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    06/21/2018
    HME News Staff

    WASHINGTON – Efforts by AAHomecare and its manufacturer members to exempt several product categories from a 25% tariff on imported materials and products from China have partially paid off.

    AAHomecare announced this week that 10 of the 48 product categories that they had targeted for exemption have been removed from an original list of 1,333.

    “I’ve never seen AAHomecare leadership act so quickly and effectively under such difficult circumstances and time constraints,” said Mitchell Yoel, senior vice president, global commercial operations, at Drive DeVilbiss.  “Getting a large group of competing manufacturers together, harnessing the relevant legal and regulatory resources, and finishing the job by getting all stakeholders to do their part so that the industry could speak with one voice to our government, all in a matter of days, was both impressive and, to my knowledge, unprecedented.”

    In a little more than a month, AAHomecare and manufacturer members engaged law firm King & Spaulding to draft industry comments and to serve as a clearinghouse for companies to confidentially submit information on product categories they wanted removed from the list, and to then submit comments to the U.S. Trade Representative.

    John Anderson, CEO of Cure Medical, also credited the efforts of the Health Industry Distributors Association (HIDA).

    “I was impressed by how quickly AAHomecare and HIDA united a coalition of DME manufacturers as a team to stop these changes,” he said. “AAHomecare leadership gathered vital information from us to help create a report on the economic impact that these tariffs would create, outlining how destructive tariffs would be for people who depend on medical devices.”

    The product categories that have been removed from the list are:

    • 40169915: Caps, lids, seals, stoppers and other closures, of non-cellular vulcanized rubber other than hard rubber

    • 73202050: Iron or steel, helical springs (o/than suitable for motor-vehicle suspension)

    • 76042910: Aluminum alloy, profiles (other than hollow profiles)

    • 85079040: Parts of lead-acid storage batteries, including separators therefor

    • 90183100: Syringes, with or without their needles; parts and accessories thereof

    • 90183900: Catheters, cannulae and the like nesi, used in medical, surgical, dental or veterinary sciences, and parts and accessories thereof

    • 90192000: Ozone, oxygen and aerosol therapy, artificial respiration or other therapeutic respiration apparatus, and parts and accessories thereof

    • 90211000: Orthopedic or fracture appliances, and parts and accessories thereof

    • 90213100: Artificial joints and parts and accessories

    • 90262080: Instruments and apparatus, other than electrical, for measuring or checking the pressure of liquids or gases


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    ‘CMS refers to comments all the time,’ says VGM’s Gallagher
    06/22/2018
    Theresa Flaherty

    WATERLOO, Iowa – With only two weeks left until a July 9 deadline, a paltry 56 comments have been submitted in response to a competitive bidding-related interim final rule.

    “And we wonder why (nothing changes),” John Gallagher, vice president of government relations for VGM, told attendees at last week’s Heartland Conference. “CMS refers to comments all the time. Take the time when you get back to your office to do the comments.”

    The IFR, published in the May 11 Federal Register, reinstates 50/50 blended reimbursement rates, but only from June 1, 2018, to Dec. 31, 2018, instead of retroactively from Jan. 1, 2017, and only in rural and non-contiguous CBAs instead of all non-bid areas.

    No one should be sitting on the sidelines at this point in the game, says Jay Witter, senior vice president of public policy for AAHomecare.

    “This IFR goes far beyond relief in rural areas,” he said. “For the first time, CMS has acknowledged there are problems. They are agreeing with us.”

    Industry stakeholders continue to press lawmakers for bid relief. In addition to ramping up the number of co-sponsors for H.R. 4229, they’re also seeking to introduce a Senate companion bill ahead of the August recess.

    To boost their efforts, VGM is launching two new surveys in the coming weeks, a cost-shifting survey and a delivery cost survey, says Gallagher.

    “We want to know what your cost is to send that vehicle out of the gate,” he said.

    Stakeholders are also keeping an eye on an upcoming proposed rule, CY 2019 Changes to the End-Stage Renal Disease Prospective Payment System, that is expected to be released just ahead of the July 4 holiday.

    “Health and Human Services Deputy Secretary Eric Hargan has said changes are coming,” said Witter. “The ESRD is the most viable vehicle for those changes. If that doesn’t happen, we will have to go back to Congress.”
     


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    06/22/2018
    Liz Beaulieu

    DALLAS – A U.S. District Court’s recent opinion prohibiting CMS from recouping alleged overpayments from a provider going through the appeals process until after the administrative law judge level sends a strong message, industry stakeholders say.

    As part of the June 4 opinion, Judge Ed Kinkeade of the U.S. District Court for the Northern District of Texas agreed to issue a temporary restraining order against CMS, the latest development in Family Rehabilitation, Inc. vs. Azar.

    “The system, which is supposed to offer a fair appeals process for providers, has been broken for some time,” said Wayne van Halem, president of The van Halem Group. “The fact that it has been acknowledged now is very important.”

    The district court in October 2017 “reluctantly dismissed” Family Rehab’s initial request for a temporary restraining order for lack of jurisdiction, prompting the home health company to appeal to the U.S. Court of Appeals for the 5th Circuit. The circuit court in March of this year clarified relevant case law and kicked it back to the district court, prompting the recent opinion.

    At issue in the case is a requirement that the ALJ hear cases and issue decisions within 90 days—a timeframe that has ballooned to multiple years due to a massive backlog at the third level of appeals.

    “Many providers can’t afford to refund the money and wait four years for a hearing,” van Halem said. “We have many clients whose cases are being assigned for hearings now that went out of business since the time we submitted them. It’s sad.”

    That was the crux of Family Rehab’s argument. It argued the continued recoupment of the $7.5 million in alleged overpayments would force the company to shut down long before an ALJ hearing, causing “irreparable injury.”

    “Having already laid off most of its employees and limiting home healthcare to only eight of its previous 289 patients, Family Rehab will be forced to permanently close its doors,” Kinkeade wrote in the opinion. “Not only is it suffering a dramatic financial hardship currently, but Family Rehab will go out of business permanently, with its remaining employees losing their employment and patients losing their healthcare provider.”

    The opinion pokes holes in CMS’s “favorite defense,” says Ross Burris, a healthcare lawyer for Polsinelli based in Atlanta.

    “They’re famous for saying, ‘You can’t sue us because there are administrative remedies,’” he said. “But what the court is saying here is, ‘Those remedies are non-existent.’”

    While the opinion has limitations, it does open the door for other providers and their lawyers to try and use the same argument, van Halem and Burris say.

    “If you’re appealing and you believe your company is going to be in dire circumstances under the recoupment—you’re not just angry; you have an immediate chance of irreparable harm—you now have an option,” Burris said.

    Elizabeth Hogue, a healthcare lawyer based in Washington, D.C., agreed.

    “This case is definitely one for providers to watch,” she said. “It now looks possible for providers to avoid recoupment in the face of multi-year wait times for hearings before ALJs.”


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    06/22/2018
    Theresa Flaherty

    WATERLOO, Iowa – Whether it’s medical supplies or a hot dog stand, if you want to build a world-class company, your employees need to provide exemplary service, said keynote speaker John DiJulius at the Heartland Conference last week.

    “Price is irrelevant,” said DiJulius, author of several books on customer service and president of The DiJulius Group, a consultant to companies like Starbucks, Chick-fil-a, and The Ritz-Carlton. “(Customers want) compassion and empathy.”

    That means empowering your front-line employees, not stifling them with restrictive policy, he said.

    That message was a recurring theme at the conference, which featured more than 70 exhibitors and a full slate of sessions covering 10 tracks, including a new executive track. Final numbers weren’t available at press time, but more than 1,000 attendees were expected, including 76 first-timers.

    Building on advice from DiJulius, keynote speaker Jared Johnson told attendees they need to employ the “pay people to think’’ philosophy.

    “When you are hiring, hire innovative thinkers to respond to the ridiculousness that comes from the federal government,” said Johnson, a motivational speaker with 12 years as an elected official and 17 years as a healthcare executive on his resume.

    Spend and demand, just not from Medicare

    Demand for HME is projected to grow about 6% annually over the next several years, and the total HME spend is projected to be nearly 30% higher in 2022 than in 2017, Mark Higley, vice president of regulatory affairs for VGM, told attendees.

    But Medicare will shrink as a portion of that, while Medicaid, private insurance and out-of-pocket will increase, he said.

    “You’re diversifying and Medicare is paying you less each year,” he said. “The cash market will go from $30 billion to $45 billion. The spend and demand for our products is incredible.”

    Medicare irks

    Until that shift happens, however, Medicare and its challenges remain top of mind. During an SBA/CMS panel discussion, attendees aired a laundry list of familiar complaints, including audits, Medicare Advantage and, of course, the competitive bidding program.

    “Who’s going to call a provider in Alabama for a bed in Massachusetts,” said one provider. “We are renting more beds now than when we had a contract for. The patients can’t wait.”

    Tangita Daramola, CMS Competitive Bidding Acquisition Ombudsman, acknowledged there are problems with the program and encouraged providers to contact the Competitive Bidding Implementation Contractor.

    “It grieves me to hear that patients in America can’t get the products and services they need,” she said.

    It’s a wrap

    Next year’s Heartland Conference is slated for June 10-12, 2019.

    “The conference accomplished its goal of connecting our members through face-to-face interactions with peers, vendor-partners, influencers and thought leaders to experience a different way of learning—all while having a little fun along the way,” said Clint Geffert, president of VGM & Associates, a division of VGM Group.


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    06/22/2018
    HME News Staff

    WASHINGTON – MedPAC’s June 2018 report to Congress recommends that CMS include more DMEPOS products in the competitive bidding program as a way to improve Medicare’s payment policies and reduce fraud and abuse.

    “The CBP has successfully driven down the cost of DMEPOS products for the Medicare program and beneficiaries,” the report states. “Compared with payment rates in the year before the CBP, Medicare’s payment rates for some of the highest expenditure products have fallen by an average of roughly 50%.”

    At the same time, MedPAC says expenditures for products not included in the program have continued to grow, making them good candidates for competitive bidding.

    “By 2015, nearly half of all Medicare expenditures on DMEPOS products were for products excluded from the CBP,” the report states. “Medicare’s payment rates for the top 10 non-CBP products in 2015 were one-third higher, on average, than private-payer rates for comparable products, and some non-CBP products continue to generate high rates of improper payments and utilization growth and to exhibit patters of potential fraud and abuse.”

    MedPAC points out that CMS has the authority to include some additional products in the program, including chest wall oscillation devices, ventilators and off-the-shelf orthotics.

    The commission even describes products that CMS is statutorily prohibited from including in the program, like parenteral nutrition, as “likely good candidates…because multiple suppliers furnish the products, and Medicare’s payment rates appear to be substantially higher than private-payer rates.”

    In the case of parenteral nutrition, MedPAC found that Medicare’s payment rate for the highest expenditure parenteral nutrition product was 24% higher compared with private-payer rates in 2015.

    MedPAC also points out that CMS’s authority to include some additional products in the program, like ostomy, tracheostomy and urological supplies, is “unclear” but worth pursuing.

    Trump tariffs: Several DME product categories dropped

    WASHINGTON – Efforts by AAHomecare and its manufacturer members to exempt several product categories from a 25% tariff on imported materials and products from China have partially paid off.

    AAHomecare announced this week that 10 of the 48 product categories that they had targeted for exemption have been removed from an original list of 1,333.

    “I’ve never seen AAHomecare leadership act so quickly and effectively under such difficult circumstances and time constraints,” said Mitchell Yoel, senior vice president, global commercial operations, at Drive DeVilbiss.  “Getting a large group of competing manufacturers together, harnessing the relevant legal and regulatory resources, and finishing the job by getting all stakeholders to do their part so that the industry could speak with one voice to our government, all in a matter of days, was both impressive and, to my knowledge, unprecedented.”

    In a little more than a month, AAHomecare and manufacturer members engaged law firm King & Spaulding to draft industry comments and to serve as a clearinghouse for companies to confidentially submit information on product categories they wanted removed from the list, and to then submit comments to the U.S. Trade Representative.

    John Anderson, CEO of Cure Medical, also credited the efforts of the Health Industry Distributors Association (HIDA).

    “I was impressed by how quickly AAHomecare and HIDA united a coalition of DME manufacturers as a team to stop these changes,” he said. “AAHomecare leadership gathered vital information from us to help create a report on the economic impact that these tariffs would create, outlining how destructive tariffs would be for people who depend on medical devices.”

    The product categories that have been removed from the list are:

    • 40169915: Caps, lids, seals, stoppers and other closures, of non-cellular vulcanized rubber other than hard rubber

    • 73202050: Iron or steel, helical springs (o/than suitable for motor-vehicle suspension)

    • 76042910: Aluminum alloy, profiles (other than hollow profiles)

    • 85079040: Parts of lead-acid storage batteries, including separators therefor

    • 90183100: Syringes, with or without their needles; parts and accessories thereof

    • 90183900: Catheters, cannulae and the like nesi, used in medical, surgical, dental or veterinary sciences, and parts and accessories thereof

    • 90192000: Ozone, oxygen and aerosol therapy, artificial respiration or other therapeutic respiration apparatus, and parts and accessories thereof

    • 90211000: Orthopedic or fracture appliances, and parts and accessories thereof

    • 90213100: Artificial joints and parts and accessories

    • 90262080: Instruments and apparatus, other than electrical, for measuring or checking the pressure of liquids or gases

    Will HHS make changes to the Stark Law?

    WASHINGTON – The Department of Health and Human Services is asking for feedback on the physician self-referral law, known as the Stark Law.

    In a request for information scheduled to be published in the Federal Register on June 25, HHS asks for feedback on “how to address any undue regulatory impact and burden of the physician self-referral law.”

    The agency has made the request as part of efforts “to help accelerate the transformation to a value-based system that includes care coordination.” It says removing unnecessary government obstacles to care coordination is one of its key priorities.

    “Through internal discussion and input from external stakeholders, CMS has identified some aspects of the physician self-referral law as a potential barrier to coordinated care,” the RFI reads.

    Specifically, HHS is requesting information in 20 different areas, including “What, if any, additional exceptions to the physician self-referral law area necessity to protect financial arrangements between HHS entities and referring physicians who participate in the same alternative payment model”; and “Please share your thoughts on the role of transparency in the context of the physician self-referral law.”

    HHS noted that the RFI is a request for information, not a request for proposal.

    The agency will accept comments for 60 days after the date of publication of the RFI.

    AAH updates: Bidding, MedPAC, Medicaid

    AAHomecare submitted two letters to Health and Human Services and CMS officials this week. The first letter detailed long-term reforms for the competitive bidding program and highlighted seven priority recommendations that the association would like to see incorporated into the next round of the program. The second letter was a response to the President’s Budget for FY2019 and identified seven proposals that would impact the HME industry, the most concerning of which being expanding the bid process to all areas of the country, including rural areas…AAHomecare is working with consumer groups like the United Spinal Association to educate and engage lawmakers to push back against recent proposals by MedPAC to add products to the competitive bidding program…AAHomecare reports that state Medicaid officials in Iowa and Rhode Island have decided to maintain current rates for DMEPOS, rather than adopt Medicare pricing. The association has now updated its Cures Scorecard, showing six states adopting Medicare pricing, 11 states planning to adopt Medicare pricing, 13 states choosing not to adopt Medicare pricing, one state adopting Medicare pricing for a limited number of codes, and 10 states still analyzing data. The association is still trying to obtain information from 10 other states.

    Drive DeVilbiss ‘empowers’ customers with new website

    PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare is preparing to launch a new, state-of-the-art website this summer, the company announced June 21. With input from customers, the new site is being designed to provide faster, more efficient 24/7 account access, allowing them to take care of their own needs. “The features of our new account management dashboard will allow providers to self-service their entire Drive account online,” said Ed Link, chief marketing officer. “We want to empower our customers to take control of their business and do it their way.” The new dashboard allows customers to generate quotes, estimate delivery charges and dates, order products quickly, track shipments, pay invoices, process returns and more. The site also features an improved search function, enhanced product pages, and live chat and other technical support services.

    Soleo makes list despite ‘headwinds’

    MCKINNEY, Texas – Soleo Health was ranked 8th among the 50 Fastest-Growing Middle Market Companies in Dallas area by the Dallas Business Journal. Each year, the journal ranks the 50 fastest-growing companies in the Dallas-Forth Worth area with revenues of $25 million to $750 million, basing its rankings on revenue growth over a three-year period. “Soleo Health was recognized in this ranking by the Dallas Business Journal for its 69% three-year annual revenue growth rate, including 2017, which was a pivotal year for our company,” said Drew Welk, CEO. “We are extremely proud to have reached significant growth and expansion milestones last year, despite industry reimbursement-related headwinds.” In 2017, Soleo Health expanded its workforce to more than 400 employees, increased its physician referral network 33%; and grew its geographic presence with four new locations. Soleo operates 19 location in the U.S., with pharmacy licenses in 50 states.

    Military exchange ramps up DME offerings

    DALLAS – The Army & Air Force Exchange has increased its online assortment of DME at ShopMyExchange.com to meet growing demand. It already offers more than 200 items online, including a wide selection of braces and safety and mobility aids. It plans to increase the number of items online by 25% by the end of 2018, and more than triple that number in 2019. “The durable medical equipment shops are part of the Exchange’s commitment to keeping military communities healthy,” said Air Force Chief Master Sgt. Luis Reyes, the Exchange’s senior enlisted advisor. “Whether helping with rehab, fitness or mobility, these products are helping make our communities physically stronger.” In addition to growing its online presence, the Exchange, the U.S. Department of Defense’s largest retailer, is growing its presence in shopping malls. It already operates shops at Forts Belvoir, Bliss, and Hood; Joint Base Lewis-McChord; and Nellis Air Force Base. The number of shops is expected to nearly triple to 14 by mid-2019.

    RESNA announces election results

    ARLINGTON, Va. – RESNA has named a president-elect and several board members. The organization has named Maureen Linden, MS, president-elect. She has served as a board member and board secretary, and has been chairwoman of the Student Design Competition. It has also named Meghan Donahue, MS, ATP, as board secretary. She has served as a board member and has been a member of its professional and special interest groups. Additionally, RESNA has named Carmen DiGiovine, PhD, ATP/SMS, RET; Rita Stanley of Sunrise Medical; and Daniel Cochrane, MS, MA, ATP, to the board. Mary Ellen Buning, PhD, OTR/L, ATP/SMS, RESNA Fellow, begins her two-year term as president on Aug. 1, while Roger Smith, PhD, OT, FAOTA, RESNA Fellow, becomes immediate past president.

    Philips named best medtech company

    ANDOVER, Mass. – Royal Philips has been recognized as Best Overall MedTech Company by the 2018 MedTech Breakthrough Awards. The awards also recognized Philips SmartSleep, a wearable that aims to improve sleep quality for people who do don’t get enough sleep due to their lifestyles, as Best Sleep Monitoring Solution. "At Philips, we're are working closely with our partners to create connected solutions that can achieve seamless care, helping them to provide the quality patient care their communities expect, while delivering on our goal of improving the lives of 3 billion people a year by 2025," said Vitor Rocha, CEO of Philips North America. "Being honored by our industry peers with the MedTech Breakthrough Awards for Best Overall MedTech Company and Philips SmartSleep validates our strategy and confirms that our digital health solutions are being recognized by those who understand what is needed to move the healthcare industry forward." The MedTech Breakthrough Awards recognize companies, products and people developing innovative solutions for today's health, fitness and medical technology industries.  

    MED Group launches professional services

    LUBBOCK, Texas – The MED Group has launched MED Professional Services, a parallel business offering to MED GPO Services. MED Professional Services will operate as a professional services organization serving the complex rehab, sleep and HME markets. It will continue to offer a payer network, credentialing services, clinical education and clinical network programs, and marketing services. It will also offer additional services, including consulting, outcomes-based programs and CEU opportunities. “MED recognizes the importance of regularly assessing market conditions and responding in ways that create value and continue to provider clinical resources to our members and business partners,” the company stated in a press release. MED has more than 500 provider members.

    Essentially Women calls for speakers

    ST. PETE BEACH, Fla. – Organizers of Essentially Women’s annual conference, “FOCUS: The EW Conference,” are accepting presentation submissions from interested speakers. The conference’s education can range from mastectomy, to audits and compliance, to marketing, to professional and personal growth, to retail sales. “We are seeking thought leaders and industry experts to share their knowledge on a variety of topics relevant to women’s healthcare providers,” said Nikki Jensen, vice president of Essentially Women. This year’s conference will take place Feb. 2-4, in St. Pete Beach, Fla. More than 300 providers and manufacturer reps typically attend the conference, which, in addition to education, features networking opportunities.

    VA requires firebreaks for home oxygen

    WASHINGTON – The U.S. Department of Veterans Affairs has mandated the use of thermal fuses, also know as firebreaks, in all of its home oxygen patient installations. The VA last month published a “Patient Safety Alert” requiring thermal fuses to be installed on every stationary and portable oxygen concentrator used by its 85,000 patients to help prevent patient deaths and limit injuries in the event of an oxygen fire. The requirement is being phased in over six months. The VA’s 21 regional Veterans Integrated Service Network Organizations, which oversee health care for vets, will also be required to formally report fires involving home oxygen. “The decision by the VA to mandate thermal fuses in all its patients’ oxygen installations is a victory for patient safety and a major step forward in ensuring that every home oxygen patient—no matter where they are in the world—benefits from the same level of protection,” said Richard Radford, managing director of Mansfield, U.K.-based BPR Medical, developer of the Firesafe cannula valve.

    NSM grows to three locations in Oregon

    NASHVILLE, Tenn. – National Seating & Mobility has a new location in Roseburg, Ore., its third in the state. Acquired assets from Douglas Medical Equipment Supply, also in Roseburg, supported NSM’s expansion into the area, according to a press release. Douglas Medical will continue to provide other home healthcare products. ATP Wayne Smith will serve NSM clients in Roseburg and surrounding areas. NSM also has locations in Eugene and Portland.

    Phillips Chiropractic opens DME company

    DODGE CITY, Kan. – Phillips Chiropractic has opened a DME company called Phillips Durable Medical Equipment, according to the Dodge City Daily Globe. Phillips has contracted with a company out of Dallas to get custom braces within about seven days, Dr. Jammie Phillips told the newspaper. “In this area, where we kind of lack the durable medical equipment, a lot of times when the doctor needs a special ACL brace or a custom-fit brace, they were having to go to Wichita or have it ordered and have it take 30, 45 days for it to come in,” Phillips said. Measurements for the braces are taken at any of the six orthopedic surgeon offices in Garden City or the two in Dodge City, he said. Phillips held a ribbon cutting on June 13 for the new business.

    Who’s the top woman in HME?

    WATERLOO, Iowa – The nomination period for the 2018 HME Woman of the Year is open. Now in its third year, the award, sponsored by VGM, recognizes one woman in the industry who has made increasingly significant contributions throughout her career to her company, community and the HME industry. Last year, 38 nominations were received, with nominations representing providers, manufacturers, association execs and other professionals. Barbara Smith, CEO of Healthline Medical Equipment, took home the award at Medtrade in Atlanta last year. HME Woman of the Year nominations are open to all women, regardless of title or position, who work within the HME industry. Nominations are due by Aug. 13 and can be submitted online. The winner will be announced during a special ceremony at Medtrade, Oct. 15-17 in Atlanta.


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    06/29/2018
    Liz Beaulieu

    WASHINGTON – A more relaxed Stark Law could be a double-edged sword for HME providers, says healthcare attorney Jeff Baird.

    In a request for information published in the Federal Register on June 25, the Department of Health and Human Services asks for feedback on “how to address any undue regulatory impact and burden of the physician self-referral law.”

    Here’s what Baird, chairperson of The Health Care Group at Amarillo, Texas-based Brown & Fortunato, had to say about why HHS’s decision isn’t surprising, and how it could be both good and bad for the HME industry.

    HME News: Are you surprised HHS is looking to relax the Stark Law?

    Jeff Baird: No, because the Stark Law has been around for more than 30 years now and it’s a very rigid law. The intent, of course, was to restrict or prohibit physicians from self-referring, but it contains a number of exceptions, because it hamstrings physicians. Still, there have been physicians and hospital systems that have gotten into trouble under the law and have had to pay civil monetary penalties for technical violations that didn’t harm the Medicare program. It has had a lot of criticism.

    HME: HHS says it sees some aspects of the Stark Law as “a potential barrier to coordinated care.” What’s the link between the law and coordinated care?

    Baird: The whole healthcare system is heading toward coordinated care, where providers must show third-party payers they’re producing good outcomes. Third-party payers, whether it’s the government or a commercial insurer, can’t afford to continue paying reimbursement in silos, where you have Provider A doing their thing and doing a good job but they’re not coordinating with Provider B, who’s not coordinating with Provider C. You have all this money going to different providers and they’re not coordinating with each other, so it’s not very efficient. Where the rub comes in is, when providers try to work together to increase efficiency, their attorneys tell them, “Well, we can do that but there’s some risk under Stark, if there is a financial arrangement.” So it has had a chilling effect.

    HME: What’s an example of an existing exception under the Stark Law?

    Baird: The In-Office Ancillary Services exception says if a physician owns 100% of an ancillary services provider, such as an ambulatory surgical center, and if he is supervising it, the physician can refer patients to the provider because there’s a real benefit to the healthcare system if Mr. Smith doesn’t have to leave the office to, for example, have blood drawn. That exception applies to almost everything—except DME.

    HME: So hypothetically, what might be a scenario that would be OK under a more relaxed law?

    Baird: Let’s say a physician wants to put together an integrated practice that includes an MD, a PT and an OT, and a DME. So you have this integrated practice owned by various people. Right now, you can’t do that because 1.) the physician has to own 100%, and 2.) it can’t involve DME. But that’s something that could become OK.

    HME: That’s great news for the DME included in the integrated practice, but not so good news for all the other providers that want to do business with the practice.

    Baird: That’s tough—loosening the Stark Law could be a double-edged sword. It may increase efficiency, but it may decrease competition. We’re seeing this right now with the increase in the number of single-source contracts out there. It’s going to be an ongoing conflict and debate, a natural tug-of-war as a result of the push toward coordinated care.


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    06/29/2018
    HME News Staff

    BOSTON – HME providers will continue to increase adoption of portable oxygen concentrators, to the tune of about 30% over the next 12 months, according to a 2Q 2018 survey on oxygen and sleep trends from Needham & Co.

    Applied Home Healthcare’s OxyGo Fit and OxyGo were the highest rated POCs at 5.9 and 5.8 out of 7, followed by Inogen’s G4 and G3, both at 5.7, and Respironics’ SimplyGo Mini at 5.1.

    Survey respondents identify an average of 42% of their ambulatory patients as candidates for POCs, a number Needham expects to increase.

    Asian inroads

    3B Medical is gaining traction in the U.S. CPAP market, the survey found, although their product ratings were lower than major manufacturers in all categories.

    3B Medical’s share of flow generator purchases is expected to increase from 1.7% to 2.2% and its share of mask purchases to increase from 1.6% to 3% over the next 12 months, according to the survey.

    Shifting shares

    ResMed looks to be losing market share, with their flow generator purchases expected to decrease by 2.1% and mask purchases to decrease by 5.8%, the survey found

    Respironics’ share of flow generator purchase is expected to increase by 1.3% and their mask purchases by 3.5%, according to the survey.

    Sleep growth

    On average, survey respondents said their sleep patient volume increased by 5.7% in the past 12 months and expect it to grow by 7% in the next 12 months.

    Of the respondents, 21% saw a decline in sleep patient growth in the past 12 months and 16% expect a decline in the next 12 months.

    Sales of travel CPAPs are expected to grow 7% in the next 12 months, which Needham attributes to Respironics’ recent entry into the market.

    Senate bill would increase access to therapeutic shoes

    WASHINGTON – Sens. Sherrod Brown, D-Ohio, and Susan Collins, R-Maine, have introduced a bill that would allow nurse practitioners and physician assistants to certify diabetes patients’ need for therapeutic shoes. “Therapeutic shoes are a proven method for preventing costly and painful complications related to diabetes, yet current Medicare regulations force patients to endure a time consuming process to obtain them,” said Collins, the founder and co-chair of the Senate Diabetes Caucus. “Our bipartisan legislation would allow nurse practitioners and physician assistants to certify their patients’ need for this important treatment method.” The “Promoting Access to Diabetic Shoes Act,” S. 3067, is endorsed by the American Association of Nurse Practitioners American Academy of Physician Assistants and the American Podiatric Medical Association, according to wire reports.

    PHS places in Top 10 workplaces

    ST. PAUL, Minn. – Pediatric Home Service has been recognized for the eighth straight year in the Star Tribune’s annual ranking of the Top 150 Workplaces in Minnesota. PHS was named the ninth best of 109 mid-sized companies. The list recognizes the most progressive companies in Minnesota based on a confidential employee survey that ranks factors like alignment, effectiveness, connection, employee engagement, leadership and basic pay, benefits and flexibility. “We know that every employee, no matter their role, contributes to the overall mission of the company,” said Kelli Ramirez, human resources manager for PHS.

    Idaho providers meet with representative’s representative

    POCATELLO, Idaho – Maag’s Prescription and Medical Supply and Big Sky AMES hosted Josh Sorenson, the field director for Rep. Michael Simpson, R-Idaho, recently. Meeting attendees talked about rural access issues in southeast Idaho. Simpson, who sits on the House Appropriations Committee, has not signed onto H.R. 4229, which would extend a retroactive delay of a second round of reimbursement cuts and address the oxygen “double dip,” or H.R. 3039, which would stop competitive bidding-related cuts for accessories for complex manual wheelchairs. The bills currently have 153 and 109 cosponsors, respectively.

    Soleo Health tapped to distribute two new drugs

    MCKINNEY, Texas – Soleo Health has been selected by Genetech to dispense two limited distribution drugs, Hemlibra for patients with hemophilia A with factor VIII inhibitors; and Ocrevus for patients with a relapsing or primary progressive form of multiple sclerosis. Soleo Health has extensive experience treating these patient groups. “Being part of manufacturer limited drug distribution networks expands Soleo Health’s clinical service offering for patients, providers and payers, and helps fuel our continued rapid growth,” said Craig Vollmer, executive vice president and Soleo Health, in a press release. “This is a testament to our reputation and commitment to providing outstanding patient care, as well as our dedication to improving clinical outcomes.”

    Calling all speakers: Medtrade Spring wants you

    LAS VEGAS – Medtrade Spring organizers seek speakers and panelists for the 2019 show, scheduled for April 17-18 at the Mandalay Bay Convention Center. Submissions are sought on the following topics: business operations, legal issues, regulations and compliance, sales and marketing, executive leadership, Medicare updates, retail and cash sales, and strategic planning. Deadline for submissions is Friday, Aug. 24. For guideline submissions, click here. Questions? Contact Toni Ward at antoinette.ward@emeraldexpo.com. For the upcoming Medtrade, Oct. 15-17 in Atlanta, organizers also remind potential attendees that the SmartSaver rates expire this Friday.

    BOC seeks Newberry nominations

    OWINGS MILLS, Md. – The Board of Certification/Accreditation (BOC) is accepting nominations for the Jim Newberry Award for Extraordinary Service. The award, named for longtime BOC member and practitioner Jim Newberry, recognizes outstanding individuals who perform extraordinary service to BOC and its community of stakeholders. “We look forward to seeing this year’s nominations as we continue to honor Jim’s amazing legacy,” said Wayne Rosen, BOCP, BOCO, FAAOP, chairman of BOC’s board of directors. “BOC is fortunate to work with a wide variety of dedicated individuals.” Last year’s inaugural award recipient was Harry “J.R.” Brandt. The deadline for nominations is Sept. 7. To submit a nomination, click here. Questions? Email info@bocusa.org or call 877-776-2200.

    United Spinal hands out awards

    WASHINGTON – Two lawmakers were recognized for their work on behalf of people with disabilities and veterans during the United Spinal Association’s Roll on Capitol Hill this week. Sen. Johnny Isakson, R-Ga., received the 2018 James J. Peters Distinguished Veterans Legislator Award; and Sen. Tammy Baldwin, D-Wis., received the 2018 Outstanding Congressional Leadership Award. Two other awards were handed out at the event: Gretchelle Dilan received the 2018 Outstanding Community Service Award; and Earle and Kathy Powdrell received the 2018 Finn Bullers Advocates of the Year Award. During the ROCH, more than 100 wheelchair users and advocates conducted more than 200 visits with lawmakers, advocating for, among other things, protecting the rights of air travelers with disabilities, and opposing the ADA Education and Reform Act.

    InfuSystem named distributor for infusion line

    MADISON HEIGHTS, Mich. – InfuSystem, a national provider of infusion pumps and related services, has been tapped by Smiths Medical, a manufacturer of specialized medical devices and equipment, as an official distributor of CADD products. Smiths Medical recently announced a strategic decision to serve its non-hospital-based infusion customers through a new distribution model that its says simplifies the way providers order, receive and deliver care with CADD products. As a result, CADD will now be available to non-hospital-based infusion providers through a limited number of distributors, including InfuSystem. “Alternate site customers of Smiths Medical, such as home healthcare providers, physician-based infusion centers, ambulatory infusion centers and other non-hospital infusion facilities, can now opt for the service of InfuSystem for the full line of CADD infusion pumps and supplies,” said Richard Dilorio, CEO of InfuSystem. “We are pleased to be partnering with Smiths Medical in servicing this important segment.”

    StripSupply secures funding

    BOSTON – StripSupply has secured seed round funding led by LaunchByte Ventures, alongside a group of serial entrepreneurs, physicians and angel investors. StripSupply, which seeks to disrupt the $11 billion glucose test strip market, provides FDA-approved strips on a subscription basis for up to 85% less than major retail pharmacies, it says. “The retail price for diabetic test strips at major pharmacies can be more than $100 for a 50-count vial; however, the manufacturing cost doesn’t typically exceed 15 cents per strip,” said Jay Hastings, CEO and founder of StripSupply. “That’s $600 a month for a person with diabetes that needs to test their glucose levels nine to 10 times a day to say health and avoid serious complications like blindness, amputation or death.” In conjunction with the investment, Tan Kabra, founder and managing director of LaunchByte Ventures, and Cindy Ngugen, CFO of Circulation, will be added to the board of directors.

    Generex taps Thompson as COO

    MIRAMAR, Fla. – Generex has named Terry Thompson as COO to lead the company’s efforts in building an end-to-end solution for patients. Thompson has extensive experience in pharmacy benefits management, network administration, claims processing, and distribution and logistics for drugs, DME and infusion therapy. His prior leadership experience includes a stint as CEO of Closer HealthCare, a DME and diabetic supply company. “Acquisitions of up-and-coming platforms and leaders will drive our strategic plan, focusing on building partnerships with hospitals, physicians, employers and patients to offer comprehensive, consumer-centric solutions for optimal health outcomes at reduced costs to the system,” he said.

    VGM: Tell us your delivery costs

    WATERLOO, Iowa – The VGM Group seeks responses to a delivery cost survey. The goal of the survey: to highlight the differences in the costs of delivering care to various geographic areas. The survey asks suppliers to provide information on time spent traveling to patient homes, estimated setup times, location of business and other items. “It is critical that we get as much feedback as possible to help give a stronger argument to legislators,” VGM stated in a bulletin on Tuesday.

    FRESCA Medical joins sleep therapy market

    SAN CLEMENTE, Calif. – The U.S. Food and Drug Administration has granted FRESCA Medical’s de novo request to market its CURVE Positive Airway Pressure delivery system for the treatment of obstructive sleep apnea. “FDA clearance of the CURVE System for obstructive sleep apnea is our first step toward becoming a recognized innovator in sleep apnea,” said John Cox, president and CEO. “This market is already one of the largest applications for cloud-based patient monitoring and engagement, and our goal is to leverage the latest connected health technology to treat, delight and engage patients and providers, while reducing healthcare costs.” The key to the Curve System, FRESCA says, is a patented SmartValve technology that allows the treatment of OSA with far less airflow than conventional CPAP systems. The company says the system has the potential to solve many of the complaints that cause sleep apnea sufferers to abandon therapy or refuse to event try it. It says the results from a prospective, controlled, randomized, crossover, evaluator-blinded trial demonstrated that the system was non-inferior to CPAP, the current gold standard in the treatment of sleep apnea. It says patients treated with the system showed significant improvement in baseline values for the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI), both within the normal range (i.e., AHI 2.9/hr, ODI 1.4/hr).

    Motivo launches Tour nationwide

    MILWAUKEE – Motivo now offers its Motivo Tour Walker nationwide, the company announced June 25. The company launched the Tour in limited release last year. The Tour, which is available at www.motivolife.com starting at $499, features, among other things, a stow-away seat design that allows users to walk upright inside the frame, rather than hunched over behind it, helping to relieve back and neck pressure by 60%. Motivo announced earlier in June that it had completed nearly $1 million in Series A financing, allowing the company to further develop and scale its new in-house manufacturing capabilities, and support its national launch and advertising campaign. The company has raised nearly $5 million in all.


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    07/02/2018
    HME News Staff

    WASHINGTON – CMS’s edits didn’t detect $18.4 million in payments in 2015 for inappropriate claims for DME provided during non-covered stays in skilled-nursing facilities, according to a report from the Office of Inspector General.

    This represents 6% of all payments for DME during non-covered stays in SNFs, the OIG says.

    CMS uses two edits that are designed to identify and reject such claims, but neither edit rejected the claims because SNFs and DME suppliers did not submit full and accurate information required for processing, according to the OIG.

    The report found:

    • For 72% of inappropriate claims, DME suppliers failed to correctly code the SNF as a facility. Instead, they coded the place of service as the beneficiary’s home, thus enabling the claims to bypass the edit that rejects separate payment for most DME provided at facilities. By definition, SNFs provide primarily skilled care and thus cannot be considered beneficiary homes.
    • For 98% of the inappropriate claims, SNFs did not submit “payment bills,” which are administrative claims that document the dates of non-covered stays and do not result in payment. No-payment bills enable another CMS edit to identify non-covered stays and reject claims for DME provided during those timeframes.

     

    CMS may have also allowed up to $3.7 million in Medicare payments for inappropriate claims for DME provided during stays in Medicare-only nursing facilities.

    The OIG recommends that CMS 1.) strengthen oversight of place-of-service codes by developing a process to determine whether DME claims with “home” as the place of service fit the circumstances permitting separate payment; 2.) assess the costs and benefits of strengthening oversight of no-payment bills by developing a process to identify non-covered stays when SNFs do not submit no-payment bills; and 3.) assess the costs and benefits of collecting and maintaining information regarding the level of care provided by Medicaid-only nursing facilities.

    CMS concurred with the OIG’s recommendations.
     


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  • 07/03/18--10:00: IFR comments pass 100 mark
  • 07/03/2018
    HME News Staff

    WASHINGTON – A competitive bidding-related interim final rule had 109 comments as of Tuesday, July 3.

    Stakeholders have been pushing for comments on the IFR, which reinstates 50/50 blended reimbursement rates—but only from June 1, 2018, to Dec. 31, 2018, instead of retroactively from Jan. 1, 2017; and only in rural and non-contiguous areas instead of all non-bid areas.

    The deadline or submitting comments is July 9.

    Submit your comments here.


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    07/03/2018
    HME News Staff

    WASHINGTON – Temporary transitional payments for home infusion therapy are moving forward, according to an upcoming proposed rule.

    The rule, which will be published in the July 12 Federal Register, contains information on the implementation of the payments, which will fix a payment gap created by the 21st Century Cures Act. The Cures Act requires Medicare to pay for services associated with providing Part B home infusion drugs, but not until 2021.

    The temporary payment, which was passed as part of a government spending bill in February, takes effect Jan. 1, 2019.

    The proposed rule also seeks comments on elements of a new home infusion therapy benefit category, proposes standards for home infusion therapy suppliers, and proposes an oversight process for organizations that accredit home infusion suppliers.
     

    OIG to CMS: Take stronger look at ‘place-of-service’ claims
    WASHINGTON – CMS’s edits didn’t detect $18.4 million in payments in 2015 for inappropriate claims for DME provided during non-covered stays in skilled-nursing facilities, according to a report from the Office of Inspector General.

    This represents 6% of all payments for DME during non-covered stays in SNFs, the OIG says.

    CMS uses two edits that are designed to identify and reject such claims, but neither edit rejected the claims because SNFs and DME suppliers did not submit full and accurate information required for processing, according to the OIG.

    The report found:
    •    For 72% of inappropriate claims, DME suppliers failed to correctly code the SNF as a facility. Instead, they coded the place of service as the beneficiary’s home, thus enabling the claims to bypass the edit that rejects separate payment for most DME provided at facilities. By definition, SNFs provide primarily skilled care and thus cannot be considered beneficiary homes.
    •    For 98% of the inappropriate claims, SNFs did not submit “payment bills,” which are administrative claims that document the dates of non-covered stays and do not result in payment. No-payment bills enable another CMS edit to identify non-covered stays and reject claims for DME provided during those timeframes.

    CMS may have also allowed up to $3.7 million in Medicare payments for inappropriate claims for DME provided during stays in Medicare-only nursing facilities.

    The OIG recommends that CMS 1.) strengthen oversight of place-of-service codes by developing a process to determine whether DME claims with “home” as the place of service fit the circumstances permitting separate payment; 2.) assess the costs and benefits of strengthening oversight of no-payment bills by developing a process to identify non-covered stays when SNFs do not submit no-payment bills; and 3.) assess the costs and benefits of collecting and maintaining information regarding the level of care provided by Medicaid-only nursing facilities.

    CMS concurred with the OIG’s recommendations.

    Compass Health, NDC increase services to Midwest
    CLEVELAND – Compass Health has entered into a Preferred Vendor Partnership with NDC Homecare, a regional distributor to HME providers in the Midwest. The partnership means providers in Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma can now enjoy next-day delivery, lower freight minimums and will-call service, something they never had access to before due to how far they were from Compass Health’s distribution centers. “We have been exploring ways to improve our level of service to HME dealers that are not strategically located near one of our distribution centers,” said Gregory Zenko, senior vice president of HME for Compass Health. “This partnership is a win-win for all—Compass Health, NDC Homecare and the smaller HME dealer who historically couldn’t meet the freight minimum required for next-day delivery because of location.” NDC has distribution facilities in Conway, Ark., and Kansas City.

    Philips Sleep and Respiratory taps Pittsburgh for new headquarters
    PITTSBURGH – Philips Sleep and Respiratory Care has reached an agreement with Walnut Capital Partners to acquire 20,000 square feet of space in a new $30 million, nine-story office building being built in Pittsburgh, according to the Post-Gazette. Philips, which currently headquarters this business in Murrysville, Pa., plans to relocate about 1,250 of 1,700 employees in the region to the new building, the newspaper reported. The company plans to keep its manufacturing, distribution and service associates and facilities at the current Westmoreland County locations, according to the Post-Gazette. Philips says the building puts the company closer to universities like Carnegie Mellon and the University of Pittsburgh, UPMC medical centers, research partners and other innovation leaders in the region, the newspaper reported.

    VMI gives military athletes a lift
    PHOENIX – Vantage Mobility International served the military community for two weeks in June for the Department of Defense’s Warrior Games at the U.S. Air Force Academy in Colorado Springs, Colo. For the second year in a row, VMI, a manufacturer of wheelchair accessible vehicles, was a sponsor of the Games, providing accessible transportation for athletes and coaches. This year, 14 VMI drivers used seven minivans to transport dozens of active-duty service members and veteran athletes for a total of 8,273 miles. VMI remained on-call to offer transportation 16 hours a day for 14 days to bring participants to competitions, practice fields and six hotels. An additional two-dozen VMI employees worked behind the scenes to ship, prepare and maintain vehicles, coordinate logistics, and juggle all the accounting, production and operation needs to keep vehicles running. The DoD Warrior Games were established in 2010 to enhance the recovery and rehabilitation of wounded, ill and injured service members and expose them to adaptive sports. In 2018, more than 300 athletes competed from all branches of the U.S. Military, as well as armed forces from the United Kingdom, Australia and Canada. The competition awarded 608 medals to athletes in 11 sports including archery, cycling, sitting volleyball, shooting, swimming, powerlifting, wheelchair basketball and more.

    Quantum, Pride offer CEUs at Medtrade
    ATLANTA – Quantum Rehab and Pride Mobility Products will offer CEUs for two classes at Medtrade: “The Case for Wheels: Selecting the Clinically Appropriate Base,” and “Clinically Speaking—Evaluation and Documentation for Power Seating Options.” Each class offers 0.20 CEUs at no charge. The classes will be lead by Julie Piriano, PT, ATP/SMS, vice president of clinical education, industry affairs and compliance officer for Quantum Rehab and Pride Mobility Products, and are designed to be interactive. “Instead of putting away their cell phones, attendees will be using them throughout the classes,” she said. “They will be voting on answers to questions and gauging perceptions. We will compare their perceptions of drive wheel configuration (during the “Case for Wheels”) with colleagues throughout the Unites States and Canada.” Medtrade takes place Oct. 15-17 at the Georgia World Congress Center in Atlanta.

    Permobil Foundation, NSM donate wheelchair
    NASHVILLE, Tenn. – The Permobil Foundation and National Seating & Mobility teamed up with Lain’s parents to get him in a new Permobil wheelchair in time for his 17th birthday and his Junior Prom. The chair, a Permobil F5 Corpus VS, features a vertical stander, allowing Lain to dance at the prom. “I will say, I have held it together all of this time, but when I saw him standing with his friends for the first time, I became very emotional,” said Lain’s mom. “He was at their height and smiling from ear to ear. I am beyond excited for all this has done for Lain and our family.” The icing on the cake: Lain and his date were named Prince and Princess of the prom. The Permobil Foundation is the philanthropic arm of Permobil.

    People news: Michael Rozaieski
    Cape Coral, Fla.-based Merits Health Products has hired Michael Rozaieski as director of product development. Rozaieski, who previously worked for Quantum Rehab, Curtis Instruments and Fuller Rehabilitation, has more than 20 years of experience in product research and development, and sales. He will be responsible for product development across the Merits, Avid (complex rehab) and Pilot (home access) product lines.


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    Rule also proposes adjustments to fee schedule methodology, establish separate payment class for oxygen
    07/11/2018
    HME News Staff

    WASHINGTON – A proposed rule released today seeks to make changes to the Medicare fee schedule and the competitive bidding program.

    The most surprising change: When current bidding contracts expire Dec. 31, 2018, beneficiaries will be able to obtain DMEPOS items from any enrolled supplier until new contracts are awarded.

    However, the process for the next round of the bidding program has not yet been initiated and CMS said it will issue that information at a later date.

    The proposed rule is contained in the CY 2019 Changes to the End-Stage Renal Disease Prospective Payment System.

    HME stakeholders predicted the rule, which was originally expected to be released at the end of June, would be a vehicle for bid-related changes.

    “Today’s proposals will help secure sustainable access to durable medical equipment,” said CMS Administrator Seema Verma, in a press release.

    The rule proposes to:

    • Revise the DMEPOS CBP by implementing lead item pricing.
    • Revise the definition of composite bid to mean the bid submitted by the supplier for the lead item in the product category.
    • Establish a new method for establishing single payment amounts under the CBP using maximum winning bids.
    • Establish three different temporary fee schedule adjustment methodologies depending on the area in which the items and services are furnished. Those methodologies are as follows:
    • Three different fee schedule adjustment methodologies depending on area in which items and services are furnished: (1) one fee schedule adjustment methodology for DME items and services furnished on/after Jan. 1, 2019, in areas currently CBAs, in event of gap in the CBP; (2) another fee schedule adjustment methodology for items and services furnished from Jan. 1, 2019, through Dec. 31, 2020, in areas that are currently not CBAs, are not rural areas, and are located in the contiguous United States (U.S.); and (3) another fee schedule adjustment methodology for items and services furnished from Jan. 1, 2019, through Dec. 31, 2020, in areas that are currently not CBAs and are either rural areas or non-contiguous areas.

     

    The rule also seeks to:

    • Establish new, separate payment classes for portable gaseous, portable liquid, and high flow portable liquid. It also proposes to establish new methodology for ensuring that all new classes for O2 and equipment are budget neutral.
    • Establish new rules to address payment for certain vents that are subject to payment rules but also perform functions of other items of DME that are subject to payment rules.

    View the proposed rule.

    View related fact sheet.

     


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    07/12/2018
    Theresa Flaherty

    WASHINGTON – CMS Administrator Seema Verma says she wants to “modernize” the agency’s long-standing competitive bidding program for DMEPOS by instituting market-oriented reforms.

    It’s a major change in attitude for the agency, which has lauded competitive bidding and the savings it has created since the program was first implemented in 2011.

    “The current structure doesn’t produce the best prices for patients and doesn’t drive optimal performance by contractors, and it’s simply not sustainable in the long term,” Verma said during a press call on July 11, following the release of a proposed rule outlining changes to the program. “In developing today’s rule, we worked with experts to leverage market principles that would support competition when contracts are re-competed under the revised bid program.”

    One of the more significant changes in the proposed rule: Replacing median-based bidding with lead-item bidding to establish prices at the maximum winning bid.

    As an example of the new methodology, Verma said rather than soliciting bids for power wheelchairs and every accessory, CMS will accept bids only on power wheelchairs. The agency will then set pricing for accessories using a scale based on the historic fee schedule amounts and on supplier data, she said.

    “This approach will streamline the bidding process, reduce the burden on suppliers and ensure that pricing is accurate,” she said. “We hope that this will bring more competition and vendors to the process and, ultimately, increase access for the beneficiaries.”

    To allow time for the revised program to take effect—a process that could take anywhere from 18 to 24 months, Verma said—the proposed rule would also temporarily extend the current reimbursement rates in bid areas, non-bid areas, and rural and non-contiguous areas, she said.

    Additionally, “beginning Jan. 1, 2019, and until new contracts are awarded, beneficiaries may receive DMEPOS items from any Medicare-enrolled supplier,” the agency stated in a press release that accompanied the proposed rule.


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    Agency pauses program with plans to implement significant changes, including some that stem from industry recommendations
    07/13/2018
    Liz Beaulieu

    WASHINGTON – All Medicare-enrolled HME providers are back in business starting Jan. 1, 2019.

    CMS stated in a July 18 proposed rule that when the current competitive bidding contracts expire Dec. 31, 2018, any Medicare-enrolled provider will be able to provide DMEPOS items to beneficiaries, until the agency initiates that next round of the program with significant changes.

    “This is another indication that the program is broken and needs to be fixed,” said Tom Ryan, president and CEO of AAHomecare. “CMS is, once again, talking about the need to make sure the DME benefit is viable and the need for stakeholder input.”

    The proposed rule follows a May 11 interim final rule that reinstated 50/50 blended reimbursement rates in rural areas from June 1, 2018, through Dec. 31, 2018.

    Any Medicare-enrolled provider may be able to provide DMEPOS items on Jan. 1, but they’ll have to do it at the current rates in bid areas, non-bid areas and rural areas.

    “There are a lot of non-contract suppliers out there that still exist,” Ryan said. “They’ve been on the sidelines, but they still exist, and now they’ll be able to go to referral sources and compete again for that Medicare business. Whether or not they want to at the price, that’s their determination.”

    In addition to the temporary “any willing provider” provision, the proposed rule extends the 50/50 blended rates in rural areas through Dec. 31, 2020, something that will cost CMS $1.05 billion.

    “That is a significant give-back,” Ryan said. “That is a cost to them. They’re putting dollars back into a benefit that has been decimated due to poor policy.”

    Still, stakeholders will continue to make the case that the blended rates should apply to all non-bid areas, not just rural areas—and CMS may be open to that idea, they say.

    “They specifically ask that question in the proposed rule: Should we extend the blended rates to all non-bid areas?” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. “If we can convince the agency, before the final rule is published, that would be another potential upside.”

    The proposed rule also provides a window into how CMS plans to run the next round of the bid program. For one, the agency plans to implement lead-item pricing using maximum bids, a methodology that stakeholders say reflects their input. Lead-item pricing means CMS will ask providers to submit bids on one major item within a product category and it will use those bids, among other factors, to set the price for that product and all others in the category.

    “It’s very similar to a clearing price, which is our language,” said Jay Witter, senior vice president of public policy at AAHomecare. “It’s a significant win that acknowledges the significant flaws to median pricing. They’re moving toward something with more auction-like principles.”

    Will this change, along with other changes that will be implemented in the next round of program—like tying surety bonds to bids, and implementing a higher bid ceiling—result in higher reimbursement rates? That’s the $64 million question.

    “I would hope that bid prices would come in at a more reasonable level,” Bachenheimer said. “It’s difficult to predict people’s behavior, but that’s the expectation.”

    As for what the proposed rule means for H.R. 4229, a bill that would provide broader relief—it would apply blended rates in all non-bid areas and retroactively from Jan. 1, 2017, to Jan. 1, 2019—AAHomecare says it’s keeping the pressure on.

    “That to me is a pressure point that has helped us get to where we are today with CMS,” Ryan said. “I wouldn’t stop.”


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    07/13/2018
    HME News Staff

    CLINTON, N.Y. – Upstate HomeCare has announced a strategic partnership with HealthSqyre, a Denver-based online CPAP marketplace.

    Per the partnership, Upstate HomeCare is the exclusive provider for CPAP devices, supplies and accessories on HealthSqyre for New York state.

    “This partnership allows Upstate HomeCare to expand its offering of its CPAP supply services across the globe using HealthSqyre’s online platform,” Upstate HomeCare stated in a press release.

    HealthSqyre allows customers to buy their supplies using insurance or cash—an option that no other online marketplace offers, according to Upstate HomeCare.

    What’s more, the online marketplace allows customers to compare product pricing using their insurance, with real-time transparency of their deductibles, co-insurances rates and out-of-pocket maximums, so they can make informed buying decisions, the provider says.

    “As more high-deductible plans become commonplace, it only makes sense that people will become more educated and look for ways to make those dollars go further,” said Gregory LoPresti, senior vice president and CEO of Upstate HomeCare.

    Upstate HomeCare expects e-commerce to become a bigger part of their sales and the HealthSqyre partnership positions the provider to leverage that growth.

    “Healthcare e-commerce is only going to become larger,” LoPresti said. “Upstate is committed to bringing customers not only the products they want but in the way they want them delivered.”

    Upstate HomeCare is based in Clinton, N.Y., with physical locations in Utica, Syracuse, Rochester, Canadaigua, Buffalo and Albany. It employs 160 people.

    ResMed, Verily join forces on sleep apnea

    SAN DIEGO – ResMed has partnered with Verily on a new joint venture to study the health and financial impacts of undiagnosed and untreated sleep apnea, the companies announced today. They will also develop software solutions to enable healthcare providers to more efficiently diagnose, treat and manage individuals with sleep apnea and other breathing related sleep disorders. “The vast majority of people with sleep apnea don’t realize they have it, and therefore don’t seek accessible, effective treatment to mitigate its effects and long-term health risks,” said ResMed Chief Medical Officer Carlos M. Nunez, M.D. “The combined industry expertise, scalable infrastructure, and data analytics capabilities of ResMed and Verily can unlock meaningful ways to identify these individuals and support their journey to improved sleep, health and quality of life.” Launched in 2015, Verily is a subsidiary of Alphabet that develops tools and devices to collect, organize and activate health data, and creates interventions to prevent and manage disease. Its mission: “Make the world’s health data useful so that people enjoy healthier lives.”

    Motivation goes exclusive with Numotion

    BRENTWOOD, Tenn. – Numotion has announced an exclusive partnership with Motivation to distribute the company’s Multisport wheelchairs in the U.S. The wheelchairs will be available on ShopNumotion.com. The Multisport is a “court-based wheelchair,” tough enough to be used across a wide range of sports and activities at both national and local club levels, Numotion says. “We are excited about this high quality, affordable option that will allow wheelchair users to participate in a variety of sports, play and exercise—ultimately promoting better health and wellness,” said John Pryles, senior vice president of sales at Numotion. There are two models available: the Multisport and Multisport Junior, each available in multiple sizes.

    Mediware bolsters home health presence

    LENEXA, Kan. – Mediware Information Systems has acquired Fazzi Associates, a Northampton, Mass.-based provider of coding services to the home health and hospice market. Fazzi also provides consulting, training, benchmarking and research to more than 1,400 agencies across all 50 states and Washington, D.C. “The acquisition creates a unique alignment between two health care (companies)—one in innovative software, the other in outsourced services, consultation, and education,” Mediware stated in a press release. “The combined company will have a greater capacity to help post-acute and community-based providers increase efficiency and improve clinical, financial, and operational performance to advance patient care.” Mediware plans to maintain Fazzi’s brand and headquarters, and retain the company’s leadership team. Dr. Bob Fazzi will serve in a strategic advisory role with Mediware, consulting on industry relations, home health advocacy, growth opportunities, and innovation.

    Bonafide touts new searching functionality

    THOUSAND OAKS, Calif. – Bonafide Management Systems now has Optical Character Recognition (OCR) functionality. The technology, being offered at no additional charge, allows customers to efficiently and instantly search all scanned documents on the Bonafide system. “We are adding this technology based on the fact that OCR will result in significant cost savings for our customers by reducing costly manual searches and manual data entry,” said Wayne Bailey, director of customer service. “With DME margins shrinking every day, we are dedicated to providing critical cost-savings opportunity with our software.” The technology works by analyzing the structure of scanned documents and recognizing elements like blocks of text, tables and images. It can then identify characters and words within the scanned document, eliminating costly data entry functions.

    Invacare to sponsor Ms. Wheelchair USA

    ELYRIA, Ohio – Invacare is the presenting sponsor of Ms. Wheelchair USA for 2018. The competition will be held in northeast Ohio July 15-22, according to a press release. “We are proud to continue our support of the Ms. Wheelchair USA program and its mission to help promote self-confidence and the achievements of women with disabilities,” said Jonathan Miller, senior director, custom manual mobility and seating, at Invacare. “Although there can be only one Ms. Wheelchair USA, all of these women should be extraordinarily proud of their accomplishments.” The weeklong event will consist of activities, competitions, community services and more. From now until July 21, the public can also vote for their favorite contestant as part of “Invacare People’s Choice.” Each $5 vote benefits the Dane Foundation, a disability services and support organization based in Cuyahoga Falls, Ohio.

    EZ-Access, VGM team up on lift

    WATERLOO, Iowa – Hannah Smith, one of six children who received specialized equipment during the VGM Heartland Conference in June, has also received a new vertical lift platform from Algona, Wash.-based EZ-ACCESS. VGM helped coordinate the donation and Nucara assisted in delivering the lift to nine-year-old Hannah’s Evansdale, Iowa, home. “VGM and its partners and members always look to step in for someone who might need just a little help,” said Jim Greatorex, vice president of VGM Live at Home. “We’ve had a long-standing relationship with EZ-ACCESS. They are a family-owned company with a history of giving back.”

    FODAC expands outreach

    TUCKER, Ga. – Friends of Disabled Adults and Children and Goodwill North Georgia are partnering to collect, repair and redistribute home medical equipment and assistive technology through a 2018 Collaborative Innovation Grant from the Home Depot Foundation. As part of the partnership, the organizations have established 10 new HME collection sites at Goodwill facilities. “Something as simple as a wheelchair or a shower bench can totally change a person’s life by unlocking their independent spirit, allowing them to engage more fully in work, community and life,” said Chris Brand, FODAC CEO. “Partnering with Goodwill will enable us to collect more equipment and help more people in need.” FODAC also received two 2018 Collaborative Innovation Grants in February.

    Executive appointments: Aeroflow, BioScrip

    Aeroflow Healthcare has named Scott Sonnone as CFO. He will play a vital role in expanding business for the Asheville, N.C.-based provider. He previously held executive positions at Zealandia Holding Company and Cane Creek Cycling Components…BioScrip, a Denver-based home infusion provider, has named Richard Denness as senior vice president, chief commercial officer. Denness has 29 years of healthcare experience, including roles at Schering-Plough, IVAX Laboratories and Vycor Medical.

    NSM expands in Oklahoma

    NASHVILLE, Tenn. – National Seating & Mobility has acquired the rehab division of All Saints Home Medical, including its locations in Oklahoma City and Tulsa, Okla. The deal makes NSM the largest complex rehab provider in the state, it says. “We look forward to partnering with health care providers and therapists across the state to provide innovative mobility solutions for their patients,” said Bill Mixon, NSM CEO, in a release. Steve Asbury, an ATP who led the rehab division will transition to NSM, along with three other ATPs.

    Ms. Wheelchair protests incontinence program

    SAINT PAUL, Minn. – Sheri Melander-Smith, Ms. Wheelchair America, has filed an official protest with the Minnesota Department of Human Services to object its plans to implement a preferred incontinence product program that would award a contract to a single company, MAMES reports. “Patients will have reduced access to high-quality incontinence products, while costs will likely go up,” said Melander-Smith in a press release. “I’m proud to join with the disability community in the fight against this unnecessary and dangerous program that puts patients at risk.” Melander-Smith also signed a petition requesting that DHS initiate an official rulemaking process before the Office of Administrative Hearings.

    AvaCare Medical buys Murse World

    LAKEWOOD, N.J. – AvaCare Medical and its sister company, Medical Scrubs Collection, have announced their most recent acquisition: Murse World, an online men’s scrub store. AvaCare says Murse World is the first and only medical scrubs store specifically geared toward male nurses, doctors and other medical professionals. “We see this as an opportunity to grow our market share in the medical scrubs industry, as well as to get into this growing demographic of male doctors and nurses,” said Steven Zeldes, president of Medical Scrubs Collection and CEO of AvaCare Medical.

    Invacare backs National Veterans Wheelchair Games

    ELYRIA, Ohio – Invacare has signed on as a National Host Sponsor of the 38th Annual National Veterans Wheelchair Games. This year’s games will take place July 30-Aug. 4 in Orlando, Fla., and will feature a variety of sporting events, including basketball, hand cycling, track and table tennis. Invacare associates will be on site throughout the week offering wheelchair repair and tune ups to address anything that may have been bumped out of place during travel, warm up or competition. The company will also have a booth during the event’s expo day. Invacare has supported the games since their inception 38 years ago.

    VA taps SoftWheel for shock absorption system

    WASHINGTON – The U.S. Department of Veterans Affairs has expanded its business relationship with SoftWheel, a Tel Aviv-based company that makes a flexible shock absorption system that’s built into wheels, according to the Times of Israel. As part of a deal between VA-approved wheelchair manufacturer Key Mobility and SoftWheel, 2,000 sets of shock-absorbing wheels will be provided to veterans over a period of three years, the news outlet reports. The VA has already approved supplying some 361wheelchairs outfitted with the technology, it says. Company officials told the Times that this is its largest deal to date. SoftWheel, which employs 34 and has production facilities in Haifa and Canada, also supplies its wheels through national complex rehab provider Numotion. Officials told the news outlet that Numotion has been buying hundreds of pairs of wheels a year.


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    07/20/2018
    HME News Staff

    SAN FRANCISCO – Add the Pacific Research Institute to the long list of economists and researchers who believe CMS’s current competitive bidding program for HME is inefficient at best and dangerous at worst.

    PRI’s study, “Reforming CMS’ Competitive Bidding Process to Improve Quality and Sustainability,” borrows on the work of Peter Cramton, an economist and outspoken critic of the program, and research firms like Dobson DaVanzo & Associates.

    “Medicare patients are receiving lower quality durable medical equipment, which is taking a toll on their health outcomes,” writes Wayne Winegarden. “Further, there is mounting evidence that the reimbursement policies are destabilizing the supplier market, portending sustainability problems in the future.”

    Winegarden says there are two “devastating flaws” with the current program: First, CMS uses the median of the winning bids as the price; and second, the agency doesn’t require a winning provider to fulfill its commitment.

    The result is what he calls “unproductive gamesmanship,” including, among other things, providers intentionally underbidding to reduce the profitability of their competitors, and provides biasing winning bids toward lower cost/lower quality equipment.

    Winegarden says CMS should set reimbursement price equal to the bid that is just high enough to ensure enough suppliers will produce the right quantity and quality of HME—a marketing-clearing price.

    Other reforms that should be made, according to Winegarden:

    •    Bidding areas should be appropriately drawn so that the costs that suppliers bear are similar across the entire area
    •    All bidders should meet minimum quality and financial standards
    •    The bidding process should be transparent so that even if providers are not selected, stakeholders can see the bid arrays and understand how the rates were actually determined
    •    All bidders should be required to submit binding bids and/or provide bid surety bonds to ensure that they are committed to fulfilling their bids at the winning price

    “These types of bidding systems have historically performed well when judged against the efficiency criteria for a competitive bidding process—it creates both allocation efficiency and quality efficiency,” he writes.

    PRI Is a nonprofit, nonpartisan organization supported by private contributions that seeks to advance free-market policy solutions.


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    ‘CMS has dug its heels even deeper’ on the controversial offset for home oxygen products
    07/20/2018
    Liz Beaulieu

    WASHINGTON – CMS’s proposed changes to the home oxygen benefit would ding reimbursement for portable equipment and portable gas contents, as well as oxygen generating portable equipment (OPGE).

    Per a recently released proposed rule, the agency seeks to create two separate payment classes for liquid equipment and liquid contents, and to apply a “budget neutrality offset” to all classes, not just stationary equipment and oxygen contents.

    The end result, per an example provided by CMS: Reimbursement would drop from $17.29 per month to $16.04 for portable equipment; from $53.32 to $49.46 for portable gas contents; and from $37.44 to $34.73 for OPGE, based on fully adjusted fee schedule amounts for non-rural areas in the Southeast.

    “Depending on a provider’s business mix and the modalities they provide, this could result in more cuts,” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. “We believe CMS has simply exceeded its authority when it applies budget neutrality to bid pricing.”

    Per CMS’s example, reimbursement for stationary oxygen equipment and oxygen contents, however, would rise from $70.23 to $72.59 per month, because the offset would be spread across the proposed seven classes.

    Stakeholders say the majority of providers no longer provide liquid equipment and liquid contents—only a small population of patients needs liquid and it’s more service intensive—which is one reason why CMS seeks to make the changes.

    “I think this is an obvious recognition by the agency that they, along with the pulmonary community, are concerned for liquid,” said Tom Ryan, president and CEO of AAHomecare. “So in that regard, this is a good thing.”

    But AAH will likely argue in its comments to the proposed rule that the reimbursement that CMS proposes for liquid equipment and liquid contents—per CMS’s example, $34.73 and $74.19 per month, respectively—still doesn’t cover costs and that the agency should make them a separate product category in the bid program.

    “If they really want to see what the market can bear for liquid, let providers bid on it separately,” Ryan said.

    Stakeholders also plan to argue in their comments that if CMS creates separate classes for liquid equipment and liquid contents there needs to be corresponding policies that specify the qualifications for this modality.

    “You need to make sure that there’s a true medical need,” Bachenheimer said.

    A bigger deal than the separate classes, however, remains CMS’s insistence that it must apply a budget neutrality offset for oxygen products. With competitive bidding now in place, stakeholders have argued that this creates a “double dip” in reimbursement. A provision in H.R. 4229 would eliminate the offset for products included in the bid program.

    “It’s clear now from this rule that CMS has dug its heels even deeper, when it comes to budget neutrality, and we have no choice but to address the issue through Congress,” Bachenheimer said.


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    07/20/2018
    Guest Commentary

    WASHINGTON – CMS’s recently issued proposed rule proposes two key improvements for the competitive bidding program: lead item pricing and clearing price to establish the single payment amounts (SPAs).

    Lead item pricing

    CMS is proposing to implement lead item pricing for all product categories, a concept CMS introduced in its 2016 final rule and that has been supported by auction economists and the industry. Under lead item pricing, suppliers bid on one item in a product category. This one item, the “lead item,” is determined based on the item with the greatest national allowed charges in the product category, for the year preceding each competition. The lead item will, therefore, be the item with the highest expenditures in the category. The bid submitted by the supplier on the lead item would be known as the “composite bid,” and the supplier’s bid could not be greater than the 2015 fee schedule. CMS announced the increase of the bid ceiling in its 2016 regulation, increasing the bid ceiling for future competitions from the previous bid ceiling to the higher 2015 fee schedules.

    The SPA for the non-lead items will be based on the relative difference in the 2015 fee schedule amounts for the non-lead item and the lead item in2015. Therefore, the payment level of the lead item will determine the prices of the remaining items in the product category. However, because the current product categories include a wide range of items that are not similar to one another, the product categories will be split into multiple and more discreet product categories. CMS is collecting in comments on the product groups to conduct lead item pricing.

    Clearing price/maximum winning bid

    CMS is proposing to replace its methodology of using the median bid to set the SPA with the clearing price, or as CMS describes it, “maximum winning bid.” This means that the SPA will be determined by the “last man in” for the lead item. This is a significant improvement from previous payment policy, and one that the industry and auction economists have been urging the agency to do for years. It means that no contract supplier will get paid less for the lead item than its bid.

    Over the last several years, AAHomecare has provided CMS with a series of detailed recommendations on how to improve the bid program, including specific regulatory and sub regulatory changes the agency needed to make. These two policy changes were among those, with the clearing price being the most important. The combination of these two improvements with the higher bid ceiling and the additional protection of bid surety bonds (designed to prevent speculative inexperienced bidders) should result in a significantly improved bidding program.

    Remember, this is a proposal (there may be changes and additional improvements)—public comments are easy to submit. Watch for the final rule details in the fall.

    Cara C. Bachenheimer is the chair of the government affairs practice at Brown & Fortunato.


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    07/20/2018
    HME News Staff

    SAN FRANCISCO – Add the Pacific Research Institute to the long list of economists and researchers who believe CMS’s current competitive bidding program for HME is inefficient at best and dangerous at worst.

    PRI’s study, “Reforming CMS’ Competitive Bidding Process to Improve Quality and Sustainability,” borrows on the work of Peter Cramton, an economist and outspoken critic of the program, and research firms like Dobson DaVanzo & Associates.

    “Medicare patients are receiving lower quality durable medical equipment, which is taking a toll on their health outcomes,” writes Wayne Winegarden. “Further, there is mounting evidence that the reimbursement policies are destabilizing the supplier market, portending sustainability problems in the future.”

    Winegarden says there are two “devastating flaws” with the current program: First, CMS uses the median of the winning bids as the price; and second, the agency doesn’t require a winning provider to fulfill its commitment.

    The result is what he calls “unproductive gamesmanship,” including, among other things, providers intentionally underbidding to reduce the profitability of their competitors, and provides biasing winning bids toward lower cost/lower quality equipment.

    Winegarden says CMS should set reimbursement price equal to the bid that is just high enough to ensure enough suppliers will produce the right quantity and quality of HME—a marketing-clearing price.

    Other reforms that should be made, according to Winegarden:

    • Bidding areas should be appropriately drawn so that the costs that suppliers bear are similar across the entire area
    • All bidders should meet minimum quality and financial standards
    • The bidding process should be transparent so that even if providers are not selected, stakeholders can see the bid arrays and understand how the rates were actually determined
    • All bidders should be required to submit binding bids and/or provide bid surety bonds to ensure that they are committed to fulfilling their bids at the winning price

    “These types of bidding systems have historically performed well when judged against the efficiency criteria for a competitive bidding process—it creates both allocation efficiency and quality efficiency,” he writes.

    PRI Is a nonprofit, nonpartisan organization supported by private contributions that seeks to advance free-market policy solutions.

    NSM expands service in Northeast

    NASHVILLE, Tenn. – National Seating & Mobility has acquired Maximum Mobility in Sayre, Pa., strengthening its presence in the Northeast. The deal positions NSM to expand its service reach across northern Pennsylvania and parts of Upstate New York. Jeff Klossner, an ATP and OT who has owned Maximum Mobility since 2003, will make the transition to NSM as a branch manager, overseeing the location as NSM’s newest branch. AccessNSM, a division of NSM, will use the retail showroom at the branch to offer a range of home accessibility products, as well. NSM already operates branches in Philadelphia, Harrisburg, Allentown, Reading and Pittsburgh, and a satellite branch in Erie.

    AAHomecare: Please Stand Up

    WASHINGTON – Registration is now open for AAHomecare’s Stand Up for Homecare Reception at Medtrade in Atlanta. The association raised more than $30,000 at Medtrade Spring, helping to fund PR, legal and research initiatives in support of the industry’s public policy goals. The reception will take place on Tuesday, Oct. 16, from 5:30-7:30 p.m. at the SkyLounge at the Glenn Hotel. “Last year’s even was standing room only, so purchase your tickets today,” AAHomecare says.

    People news: CHME, Invacare

    Foster City, Calif.-based CHME has added Susan Wong as vice president of finance. Wong, who has 20 years of “progressive” experience leading the financial and accounting efforts of small- and mid-sized companies, starts working at the company on Aug. 6. She specializes in technology and health care, and companies that are evolving. At CHME, Wong will be responsible for assisting with the execution of CHME’s business plan for market growth…Elyria, Ohio-based Invacare has appointed Diana Ferguson to its board of directors. Ferguson currently serves as the CFO for Cleveland Avenue, a privately held venture capital firm that invests in restaurant, food and beverage concepts, and emerging brands. She also serves as principal of Scarlett Investments, a firm that invests in and advises middle-market businesses. Ferguson was unanimously appointed by the board after a search conducted by an executive search firm. Invacare now has nine directors, eight of whom are considered independent.

    Rick’s Medical Supply makes acquisition

    ROSEBURG, Ore. – Rick’s Medical Supply will acquire Douglas Medical Equipment Supply effective Aug. 1, according to local news reports. The DMES location here will continue to operate, and will also serve as the new home for the Scrubs and More Store, a division of Rick’s that specializes in surgical scrubs and related supplies. Rick’s also plans to open a new retail store in North Bend in September. Rick’s Medical Supply got its start in 1974 and offers a full line of DME, including oxygen, CPAP, beds and wheelchairs, and medical supplies

    AAH survey seeks input on sole-source contracts

    WASHINGTON – AAHomecare’s Medical Supplies Council is conducting a survey to evaluate the impact of sole-source contracts and narrow network arrangements on beneficiary access. Specifically, beneficiaries and case managers in Illinois, Indiana, Ohio, Nebraska, New Hampshire, New Jersey, Tennessee and Texas are asked to share their experiences. AAHomecare is asking providers to share the link to the survey on social media and with referral sources, and to engage with consumer advocacy groups. Information from the survey will be used in outreach with payers.

    WOY selection committee announced

    WATERLOO, Iowa – Barbara Smith, the 2017 HME Woman of the Year, will serve on the this year’s HME Woman of the Year Honorary Selection Committee. Rounding out the committee are Douglas Coleman, CEO of Rocky Mountain Medical Equipment, DBA Major Medical; Liz Beaulieu, editor of HME News; Rita Stanley, vice president of government relations at Sunrise Medical; and Andrew Morse, assistant to the president for Board and Governmental Relations at the University of Northern Iowa. VGM will review the committee’s recommendations and select four finalists to attend the awards ceremony at Medtrade. There were 38 nominations last year. “Although we can only select one winner, it is always rewarding to read through the amazing work that women continue to do to strengthen the industry we all serve so passionately,” said Clint Geffert, president of VGM & Associates. Nominations are open until Aug. 13 and can be submitted here.  

    Amazon eyes medical supplies pilot

    SEATTLE – Amazon is reportedly looking to create a pilot program with Xealth and at least two hospital networks that would allow doctors to recommend bundles of medical supplies and have them delivered to patients’ home upon discharge, according to an article on cnbc.com. The pilot is still under review, but it is expected to start in a matter of months. It would provide patients easy access to supplies they need via Amazon Prime, although those without Prime membership will have access via other e-commerce providers, according to the article. Xealth, a start-up company, recently partnered with ResMed on a pilot that allows primary care physicians at Providence St. Joseph Health to access data from CPAP devices right from their electronic medical record software.

    Numotion forms foundation

    BRENTWOOD, Tenn. – Numotion has launched the Numotion Foundation to support people and causes that enhance the lives of people living with disabilities. For each new wheelchair sold, Numotion will make a contribution to the foundation. The foundation will also engage employees and supporters to donate funds and provide a centralized structure to distribute funds on behalf of Numotion to relevant organizations and programs. “It is our hope that through the foundation’s efforts we can help to further enhance the great work that so many of our long-standing partners are doing to improve the lives of those with disabilities,” said Mike Swinford, CEO of Numotion.

    HIDA brings HISCI under its umbrella

    ALEXANDRIA, Va. – The Health Industry Distributors Association will merge with the Healthcare Industry Supply Chain Institute, effective Sept. 1. HISCI members will become affiliate members of HIDA and HISCI leadership will continue to guide its activities. “The addition of HISCI’s members into the HIDA network is a ‘win’ for both organizations and their members,” said Matt Rowan, HIDA president and CEO. “This combination will add new dimensions to HIDA’s networking and educational value, and enhance the development of industry best practices.” The HISCI Annual Meeting will take place Sept. 27, 2018, at HIDA’s Streamlining Healthcare Expo & Business Exchange in Chicago.

    Allegiance Group gets certified

    OVERLAND PARK, Kan. – The Allegiance Group, a provider of patient-pay collections, has announced that its COLLECTPlus application has earned certified status for information security by HITRUST. The status demonstrates that COLLECTPlus has met key regulations and industry defined requirements, and is appropriately managing risk, according to a press release. “The HITRUST CSF is the gold-standard that needs to be met, and Allegiance Group is pleased to be able to demonstrate its commitment by achieving HITRUST CSF Certification,” said Anne Orrick, COO. “Organizations like ours are under great pressure to meet complex compliance requirements that include technical and process elements, such as HIPAA< NIST, ISO and COBIT.” COLLECTPlus, the Allegiance Group’s signature product, allows the company to integrate with a provider’s billing system and automate their entire private-pay billing and collections cycle.

    Innovest Global secures contract with Byram Healthcare

    CLEVELAND – Innovest Global has announced that it has secured a call center contract with Byram Healthcare. “Byram Healthcare is well-positioned for continued growth and ran a competitive bid process to find a call center partner that would assist and support its growth,” Innovest Global stated in a press release. “The new contract builds on an existing relationship and Byram Healthcare believes that the Innovest Call Center will generate additional sales for Byram.” Innovest Global has completed the training a 12-person team that will be deployed for Byram Healthcare. The contract is the largest to date for Innovest Global’s Commercial & Industrial Division. Byram, a provider of disposable medical supplies, was acquired by Owens & Minor, a Fortune 500 global healthcare solutions company, last year. It specializes in supplies for diabetes, ostomy, wound care, urology and incontinence, as well as enteral nutrition products.

    CPAP therapy reduces risk of heart failure for all, study finds

    YARMOUTH, Maine – Sleep apnea not treated with CPAP therapy was associated with an increased risk of heart failure in patients of all ages, according to a nationwide cohort study recently published in the Journal of the American Heart Association. Using nationwide databases, the study followed the entire Danish population from 2000 until 2012. Patients with sleep apnea receiving and not receiving CPAP therapy were identified and compared with the background population. The primary end point was first-time hospital contact for heart failure and adjusted incidence rate ratios of heart failure were calculated using Poisson regression models. Among 4.9 million individuals included, 40,485 developed sleep apnea during the study period (median age: 53.4 years, 78.5% men), of whom 45.2% received CPAP therapy. Crude rates of heart failure were increased in all patients with sleep apnea, relative to the background population. In the adjusted model, the incidence rate ratios of heart failure were increased in the untreated sleep apnea patients of all ages, compared with the background population. Comparing the CPAP-treated patients with sleep apnea with the untreated patients with sleep apnea showed significantly lower incidence rate ratios of heart failure among older patients.


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    07/25/2018
    HME News Staff

    WASHINGTON – A group of senators and representatives from West Virginia has sent a letter to CMS Administrator Seema Verma saying the agency’s May 9 interim final rule “does not go far enough” to ensure continued access to DME for the elderly and disabled in rural areas.

    The group points out that, while the IFR reinstates 50/50 blended reimbursement rates, it only does so for rural and non-contiguous areas, not all non-competitive bidding areas.

    “We were hopeful that the IFR would prevent further closures and begin to move toward adequate reimbursement for our providers by addressing this issue,” the group wrote in the July 18 letter. “Unfortunately, this did not occur.”

    The letter was signed by Sens. Joe Manchin and Shelley Moore Capito, and Reps. David McKinley, Alex Mooney and Evan Jenkins.

    The lack of more widespread relief, coupled with a 38% reduction in the number of providers in West Virginia, has left much of the Medicare and Medicaid patients in the state in crisis, the group says.

    “West Virginia is a rural state and our seniors rely on the compassionate care that our small businesses provide, including home delivery, setup assistance and prompt service when problems arise,” they wrote. “Without this type of service the patient will require a trip to the hospital emergency room or worse possible death."

    The group asks CMS to respond to the letter by Aug. 15.

    “We implore you to take into account the unique challenges that small providers in our rural state face as CMS considers the final rule,” they wrote.


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    07/26/2018
    HME News Staff

    ATLANTA – Patientco, a patient billing and payment technology company, has raised $28 million in Series B growth capital.

    The investment was led by Accel-KKY, with participation from existing investor BlueCross BlueShield Venture Partners/Sandbox Advantage Fund. It will be used to accelerate growth, expand sales and marketing, and further product innovation.

    “We are solving an unprecedented affordability crisis in health care,” said Bird Blitch, co-founder and CEO of Patientco. “We are excited to partner with Accel-KKR to continue our growth and help more health systems solve this complex challenge.”

    Patientco serves more than 2,000 healthcare locations across the U.S. and has more than $1 billion in payments processed.

    TwelveStone gains additional investment

    MURFREESBORO, Tenn. – TwelveStone Health Partners will receive an additional $4.3 million investment from Claritas Capital to fuel expansion efforts for its packaged pharmacy, infusion center, and technology platform business lines. The Nashville-based PE firm previously invested $3.35 million in TwelveStone in June 2017, according to a press release. “This is a significant vote of confidence in our team,” said Shane Reeves, CEO of TwelveStone. “Post-acute care is rapidly expanding, and with Claritas we have the ability to scale and achieve the speed to market necessary for rapid growth.”

    DME Express acquires Advanced Therapeutics

    BATON ROUGE, La. – DME Express, which provides DME to the hospice and nursing facilities, has acquired Maryland-based Advanced Therapeutics, bringing its patient population to more than 10,000 throughout Louisiana, Mississippi, Arkansas, Texas, Alabama, Maryland, Virginia, The District of Columbia and Hawaii. “This transaction will enable us to continue our strategy of new market expansion by acquiring high quality regional operations in fragmented markets ripe for consolidation, where DME Express can provide superior service, lower costs and higher quality equipment to customers,” said Mark Borneleit, DME Express CEO. It’s the company’s fourth add-on acquisition since partnering with Waypoint Capital Partners.


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