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    Not so, says one respondent: ‘If we don’t drive change, nobody else will’
    07/27/2018
    Liz Beaulieu

    YARMOUTH, Maine – The results of a recent HME Newspoll show an industry divided over the benefits of lobbying, with one camp citing Medicare as a lost cause and another believing too much is at stake not to advocate.

    Only 47% of respondents to the poll say they submitted comments to a recent interim final rule that laid out CMS’s plans to offer relief from competitive bidding, but only from June 1, 2018, through Dec. 31, 2018, and only in rural and non-contiguous areas, not all non-bid areas.

    “If the rates from July 1, 2016, are allowed to remain in place after Dec. 31, 2018, the business model is unsustainable, because of the amount of support staff necessary to document, bill and fight audits on HME,” wrote Chuck Williams of Williams Bros. Health Care Pharmacy in Washington, Ind., who submitted comments.

    By a July 9 deadline, 121 stakeholders had submitted comments to the IFR. Among the 53% of respondents who didn’t submit comments was Shalon James of Access2Mobility in Tyler, Texas. She says she has participated in lobbying efforts in the past, but because her business is in a non-bid area, it’s less impacted by the program.

    “(Also,) I have not recently participated in the efforts to reform competitive bidding because, frankly, I feel that it won’t do any good, not with the people we currently have in office,” she wrote. “It is my hope that, after the November elections, we will start seeing some positive changes.”

    That’s maybe the reason why 77% of respondents say they have not scheduled and do not plan to schedule a meeting with their lawmakers to discuss bid relief when they’re back in their home districts for the August recess.

    “Sen. Lindsey Graham, R-S.C., doesn’t care about us as an industry and (based on) previous comments from him he believes that competitive bidding is great,” wrote one respondent. “He doesn’t want to hear the truth about it.”

    Other respondents, however, have submitted comments to the IFR and plan to call or visit with their lawmakers.

    “Small business owners are having to look at their friends and neighbors, and decide if they can afford to help them or not in the future,” wrote Jerry Roberts of A Plus Medical Equipment in Dexter, Mo. “That is the core of why we as suppliers are in this industry to begin with! Despite the full-court press, there is still much to be done to change the landscape.”

    Those respondents say with another rule now up for comment—this one detailing CMS’s plans to extend relief through Dec. 31, 2020, and to make several positive changes to the bid program going forward—now’s not the time to back off from lobbying.

    “If we don’t drive change, nobody else will,” wrote Greg Dunn of Alpine Home Medical in Salt Lake City. “Those providers standing on the sidelines need to get involved or they will get what’s coming to them.”


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    07/27/2018
    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.

    Moneyline: Patientco, TwelveStone receive investments; DME Express makes buy

    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.

    Survey: Mobility devices hamper employment

    YARMOUTH, Maine – The majority of wheelchair users say using a mobility device has negatively impacted them while working or job hunting, according to a new survey.

    The survey, conducted on behalf of the Toyota Mobility Foundation, highlights the need for innovative assistive technology to help people with limited mobility succeed in the U.S. workplace, according to a press release.

    More than one-third (36%) of wheelchair users in the U.S. say they have been unable to work as a result of their device; one-quarter (27%) say they feel their talent has been wasted; and one-fifth (20%) say they have been given less responsibility at work.

    “With potentially millions of people around the world unable to work or be as productive due to their current mobility devices, there are clear social and economic implications which highlight the urgent need for innovation in the field of assistive technology,” said Ryan Klem, director of programs for the foundation, in the release.

    The survey was commissioned as part of the foundation’s $4 million Mobility Unlimited Challenge, which launched in November. A survey released in April gathered data highlighting the pain caused to wheelchair users by outdated technology.

    Stakeholders push back against ostomy recommendation

    WASHINGTON – The Access & Care Coalition, led by the United Spinal Association, has retained a lobbying group to boost efforts to prevent expanding competitive bidding to ostomy and urological supplies, according to a bulletin from AAHomecare. A June MedPAC report included recommendations to include the two product categories in Medicare’s bid program. The coalition is part of a coordinated effort by AAHomecare, consumers and other stakeholders who believe that a proactive approach against the recommendation is important. In March, AAHomecare released a white paper and issue brief on the subject.

    Medtrade, VGM shine spotlight on retail

    ATLANTA — This year’s Medtrade will once again dedicate several educational sessions and show floor space to retail, including a new breakfast session led by VGM’s Rob Baumhover called “Rise & Retail,” on Wednesday, Oct. 17, from 7:30 a.m. to 9 a.m. “Members like the opportunity to sit with their peers in small group settings getting into the weeds of retail best practices,” said Baumhover, director of retail. Other sessions in the retail track include “Experience Matters: Build and Grow Your Retail Business Brick by Brick,” on Monday, Oct. 15; “Retail Caring for Customers Beyond the Barriers of Insurance,” on Tuesday, Oct. 16; and “Stop Complaining about Amazon. You have the Competitive Advantage,” on Wednesday, Oct. 17. Baumhover will also host a “retail table” to help attendees learn merchandising and in-store marketing ideas. To register for Medtrade, go here.

    B&F adds two healthcare attorneys

    AMARILLO, Texas – Brown & Fortunato has added Markus Cicka and Beth Anne Jackson as its two newest shareholders, bringing its total number of health law attorneys to 17, according to an announcement. Cicka has 25 years of healthcare law under his belt, including as partner at two national law firms and as an in-house compliance officer and director for a state Medicaid program integrity unit. He is admitted to practice in Texas, Missouri and Illinois. Jackson has more than 21 years of experience with contracts, and policies and procedures at hospitals, health care systems, ambulatory surgery centers, drug and alcohol treatment centers, physician groups and other providers. She is admitted to practice in Texas and Pennsylvania.

    House repeals device tax

    WASHINGTON – The House of Representatives voted earlier this week to repeal a 2.3% excise tax on medical devices. The tax, created under the Affordable Care Act, is not set to take effect until 2020. Lawmakers on both sides of the aisle have sought to repeal the tax, arguing that it would lead to higher prices for consumers and the loss of manufacturing jobs. Most HME was excluded from the tax.

    bflow partners with Ability Network

    FRESNO, Calif. – bflow Solutions has moved its post-acute business management solutions, including its EDI, esMD and OASIS transactions, to Ability Network. “This transition gives us the necessary technological advances we need to power our ambitious initiatives for the bflow platform,” said Ted Jones, COO of bflow Solutions. Ability Network provides core connectivity, administrative, clinical and performance improvement capabilities to more than 44,000 facilities.

    Norco to host fundraiser

    SPOKANE, Wash. – Norco will host a fundraiser for Rep. Cathy McMorris Rodgers, R-Wash., on Aug. 6 at its location here. VGM will co-host. McMorris Rodgers has been a champion for the HME industry: In 2017 she introduced H.R. 4229, a bill that would provide relief from Medicare’s competitive bidding program in non-bid areas and that has 155 co-sponsors. Individual sponsors are $75; PAC sponsors $1,000; and host sponsors $2,500. For questions or to RSVP, contact Emily Harken at emily.harken@vgm.com.

    PHS adds location in Milwaukee

    MILWAUKEE – Pediatric Home Service (PHS) has expanded its services across Wisconsin with a new location here. “We’ve been serving families with respiratory therapy in western Wisconsin for nearly 30 years,” said Mark Hamman, president. “Our Milwaukee satellite location supports requests to provide services throughout Wisconsin.” The Milwaukee location will offer respiratory therapy and equipment, with high-tech care provided by neonatal pediatric specialists who are available 24/7. Clinicians will also support enteral nutrition. PHS currently supports more than 5,000 children and their families in Minnesota, Wisconsin, northern Iowa, and eastern North Dakota and South Dakota.

    Citus Health chosen by OptionOne Pharmacy

    NEW YORK – Citus Health, a digital health solutions provider for the post-acute care industry, has been chosen by OptionOne Pharmacy, a home infusion provider, to enhance the company’s digital capabilities with patient engagement and outcomes tracking solutions. OptionOne will roll out the Citus Health Call Bell HIPAA-compliance, secure messaging solutions to streamline patient to staff and staff to staff communications, and eliminate inefficient phone and paper processes, according to a press release. With Citus Health, OptionOne will also have access to: supply tracking and management to minimize or eliminate under- or over-supply in patient homes; patient and physician electronic signatures and documentation required for billing; digital triage for instant responses to common questions; translation capabilities to facilitate staff and patient communications in over 90 languages; and outcomes tracking that allows for patient surveys and important data collection.

    PlayMaker strengthens data analytics play

    NASHVILLE, Tenn. – PlayMaker Health has acquired viaDirect Solutions, a provider of market intelligence and data analytics for the post-acute care sector. “viaDirect delivers incredible data insights that forward-thinking providers can leverage to drive significant business development,” said John Griscavage, who will remain CEO of the company. “Incorporating their market intelligence and data analytics into our purpose-built post-acute platform gives our current and potential clients the most comprehensive view of their market, from untapped referral sources to opportunities for expansion.” viaDirect principals John Kiehl and Ginger Voss will join the PlayMaker leadership team, with Kiehl leading the data analytics strategy and Voss managing strategic partnerships. The company has also refined its brand, company name and website: It is now known as PlayMaker Health.

    Another court issues TRO on CMS

    BROWNSVILLE, Texas – A court has again issued a temporary restraining order prohibiting CMS from recouping overpayments until after the administrative law judge level, this time on behalf of Adams EMS, according to healthcare attorney Elizabeth Hogue. In June, the U.S. District Court for the Northern District of Texas issued a TRO on behalf of Family Rehabilitation. In this most recent case before the U.S. District Court for the Southern District of Texas, Health Integrity, a ZPIC, determined that Adams EMS received $148,035 in overpayments on claims submitted from July 17, 2012, to Jan. 15, 2016, an amount it extrapolated to $418,035. Adams successfully argued that it was being deprived of due process because of the massive backlog at the ALJ and that recoupment before it had its day in appeals court would put the company out of business. “So there it is; yet another court decision granting relief for providers from recoupments,” Hogue wrote in an email bulletin. “Providers now have tools that they didn’t have before. Use them to protect your patients, businesses and employees.”

    People news: Dennis Sharpe

    Anaheim, Calif.-based MK Battery has announced that Dennis Sharpe, director of global HME business, will retire as of Aug. 31, 2018, closing out what the company calls a “brilliant 32-year career.” “Dennis has been the heart and soul of our mobility business,” said Wayne Merdinger, executive vice president and general manager. “He helped pioneer the evolution from flooded automotive types to Sealed VRLA batteries for use in wheelchair applications. Since then, he has continued to cultivate extraordinary customer relationships, represent MK Battery on international wheelchair standards committees, advocate for the industry on Capitol Hill, provide invaluable technical knowledge about batteries to industry stakeholders, and serve as an integral member of our senior management team.” Sharpe plans to focus his efforts on marketing his own brand of wines on the central coast of California.

    BOC offers CDME exam

    OWINGS MILLS, Md. – The Board of Certification/Accreditation (BOC) will hold a DME workshop and exam at BECO Tower II in Owings Mills, Md., on Aug. 29-30. On Aug. 29, Jeff Hedges, CDME, president and CEO of R.J. Hedges & Associates, will give a workshop, “An Introduction to the Certified Durable Medical Equipment Specialist.” On Aug. 30, BOC will offer the CDME exam. The workshop is free, and eligibility requirements for the exam are a high school diploma and 500 hours of experience in the DME industry. Reserve your spot here.


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  • 07/30/18--12:06: A more relaxed Stark Law?
  • 07/30/2018
    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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    07/31/2018
    HME News Staff

    WATERLOO, Iowa – The VGM Group has added a study that shows the cost shift that is happening as a result of reduced access to DME for Medicare beneficiaries to its lobbying toolbox.

    The VGM-sponsored study by Leitten Consulting shows that:

    • Fall-related injuries due to failure to provide needed mobility equipment results in a cost shift of between $4,705 and $5,029;
    • COPD-related exacerbations due to failure to provide supplemental oxygen therapy results in a cost shift of about $14,350; and
    • OSA-related complications due to failure to provide CPAP therapy results in cost shift of $1,631.


    “When this happens, Medicare incurs substantial increased Part A costs to treat medical complications caused by not having the needed DME,” Brian Leitten writes in the study.

    This most recent study builds on another study by Leitten Consulting released last year that shows, for every dollar spent on DME, Medicare could save anywhere from $11 to $29 in payments for direct treatment.

    VGM says the most recent study will be an important tool in its continued discussions with elected officials about the negative impact of Medicare’s competitive bidding program.

    “(The study) provides a clear picture of the negative impact caused by both the delay and lack of access to proper equipment due to CMS’s competitive bidding program,” said John Gallagher, vice president of government relations. “The dramatic reduction in DMEPOS providers, coupled with cost shifted from prevention to treatment, are, in fact, coming at a significant larger cost to Medicare.”


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    08/03/2018
    Theresa Flaherty

    WASHINGTON – As lawmakers head into their August recess, industry stakeholders will keep the focus on a recent proposed rule overhauling Medicare’s competitive bidding program.

    CMS is accepting comments on the proposed rule, which would, among other things, not extend the current bid contracts and temporarily allow any Medicare-enrolled provider to serve beneficiaries, until Sept. 10.

    “CMS has made some dramatic improvements, but we’re lining up some additional refinements and tinkering with the details,” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. “I think keeping legislators involved and sharing how the industry feels about where CMS is at is important to communicate over the next few weeks.”

    Industry response to the rule, which would also swap median price for clearing price, has been largely positive.

    However, the proposed “any willing provider” provision could actually create more, not fewer, access issues, says Karyn Estrella, executive director of the Home Medical Equipment and Services Association of New England, who will be talking up the issue with lawmakers in the region in August.

    “Contracted suppliers are no longer bound by these large CBAs,” she said. “I know one large oxygen supplier who said they are going to significantly reduce their service area.”

    Also a topic in August meetings: H.R. 4229, a bill that would extend 50/50 reimbursement rates and address the oxygen “double dip.” VGM’s John Gallagher and several HME providers will meet with the bill’s sponsor, Rep. Cathy McMorris Rodgers, R-Wash., on Aug. 6.

    “We need to see what needs to be adjusted in the language going forward,” said Gallagher, vice president of government relations for VGM. “Our hope is that CMS makes the adjustments in the final rule, but we still have to have the language to use as a club to say, ‘Change it.’”

    Although comments on the rule aren’t due until next month, AAHomecare is aiming for submitting theirs in mid-August, says Bachenheimer. With the final rule due Nov. 1, and reviews by the Office of Management and Budget and Health and Human Services, CMS is working with a very compressed timeframe.

    “It’s important to get comments in as early as possible to ensure some consideration,” she said.


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    ‘I get little comfort from knowing I was right’
    08/03/2018
    Liz Beaulieu

    COLLEGE PARK, Md. – When CMS outlined significant changes to its competitive bidding program in a recent proposed rule, one person came to mind: Peter Cramton.

    Cramton, an economics professor at the University of Maryland and an auction expert, has been a vocal critic of the way CMS originally designed the program—going back to at least 2010.

    Here are Cramton’s thoughts on CMS’s about-face on competitive bidding and the agency’s plans to finally reform the program with more standard auction principles, including a clearing price/maximum winning bid methodology.

    HME News: Remind me, how did you get interested in CMS’s bid program to begin with?

    Peter Cramton: Nancy Johnson, the six-time congresswoman from Connecticut, called me and asked if I would take a look at the DME auction rules. I did and I was shocked. I told her, “These rules can’t work. There are fatal flaws.” She then asked if I would be willing to talk to congressional leaders about this and I said yes. Thus began my multi-year effort to reform DME auction rules.

    HME: At one point, you were one of 166 auction experts who wrote CMS detailing the flaws in its program. You even hosted a mock auction to demonstrate how more standard auction principles would work better.

    Cramton: Together with my colleagues, I made quite an effort to convince HHS, CMS and Congress about the problems, and how they could be fixed.

    HME: What were you—and the industry—up against?

    Cramton: CMS acted like its mission was to defend the status quo and had no interest in fixing the mess. HHS had too many fires to put out. I was told, “We have dozens of programs needing reform and can only fix five. Why should this make the top five?” I explained that it was actually easier to fix it than to stumble along. Congress was the most supportive, but getting legislation passed was a huge ask.

    HME: Have you been keeping up with how the bid program has been going?

    Cramton: I have had a few meetings with folks at the top of HHS on this matter, beginning in March. I found there was consensus about the flaws and a true desire to address the key problems: non-binding bids, median pricing rule, and zero transparency. I’m hopeful that the program will be fixed. CMS did retain an auction expert, which is a very good sign.

    HME: Did they not retain an auction expert previously?

    Cramton: The rules were created without any guidance from any expert in auctions. It is like building a bridge without a bridge expert. The bridge will fail.

    HME: Have you examined the recent proposed rule?

    Cramton: I have yet to carefully review the proposed design, so I will not comment on specifics, but I am now optimistic that the rules will be fixed. Of course, the details matter. I hope to take a closer look and comment on the rules later this month.

    HME: Since the proposed changes are ones that you and other experts have argued for, do you feel validated?

    Cramton: Yes, but I get little comfort from knowing I was right. I just want to see the program fixed, which will save lives and money, and improve the care that beneficiaries receive.

    HME: How do you predict the bid program will run differently if the proposed changes are implemented?

    Cramton: I do expect prices to increase in many cases, but most importantly, I expect services to improve. The net effect will be lower cost and better service for beneficiaries. The reason prices can rise but costs can fall is that improved utilization will reduce the number of unserved beneficiaries from ending up in the emergency room.

    HME: Last words?

    Cramton: It has been a long ride. I am hopeful that the needed reforms will be made. Better late, than never.


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    08/03/2018
    HME News Staff

    WATERLOO, Iowa – A study sponsored by The VGM Group shows the cost shift that is happening as a result of reduced access to DME for Medicare beneficiaries.

    The study by Leitten Consulting shows that:

    ·      Fall-related injuries due to failure to provide needed mobility equipment results in a cost shift of between $4,705 and $5,029;

    ·      COPD-related exacerbations due to failure to provide supplemental oxygen therapy results in a cost shift of about $14,350; and

    ·      OSA-related complications due to failure to provide CPAP therapy results in cost shift of $1,631.

    “When this happens, Medicare incurs substantial increased Part A costs to treat medical complications caused by not having the needed DME,” Brian Leitten writes in the study.

    This most recent study builds on another study by Leitten Consulting released last year that shows, for every dollar spent on DME, Medicare could save anywhere from $11 to $29 in payments for direct treatment.

    VGM says the most recent study will be an important tool in its continued discussions with elected officials about the negative impact of Medicare’s competitive bidding program.

    “(The study) provides a clear picture of the negative impact caused by both the delay and lack of access to proper equipment due to CMS’s competitive bidding program,” said John Gallagher, vice president of government relations. “The dramatic reduction in DMEPOS providers, coupled with cost shifted from prevention to treatment, are, in fact, coming at a significant larger cost to Medicare.”

    Riverside Co. exits respiratory market

    CLEVELAND – The Riverside Company, a global private equity company based here, has sold Specialized Medical Services to Lincare.

    Milwaukee-based SMS is a provider of respiratory equipment, logistics solutions and related medical products to long-term care centers like skilled nursing facilities.

    Under Riverside’s hold, SMS’s footprint grew to cover more than 45 states and 3,200 facilities, and its revenue grew more than seven times, according to the firm.

    Riverside initially entered the respiratory market in 2006, when it invested in RCS Management. When it acquired SMS in 2012, it named the combined company SMS.

    “Combined with other add-on acquisitions, such as Future Medical and Premier Medical, SMS established itself as the largest respiratory equipment provider for SNFs in the nation,” the firm stated in a press release.

    Riverside says it has made more than 130 investments in the healthcare sector.

    Lincare is a subsidiary of Germany-based Linde AG.

    Insulet reduces net loss

    BILLERICA, Mass. – Insulet Corp., maker of the Omnipod Insulin Management System, reported revenues of $124.3 million for the second quarter, a 13% increase compared to the same period last year. It reported revenues of $78.1 million for the Omnipod in the U.S., a 19% increase. Insulet reported a net loss of $1.7 million for the second quarter compared to a net loss of $7.8 million for the same period last year. Among the company’s highlights in the second quarter: It assumed direct European operations for the Omnipod on July 1; it commenced a limited market release in the U.S. for the Omnipod DASH, its next generation platform; and it secured in-network coverage for Omnipod with UnitedHealthcare. “Our commitment to operational excellence is driving our strong revenue growth and continuing gross margin expansion,” said Patrick Sullivan, chairman and CEO. “We are on track to achieve positive operating income in 2018 and our 2021 revenue and gross margin targets.”

    Aeroflow launches contest for pumping room makeover

    ASHEVILLE, N.C. – Aeroflow Breastpumps, a subsidiary of Aeroflow Healthcare, has launched a contest for a Pumping Room Makeover as part of World Breastfeeding Month. The new initiative, with support from sponsors like Lansinoh and Spectra, will provide one grand prizewinner with a pumping room makeover at their business. To enter, employees or employers fill out a quick entry form and submit photos of potential lactation room locations at their businesses. Aeroflow will accept entries from Aug. 1 to Aug. 31. The company’s team members will personally visit the winning business to set up the perfect pumping room with items like a comfortable chair, mini-fridge, microwave and pumping accessories. In addition to the grand prize, there will be five $500 gift basket prizes, filled with breastfeeding and pumping accessories.

    Homecare Medical Supply joins Respiratory Services of WNY

    AUBURN, N.Y., and BUFFALO, N.Y. – Homecare Medical Supply in Auburn, N.Y., has become a branch of Respiratory Services of Western New York in Buffalo, N.Y., according to the Olean Times Herald. Homecare Medical Supply will retain its name and location, and the son of the founders, Joe Manning, and granddaughter Cynthia Manning, will continue to manage the store, the newspaper reported. Respiratory Services of Western New York is a full-service provider of home respiratory and medical equipment and supplies with four additional branches in the Buffalo and Rochester areas. “We are very excited to add this great location to our growing family of stores,” said Michael McCartney, owner and CEO of Respiratory Services of Western New York. “Homecare Medical Supply is a perfect fit and with our expanded line of products, I’m sure this will be smooth sailing all the way.”

    Mediware acquires BlueStrata EHR

    LENEXA, Kan. – Mediware Information Systems has acquired St. Louis-based BlueStrata EHR, a cloud-based electronic health record system for long-term post-acute care providers. The deal will allow Medicare to better address the healthcare needs of the aging populations and the business and process needs of the post-acute market. “BlueStrata EHR provides Mediware with a high-quality solution and a new market opportunity where we can share our expertise in improving care through technology,” said Bill Miller, Mediware CEO. “Together with BlueStrata EHR, Mediware now offers the broadest set of solutions in the post-acute software market, including home health, hospice and rehab.”

    Marx, Maughan join AAH board

    WASHINGTON – AAHomecare has added two new members to its board of directors: Scott Maughan, president of Salt Lake City-based Alpine Home Medical; and Josh Marx, managing director of sleep and vice president of business development for Cleveland-based Medical Service Company. “We’re extremely fortunate to add these accomplished individuals to our leadership team,” said Tom Ryan, president & CEO of AAHomecare.  “Scott and Josh bring high levels of expertise in HME to the board, and I know that the association will benefit from their demonstrated passion and commitment to this industry.” The two seats on the board opened up following the resignation of Byram Healthcare’s Perry Bernocchi and the transition of Hoveround’s Deb Silvers to chair of the AAHomecare Regulatory Council.

    Sunrise goes Down Under for buy

    FRESNO, Calif. – Sunrise Medical has acquired Magic Mobility, a manufacturer of all-terrain power wheelchairs based in Melbourne, Australia.

    The deal expands Sunrise’s existing product portfolio of wheelchairs, scooters, and seating and positioning products.

    “The opportunity of offering our customers greater possibilities in terms of power wheelchairs is at the heart of this acquisition,” said Jim Barratt, senior vice president of commercial operations for Sunrise. “The inclusion of the Magic Mobility portfolio, which is at the leading edge of outdoor, go-anywhere, all-terrain power wheelchairs, further enables people to enjoy their life and experience an enhanced choice of product capabilities.”

    Magic Mobility, which was formed in 1994 by rehab industry professionals, has 24 employees.

    “We are thrilled by this transition, which will ensure that the 24-year-old Australian brand can grow and develop even further for decades,” said Jill Barnett, general manager of Magic Mobility. “Our desire has always been to grow awareness and provide more access to our products and the Magic way of life.”

    Sunrise Medical’s leading market brands include Quickie, Sopur, Zippie and JAY. The company employs 2,300 associates worldwide, with facilities in the U.S., Mexico, Germany, the U.K., Spain, Poland, Holland and China.

    NSM to distribute robotic eating device

    NASHVILLE, Tenn. – National Seating & Mobility is partnering with Desin to distribute its Obi robotic eating device nationwide. The device, which fits within the size of a dinner placemat, features a robotic arm that can select food from four compartments and deliver it to the diner, so they can eat from a spoon, according to a press release. “This product showcases the powerful impact technology can bring to our industry,” said Bill Mixon, NSM CEO. “We are pleased to add Obi to the list of assistive technology solutions available for our clients.” The Obi was recently selected as a gold winner in the Rehabilitation and Assistive-Technology Products Category at the 20th annual Medical Design Excellence Awards (MDEA) competition. “The partnership with NSM is a game changer in our mission to make Obi more easily available nationwide,” said Jon Dekar, inventor and co-founder of Desin.

    Abbott upgrades FreeStyle Libre

    ABBOTT PARK, Ill. – The U.S. Food and Drug Administration has approved Abbott’s FreeStyle Libre 14-day Flash Glucose Monitoring System. The system has a one-hour warm-up period, compared to 12 hours with the FreeStyle Libre 10-day system, which received FDA approval in September 2017. The Libre is the No. 1 continuous glucose monitoring device in the world, with more than 800,000 users in more than 43 countries, according to a press release. It was approved for Medicare coverage in January.

    Medtrade: Early bird gets the worm

    ATLANTA – Early rates for Medtrade 2018 expire Aug. 25. The early rates allow attendees to save $100 on a conference pass and $50 on an expo pass. This year’s show is scheduled for Oct. 15-17 at the Georgia World Congress Center. To register, click here.

    Bill targets MCO-related cuts to DME

    SPRINGFIELD, Ill. – A bill has been introduced in the Illinois General Assembly that would help to address concerns surrounding 10% to 50% cuts to medical supply companies by certain managed care organizations, according to the Herald & Review. House Bill 5930, co-sponsored by Reps. David McSweeney, R-Barrington Hills, and Gregory Harris, D-Chicago, would prohibit medical supply companies from being paid less than 10% below Medicaid “fee for service” rates by MCOs, the newspaper reported. It would also require “minimum quality standards” for medical supply companies and prohibit managed care organizations from signing “sole-source” contracts. “The quality standards, McSweeney said, would help to ensure that patients are well-served by companies accepting the rock-bottom payments being mandated by at least one of the state’s contract Medicaid managed care companies, IlliniCare Health,” the newspaper reported. McSweeney hopes to get the bill passed during the upcoming fall veto session or the 2019 spring session.

    Invacare rebrands Top End

    ELYRIA, Ohio – Invacare is refreshing its Top End wheelchair brand with a new logo and a new website set to launch in the third quarter. The new “t-racer” logo provides a visual representation of the brand: cutting edge, sleek and performance focused, Invacare stated in a press release. “The decision to rebrand Top End is about more than just changing the logo,” said Jonathan Miller, senior director, mobility and seating, at Invacare. “It’s about promoting the incredible team behind our products, highlighting our championship legacy and, most importantly, helping users discover their full potential.” The new website will feature an intuitive design, and will allow consumers to order stock products and parts online, Invacare says. Top End joined Invacare in 1993 as the manufacturer of the company’s performance, recreational and sports wheelchairs, including the Top End Eliminator NRG Racing Wheelchair coming soon.

    CU hits milestone

    BILLINGS, Mont. – Computers Unlimited, developers of TIMS Software, celebrates 40 years in business this year. The company was co-founded in 1978 by Dr. Mike Schraer and is now run by President David Schraer. It has three different software application divisions for three different industries: medical, industrial and audiology. CU got its start by servicing local industrial gas and welding companies, expanded its services to HME companies in the 1980s and to speech, language and pathology companies through an acquisition in 2010. In its 40th year, the company highlights its ability to adapt to the more mobile work environment and to attract long-term employees. “The development of three new smartphone apps called TIMS Assistant, TIMS Delivery and TIMS Plat are a reflection of our DNA—our people make it happen,” David Schraer said. “I’m very proud that our staff members are long-term, which is something you don’t see too often in today’s business climate. We all share the same vision—to meet the every-changing needs of our users.”


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  • 08/07/18--12:54: VGM tallies costs by region
  • 08/07/2018
    HME News Staff

    WATERLOO, Iowa – The VGM Group has released the results of a “Delivery Cost Survey” that puts into perspective how costly it is for HME providers to provide patients with the necessary equipment.

    In New England, for example, providers report that it costs them $22.43 in vehicle costs per delivery and $18 in labor costs per hour, according to the survey. When you take into account the 23.33 miles from business to home and the 31.67 minutes it takes for in-home set up, that’s an average total delivery cost of $67, the report says.

    “With the DME industry being a high-touch healthcare service, understanding the costs involved in caring for beneficiaries must be taken into account when determining reimbursement rates,” VGM stated in a bulletin.

    VGM has calculated costs for seven other regions: Far West, Great Lakes, Mideast, Southeast, Plains, Rocky Mountain and Southwest.

    More than 200 independent providers completed the survey.


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    08/08/2018
    HME News Staff

    ELYRIA, Ohio – Invacare reported net sales of $246.2 million for the second quarter of 2018 compared to $233.5 million for the same period last year, about a 5.4% increase. It reported a net loss of $16.5 million vs. $23.5 million. For North America HME, Invacare reported net sales of $79.9 million for the second quarter of 2018 compared to $77.7 million for the same period last year, a 2.8% increase or 2.3% on a constant currency basis. The company credits mobility and seating products for driving the increase. “We are pleased that the NA/HME segment realized constant currency net sales growth of 2.3% compared to 2Q17,” said Matt Monaghan, chairman, president and CEO. “This is the fourth consecutive quarter of constant currency flat to positive sales growth in this segment, driven by a greater than 10% increase in sales of mobility and seating products. The growth in our mobility and seating product category reflects the competitiveness of our products and our alignment with our provider customers and end users.”

    Inogen increases revenues, income

    GOLETA, Calif. – Inogen reported total revenues of $97.2 million for the second quarter of 2018, a 51.6% increase compared to the same period last year. It reported a net income of $14.6 million vs. $8.3 million. Inogen says direct-to-consumer sales increased 74.3% in the quarter compared to the same period last year, driven by increased sales rep headcount and additional consumer advertising; and domestic business-to-business sales increased 55.7%, driven by continued strong demand from the company’s private label partner and traditional HME providers. Inogen says it has increased the number of employees that it plans to hire in Cleveland, where it has a new office, to 500, two-thirds of which it expects to be sales reps. It originally planned to hire 240 employees. The company also says it is increasing its revenue guidance for 2018 to $340 million to $350 million, up from $310 million to $320 million; and its net income guidance range to $45 million to $48 million, up from $38 million to $41 million.

    BioScrip sees improvements

    DENVER – BioScrip reported net revenues of $175.8 million for the second quarter of 2018 compared to $168.6 million for the same period last year. Net loss from continuing operations was $15.1 million, a $14 million improvement. Adjusted EBITDA was $11.4 million, a 14% increase, driven in part by a $3 million reduction in operating expenses, reflecting ASC 606 pro forma adjustments. “We remain increasingly confident that BioScrip can achieve at least $75 million in adjusted EBITDA in 2019 and are positioning the company for revitalized longer-term revenue growth and enhanced profitability through key initiatives in sales force productivity, revenue cycle management, procurement and managed care relationships,” said CEO Dan Greenleaf in a press release.


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    08/09/2018
    HME News Staff

    WATERLOO, Iowa – The VGM Group has released the results of a “Delivery Cost Survey” that puts into perspective how costly it is for HME providers to provide patients with the necessary equipment.

    In New England, for example, providers report that it costs them $22.43 in vehicle costs per delivery and $18 in labor costs per hour, according to the survey. When you take into account the 23.33 miles from business to home and the 31.67 minutes it takes for in-home set up, that’s an average total delivery cost of $67, the report says.

    “With the DME industry being a high-touch healthcare service, understanding the costs involved in caring for beneficiaries must be taken into account when determining reimbursement rates,” VGM stated in a bulletin.

    VGM has calculated costs for seven other regions: Far West, Great Lakes, Mideast, Southeast, Plains, Rocky Mountain and Southwest.

    More than 200 independent providers completed the survey.

    CMS issues guidance on national PA program

    WASHINGTON – CMS has published guidance for power mobility device providers on the transition to the national prior authorization program. “Inclusion of Power Mobility Device Codes in the Prior Authorization Program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items” lists all the HCPCS codes that will be included in the program starting Sept. 1, according to a bulletin from AAHomecare. For states not currently in the demonstration, the MACs will start accepting prior auth requests Aug. 18. For the 19 states currently in the demonstration, MACs will no longer accept prior auth requests for items that will not be part of the national program.

    BioScrip sees improvements

    DENVER – BioScrip reported net revenues of $175.8 million for the second quarter of 2018 compared to $168.6 million for the same period last year. Net loss from continuing operations was $15.1 million, a $14 million improvement. Adjusted EBITDA was $11.4 million, a 14% increase, driven in part by a $3 million reduction in operating expenses, reflecting ASC 606 pro forma adjustments. “We remain increasingly confident that BioScrip can achieve at least $75 million in adjusted EBITDA in 2019 and are positioning the company for revitalized longer-term revenue growth and enhanced profitability through key initiatives in sales force productivity, revenue cycle management, procurement and managed care relationships,” said CEO Dan Greenleaf in a press release.

    Option Care debuts in Louisiana

    NEW ORLEANS – Option Care has opened its first care management center in Louisiana, the home infusion provider announced Aug. 7. The center opened June 11 in Elmwood. Through the center, Option Care’s team of clinicians, nurses, pharmacists, techs and dieticians can now deliver home and alternative site infusion services to patients who rely on infusion therapies for a variety of conditions, including infectious diseases, and nutritional and gastrointestinal disorders. The company says its team of 1,800 are able to provide home infusion services coverage for nearly all patients across the United States.

    CMS to pay more for CPAP alternative

    MINNETONKA, Minn. – An alternative to CPAP therapy has been approved by CMS for a new technology add-on payment to hospitals. The NTAP program will provide additional reimbursement on top of the standard Medicare Severity Diagnosis Related Group payment to hospitals under the Medicare Hospital Inpatient Prospective System for Respicardia’s remedēSystem, an implantable device that treats the effects of central sleep apnea by restoring a more normal breathing patter during sleep. The add-on payment goes into effect Oct. 1. The NTAP program recognizes innovative medical technologies that substantially improve the diagnosis or treatment of Medicare beneficiaries.

    Circadiance secures two more patents

    PITTSBURGH – Circadiance has received two additional patents for its SleepWeaver line of soft cloth CPAP masks. The U.S. Patent and Trademark Office has granted a patent titled “Full Face Cloth Respiratory Mask” to Circadiance covering certain features of the SleepWeaver Anew Soft Cloth Full Face CPAP Mask and the United Kingdom Patent Office has granted a patent titled “Improved Respiratory Mask with Disposable Cloth Body” covering certain features of the SleepWeaver Elan Soft Cloth CPAP Mask. “These patents provide further validation of the novelty of our CPAP mask solutions,” said David Groll, founder and CEO of Circadiance. Circadiance now holds nine U.S. and international patents around its cloth mask technology. In addition to its SleepWeaver line, Circadiance offers the Smart Monitor infant apnea monitors and the NeoPAP neonatal CPAP and high flow respiratory support system.

    People News: Merits

    Cape Coral, Fla.-based Merits Health Products has named Joe McKnight as its western regional sales manager. McKnight has worked for, managed and owned companies in complex rehab technology, DME, and other medical products and services industries since 1977. He currently serves as a board member of NRRTS; is a special interest group co-chair for seating and wheeled mobility for RESNA; and holds other board positions, including positions with the Muscular Dystrophy Association and the ALS Association.  


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    60% of non-contact suppliers, 33% of contract suppliers say they’re out
    08/17/2018
    Liz Beaulieu

    YARMOUTH, Maine – The majority of non-contract suppliers who responded to a recent HME Newspoll (60%) say they won’t try to pick up Medicare business starting Jan. 1, 2019.

    In a recent proposed rule, CMS outlined its plans to implement an “any willing provider” provision when the current competitive bidding contracts expire, allowing any Medicare-enrolled provider to serve beneficiaries while it overhauls the program.

    “I will choose to not service Medicare patients because Medicare’s reimbursement rates are too low across the board,” wrote a non-contract supplier, one of 109 respondents to the poll. “I cannot afford to provide equipment and service at the current rates. There would need to be a significant increase in rates, especially for respiratory equipment, to make it feasible.”

    Therein lies the rub for the majority of non-contract suppliers: They may be able to do business again with Medicare on Jan. 1, but they have to do it at the current fee schedules in their area, which have been drastically reduced by the bid program.

    Still, for other non-contract suppliers, they say they see the “any willing provider” provision as a means to an end: staying in business.

    “Being able to again provide Medicare beneficiaries with products and services could mean the difference between staying open or closing our doors,” wrote William Caldwell of City Home Medical Supply in Elkton, Md. “We intend to begin an aggressive campaign to notify hospitals, doctors and area patients of our ability to provide services. All avenues to increase revenues to better serve the community will be considered and implemented.”

    For contract suppliers, the majority (67%) say they will continue to do business with Medicare on Jan. 1, and the majority (55%) say they don’t think their market share will suffer much under an “any willing provider” provision.

    “I think it will cut into the Medicare business I am already doing, but it may not be that significant, so I am planning for about a 15% drop in Medicare revenue,” wrote one respondent.

    For other contract suppliers, however, they say their expired contracts give them a get-out-of-jail-free card.

    “We currently have the contract for enteral and we will stop accepting new referrals, as we are losing money servicing these customers,” wrote Ted Oury of Diamond Medical Equipment & Supply in Little Rock, Ark. “When we made the decision to decline most bids, we moved full force into retail with a new location and higher-end equipment for cash. The result has been better than we anticipated. We would love to provide service to Medicare beneficiaries, but until reimbursements are reasonable we will continue with retail and other forms of reimbursement.”


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    08/17/2018
    HME News Staff

    WATERLOO, Iowa – The VGM Group has released an interactive tool that allows providers to assess what areas CMS has deemed bid, non-rural, rural and non-contiguous. The tool provides maps for all 50 states, allowing providers to determine what area a zip code falls under. “With the proposed changes coming down from CMS excluding relief from the non-bid areas and opening up competitive bidding areas to any willing provider, it is important that providers understand what they will be reimbursed and where those lines fall on a map,” said John Gallagher, vice president of government relations. “This new tool will allow providers to easily access that information”…VGM has also released sample templates for commenting on CMS’s recent proposed rule outlining changes to the bid program. Because the rule covers several aspects of the program, VGM has organized the templates by policy area: lead-item pricing, oxygen and budget neutrality, fee schedule adjustment amounts, multi-function vents, and national mail-order programs for test strips. VGM advises providers to add at minimum a paragraph of personal testimony to the template for “the most effective comment.”

    CRT providers report reduced access, NCART survey finds
    WASHINGTON – An alarming 65% of complex rehab providers say CMS’s application of bid-related pricing to accessories for complex manual wheelchairs has reduced their ability to provide these products to Medicare beneficiaries, according to a new survey from NCART.
    An additional 22% say they have been holding off on limiting the accessories they provide, but if nothing changes in the next 90 days, they’ll have no choice.
    “That equates to 87% of the Medicare CRT suppliers indicating that currently, or within the next 90 days, they will not be able to provide the right complex rehab wheelchair systems that Medicare beneficiaries with significant disabilities require,” NCART stated.
    To evaluate the impact of bid pricing on accessories for complex manual wheelchairs, NCART conducted a confidential survey, generating responses from 45 companies with 402 Medicare supplier locations across the country.
    Stakeholders plan to use the survey results to lobby Congress to pass H.R. 3730 and S. 486, bills that would stop bid-related pricing for accessories for complex manual wheelchairs. The pricing has been in place since Jan. 1, 2016.

    Aeroflow buys sleep business
    ASHEVILLE, N.C. – Aeroflow Healthcare has acquired the CPAP resupply program of Vernon, Conn.-based Med-Caire.
    Following the acquisition, patients throughout Connecticut, North Carolina and South Carolina, where Med-Caire has a presence, will now have access to Aerflow’s resupply program.
    “By acquiring Med-Caire’s CPAP resupply line of business, Aeroflow is advancing its mission of improving its patients’ quality of life by expanding the geographic area in which they are served,” said Andrew Amoth, corporate development manager, in a press release.
    Med-Caire will refocus its business, assisting patients in other medical and geographical areas, according to the release. The family owned and operated company, which has a staff of 25, provides home respiratory and DME supplies.
    Aeroflow says it will continue seeking opportunities to expand through mergers and acquisitions.

    Viemed increases vent patient count by 35.3%
    LAFAYETTE, La. – Viemed Healthcare on Aug. 13 reported revenues of $15.5 million for the second quarter, a 42% increase compared to the same period last year and a 10% increase compared to the first quarter.
    The company reported a gross margin of $11.3 million for the second quarter, a 44% increase compared to the same period last year.
    Specifically, Viemed reported its ventilator patient count grew by about 35.3% in the second quarter compared to the same period last year and about 8.4% compared to the first quarter.        
    Looking forward, the company expects to generate revenues of about $16.3 million to $16.7 million and similar gross margin in the third quarter.
    In addition to its financial results, Viemed reported that it has added a new independent director to its board: Bruce Greenstein, who recently joined LHC Group as chief innovation and technology officer. Greenstein was previously chief technology officer at the U.S. Department of Health and Human Services.

    Best Buy makes big healthcare buy
    MINNEAPOLIS – Best Buy has signed a definitive agreement to buy Great Call, a San Diego-based provider of connected health and personal emergency response services to the aging population, for $800 million in cash. Great Call says it has more than 900,000 paying subscribers. “We know technology can improve the quality of life of the aging population and those who care for them,” said Hubert Joly, chairman and CEO of Best Buy. “Now, we have a great opportunity to serve the needs of these customers by combining GreatCall’s expertise with Best Buy’s unique merchandising, marketing, sales and services capabilities.” Best Buy says the acquisition will augment its existing efforts in the health space and will help fuel further growth in the consumer and commercial markets. The company says it already has a growing business selling health- and wellness-related products and has invested in health-related initiatives that involve several leading healthcare providers and insurers. Great Call will maintain its headquarters and its care centers in Carlsbad, Calif., and Reno, Nev. David Inns, who has been with Great Call since it was formed in 2006, will remain CEO. “By joining forces, we can do even more for this population, combining our products, services and expertise with Best Buy’s customer focus and scale to meaningfully expand our reach,” Inns said.

    VirtuOx buys Instant Diagnostic Systems
    CORAL SPRINGS, Fla. – VirtuOx, an independent testing facility specializing in at-home testing for sleep disorders and respiratory diseases, has acquired Decatur, Ala.-based Instant Diagnostic Systems. The deal allows VirtuOx to grow strategically in the lab services sector. “This is an ideal acquisition for us,” said Steven Lica, CEO of VirtuOx. “No only do we increase our POX testing and HST testing platform, but we have also gained a valuable and experienced team with IDS, a pioneer in our space.” IDS is also an IDTF specializing in home-based diagnostic testing and has performed nearly 2 million pulse-oximetry studies, according to its website. M&A firm Vertess, which facilitated this deal, seeks additional acquisitions on behalf of VirtuOx in the areas of home sleep testing, pulse oximetry, cardiac telemetry, monitoring, insomnia and related IT products and services.

    Regional Health pilots home mods, HME concept
    STURGIS, S. Dakota – Regional Health HOME+ Home Medical Equipment held a grand opening for its new 3,600-square foot store on Aug. 17, according to the Rapid City Journal. The company originally occupied 700 square feet inside the Massa-Berry Clinic in Sturgis, but the clinic moved to Regional Health Sturgis Hospital. “They didn’t have room for us (in the new clinic),” Brittany Battista, manager, told the newspaper. “We wanted to stay in the community and wanted to broaden our retail and home modification (services), so this was a perfect location.” The larger space allows the company to demo chair and stair lifts, and wheelchair-accessible sinks and cupboards. It also accommodates an expanded display of connected home devices, home and bath safety equipment, roll-in showers, walk-in bathtubs, grab bars and wheelchair ramps. Regional Health is using the new location as a pilot for potential expansion in Rapid City and Spearfish, according to the newspaper.

    Rehab Medical eyes national footprint
    INDIANAPOLIS – Rehab Medical now has a presence in 13 states and the complex rehab provider is eyeing a national footprint, according to the Indiana Business Journal. The company hasn’t decided how to accomplish that, though—organically or through acquisitions. Rehab Medical, which started as part of a larger company, Orbit Medical, provides complex power wheelchairs and mobility devices, as well as wound-therapy products, beds and some orthotics. In a rapidly consolidating market, Rehab Medical told the newspaper it differentiates itself from its competition with service, speed and compassion. “This business is so service-driven, and the ability to get a patient a piece of equipment quickly and efficiently is really tough,” Kevin Gearheart, president, told the newspaper. “Some patients have to wait six months. We’re able to do that in half the time.”

    Southeastern Medical Supply under new ownership
    LAKELAND, Fla. – Jose Escobedo, ATP, CRTS, has purchased Southeastern Medical Supply based here, with an eye toward expanding its reach throughout Florida and narrowing its focus on complex rehab. Right now, the company, which was founded in 2002, is a one-stop shop for DME. Escobedo, who serves as president and CEO, has 30 years of experience in the industry, with a specialty in complex rehab.

    Supreme Medical adds CBD products
    MOBILE, Ala. – Supreme Medical has partnered with Green Roads to add CBD products to its roster of distributed products. Green Roads produces more than 50 CBD products that are formulated by a licensed compound pharmacist using high quality, broad-spectrum hemp oil and other natural ingredients, according to a press release. Supreme Medical believes the CBD industry is poised to generate more than $2 billion in revenue by 2020. “This product category represents a huge opportunity to generate new cash sales at great margins for your business,” the company stated.

    Uni-flo2 publishes white paper
    LEHIGH VALLEY, Pa. – Uni-flo2 has released a white paper that outlines issues related to the method of delivery in supplemental oxygen therapy and highlights the advantages of single-prong nasal cannulas for COPD patients. “Breathe Easier: Single-Prong Cannula Represents Important Breakthrough in Oxygen Therapy for COPD Patients” is authored by Campbell Cauthen, RRT, co-inventor of Uni-flo2. The reported benefits of a single-prong cannula include greater comfort, freedom of movement, improved sleep and enhanced personal appearance, according to the company’s survey of patients. Uni-flo2 has recently ramped up its marketing efforts.

    Brightree invites users to conference
    ATLANTA – Registration is open for the Brightree Summit, the company’s one-day user conference. The Summit will take place Oct. 15 at the Omni Atlanta Hotel in conjunction with Medtrade. The theme of this year’s Summit is “Empowering Care.” “Yes, Brightree focuses on the business side of the house for HME providers, with technology and services to run operations efficiently, but boosting nearly every step in the HME process also empowers suppliers to provide the best care for patients,” the company stated. “Simply put, Brightree delivers technology so providers can do more of what they do best.” Attendees can expect a variety of training, education and consulting tracks covering e-purchasing, billing and A/R, patient collections, mobile delivery and more. They can also expect a new advanced training track geared toward users with two-plus years of experience on rules engine, productivity and management, and site settings.


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    08/21/2018
    HME News Staff

    WASHINGTON – AAHomecare argues that CMS should pay HME providers in competitive bidding areas a higher rate during an upcoming “gap period” in the program, according to comments submitted by the association this week in response to a recent proposed rule.

    AAHomecare recommends that CMS establish rates in the former CBAs at the current SPA rates but provide an increase to those rates by all the CPI-U increases from 2013 through 2018.

    “AAHomecare has serious concerns about the agency’s proposal to apply the current CBP SPAs, plus a single inflation index, in the former CBAs until the next round of bidding can be implemented,” the association writes. “Since CMS recognized these SPAs are deficient due to the median price methodology, we see no reason why inadequate rates should continue, particularly when there no longer remains the increased market share that was the balancing rationale for the lower bid prices.”

    In its 26 pages of comments, AAHomecare also argues for applying 50-50 blended rates not only in rural and non-contiguous areas from Jan. 1, 2019, through Dec. 31, 2020, but also in the remaining non-bid areas.

    “We believe the access and DME supplier viability problems CMS has identified are not limited to the rural and non-contiguous areas and strongly recommend that CMS provide the same payment relief in the remaining non-CBAs,” the association writes.

    Additionally, AAHomecare recommends that CMS: consider a more comprehensive effort to modernize the home oxygen benefit and overhaul its gap-filling methodology to establish fees for newly covered items paid on a fee schedule basis.

    “I hope our comments will help spur HME companies and other stakeholders to share their input on the proposed rule with CMS, as well,” said Tom Ryan, president and CEO of AAHomecare. “The final version of the rule will have a tremendous impact on our industry for years to come, so it’s critical that we make our best case for improving CMS’s reimbursement policy now.”

    CMS is accepting comments on the rule until Sept. 10. Currently, it has received 26 comments.


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    08/23/2018
    HME News Staff

    WASHINGTON – AAHomecare emphasized the importance of coordinated care in its comments to CMS on possibly relaxing the Stark Law.

    The Stark Law is designed to prevent physicians from ordering services and products for Medicare beneficiaries when the motivation is to make money.

    In its comments, however, AAHomecare states that the Stark Law may “overly limit” healthcare providers—not only physicians but also HME providers, therapists (respiratory, physical and occupational), home health agencies and pharmacies—from coordinating care to treat beneficiaries more cost effectively.

    “While it is important that the Medicare program encourage coordination, it is equally important that protection against fraud be maintained,” states AAHomecare. “This is a balancing act.”

    AAHomecare also emphasized that a prohibition against allowing physicians to provide DME not listed in the “allowed products” category remain in place to ensure the infrastructure necessary to service beneficiaries; preserve beneficiary choice of products; and ensure accreditation standards are met.

    The Department of Health and Human Services published a request for information, “Medicare Program: Request for Information Regarding the Physician Self-Referral Law” in June.

    Association points to burdensome resupply requirements

    AAHomecare also submitted comments to a June report from the Office of Inspector General that said most Medicare claims for CPAP supplies did not comply with requirements.

    In a letter to Inspector General Daniel Levinson, the association pointed out that the local coverage determinations for CPAP are known for being one of the most complicated, with overly burdensome requirements.

    While the OIG report cited proof of delivery issues in 36 out of 110 errors, AAHomecare pointed to the fact that CMS in recent months has provided guidance to allow additional flexibility. For example: The date of service on the claim can now be the ship date, the actual receipt date or the date the shipping label is printed, instead of the narrow definition of the date of service only being the ship date.

    AAHomecare also suggested that the sample of 110 claims may not paint an accurate picture.

    “In closing, AAHomecare would request the OIG to recommend that CMS continue to look at the overly burdensome nature of PAP supply requirements in an effort to work with the industry to ensure that beneficiaries have access to needed supplies for their sleep therapy,” it wrote.


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    08/24/2018
    Theresa Flaherty

    WASHINGTON – Industry stakeholders feel they have a “fair shot” at getting broader reimbursement relief for HME providers in all non-competitive bidding areas, rather than in the limited areas proposed by CMS.

    In comments submitted last week on a recent proposed rule, AAHomecare urged CMS to apply 50-50 blended rates not only in rural and non-contiguous areas from Jan. 1, 2019, through Dec. 31, 2020, but also in the remaining non-bid areas.

    “It was mentioned in the interim final rule as a possibility, and the proposed rule suggested they considered it but wanted more comments on that, which I think kind of set the table,” said Tom Ryan, president and CEO of the association. “We also talked about the 21st Century Cures Act and the intent of Congress, which is that the relief would be more broad. For all those reasons, I feel optimistic we can get there.”

    AAHomecare also recommends that CMS establish rates in the former bid areas at the current SPA rates but provide an increase to those rates by all the CPI-U increases from 2013-18.

    With AAHomecare’s comments now submitted, the race is on to educate lawmakers.

    “It’s complicated and there are not a lot of details,” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. “We need to educate our allies, staff and leadership of the committees of jurisdiction. Hopefully, they can echo similar concerns and make similar recommendations, as well. That’s really the goal.”

    Stakeholders have been laying the groundwork for broader relief all along, says VGM’s John Gallagher, who, along with a group of providers, met with rep. Cathy McMorris Rodgers, R-Wash., earlier this month, and will meet with Rep. Greg Walden, R-Ore., chairman of the Committee on Energy and Commerce on Aug. 27.

    “McMorris Rodgers wants to sit down with CMS and really go over the impact of the program and possible regulatory fixes,” said Gallagher, vice president of government relations. “Along with the recent letter from West Virginia—we are trying to get similar letters from Iowa, Montana and hopefully Kentucky—if we can get those raising questions, that’s what we want to happen.”

    Providers need to speak up too, say stakeholders. For its part, VGM has created a template that breaks down five of the main proposals in CMS’s proposed rule.

    “All you’ve got to do is add in specific paragraphs on how it impacts you in, say, Raleigh-Durham, N.C.,” said Gallagher. “Then, just fire it off by email or mail.”

    Comments are due Sept. 10 and a final rule is expected around Nov. 1.


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    08/24/2018
    HME News Staff

    WASHINGTON – AAHomecare emphasized the importance of coordinated care in its comments to CMS on possibly relaxing the Stark Law.

    The Stark Law is designed to prevent physicians from ordering services and products for Medicare beneficiaries when the motivation is to make money.

    In its comments, however, AAHomecare states that the Stark Law may “overly limit” healthcare providers—not only physicians but also HME providers, therapists (respiratory, physical and occupational), home health agencies and pharmacies—from coordinating care to treat beneficiaries more cost effectively.

    “While it is important that the Medicare program encourage coordination, it is equally important that protection against fraud be maintained,” states AAHomecare. “This is a balancing act.”

    AAHomecare also emphasized that a prohibition against allowing physicians to provide DME not listed in the “allowed products” category remain in place to ensure the infrastructure necessary to service beneficiaries; preserve beneficiary choice of products; and ensure accreditation standards are met.

    The Department of Health and Human Services published a request for information, “Medicare Program: Request for Information Regarding the Physician Self-Referral Law” in June.

    Association points to burdensome resupply requirements

    AAHomecare also submitted comments to a June report from the Office of Inspector General that said most Medicare claims for CPAP supplies did not comply with requirements.

    In a letter to Inspector General Daniel Levinson, the association pointed out that the local coverage determinations for CPAP are known for being one of the most complicated, with overly burdensome requirements.

    While the OIG report cited proof of delivery issues in 36 out of 110 errors, AAHomecare pointed to the fact that CMS in recent months has provided guidance to allow additional flexibility. For example: The date of service on the claim can now be the ship date, the actual receipt date or the date the shipping label is printed, instead of the narrow definition of the date of service only being the ship date.

    AAHomecare also suggested that the sample of 110 claims may not paint an accurate picture.

    “In closing, AAHomecare would request the OIG to recommend that CMS continue to look at the overly burdensome nature of PAP supply requirements in an effort to work with the industry to ensure that beneficiaries have access to needed supplies for their sleep therapy,” it wrote.

    Lincare pays $5.25M to resolve allegations

    CLEARWATER, Fla. – Lincare has paid $5.25 million to resolve allegations that it violated the federal False Claims Act and the Anti-Kickback Statute by offering illegal price reductions to Medicare beneficiaries, according to the U.S. Attorney’s Office for the Southern District of Illinois. The government alleged that, from 2011 to 2017, Lincare attempted to gain a competitive advantage in the market by unlawfully waiving or reducing co-insurance, co-payments and deductibles for beneficiaries who participated in a Medicare Advantage Plan operated through a private insurer. The allegations were first brought to light in a 2015 whistleblower lawsuit filed by Brian Thomas, a former billing supervisor at Lincare, who will receive $918,750 from the settlement proceeds.

    Mediware acquires Rock-Pond Solutions

    LENEXA, Kan. – Mediware Information Systems has acquired Rock-Pond Solutions, a business intelligence and analytics software provider for the home infusion, home medical equipment, and specialty pharmacy industries. The deal will allow Mediware to develop better solutions for the post-acute care market. It will also support more collaborative work on Mediware’s CareTend product roadmap. “(Rock-Pond’s) highly regarded team brings deep experience in post-acute care and they have successfully helped Mediware’s CareTend software become the strong solution it is today,” said Bill Miller, Mediware CEO in a press release.

    OIG finds a few overpayments, Liberty disagrees

    PORT ST. LUCIE, Fla. – Liberty Medical mostly complied with Medicare requirements for inhalation drugs, according to a new report from the Office of Inspector General. The OIG sampled 100 claims and found 94 in compliance. Of the remaining six claims, the agency says Liberty did not provide medical records for four, and lacked proof of delivery for two, resulting in an overpayment of $2,408. As a result, the OIG estimated that Liberty received $47,5626 in overpayments and recommended that the provider refund the money to Medicare contractors. Liberty disagreed with the OIG’s recommendations, saying that it provided sufficient documentation to establish medical necessity, and that it provided additional proof of delivery documentation for six of eight disallowed sample claims.

    VGM Fulfillment expands footprint

    WATERLOO, Iowa – VGM Fulfillment has opened a resupply distribution center in Nashville, Tenn. The 40,000-square-foot warehouse is staffed with 22 existing employees who are familiar with CPAP resupply, according to a press release. “Expanding our operations to a logistics hub like Nashville allows us to route some of our resupply order volume to the new facility—ensuring that patients located in the southern and eastern United States will receive their orders even quicker, resulting in greater patient satisfaction,” said Jeremy Stolz, president of VGM Fulfillment. “We’ve experienced tremendous growth year over year. This expansion will allow us to ship more packages per day all while improving transit times.” VGM Fulfillment ships more than 2 million orders annually, and recently launched a resupply program for compression stockings.

    Golden Technologies video earns honors

    OLD FORGE, Pa. – Golden Technologies has been named a bronze winner in the 39th Annual Telly Awards for its product launch video for the MaxiComfort power recliner, it announced in a press release. The video was honored in both the general/home furnishings and the craft-directing for promotional video categories. “It is a credit to the huge undertaking involved in elevating our marketing to the next level, hiring talented people to help us create real product lifestyle pieces that not only inspire consumers but help us illustrate the way these products can make you feel,” said Tim Robinson, director of digital media. The Telly Awards honor excellence in video and television.

    GAO sides with C2C on QIC contract

    WASHINGTON – The Government Accountability Office agrees that CMS failed to properly assess “potential organizational conflict” when the agency awarded Maximus the DMEPOS QIC contract. The GAO’s decision comes after C2C Solutions, the current QIC contractor, protested the award. The GAO’s decision sustains C2C’s protest. “Protest that the agency failed to evaluate a potential impaired objectivity organizational conflict of interest is sustained where the awardee’s wholly-owned subsidiary would review decisions on appeal from the parent company’s own claims decisions, and the agency did not meaningfully consider whether this structure created an impaired objectivity organizational conflict of interest,” the GAO stated. Additionally, “protest that the agency failed to evaluate a potential unequal access to information organizational conflict of interest is sustained where the record does not demonstrate that the agency reasonably evaluated a potential unequal access to information conflict arising from the relationship between the awardee and one of its subsidiaries,” it stated.

    Somnoware enhances platform

    SUNNYVALE, Calf. – Somnoware, a provider of digital health software, has launched an enhanced DME-ordering capability for enterprise healthcare systems. The expanded interoperability with electronic medical record or EMR software enables customers to manage patients who have historically not been on the platform. “This will allow enterprise healthcare systems to rapidly deploy Somnoware across all their facilities without changing their existing processes, resulting in improved care coordination and reduced costs,” the company states. With the enhanced DME ordering capability, physicians and care providers can now place orders within their existing EMR system. The order is then transmitted automatically via Somnoware to the DME company for fulfillment. During the transmission, Somnoware appends other relevant patient information to the electronic order, so the DME company receives complete patient records. Also, if the DME order was originally placed by a non-physician, Somnoware offers the opportunity for the physician to electronically sign the order and append notes before it is sent to the DME company.

    eSolutions gets new CEO

    OVERLAND PARK, Kan. – eSolutions, a provider of revenue cycle management analytics and cloud-based workflow solutions, has named Gerry McCarthy CEO. McCarthy has more than 20 years of healthcare experience, most recently as president of TransUnion Healthcare, where he oversaw the rapid growth and strategic direction of the company. He replaces Gene Creach, who is retiring after 18 years at the company. Creach helped eSolutions grow to process more than 50 million claims a year for more than 30,000 providers. The company also provides nationwide Medicare connectivity across all nine Medicare administrative contractors. Its customers span hospitals, home health and hospice agencies, skilled nursing facilities, DME suppliers, physician practices and other provider types.

    VMI donates van

    PHOENIX – Vantage Mobility International has provided an accessible van to Ability360, a nonprofit organization that offers programs to empower people with disabilities. The van will be used to transport members and enable them to experience the most accessible sports and fitness center in the metro area, according to a press release. “Ability360 as an organization does so much for our community and reflects Vantage Mobility International’s values and mission to always remember the challenges our customers face and our desire to improve their independence and access to the greater community,” said Steve Morris, COO of VMI.

    Quantum Rehab backs Team Gleason

    EXETER, Pa. – Quantum Rehab has pledged to contribute $50,000 to the Team Gleason Foundation, a nonprofit that aims to provide leading edge technology, equipment and services to individuals with ALS. Quantum Rehab will also pay for seat-elevation technology, like its iLevel system, to be distributed by Team Gleason to individuals living with ALS. “Those living with ALS face daily challenges,” said John Storie, vice president, Quantum sales-Eastern America. “Access to life-sustaining mobility should not be one of them. It’s our privilege to work with Team Gleason to ensure that those living with ALS have the best mobility technology and the highest quality of life possible.” Team Gleason, founded by Steve Gleason, a former New Orleans Saints football player, after his diagnosis with ALS in 2011, is accepting applications from individuals living with ALS who are interested in a power seat elevator.

    NRRTS taps Dickerson as next president

    LUBBOCK, Texas – NRRTS has announced the results of its 2018 board elections, including Gerry Dickerson as president-elect. Dickerson works for National Seating & Mobility and has been a NRRTS registrant since 1994. Katie Roberts, who works for Cimarron Medical Services and has been a registrant since 2007, has been named vice president; Mike Osborn, who works for Alliance Rehab and Medical Equipment and has been a registrant since 2000, has been named treasurer for a second term; and Carey Britton, who works for NSM and has been a registrant since 2002, has been named secretary. Directors at large are Bob Harry of AABON Home Health Care Supply, a registrant since 2008; and Toby Bergantino of NuMotion, a registrant since 1993. Doug Crana of Consolidated Medical has been elected review chair, Region B; and Tom Simon of NuMotion has been appointed Review Chair, Region A.

    Short takes: Medical Service Co., CareCentrix

    Cleveland-based Medical Service Co. has been named a 2018 NorthCoast 99 winner. Winners represent the best workplaces in northeast Ohio. It’s the seventh time the provider has been recognized…Leslie Norwalk has been elected to CareCentrix’s board of directors. Norwalk has more than two decades worth of healthcare experience, including serving as Acting CMS Administrator during the Bush Administration.


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    ‘However, some effects may take longer to appear, underscoring the importance of CMS’s continued monitoring activities’
    08/28/2018
    HME News Staff

    WASHINGTON – The average reduction in payment rates in non-competitive bidding areas for five DME items with the highest expenditures in 2016 was 46%, according to a new report from the Government Accountability Office.

    In its review of the effects of reduced payment rates in non-bid areas, the GAO also found that: the number of suppliers furnishing rate-adjusted items in non-bid areas in 2016 decreased 8% compared to 2015; and beneficiary utilization of rate-adjusted items in non-bid areas in 2016 showed little change compared to 2015.

    “GAO interviewed stakeholder groups that reported anecdotal examples of specific beneficiary access concerns they attributed to the rate adjustments, but stakeholders could not provide evidence to substantiate that the access issues were widespread,” the agency wrote in its report. “GAO’s findings are consistent with CMS’s monitoring results, which indicate that there were no widespread effects on beneficiary access in the year after the adjusted rates went into effect.”

    The GAO continued: “However, some effects may take longer to appear, underscoring the importance of CMS’s continued monitoring activities.”

    In a response to the report, the County for Quality Respiratory Care said it agrees that the impact of the reduced payment rates are not yet reflected in CMS’s monitoring activities.

    “Since the report does not address the impacts of the policy on new patients with COPD, nor does it cover 2017 and beyond, it is essential for GAO to continue monitoring utilization rates,” said Dan Starck, chairman of the CQRC.

    The CQRC also pointed out that the number of suppliers furnishing oxygen, specifically, in non-bid areas in 2016 decreased at a higher rate, 10%.

    “This report validates what oxygen providers have been warning for years: that insufficient reimbursement rates make it harder to stay in business and serve Medicare patients who require supplemental oxygen and respiratory care to live independently,” Starck said. “No business can take on (these cuts) to reimbursement and expect to survive long.”

    On Jan. 1, 2016, CMS used competitive bidding pricing information to adjust rates for 393 items in non-bid areas. The agency estimates these adjustments will save the Medicare program about $3.6 billion between fiscal years 2016-20.


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    ‘More and more companies are making the switch’ says Ronda Buhrmester
    08/29/2018
    Liz Beaulieu

    WATERLOO, Iowa – A CMS work group on electronic medical documentation could go a long way toward relieving one of the HME industry’s biggest pain points: better documentation, says the VGM Group’s Ronda Buhrmester.

    “We’ve seen suppliers struggling to get better documentation from physicians for years,” said Buhrmester, a reimbursement specialist. “Doctors don’t put the proper information in medical records. It’s not intentional; they don’t know what to put in there. And now suppliers are pushing back: ‘We need better documentation.’”

    VGM announced recently that it had joined the work group, which has bi-monthly conference calls.

    One way to get better documentation is developing templates for physicians to use. Buhrmester says one of the first goals of the work group is helping to further develop templates for home oxygen therapy and diabetes supplies.

    “The templates do not direct doctors, which CMS doesn’t like,” she said, “but they help to make sure they touch on all the coverage criteria.”

    The return to templates is an irony that’s not lost on Buhrmester, but she says CMS has recognized that this “reactive game” of back-and-forth between physicians and suppliers for the correct documentation costs time and money.

    “I know we feel like CMS doesn’t listen, but they are listening,” she said. “It just takes time to change things, with making sure all the steps are being followed.”

    Bigger picture, the work group has also targeted as a goal: advancing the secure and standardized electronic data exchange for medical documentation requests and responses.

    “Unless you’re a DME company that’s part of a health system, you’re not likely to have access to electronic medical records,” Buhrmester said. “That will be very beneficial—when we get there.”

    As part of its work with the group, VGM plans to survey its provider members to get the lay of the land for electronic documentation in the HME industry.

    “I’d say 70% of suppliers, maybe more, are using an electronic system,” Buhrmester said. “It’s more efficient and saves money. More and more companies are making the switch.”


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    08/31/2018
    HME News Staff

    WASHINGTON – The average reduction in payment rates in non-competitive bidding areas for five DME items with the highest expenditures in 2016 was 46%, according to a new report from the Government Accountability Office.

    In its review of the effects of reduced payment rates in non-bid areas, the GAO also found that: the number of suppliers furnishing rate-adjusted items in non-bid areas in 2016 decreased 8% compared to 2015; and beneficiary utilization of rate-adjusted items in non-bid areas in 2016 showed little change compared to 2015.

    “GAO interviewed stakeholder groups that reported anecdotal examples of specific beneficiary access concerns they attributed to the rate adjustments, but stakeholders could not provide evidence to substantiate that the access issues were widespread,” the agency wrote in its report. “GAO’s findings are consistent with CMS’s monitoring results, which indicate that there were no widespread effects on beneficiary access in the year after the adjusted rates went into effect.”

    The GAO continued: “However, some effects may take longer to appear, underscoring the importance of CMS’s continued monitoring activities.”

    In a response to the report, the Council for Quality Respiratory Care said it agrees that the impact of the reduced payment rates are not yet reflected in CMS’s monitoring activities.

    “Since the report does not address the impacts of the policy on new patients with COPD, nor does it cover 2017 and beyond, it is essential for GAO to continue monitoring utilization rates,” said Dan Starck, chairman of the CQRC.

    The CQRC also pointed out that the number of suppliers furnishing oxygen, specifically, in non-bid areas in 2016 decreased at a higher rate, 10%.

    “This report validates what oxygen providers have been warning for years: that insufficient reimbursement rates make it harder to stay in business and serve Medicare patients who require supplemental oxygen and respiratory care to live independently,” Starck said. “No business can take on (these cuts) to reimbursement and expect to survive long.”

    On Jan. 1, 2016, CMS used competitive bidding pricing information to adjust rates for 393 items in non-bid areas. The agency estimates these adjustments will save the Medicare program about $3.6 billion between fiscal years 2016-20.

    Lifeway Mobility targets growth through investment

    HARTFORD, Conn. ­– Lifeway Mobility, an accessibility solutions company started by former Numotion CEO Paul Bergantino, has received a “major investment” from Cleveland-based Rockwood Equity Partners.

    As part of the transaction, Rockwood will provide additional capital and resources to enable Lifeway Mobility to accelerate its plans to become the leading provider of accessibility and safety solutions for people with mobility challenges and those wishing to age in place, according to a press release.

    Lifeway Mobility offers solutions like stair lifts, elevators, wheelchair lifts, ramps and bath safety solutions in Connecticut, Massachusetts, Rhode Island, southern New Hampshire, Minnesota, southern and western Wisconsin, Illinois and northwest Indiana.

    Also as part of the transaction, Lifeway Mobility has made a “major investment” in Extended Home Living Services, a provider of accessibility equipment, lifts, elevators and modifications in the Chicago area, run by Elizabeth and Stephen Crandall.

    Bergantino launched Lifeway Mobility in 2015, nearly 25 years after he started Connecticut Rehab. Connecticut Rehab became ATG Rehab and, when it merged with United Seating & Mobility, became Numotion.
    Rockwood Equity Partners targets companies that generate $10 million to $75 million in revenue, with $2 million to $7 million in EBITDA.

    Bridge Connector secures more funding

    PALM BEACH GARDENS, Fla. – Bridge Connector, an integration platform as a service, has completed a $5.5 million round of fundraising, led by Tampa-based Axioma Ventures. Axioma’s total investment in Bridge Connector is now $10 million, according to a press release. “Between $10 million in total funding and Axioma's expert counsel, we can aggressively pursue our mission to conquer the interoperability challenge with better technology, strategic partnerships, and smart hires,” said David Wenger, CEO and founder of Bridge Connector. “Connecting disparate systems is a tedious, time-consuming, and expensive process, and we have significantly reduced development times and project costs.” Bridge Connector, which also has locations in Knoxville and Nashville, Tenn., will increase its number of employees from 45 to 100 by the end of the year.

    Inogen’s Scribner to leave

    GOLETA, Calif. – Matt Scribner, Inogen’s executive vice president of operations, will leave the company, effective Jan. 2, 2019. Bart Sanford, most recently senior vice president of operations at Cepheid, a molecular diagnostics company, will step into the role on Sept. 17, 2018, to ensure an orderly transition, according to a press release. “Matt has been a part of the company’s success and I want to thank him for his many contributions to Inogen over the years and wish him the best in his future endeavors,” said CEO Scott Wilkinson. “We are looking forward to Bart’s contributions as we continue to drive portable oxygen concentrators to become the standard of care for ambulatory oxygen patients worldwide in this large and growing market.”

    Bonafide launches ‘Amazon-style’ shopping portal

    THOUSAND OAKS, Calif. – Bonafide Management Systems has launched its Facility Portal, an online shopping portal to allow HME providers to sell to healthcare facilities. The portal is directly linked to back-office billing operations, inventory and delivery systems, according to a press release. The “Amazon-style” shopping experience allows healthcare facility nurses to create patient profiles, place rental and sale orders, suggest patient-specific items based on a clinical algorithm, and schedule delivery, service and pickup. “Our customers who are using this software are reporting dramatically reduced cost, better order processing and much better visibility into what is happening with their drivers and customers,” said Wayne Bailey, director of client services.

    NSM reaches statewide service in California

    NASHVILLE, Tenn. – National Seating & Mobility is expanding in California with the acquisition of Tri County Mobility in Goleta. NSM now has 15 locations in California, positioning the national complex rehab provider to supply equipment and services statewide. “This acquisition strengthens our service capability in the central coast region of California,” said Bill Mixon, CEO. Tri County Mobility has been providing equipment and services in the Santa Barbara area for more than 30 years. Greg Nelson, owner of Tri County Mobility, will transition to the NSM team as branch manager. Emily Cotton, ATP, will also stay on, along with three additional employees currently serving area clients from the branch. NSM also has branches in Anaheim, Bakersfield, Chatsworth, Fairfield, Fresno, Hayward, Los Angeles, Redding, Redlands, Sacramento, San Diego, San Jose, Santa Rosa and Stockton.

    Sunrise Medical taps new president, CEO

    FRESNO, Calif. – Sunrise Medical’s board of directors has appointed Thomas Babacan as the company’s new president and CEO. Prior to joining Sunrise, Babacan was the CEO of AHT Cooling Systems, a global producer for commercial refrigeration and freezing systems; and CEO of VAG-Group, a manufacturer of water solutions. “In Thomas Babacan, Sunrise Medical has found a president and CEO who in his previous positions has demonstrated strong leadership and strategic skills,” said Johan Ek, chairman of Sunrise. “Thomas, with his global sales and operations experience, is well suited to lead Sunrise Medical on its ambitious growth journey.” Babacan will start his new position on Nov. 1. Former president and CEO Thomas Rossnagel announced in May 2017 that he would leave the company for family reasons. Ek has been serving as acting CEO.

    Short takes: MK Battery, ResMed, Invacare

    In conjunction with NRRTS, MK Battery has received approval for a 0.1 CEU course titled “Battery Technologies.” The one-hour course provides in-depth instruction on the proper selection, installation, care and maintenance of batteries used in power mobility equipment, and is geared toward technicians, ATPs and others who cater to the HME/mobility market. To schedule a course: sales@mkbattery.comResMed has upgraded its Astral life support ventilators to include optional AutoEPAP in iVAPS for U.S. patients. AutoEPAP automatically adjusts a patient’s expiratory pressure in response to flow limitations or obstruction of the upper airway. Other upgrades include easily changeable interfaces and customized program names…Invacare supported the Raley Road Trip, Rick Raley’s 13-day, 1,500-mile handcycle journey from New York City to Pinellas Park, Fla., to raise funds and awareness about the “invisible wounds of war.” Raley, a paralyzed U.S. Army veteran and Purple Heart recipient, is one of Invacare’s Top End Factory Pilots and is using a Top End handcycle for the journey. Raley, who completed the journey on Aug. 25, has lost nine friends to suicide since returning from Iraq.

    Meet Numo, the service dog

    BRENTWOOD, Tenn. – Numotion has teamed up with Summit Assistance Dog, a nonprofit that provides highly skilled mobility assistance dogs to people living with disabilities, to sponsor its own service dog, Numo. At the end of a two-year training program, Numo will be matched with an individual to help increase his or her independence and confidence. Numo, a nine-month old Labrador Retriever born in Australia, will go through six levels of training. He currently lives on a houseboat with his trainer Geoff in Seattle. You can follow Numo on Instagram at numotheservicedog.


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    09/07/2018
    HME News Staff

    WASHINGTON – A coalition of 20 patient and physician groups is asking CMS to remove liquid oxygen from its competitive bidding program.

    “For too long, patients who require a high-liter flow of oxygen have not been able to leave their homes, jeopardizing their physical and mental health and quality of life,” stated seven organizations leading the coalition. “Everyone deserves the opportunity to live a full and healthy life and, together, we ask CMS to use its existing authority to exclude oxygen from competitive bidding.”

    The coalition, which includes the American Association for Respiratory Care and the American Lung Association, made the argument in comments that it submitted to a recent proposed rule. In the rule, CMS proposes creating two separate payment classes for liquid equipment and liquid contents, in an attempt to increase access to the therapy.

    The coalition commends CMS for its “recognition of numerous problems associated with access to oxygen, in general, and liquid oxygen systems, specifically.”

    “However, our organizations recognize that CMS’s proposal will not, ultimately, solve the problems facing patients—especially those who require liquid oxygen,” the organizations state.

    The coalition says it looks forward to working with CMS and Congress to ensure patients receive the oxygen treatments that they need.

    Other organizations in the group are: Allergy & Asthma Network, Alliance for Patient Access, Alpha-1 Foundation, American Sleep Apnea Association, American Thoracic Society, CHEST/American College of Chest Physicians, Children’s Interstitial Lung Disease Foundation, COPD Foundation, Foundation for Sarcoidosis Research, Hermansky-Pudlak Syndrome Network, LAM Foundation, Lung Transplant Foundation, LUNGevity, National Association for Medical Direction of Respiratory Care, Pulmonary Fibrosis Foundation, Pulmonary Hypertension Association, Tuberous Sclerosis Alliance and U.S. COPD Coalition.

    ASAA details sleep apnea’s impact

    WASHINGTON – The American Sleep Apnea Association released a report on Sept. 5 that details the impact of sleep apnea on patients and families.

    “Raising Voices for Progress in Treatment and Care” is based on first-person accounts shared at the AWAKE meeting in June, and the results of a patient and caregiver survey that attracted 5,630 responses around the country.

    "The powerful testimonies delivered on June 8 and through the survey illustrate the good, the bad, and the ugly of the patient journey with sleep apnea; these testimonies also chart an advocacy agenda to address our community's many and varied unmet needs," said Adam Amdur, ASAA’s chief patient office, in a press release.

    The release of the report coincides with ASAA’s annual Sleeptember awareness events.

    Key findings from the report include:

    ·      Patients rated fatigue (80%) and daytime sleepiness (78%) as the two symptoms with the most severe impact.

    ·      Barriers to diagnosis include low awareness of the condition among the public and medical professionals; lack of access to specialists and sleep testing centers; misperceptions and stigma related to the condition and its treatment; burdensome testing procedures; and financial constraints. Many participants described being symptomatic for years—or decades—before getting diagnosed.

    ·      Obstacles to effective therapy include problems associated with diagnosis, as well as uncomfortable or inconvenient design of therapeutic devices; side effects and other challenges tolerating treatments; inadequate or punitive insurance coverage policies; and misdiagnosis and/or other medical complications.

    ·      CPAP was the most-cited therapy in response to the open-ended survey question, "What have you found that helps the most?" However, persistence was required to determine and maintain effective machine settings, find a well-fitting mask and good seal, and properly clean and maintain equipment. More initial instruction, ongoing support, and better customer service were sought by many CPAP-treated individuals. 

    For more information about Sleeptember awareness activities and other sleep health resources, visit www.sleeptember.org.  

     Medtrade adds bidding track

    ATLANTA – Medtrade has added a track called “The New Competitive Bidding” to its educational lineup, in response to a recent proposed rule that would allow any Medicare-enrolled provider to supply DME to beneficiaries starting Jan. 1, 2019. “If you are considering a dive back into Medicare when the gap period starts, Medtrade is the ideal place to learn literally everything about your options,” said Kevin Gaffney, group show director. The track will address: a historical view of CB and how CB so quickly went off the rails; meaningful changes to CB contained in the anticipated final rule; reimbursement under the anticipated final rule; and practical steps to submit a bid. In addition, the track will have an interactive question and answer session with industry experts. The track is sponsored by Brown & Fortunato and speakers include the law firm’s Jeff Baird and Cara Bachenheimer. It is available to all attendees who purchase an educational conference pass.

    Numotion helps promote Sing Me a Story

    BRENTWOOD, Tenn. – Numotion has partnered with Sing Me a Story Foundation to help share unique stories of kids served by the Muscular Dystrophy Association. Sing Me a Story, a nonprofit organization based in Nashville, Tenn., teams children with songwriters to create wonderful stories and songs. “This is an opportunity to bring together the missions of three organizations in a truly unique and positive way,” said Bret Barczak, chief marketing officer at Numotion. “Allowing kids to be kids by using their creativity, and then having a professional songwriter turn their message into a song that conveys the heart and spirit of these awesome kids was something that we saw as a great opportunity to get involved with and help promote.” Numotion customer and MDA Ambassador Carlee Beam recently met with the Sing Me a Story team to write and illustrate her own story about her family and her journey living with spinal muscular atrophy. Carlee’s personal story was put to music by singer/songwriter Rachael Davis and is called “One Strong Little M’am.”

    Company finds stolen HME for sale on eBay

    BOLIVAR, Mo. – Citizens Memorial Healthcare has terminated an employee after he allegedly stole home medical equipment from the company and listed it for sale on eBay, according to the Bolivar Herald Free Press. The director of CMH’s HME division contacted the Bolivar Police Department to report that three Trilogy 100 vents, which cost $9,000 each, were allegedly stolen and listed for sale on eBay under an account registered to employee Joseph Gambino. Gambino, who faces a class C felony charge in Polk County Circuit Court, had 401 items related to medical equipment listed on his eBay account, the newspaper reported.

    QS/1 tapped for NCPDP program

    SPARTANBURG, S.C. – QS/1 will participate in the Surescripts Early Adopter program for the new National Council for Prescription Drug Program’s (NCPDP) SCRIPT standard version 2017071. The NCPDP SCRIPT standard, which CMS is working to implement in early 2020, is used to securely exchange information between prescribers, dispensers, and Medicare prescription drug plans, including the 4.8 million e-prescriptions that Surescripts transmits each day. “Given QS/1’s experience in implementing previous versions of the NCPDP SCRIPT standard, Surescripts is confident QS/1 will again guide community pharmacies as the January 2020 deadline approaches,” said Mike Pritts, chief product officer for Surescripts, in a press release. QS/1 offers an integrated suite of software solutions for pharmacies and HME providers.

    PFQC launches consumer newsletter

    WATERLOO, Iowa – People for Quality Care has launched a consumer e-newsletter. The monthly newsletter features advocacy and lifestyle articles, and opportunities to self-advocate on legislative initiatives. “The newsletter has been a great tool this summer in keeping HME priorities in top-of-mind awareness for the public and activating them on key calls to action,” said Ashley Plauché, legislative partner for People for Quality Care, a division of VGM Group, and manager of government affairs for AAHomecare. The June edition featured an article about the recently released interim final rule and encouraged readers to reach out to lawmakers. Forty-three percent of those who opened the newsletter, clicked through to send letters to Congress, according to PFQC. To sign up for the newsletter, go here.

    Noridian releases error rates

    FARGO, N.D. – Parenteral nutrition tops the list of error rates recently released by the Jurisdiction D DME MAC Noridian, AAHomecare reports. Codes B4185, B4193, B4197 and B4199 had a 100% error rate from TPE audits for the second quarter of 2019. Right behind parenteral nutrition was surgical dressings with an 86% error rate; hospital beds with a 72% error rate; and glucose monitors with a 65% error rate. AAHomecare did note that the error rates for enteral nutrition (20%) and manual wheelchairs (32%) did improve from the last quarter. Noridian started publishing error rates last October. AAHomecare has been advocating for Jurisdiction B and C DME MAC CGS to also publish quarterly error rates from TPE audits.

    Minnesota backpedals on incontinence program

    SAINT PAUL, Minn. – Minnesota’s Department of Human Services has tabled its plan to implement a preferred provider program for incontinence supplies after MAMES was granted a temporary restraining order on Aug. 24, according to a press release. The program, which was opposed by medical suppliers, disability advocates and the governor, would have awarded a single contract to provide incontinence supplies to Medicaid beneficiaries. “This program posed a mortal risk to dozens of Minnesota small businesses, and the patients they serve,” said Rose Schafhauser, MAMES’s executive director, in a release. “14,000 Minnesotans rely upon the incontinence benefit to maintain their independence. Without high-quality products that fit well, many patients are afraid to leave their homes.”

    NSM expands Lone Star presence

    NASHVILLE, Tenn. – National Seating & Mobility has acquired Seating and Mobility Solutions in Waco, Texas, increasing its presence in the state. “Seating and Mobility Solutions has been a respected Waco-area CRT provider,” said Bill Mixon, NSM CEO. “We look forward to working with their clients and bringing additional services and advanced solutions to the community.” ATPs Robert Morgan and Bill Holt will transition to the NSM team. NSM now has 10 locations in Texas, with branches in Dallas, Austin, Midland, Abilene, Houston, San Antonio, Beaumont and McAllen.

    Sports ‘N Spokes announces photo contest

    PHOENIX – Sports ‘N Spokes, the sports and recreation magazine of the Paralyzed Veterans of America, and Cure Medical, a manufacturer of intermittent catheters, have joined forces on the Wheels UP! accessible travel photo contest. The event kicked off Sept. 1, with a photo contest and prize giveaways. The goal of the campaign, now in its eighth year, is to encourage people with disabilities to explore their world through accessible travel and adaptive sports. “For SPORTS `N SPOKES, the Wheels UP! event is much more than a simple photo contest,” said Christopher Di Virgilio, Wheels UP! co-founder and Sports ‘N Spokes web content manager, in a press release. “It’s a way to bring a community together and encourage people to seek out an active, healthy lifestyle while exploring the world around them.” The contest ends Sept. 14. Submit your photos here.

    Numotion buys large regional complex rehab provider

    BRENTWOOD, Tenn. – Numotion has acquired the complex rehab and home access division of Total Respiratory & Rehab, extending its reach in Nebraska, Iowa and Missouri. Total’s 74 complex rehab and home access employees, including 17 ATPs, will join Numotion. “Numotion’s infrastructure and technologies will ensure our customers have the absolute best and most rapid customer service experience the industry has to offer,” said Jon Novak, CEO of Total. Total, which has been in business for more than 12 years, will continue to provide respiratory services.

    ResMed renews patent battle with F&P

    SAN DIEGO – ResMed has filed a new petition with the U.S. International Trade Commission to stop the alleged infringement of its patented technology by New Zealand-based Fisher & Paykel Healthcare. ResMed seeks an order banning the importation and sale in the U.S. of F&P’s Simplus full-face mask, Eson nasal mask and Eson 2 nasal mask for allegedly infringing five ResMed patents related to mask system and cushion design. ResMed has also filed a new lawsuit in the U.S. District Court for the Southern District of California seeking monetary damages, plus an infringement against future sales. F&P, which will contest the allegations, has cut its fiscal year 2019 net profit outlook due to expected legal expenses, according to news reports.

    CAIRE launches oneCAIRE

    BALL GROUND, Ga. – CAIRE has launched a new global campaign, oneCAIRE, to recognize the individual needs of each business partner. “CAIRE’s consultative-selling style differentiates the CAIRE brand in the marketplace and identifies those programs that are designed to be customizable to fit large, mid-size and small customers,” the company stated in a press release. “Retail Partner Program, Non-Delivery Program, O2 Discharge Program and CAIRE-sponsored training are just some of the things that CAIRE offers to their business partners.” Behind each of these programs is a portfolio of products that includes liquid, stationary, and portable oxygen therapy solutions. Also included: the new telehealth solution, CAIREview powered by SynsorMed.


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