recently. The two affordable models, the TEN100 and TEN200, will launch this spring. Sunset, a manufacturer of respiratory equipment, will also add a new nebulizer and a new knee scooter to its line this spring. “This is an exciting time at Sunset,” said P.J. Ruflin, director of sales. “While we are expanding, we still have the same great value and commitment to our customers that they've come to expect from us.”

HOMES seeks board members
NEW BEDFORD, Mass. – HOMES is accepting applications to serve on its board of directors. The term for providers is three years (May 2018–2021) and for associates, two years (May 2018–2020). Provider and associate members can click here to view the application. Deadline is Friday, March 23. FMI: contact Jason Morin at 978-815-1523.

AvaCare opens online shop to hospitals, nursing homes
LAKEWOOD, N.J. – AvaCare Medical, an online medical supply and equipment company, has expanded into the hospital and nursing home industries. The company has developed a program that allows these organizations to place all orders online by selecting the purchase order option, instead of the standard methods of payment. These organizations will also be able to access special bulk-order pricing with each purchase. The program combines purchase orders with the ease of online purchasing to afford organizations that can’t pay via credit card the same checkout process as the company’s online buyers. “We have raised our sales expectations for the coming year based on the new revenue this will bring us,” said Mark Bakst, CFO. “This is an exciting new market for us.”

Option Care tapped to provide new HIV therapy
BANNOCKBURN, Ill. – Option Care has been selected by Theratechnologies as an infusion provider for Trogarzo, multidrug resistant human immunodeficiency virus type 1 (HIV-1) infections. Option Care will provide personalized care management support to patients receiving Trogarzo infusions. “Our ability to provide unmatched home and alternate treatment site infusion services allow us to partner with innovators bringing groundbreaking therapies like TrogarzoT to market,” said Matt Deans, vice president, business development at Option Care.

Drive DeVilbiss marks World Sleep Day
PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare will recognize World Sleep Day on March 16 to raise awareness of the importance of sleep and the prevalence of undiagnosed sleep apnea specifically in Latin America. In a study to determine the most common sleep disorders in four Latin American countries published in the Journal of Clinical Sleep Medicine, 60.2% of subjects reported snoring, 16.4% reported excessive daytime sleepiness and 12.3% reported observed apneas. “Poor quality sleep or sleep deprivations has been associated with many health issues, including poor memory and attention span, diabetes, obesity and a weakened immune system,” said Wally Haddick, vice president of sales for Latin America.

People news: Florida Healthcare Law Firm
Delray Beach, Fla.-based Florida Healthcare Law Firm has added attorney Michael Silverman to expand its pharmacy and DMEPOS offerings. "For years, we've had a hole in our practice with pharmacy clients needing help with pharmacy benefits manager (PBM) issues—not anymore," said Jeff Cohen, who is board certified as a specialist in healthcare law and founded the Florida Healthcare Law Firm in 2008. “Michael is a PBM expert, and a fantastic resource for not only our pharmacy clients, but also our durable medical equipment (DME) clients.” Silverman joins attorney Susan St. John in handling a variety of issues in the DME industry, including ZPIC audits. Previously, Silverman served as the general counsel and compliance officer to a nationally licensed mail-order DMEPOS and pharmaceutical provider.

Sleep: It’s still not a priority, survey finds
AMSTERDAM – The majority of adults globally view sleep’s impact on their overall health and wellbeing to be significant, yet only 29% of them say they feel guilty for not maintaining good sleep habits. That’s compared to 49% who feel guilty for not exercising regularly and 42% for not eating healthy. The findings come from an annual survey conducted by Philips, “Better Sleep, Better Health. A Global Look at Why We’re Still Falling Short on Sleep,” that reviewed the sleep habits of 15,000 adults across 13 countries. Other findings from the survey, released ahead of World Sleep Day on March 16: 61% say they have a medical issue that impacts their sleep, with 26% saying it’s insomnia and 21% saying it’s snoring; and 77% say they have tried to improve their sleep in some way, with listening to soothing music one of the most popular at 36%.

WASHINGTON – Despite support from key committees of jurisdiction in Congress, the omnibus bill does not contain language providing relief from Medicare’s competitive bidding program.

The bill does, however, contain language referring to a bid-related interim final rule that has been stuck at the Office of Management and Budget since August. It states:

The agreement encourages CMS to promulgate the pending Interim Final Rule entitled "Durable Medical Equipment Fee Schedule, Adjustments to Resume the Transitional 50/50 Blended Rates to Provide Relief in Non-Competitive Bidding Areas."

“While we are gratified to see that Congress is again asking federal officials to move the IFR forward, we are also concerned that leaders in the House and Senate have missed this opportunity to provide much-needed relief for home medical equipment providers and patients, especially those in rural America, by failing to include provisions from H.R. 4229,” said Tom Ryan, president and CEO of AAHomecare.

Stakeholders had made a hard press in recent weeks to get H.R. 4229 included in the omnibus bill, including meeting with Senate Majority Leader Mitch McConnell, R-Ky.

FARGO, N.D. – Noridian Healthcare Solutions has been awarded a $227 million Supplemental Medical Review Contractor (SMRC) contract by CMS. The primary role of the SMRC is to conduct nationwide medical review of Part A, Part B and DME providers as directed by CMS. Its responsibility is to review medical records and related documentation to ensure that claims are processed in accordance with CMS guidelines. The SMRC contract was previously held by StrategicHealthSolutions. To support the new contract, Noridian will be hiring about 300 people at its Fargo headquarters and throughout the country. Noridian also holds Medicare Administrative Contractor (MAC) contracts for DME for jurisdictions A and D, as well as the Pricing, Data Analysis and Coding contract.

Bachenheimer opens DC office for Brown & Fortunato

WASHINGTON – Cara Bachenheimer, a long-time advocate of the HME and complex rehab industries, is opening up a Washington, D.C., office for Amarillo, Texas-based Brown & Fortunato. Bachenheimer has worked for Invacare, most recently as senior vice president of government relations, for more than 14 years. Invacare will be Bachenheimer’s first client. “I appreciate Invacare’s continued support as I step away to help other businesses understand the impact of and help share future healthcare legislation and regulations,” she said. “I am pleased to continue to support Invacare’s government relations and lobbying efforts as a consultant for the company.” At Brown & Fortunato, Bachenheimer will expand her services in government relations, and legislative and regulatory matters. “We are excited that Cara is joining our firm,” said Jeff Baird, chairman of Brown & Fortunato’s National Health Care Group. “Cara’s expertise, coupled with our core practice areas, creates an exciting synergy.” Brown & Fortunato represents pharmacies, HME providers, home health agencies, hospitals, manufacturers, labs and other healthcare providers.

VA slow to repair wheelchairs, OIG finds

WASHINGTON – The Office of Inspector General has found that veterans waited an average of 69 days for power wheelchair and scooter repairs, more than a month beyond a 30-day timeliness benchmark set by the agency, according to a new report. “These delays occurred because staff and prosthetic service managers at the respective VA medical facilities did not always effectively manage and monitor repair requests,” the OIG stated in a report. “VA medical facility staff, including prosthetic service staff, did not always promptly input repair requests in the consult management systems so the requests could be properly tracked. Moreover, prosthetic service staff did not effectively monitor the completion of the repairs after the purchase orders for the repairs were issued and the consults were closed.” The OIG reviewed a statistical sample of power wheelchair and scooter repairs at eight VA medical facilities in Veterans Integrated Service Network 7. It identified about 380 veterans in the network who experienced delays in the completion of about 480 of the 1,200 repairs in fiscal year 2016. The OIG recommends that the director of VISN 7 implement controls to ensure medical facility staff initiate repair consults as soon as power wheelchair and scooter repair requests are received. It also recommends that staff follow consult documentation procedures, monitor and follow up on repairs until they are complete, and monitor vendors to ensure they meet agreed-upon delivery dates for repairs. The VISN 7 director concurred with the OIG’s report and recommendations, and provided an action plan to address them.

Baystate Health drops home infusion, respiratory services

SPRINGFIELD, Mass. – Baystate Health is handing over its home infusion and respiratory services business to CVS, according to the Greenfield Recorder. Baystate Home Infusion & Respiratory Services will close by the end of the month. After a strategic review, Baystate Health found “durable medical equipment and home delivery of respiratory services, and related equipment and supplies, are not a core business of Baystate Health,” a spokeswoman for the healthcare system told the newspaper. “The changing healthcare environment guided our decision-making.” The spokeswoman, Molly MacMunn, added, “We recognized that the services and opportunities to deliver home infusion and respiratory services to our patient population could be done in more innovative and efficient ways by companies whose core business focus is in the area of durable medical equipment and home delivery of respiratory services and related equipment and supplies.” Baystate Health services more than 800,000 people throughout western New England.

CAIRE achieves accreditation, goes direct with certain products

BALL GROUND, Ga. – CAIRE has achieved accreditation with the Accreditation Commission for Health Care (ACHA), the manufacturer of oxygen therapy devices announced March 23. Accreditation paves the way for CAIRE to sell certain products (the Focus and FreeStyle series of wearable technology, Eclipse 5 POC and Companion 5 stationary oxygen concentrator) direct to consumer. “CAIRE is always looking for ways to differentiate ourselves in the marketplace and this accreditation demonstrates our commitment to quality and the continuous improvement of our customer experience through industry standard best practices,” said George Coppola, director of marketing. CAIRE continues to sell its full line of products to HME providers. To achieve accreditation, healthcare organizations must demonstrate compliance with numerous national standards. ACHC, a CMS Deeming Authority for home health, hospice and DMEPOS, has been accrediting healthcare organizations since 1986.

3B Medical obtains ‘quick ramp’ to POCs

WINTER HAVEN, Fla. – 3B Medical has acquired VBOX, a research and development company for portable oxygen concentrators. 3B Medical now has exclusive global licensing to VBOX’s extensive portfolio of intellectual property, including 14 U.S. and eight foreign patents. “The agreement provides 3B Medical with a very quick ramp to market for the most technologically advanced wearable oxygen concentrator in the world,” said Alex Lucio, CEO of 3B Medical. 3B Medical entered the oxygen therapy space last year, with the launch of the Cirrus 5 stationery concentrator, and said it planned to set its sights on POCs in 2018.

New online store offers braces and more

TAMPA, Fla. – A new online store, Braces, Bandages & Beyond, has launched. The site carries a wide array of items like neck and back braces, splints, and compression stockings, as well as DME like wheelchairs. "I saw an unmet need in the marketplace and I wanted to fill that," said Greg Grambor, president of VascularPRN, a distributor of compression devices, who launched the site. "Braces, Bandages, & Beyond is my attempt to bring great selection, great service, and low prices together in a modern online store."

Permobil increases prices

LEBANON, Tenn. – Permobil will implement a 3% price increase on all seating and positioning products, excluding OBSS/NUTEC products, on April 2. The company has grown in recent months, acquiring Comfort Company, OBSS Custom Contoured Seating and NUTEC Custom Configured Seating systems, and continues to expand its ROHO seating and positioning portfolio. It has also added a dedicated seating and positioning sales team to better support providers. “This furthers our mission to continually deliver amazing products to our end users through our partnerships with dedicated and experienced providers like you,” the company stated in a notice. “This mission has also resulted in significant investments in premium materials, manufacturing and operational talent here in the U.S.”

VGM’s Homelink marks silver anniversary

WATERLOO, Iowa – Homelink is celebrating 25 years of connecting commercial insurance and workers’ compensation programs to home medical equipment and services, according to a press release. Homelink, a division of VGM Group, facilitates about 1,400 referrals per day and has grown from two employees to more than 400 employee owners. “Most of our growth is because people on the floor handling day-to-day operations do such a remarkable job taking care of our customers,” said Dave Kazynksi, Homelink president. “Our personal interaction paired with cost containment processes and dynamic system capabilities are what ensure our clients and their customers have a positive experience and achieve great outcomes.”

MAMES seeks board nominations

STILLWATER, Minn. – MAMES is seeking nominations for its board of directors. The nominees will be voted on at the association’s Spring Convention, April 25-27 in Des Moines, Iowa. Specifically, MAMES seeks to fill one regular board position each in Iowa, Kansas, Missouri, North Dakota and South Dakota, and two in Nebraska. It also seeks one associate director position. The three-year terms are effective from 2018-2021. The deadline to apply is 5 p.m. CST on March 30.

Parachute Health secures $5.5M in funding

NEW YORK – DME technology platform Parachute Health has raised $5.5 million to expand nationwide. The company integrates directly with Epic and other widely used electronic medical record software programs to create a completely digital prescription ordering process for DME based on machine learning technology that ensures compliance with ever-changing insurance requirements. “Despite decades of advancement across industries, healthcare still relies on the fax machine,” said CEO David Gelbard. “With Parachute, we are improving the experience.” The company will expand nationwide following a successful beta period last year. It estimates it currently covers 60% of the healthcare market in New York and has served more than 100,000 patients. It also has a presence in several other states. Parachute’s investors include Greater New York Hospital Association Ventures, Loeb Holding Corp., Anthony Welters (former executive vice president/office of CEO for United Health Group), Fred Browne (former president of McKesson Extended Care) and other healthcare innovators. Parachute is also in the middle of a Series A funding round to launch additional products and services. Gelbard founded the company after his 80-year-old father underwent back surgery and the walker that was ordered for him through his Medicare plan never arrived. During this time, he took over the family’s pharmacy and recognized firsthand the need to modernize the DME industry through technology. Before founding Parachute, Gelbard was an investment professional at Falcon Investments, a private equity firm with more than $2.5 billion in assets under management.

LAS VEGAS – After a brief timeout for Medtrade Spring in Las Vegas last week, AAHomecare officials are back at it in Washington, D.C.

“We’ll be lobbying again on the Hill with our champions,” President and CEO Tom Ryan told attendees at the Washington Update at Medtrade Spring on Wednesday. “We are also getting a meeting on the docket in the next week or so with (Health and Human Services) Deputy Secretary Eric Hargan. We’re not going away.”

Ryan acknowledged the sting of not getting language from H.R. 4229 included in a recent omnibus bill, but he says the industry needs to keep building on recent grassroots efforts for the bill, which currently has 138 co-sponsors.

Ryan said the industry also needs to keep pressuring CMS to enact an interim final rule that has been stuck at the Office of Management and Budget since August. Its efforts got a boost when Congress did include in its omnibus bill a statement “encouraging” CMS to “promulgate” the IFR.

“It’s been a challenge—it’s not just a rural issue, it’s a national issue,” he said.

Beyond immediate relief, AAHomecare continues to work with CMS on long-term fixes to competitive bidding, including pressuring the agency to use historical claims data to determine supplier capacity; increase the transparency of the program; and remove its authority to bundle payments for CPAP and standard power wheelchairs.

AAHomecare also plans to more closely monitor the Medicare Payment and Advisory Committee, after being caught off-guard by a recent report that recommended CMS expand the bid program to include more product categories such as off-the-shelf orthotics and urological supplies. The association has created a workgroup to develop white papers and make recommendations to MedPAC ahead of its next report, expected in June.

“We needed to go on the offense,” said Kim Brummett, vice president of payer relations. “We’re included in the June report; it probably won’t be any better for us.”

LAS VEGAS – Las Vegas may be known as Disneyland for grownups, but at last week’s Medtrade Spring, the mood was all business.

With competitive bidding’s devastating effect on the HME industry, the number of attendees and exhibitors at the show has thinned, but those who were there had their sleeves rolled up, says Show Director Kevin Gaffney.

“They had some good conversations,” he said. “Everybody would like to see more people on the floor, but the companies that are coming here are solid companies.”

This year’s show, which took place March 27-29 at the Mandalay Bay Convention Center, featured 200 exhibitors and educational programming across 10 tracks.

The track that drew the most attention: retail.

“Providers not only want to see new products, they want to learn to create a retail environment,” Gaffney said.

Fortunately, for those providers interested in retail, many manufacturers have upped their game, opting for sleeker designs that fit better into today’s lifestyles.

“Everything we do from design to packaging comes from the consumer lens,” said Jim Daniels, CEO of Convexity Scientific, which debuted the FLYP, a pocket-sized nebulizer, which won gold in the New Product Pavilion’s Providers’ Choice Awards.

Long-time exhibitor Pride Mobility Products has revamped its design team and was showing several revamped products at the show, including the latest models in its popular Jazzy line.

“When they’re calling a power wheelchair sexy, you know you’ve done something right,” said Micah Swick, director of sales.

Swick had no complaints about the show.

“We’ve had a good show,” he said. “I know the show is smaller, but we’re entering a new era.”

Indeed, provider Todd Usher hadn’t planned on coming to Medtrade Spring this year, but he was glad he did.

“I was invited by several (of my vendors),” said Usher, co-founder of Home Oxygen Company in Modesto, Calif. “It’s important to network with them. The show is still valuable for that, and education.”

WASHINGTON ­– Cara Bachenheimer has a new gig that allows her to double-down on her efforts advocating for the HME industry.

Bachenheimer is opening a Washington, D.C., office for Amarillo, Texas-based law firm Brown & Fortunato on June 1, a move that will expand her legislative and regulatory work beyond Invacare, where she has worked for more than 14 years.

Here’s what Bachenheimer, who will count Invacare as her first client, had to say about why lobbying is more important than ever before.

HME News: What made your pursue an opportunity outside of Invacare, where you have been senior vice president of government relations for years?

Cara Bachenheimer: I see this as a natural next step in my career. The work I’ve been doing for Invacare has also benefitted others in the industry, so it’s natural to now broaden my representation. I’m continuing to represent Invacare, which I’m really excited about—they’re a great company doing great things—but I’m also excited about doing what I do on multiple levels, whether it’s for manufacturers, distributors, providers or other entities.

HME: Why is the combination of Bachenheimer and Brown & Fortunato a good one?

Bachenheimer: Their clients may want to get involved in lobbying, and my clients may want legal help, so I really see it as a win-win.

HME: From a lobbying perspective, there’s some frustration that the industry hasn’t been able to move the needle more toward bid relief than it has. Is the industry’s lobbying making a difference?

Bachenheimer: The industry has come so far in the past 25-30 years, in terms of its active participation in lobbying from all sizes and levels. People understand now that it’s not critical; it’s mandatory. There have been some incremental victories—they may be small, but that’s how progress is made. D.C. is very difficult for everybody, not just HME. It’s an incredible web to manage and be successful in. I applaud the industry for the huge progress it has made.

HME: You’ve been at this for a number of years now, and it’s been battle after battle. Why stick with it?

Bachenheimer: It’s something that I learned from my early law practice days: If you’re not excited about what you’re doing—if it doesn’t feel like you’re making a positive difference—it’s not worth your time. This industry has so much potential and improves the quality of life for so many people. That’s what motivates me. That’s what motivates everyone in the industry. It sounds corny, but it’s true.

BOSTON – DME is one of five possible points of entry for Amazon to dominate the healthcare market, according to a new report from global management consulting firm L.E.K. Consulting.

“Anyone who thinks of Amazon as just a very big digital retailer needs to think again,” says Rob Haslehurst, managing director at L.E.K and report co-author. “They have repeatedly shown that they have the capabilities, the patience and the deep pockets to disrupt industry after industry. Health care is no exception.”

Earlier this year, Amazon announced its entry into the healthcare market through an alliance with JP Morgan Chase and Berkshire Hathaway.

L.E.K. calls DME a “no-brainer” for Amazon, as it already sells general medical supplies and equipment to consumers.

“Amazon’s core competencies in logistics and distribution, and its existing B2B e-commerce platform will allow it to easy expand into hospital and provider supply, disrupting the traditional group purchasing organization contract model,” the report states. “Amazon has already obtained licenses to distribute medical supplies to providers in 43 states.”

Other points of entry for Amazon are mail-order and retail pharmacy (it has secured approval as a wholesale distributor from 12 state pharmaceutical boards); pharmacy benefit manager (it could partner with existing PBMs to gain a pharmacy network and claims adjudication capability); telemedicine or in-home health care (it could leverage its Echo smart speaker for virtual house calls and its Alexa personal assistant to book physician visits and more); and AI-powered diagnostics and continuous care (Alexa already delivers first-aid information and voice-driven self-care instructions in an offering introduced by the Mayo Clinic).

There are three reasons to believe Amazon is serious about health care, the report says.

"One, they are one of the largest private employers in the U.S. and would reap huge financial benefits from lowering healthcare costs,” said Joseph Johnson, managing director and report co-author. “Second, the U.S. healthcare system is notoriously inefficient, and Amazon CEO Jeff Bezos loves to attack inefficiencies. And third, health care is the kind of big, complex opportunity that Bezos likes to sink his teeth into."

VGM helps protect sleep contract

WATERLOO, Iowa – The VGM Group has helped providers in Maryland, Washington, D.C., and Virginia beat back CareFirst BlueCross BlueShield’s plans to reduce the number of providers in its network that are authorized to provide CPAP equipment. The insurer planned to limit its network to a few providers after Feb. 15, 2019. When VGM heard from members about CareFirst’s decision, it filed a complaint with the Maryland Insurance Administration and after some back and forth CareFirst agreed to allow any contracted provider to continue providing sleep-related equipment at the contracted reimbursement rate, as long as they meet a set of requirements. “We want to make sure our membership community has access to as many payers as possible to provide better access for patients and their families,” said Clint Geffert, president of VGM & Associates.

Prometheus turns into Prochant

CHARLOTTE, N.C. – The Prometheus Group, a provider of HME revenue cycle management services, is rebranding to Prochant. Along with a new name, the company has a new logo, graphics, website and messaging. “Our combination of solid processes and a team of highly skilled specialists is a winning formula that helps us make our customers more profitable,” said Joey Graham, general manager and vice president of operations for Prochant. “The new branding more accurately explains how we do what we do.” The new name consists of two parts: pro and chant, with pro representing the professional and proactive nature of the company’s team members; and with chant representing the persistent and relentless nature of its activities. Prochant has two services offerings: full-service billing and staff augmentation.

Med Mart debuts ‘virtual showroom’

CINCINNATI – Med Mart has a new “virtual showroom” that allows customers to view equipment and communicate with product specialists via video. Using mobile wireless cameras, the specialists show customers products from Med Mart’s 10,000-square-foot warehouse and answer questions. “The virtual showroom is a game-changing option for shoppers who don’t live near a Med Mart retail store, or who aren’t able to easily leave their home due to limited mobility,” the company states in a press release. “Photos can only do so much, and when you’re buying medical products, it’s even more important that you understand the features of the product so that you can know if it’s the right option for you.” Med Mart has three stories in Ohio and serves the entire country through an e-commerce website. It carries more than 5,000 products, including lift chairs, hospital beds, power wheelchairs and more.

Soleo Health opens new location in West Virginia

MCKINNEY, Texas – Soleo Health has expanded its national specialty infusion pharmacy platform to 19 states with licensure in 50 states. It recently opened a state-of-the-art pharmacy in West Virginia that allows the company to care for patients not only in West Virginia but also western Pennsylvania and the Ohio Valley. “As one of the fastest growing specialty infusion companies in the industry, we have experienced double-digit growth every year since our inception in 2014 and care for thousands of patients while adding hundreds of new team members to our dedicated staff,” said Drew Walk, CEO. The West Virginia location, as with most of Soleo’s pharmacy locations, offers the flexibility of receiving care at home or at an on-site ambulatory infusion suite. In the past several months, Soleo has also opened several other specialty infusion pharmacy locations throughout the country, including in Orlando, Fla.; St. Louis; and Denver.

NSM joins AAH…

NASHVILLE, Tenn. – National Seating & Mobility has joined AAHomecare as a bronze corporate partner. NSM says the partnership is representative of the provider’s ongoing commitment to public policies that protect access to manual and power complex wheelchairs and mobility related products. “We have been impressed by the scale, capability and effectiveness of AAHomecare in representing the critical areas of our industry,” said Bill Mixon, CEO of NSM. “With specialists on staff and relationships with respected advisors, the association is a credible presence on the front lines on Capitol Hill and at state and federal agencies. We are proud to partner with them in the fight to represent the CRT industry, and we look forward to working together to also impact the mobility industry and the AccessNSM clients we serve.” Corporate sponsorships strengthen AAHomecare’s impact in areas like payer relations, value-based reimbursement models and research. They also support the association’s legislative and regulatory representation of the complex rehab industry.

…and VGM Live at Home

NASHVILLE, Tenn. – AccessNSM, a division of National Seating & Mobility, has joined the VGM Live at Home nationwide community of home accessibility providers and certified modification contractors. NSM says the partnership will connect AccessNSM with VGM’s network of business tools and resources, as well as vendor programs. “The new partnership with VGM is a natural fit for AccessNSM,” said Kalen McKenzie, vice president of the division. “VGM has made great strides bringing the home access industry together, and we look forward to utilizing their resources in providing the best services and solutions for our clients.” AccessNSM offers everything from stair, wheelchair and vehicle lifts to ramps to bathroom accessories.

NRRTS extends amnesty program

LUBBOCK, Texas – NRRTS has extended an Amnesty Program for awarding the CRTS designation to new or current registrants who meet certain criteria through June 1. The organization has awarded the designation to about 30 registrants since the program launched on Jan. 1. Registrants must meet the following criteria to be eligible for the program: They must have a minimum of three years of experience providing direct services to consumers; they must be an ATP in good standing for a minimum of three years at the time of their application; and they must complete the application for registry to the satisfaction of the review chair within the timeframe. Current registrants who meet the criteria will be awarded the CRTS designation on their 2018 renewal.

Attendees FLYP for new product at Medtrade Spring

LAS VEGAS – Medtrade Spring attendees tapped the FLYP Nebulizer for a gold in the New Product Pavilion’s Providers’ Choice Awards. X-top for Men received silver, and Werth Folding Walker Storage Rack received Bronze. FLYP by Convexity Scientific is described by company officials as a “game-changing, pocket-portable nebulizer” that’s prescribed by physicians for respiratory conditions like asthma and COPD. X-top for Men by McAirland’s is specifically designed for the male anatomy and provides 360-degree leak-proof protection for any activity. The Werth Folding Walker Storage Rack by Werth holds walkers individually, allowing for quick and easy selection and removal. Medtrade Spring has been taking place at the Mandalay Bay Convention Center in Las Vegas since Monday.

Goodwill HME offers free shipping on incontinence products

LAWRENCEVILLE, N.J. – Goodwill Home Medical Equipment, a division of Goodwill Industries that provides affordable medical equipment and supplies, now offers free shipping on all incontinence product orders of $50 or more. The nonprofit says it offers a wide variety of incontinence products, including tab closure briefs, underwear pull-ups, underpads and wipes, from trusted brands. Because its customers receive donated unused medical supplies and/or gently used medical equipment and they pay cash, they receive reduced rates. A standard wheelchair that sells for $500, for example, is available through Goodwill for $110, the nonprofit says.

Accreditation news: BOC, CHAP

Owings Mills, Md.-based Board of Certification/Accreditation has won a Stevie Award for Innovation in Customer Service, the company announced March 27. It’s BOC’s eighth consecutive Stevie Award. The company’s bronze award in the “New Product Development for Customer Demand” category recognizes its focus on new strategies and tactics for continuously improving service to its customers. In its entry submission, BOC highlighted its recently launched Compounding Accreditation, which was created after pharmacies began requesting it, and its Durable Medical Equipment Specialist certification, which the company plans to expand with additional locations this year. The Stevie Awards were created to honor and generate public recognition for the achievements and positive contributions of organizations and working professionals worldwide. Winners were announced during a gala banquet on Feb. 23 at Caesars Palace in Las Vegas…CMS has renewed Washington-based Community Health Accreditation Program’s home health accreditation for use by home health agencies to demonstrate compliance with the Medicare home health Conditions of Participation or CoP. More than 2,000 home health agencies use CHAP accreditation for this purpose and have received CMS deemed status post-survey.

WASHINGTON – AAHomecare’s Executive Committee will examine e-prescribing platforms to recommend the best solution for its provider members.

“It’s time for the HME community to move away from the fax machine and individual paper prescriptions, and fully embrace e-prescribing,” said Steve Ackerman, AAHomecare chairman and president of Spectrum Medical, in a bulletin. “Companies that invest in e-prescribing will be able to fill orders more efficiently to the benefit of patients and caregivers, while also reducing documentation errors and audits.”

AAHomecare will study leading e-prescribing platforms in terms of their suitability for the HME sector and recommend the best solutions. The association will subsequently work with companies supplying these platforms to provide additional guidance and to help promote the industry’s use of this technology.

“The healthcare field is rapidly moving toward increased usage of electronic communications and record keeping, and HME suppliers need to keep up,” said Ackerman. “While our companies will always rely on dedicated professionals to make sure that our patients are receiving a high standard of care, we also need to automate processes wherever it makes sense to do so.”

WASHINGTON – AAHomecare’s Executive Committee will examine e-prescribing platforms to recommend the best solution for its provider members.

“It’s time for the HME community to move away from the fax machine and individual paper prescriptions, and fully embrace e-prescribing,” said Steve Ackerman, AAHomecare chairman and president of Spectrum Medical, in a bulletin. “Companies that invest in e-prescribing will be able to fill orders more efficiently to the benefit of patients and caregivers, while also reducing documentation errors and audits.”

AAHomecare will study leading e-prescribing platforms in terms of their suitability for the HME sector and recommend the best solutions. The association will subsequently work with companies supplying these platforms to provide additional guidance and to help promote the industry’s use of this technology.

“The healthcare field is rapidly moving toward increased usage of electronic communications and record keeping, and HME suppliers need to keep up,” said Ackerman. “While our companies will always rely on dedicated professionals to make sure that our patients are receiving a high standard of care, we also need to automate processes wherever it makes sense to do so.”

Medicare Advantage gets 3.4% increase

WASHINGTON – CMS will increase average payments for health insurers that manage Medicare Advantage plans by 3.4% for 2019, the agency announced on April 1. CMS initially proposed a 1.84% increase, according to news reports. The agency will also make a number of policy changes to MA plans, including codifying key aspects of the Star Ratings system and revising the regulations controlling maximum out-of-pocket limits.

VGM joins work group on electronic medical documentation

WATERLOO, Iowa – The VGM Group and its membership has been invited to participate in a CMS work group on electronic medical documentation. VGM will represent DMEPOS providers in the work group, which will have representation from several different provider groups. “While the concept of electronic medical records is not new, this initiative of utilizing technology to allow providers the opportunity to easily communicate and receive proper patient documentation is something that the DME industry struggles to gain from other provider communities,” VGM stated. “We look forward to sharing the developments and engaging with our membership to offer proper feedback as these standards are set.” The work group seeks to, among other things, establish pilot programs with providers to demonstrate secure exchange of health information, and support adoption of real-world use cases to advance secure and standardized electronic data exchange for medical documentation requests and responses.

Oklahoma providers meet with Rep. Cole

NORMAN, Okla. – Members of the Oklahoma Medical Equipment Providers Association and the VGM Group hosted Rep. Tom Cole, R-Okla., at an event at Norman Regional Home Medical Equipment. Members discussed how DME and complex rehab providers care for patients. Cole was especially interested in the industry’s efforts to keep patients in their homes. Also of interest: the flaws of Medicare’s competitive bidding program, as his district falls within the Oklahoma City bid area. Jason Price of the Oklahoma Department of Rehabilitation Services, who has cerebral palsy and uses a wheelchair, was there to discuss with Cole the importance of people with disabilities being able to lead active lives and contribute to their communities. “There are already enough obstacles for disabled employees to overcome in pursuing a career,” he said. “I do not want to see more obstacles because they don’t have access to this equipment they depend on.”

CMS officials on docket for Heartland

WATERLOO, Iowa – CMS officials will participate in a panel discussion at VGM’s Heartland Conference. CMS Competitive Bidding Acquisition Ombudsman Tangita Daramola and Small Business Administration Deputy National Ombudsman Natalie Dunca, along with contractors from CGS, C2C and Noridian, will participate in the 90-minute session. “VGM has maintained a working relationship with Tangita and her staff at CMS in an effort to improve CMS programs and keep DME suppliers informed of CMS updates,” stated Ronda Buhrmester, VGM’s reimbursement expert and session moderator. “By bringing them to the Heartland Conference, members will have the opportunity to share firsthand how regulations, reimbursements and audits are affecting their business.” This year’s Heartland Conference takes place June 19-21. FMI: www.vgmheartland.com.

Regulatory updates: Low volume appeals, prior auths

CMS will be accepting expressions of interest for low volume appeals from April 12-June 8, 2018, for all NPIs. An EOI must be submitted for each NPI. The appeals are only offered to appellants that have less than 500 appeals sitting at OMHA and/or the Medicare Appeals Council as of Nov. 3, 2017, and each appeal must have a total billed amount of $9,000 or less. More information can be found here*…CMS has removed the following items from the prior authorization Master List: hospital bed semi-electric (E0260); CPAP (E0601); oxygen concentrator (E1390); and wheelchair (K0004). CMS is required to adjust the payment threshold for inflation annually. The payment threshold is $1,018 or greater, or an average monthly rental of $102 or greater. The four items did not meet the payment threshold.

Ascensia expands access for Contour products

BASEL, Switzerland – Ascensia Diabetes Care has improved access to its Contour Next meters and test strips for UnitedHealthcare members, it announced today. Effective April 1, individuals can access the brand’s products through their pharmacy benefit at a tier 2 co-pay level. Previously, a prior authorization was required. “This change will give more people the opportunity to access these products, and at a reasonable cost,” said Robert Schumm, vice president and managing director of Ascensia Diabetes Care US.

AOPA’s Fise to step down

ALEXANDRIA, Va. – Tom Fise will step down from his role as executive director of the American Orthotic & Prosthetic Association when his contract expires at the end of 2018. “On behalf of AOPA, I would like to thank Tom for his dedication and commitment to the orthotic and prosthetic industry,” said Jim Weber, president of AOPA, in a press release. “His legislative and regulatory experience has been most valuable to AOPA as he has worked to champion our association’s needs to Congress, CMS and other regulatory bodies.” Fise has been with AOPA nearly 12 years. AOPA’s executive committee has appointed a seven-member search committee to find Fise’s successor. It has also engaged Sterling Martin Associates, a leading national executive search firm, to guide the process. Sterling Martin focuses exclusively on the association and nonprofit sectors, and has significant experience in the healthcare space. AOPA anticipates filling the position by the end of August, allowing sufficient time for a successful transition of leadership.

VMI exec to receive recognition

ALEXANDRIA, Va. – Tim Barone, president and CEO of Vantage Mobility International, will receive a 2018 Distinguished Service Award from the Military Officers Association of America at an event on Capitol Hill in April. The award is given in recognition of contributions to the military community. Past recipients include Tom Brokaw and Colin Powell. Military Officers Association of America (MOAA) is the nation's largest military officers' association with more than 350,000 members from every branch of uniformed service, including active duty, retired, National Guard, Reserve, and former officers and their families and survivors.

ResMed names Ghoshal CTO

SAN DIEGO – ResMed didn’t have to look far to find its first chief technology officer. The company announced April 2 that it had named Bobby Ghoshal as CTO. Ghoshal had been the COO of Brightree, which ResMed bought in 2016. In his new role, Ghoshal will lead ResMed’s global healthcare informatics and data analytics team to drive its cloud-based digital health platforms, as well as investments in emerging health technologies like artificial intelligence and machine learning. Prior to his role at Brightree, Ghoshal was vice president of information technology at ResMed. Raj Sodhi, who is currently president of software-as-a-service businesses at ResMed, had previously led the company’s healthcare informatics team. “I’m excited for Bobby’s return to the ResMed team,” Sodhi said. “With Bobby as CTO, I can be fully focused on expanding the capabilities of ResMed’s SaaS solutions for out-of-hospital care, while Bobby leads the next level of tech innovation, investments and partnerships that will take our digital health capabilities to new frontiers, for the ultimate benefit of patients, physicians, providers and payers.”

AADE releases tip sheet for mail-order diabetes program

CHICAGO – The American Association of Diabetes Educators has released a tip sheet for navigating Medicare’s national mail-order program for diabetes testing supplies. The tip sheet, which was developed by the AADE’s Professional Practice Committee, provides information on: what is the program, why has it caused concern and what can diabetes educators do to help. The tip sheet recommends that diabetes educators explain the program and how it works to people with diabetes; walks them through the CMS website, which can be overwhelming; write “no substitutions” on prescriptions for those that require a particular brand for a significant reason; encourage those who are sent incorrect supplies to call 1-800-Medicare or the fraud hotline of the Office of Inspector General; and point out that if their brand isn’t available through the program they may purchase supplies at their local pharmacy, if the pharmacy accepts Medicare reimbursement and assignment, with a 20% coinsurance after the Part B deductible is met.

Byram Healthcare signs up for eOrdersPlus

CARMEL, Ind. – Byram Healthcare will participate in the Preferred Supplier Program with Stratice Healthcare. As part of the program, Byram will use Stratice’s eOrdersPlus solution to better serve its physician partners and patients with their medical supply needs in urology, diabetes, wound care, ostomy and incontinence. The solution’s direct electronic connectivity replaces an otherwise inefficient, largely paper-based ordering process, the companies say. “eOrdersPlus will help improve health data exchange between prescribers and suppliers, resulting in operational efficiencies and improved patient care,” said Perry Bernocchi, CEO of Byram. eOrdersPlus is available to healthcare providers and prescribers through direct integration with electronic healthcare record systems used in the practice setting, as well as through a HIPAA-secured web-based portal for use by all physicians and their staff.

YARMOUTH, Maine – Electronic ordering and documentation have dominated the headlines in recent weeks, and it’s about time, say the respondents to a recent HME Newspoll.

AAHomecare recently announced that it would be researching e-prescribing platforms to recommend the best solution for its provider members, and the VGM Group recently announced that it would be joining a CMS work group to advance electronic medical documentation.

“We are an independent DME company and not affiliated with a hospital, (so) we don’t have access to Epic and other systems—our notes and prescriptions come in via fax,” wrote one respondent. “We have hopes that this will change with AAH and VGM working on an electronic solution for the industry. We very much see the need to handle this documentation electronically. This would save so much time, which will, in turn, benefit the patient and ourselves.”

Parachute Health and Apria Healthcare also announced recently that they are now more widely offering their e-prescribing platforms to providers.

While a majority of respondents to the poll say they are already using electronic technology in their businesses (67%), there are still significant stumbling blocks to it being ubiquitous. Chief among them: the number of platforms being offered and used.

“We accept e-referrals on multiple platforms,” wrote Josh Marx of Medical Service Company based in Cleveland. “Some of them result in efficiency gains through streamlining processes, but others are niche platforms that specific doctors want us to use due to their own preferences. That makes it hard for our teams to manage, when there are multiple ordering platforms with varying degrees of integration into our ERP.”

Another stumbling block: Electronic ordering requires buy-in from both providers and referral sources, and some referral sources are holding back, respondents say.

“As a pharmacy/DME, we are at the mercy of the processes the pharmacy side of the business chooses to use,” wrote one respondent. “That means we still use a paper fax machine and have zero communication between pharmacy and DME computer systems.”

Respondents agree, however, that when and where electronic technology is leveraged, the benefits are significant, with the most significant among them being increased productivity by their order verification teams (39%), followed by reduced faxes and phone calls (35%).

“It saves money all around,” wrote Abel Guevara of Harbor Home Medical in Austin, Texas.

WASHINGTON – AAHomecare execs met with HHS Deputy Secretary Eric Hargan on April 11 to discuss competitive bidding relief and other industry priorities.

AAHomecare President and CEO Tom Ryan and Senior Vice President of Public Policy Jay Witter met with Hargan and other HHS/CMS officials to discuss the status of the interim final rule, which Congress included in its recent omnibus bill, “encouraging” CMS to “promulgate” the IFR.

Also on the agenda: long-term reform for the bid program; the status of provisions in the Cures Act directing CMS to use stakeholder input, travel and cost considerations, and other local data in making cost adjustments in non-bid areas starting in January 2019; and concerns about language included in the 2019 White House Budget that proposed expanding the bid process to non-bid areas.

AAHomecare is asking its members to reach out to their legislators in the coming weeks to keep the pressure on HHS and CMS to move on the IFR and competitive bidding reforms.

Inogen reports data security incident

GOLETA, Calif. – An Inogen employee’s email account was accessed by unknown persons outside the company without authorization, it announced in an April 13 Form 8-K filing with the Securities and Exchange Commission.

Some of the account’s messages—and the files attached to them—may have contained personal information belonging to Inogen rental customers. That personal information included names, addresses, telephone numbers, email addresses, dates of birth, dates of death, Medicare identification numbers, insurance policy information and/or type of medical equipment provided. It did not include payment card information or medical records.

Additionally, the unknown persons may have gained access to Inogen’s non-public financial information.

The unauthorized access appears to have occurred between Jan. 2, 2018, and March 14, 2018.

Inogen is notifying approximately 30,000 current and former customers of the incident. It will provide resources, including credit monitoring and an insurance reimbursement policy, to assist them.

In the wake of the incident, Inogen, which has hired a forensics firm to help investigate the incident and bolster its security, has required all email users to change their passwords. It has also implemented multi-factor authentication for remote email access and has taken additional steps and other preventative measures to further limit access to its systems, including enhanced training.

Medforce Technologies acquired

SUFFERN, N.Y. – Medforce Technologies, the productivity-enhancing software and services provider, has been acquired by U.K.-based technology firm Ideagen for $8.7 million.

Ideagen says Medforce, its first acquisition in the U.S., adds an established suite of intellectual property and a skilled workforce to its growing global headquarters.

“Medforce is a valuable addition to the group and is in line with our strategy of acquiring businesses that have strong IP and recurring revenues,” said David Hornsby, Ideagen’s CEO.

Ideagen says Medforce generated revenues totaling $4.7 million for 2017, with 82% of that recurring.

Overall, Medforce represents Ideagen’s 13th acquisition in just more than a decade and means the company now has a major operational presence in the U.S., U.K., Asia and Central Europe. More recently, it has integrated Gael Ltd, IPI Solutions Ltd, Covalent Software Ltd and PleaseTech Ltd as part of a “buy-and-build” growth strategy.

NSM consolidates in Chicago…

NASHVILLE, Tenn. – National Seating & Mobility has opened a new branch in Chicago to consolidate three existing branches in the area. “Merging the three existing Chicago area branches within our new location enables us to enhance the services provided for our clients in the area,” said Bill Mixon, CEO. “The larger location allows our Chicago team to combine resources, increase evaluations and streamline routing and service scheduling so we can serve our clients better and faster.” Branches in Broadview, Bridgeview and Lombard, Ill., will merge into the new location in Countryside, Ill. Twelve ATPs and 23 team members, including technicians, funding specialists and customer service representatives, will staff the new branch. “We look forward to continuing our work alongside area physicians and therapists to provide the best customized solutions for individuals with mobility challenges in Chicago,” Mixon said.

… makes buy in Michigan

NASHVILLE – National Seating & Mobility has acquired Reflection Medical in Temperance, Mich., it announced April 13. The move expands the provider’s reach in southern Michigan and northwest Ohio. NSM also operates branches in Columbus, Cleveland, Youngstown and Toledo, Ohio, and in Freeland, Lansing, Flint, and Detroit, Mich. “Reflection Medical’s reputation for customer service and client care make them a great cultural fit for us,” said Bill Mixon, NSM CEO in a press release. NSM has been on a growth spree, making acquisitions and opening branches, including its first in Maine, in March.

VGM launches weekly podcast

WATERLOO, Iowa – VGM Group has launched Industry Matters, a weekly podcast featuring interviews with industry leaders. Recent guests included Ty Bello of Team@Work Coaching and Larry Dalton of the Oklahoma Medical Equipment Providers Association. “Our goal is to keep the information intriguing and informative, and to provide solutions to help our audience succeed in an ever-changing and difficult business environment,” said Collin Brecher of VGM Government Relations and podcast host. The 30-minute podcasts are released every Wednesday through Stitcher Radio, Apple Podcasts and Google Play.

Update: C2C phone demo

WASHINGTON – C2C Innovative Solutions, the QIC contractor, reopened 54,138 claims and withdrew 27,132 claims from the Administrative Law Judge backlog in 2017, according to a bulletin from AAHomecare. Of those who participated in the telephone demonstration, 64% of the claims were found fully favorable and 3% were found partially favorable. AAHomecare also reports that C2C has also lost their QIC contract, a decision it expects the contractor to appeal.

BBMK, Allegiance Group strike partnership

MIDDLETOWN, N.J., and OVERLAND PARK, Kan. – BBMK Technologies, the provider of a cloud-based homecare software solution called NikoHealth, has entered into an agreement with the Allegiance Group. Per the agreement, NikoHealth customers will have access to COLLECTPlus, a proprietary private-pay billing collections solution from the Allegiance Group. “This relationship will complement the services offered by NikoHealth in the HME/DME market," said Michael Kutsak, NikoHealth's CEO. “We are really excited about the new integration of these products, which will provide our customers additional tools to further improve their financial position.”

MAMES honors Heitkamp, Thune

DULUTH, Minn. – The North Dakota and South Dakota members of the Midwest Association of Medical Equipment Services & Supplies have presented Sen. Heidi Heitkamp, D-N.D., and Sen. John Thune, R, S.D., with MAMES Legislative Champion Awards this month for their work supporting the HME industry. Heitkamp and Thune have both been champions of the industry’s efforts to provide relief from Medicare’s competitive bidding program in rural areas. After being presented with the award, Heitkamp indicated that she would be willing to work with Thune to introduce a Senate companion bill to H.R. 4229, according to a MAMES bulletin. Thune has also pressed HHS Secretary Alex Azar to approve an interim final rule that would provide relief.

SleepScore acquires app and wearable that detects snoring

CARLSBAD, Calif. – SleepScore Labs, a joint venture between ResMed, Dr. Mehmet Oz and Pegasus Capital Partners, has acquired Netherlands-based digital health company Sleep.ai. Founded in 2014, Sleep.ai created an app and wearable for detecting if a user is snoring and/or grinding their teeth, and helps dentists monitor patients after they’ve begun dental treatment for either condition. “We are only at the beginning of what we can do to help improve people’s lives by diagnosing and improving their sleep health, helping them get better treatment and outcomes,” said Michiel Allessie, Sleep.ai founder and CEO, who will join the SleepScore Labs team in Carlsbad, Calif., as vice president of snoring and bruxism. “With the knowledge and the drive of the team at SleepScore Labs, along with the available technology, I believe we can really change the landscape of sleep in the coming years and help people significantly improve their sleep health.” The Sleep.ai app, which has been downloaded more than 250,000 times form the App Store and Google Play store, will be available on its own website and that of SleepScore Labs. Terms of the deal were not disclosed.

Maker of CPAP alternative to go public

MINNEAPOLIS – Inspire Medical Systems, the maker of FDA-approved neurostimulation technology that provides treatment for moderate to severe OSA, has filed paperwork for an initial public offering of its common stock. The number of shares to be offered and the price range for the offering have not yet been determined. Inspire has applied to list its common stock on the New York Stock Exchange under the ticker symbol “INSP.” BofA Merrill Lynch and Goldman Sachs & Co. LLC are serving as join lead book-running managers for the proposed offering. Guggenheim Securities, Stifel, and Wells Fargo Securities are acting as co-managers. In 2016, Inspire Medical Systems accumulated $37.5 million in venture funding to increase sales of its pacemaker-sized, implantable device.

WASHINGTON – CMS will once again hold a Special Open Door Forum on templates and clinical data elements for respiratory related items this Thursday at 3 p.m. EST.

The agency says the purpose of the forum is to allow physicians, provider and supplier professional associations, and/or all other interested parties to provide feedback on the most recent draft templates and CDEs that are currently posted on the CMS website. The templates and CDEs are meant to assist with documenting face-to-face encounters, detailed written orders or written orders prior to delivery, and lab test results.

CMS discussed a third draft of the templates and CDEs for oxygen during a Special Open Door Forum* in January 2017. Those drafts included suggested CDEs and visual examples.

Feedback and questions on the most recent drafts can be sent to clinicaltemplates@cms.hhs.gov.

To participate in the forum, dial 1-800-837-1935 and use the conference ID 9796898.

WASHINGTON – Office of Management and Budget Director Mick Mulvaney said this week that the agency is working to release an interim final rule that would provide relief from Medicare’s competitive bidding program, but he gave no timeline for when that might happen.
“I will say this: I have probably received more calls about this than any other rule put together,” he said during a hearing for the fiscal year 2019 budget on Wednesday. “Since we’re aware of the urgency to members of both parties, I’m interested in getting it out as quickly as we possibly can. That being said, it’s a fairly complex rule, and it’s absolutely critical that we get it right because of the scope of this rule, so I won’t be able to comment.”
Mulvaney’s comments were made in response to Rep. Kevin Yoder, R-Kan., who asked, “Can you share an update where the rule is in this process, and how far away from finalization that might be, and what steps is OMB taking right now to review the rule in a timely manner?”
Mulvaney stated that IFR is currently under review at the Office of Information & Regulatory Affairs and said he couldn’t comment further.
The industry has kept the pressure on lawmakers, urging them to contact Mulvaney about the IFR, which has been stuck at the OMB since August. In March, they included language in the omnibus bill encouraging CMS to implement the IFR.