WASHINGTON – AAHomecare is asking government officials to include DMEPOS suppliers in the first group of health care professionals to get vaccinated for COVID-19.        

In letters to officials at the Department of Health and Human Services and leadership at Operation Warp Speed, AAHomecare stressed the close contact that suppliers have with patients in home-based settings and highlighted the important role the industry plays in meeting the challenges posed by the pandemic.  

“DMEPOS suppliers are in patients’ homes every day and play a central role in helping individuals infected with COVID-19 manage their health care needs at home so that hospitals and acute care facilities have the capacity to handle those requiring more intensive care,” the letter states. “In addition to directly interfacing with infected individuals, many of the products and services provided by DMEPOS suppliers require their staff to enter homes with other caregivers or family present to set up the equipment for use.” 

YARMOUTH, Maine – Industry reactions to CMS’s plans not to move forward with the bulk of the competitive bidding program were a mixed bag, but a number of respondents to a recent HME Newspoll say they were disappointed that the agency plays by a “different set of rules.” 

In October, CMS announced that it had dropped 13 product categories from Round 2021 because they did not achieve “expected savings.” 

“It did not impact us too much, except we were upset that CMS plays by a different set of rules when the bid would probably have paid out better for the suppliers,” wrote one respondent. “How does this work? They want their cake and eat it, too? Meanwhile, we as suppliers are struggling to keep up with cost when setting up Medicare patients.” 

Round 2021 was the first round of bidding under a modified program that included lead-item pricing and other changes to make the process fairer. 

For providers who had hoped to see a return to more sustainable reimbursement rates, it was a major blow.  

“I had really hoped that this would be the round where we would see rates increase, which would have had a ripple effect across other payers, so many of which have rates tied to Medicare,” wrote one respondent.  

Looking forward, respondents were evenly split on whether the announcement would have an impact on their strategic plans for 2021. With bid contracts off the table, some are deciding whether they want to stay in the Medicare business. 

“We had categories that we were planning on exiting in competitive bid areas, if we did not receive bids,” wrote one respondent. “Now we are reassessing what we are going to do in those categories. It also solidifies our shift away from competitive bid areas and toward rural areas.” 

At the end of the day, it’s access to HME that will continue to suffer, say respondents. 

“All the money spent on this program, all they did was limit access for beneficiaries,” wrote one respondent. “The issue now is the allowable for the 13 categories remains at the lower-than-cost amounts that the national companies bid, so there is still not going to be sufficient access to needed equipment and services. We field calls all the time with beneficiaries at their wit’s end.” 

WASHINGTON – AdvaMed and CapView Strategies make the case for covering digital health technology under the existing DME benefit in a new 56-page white paper titled “Modernizing Medicare Coverage of Digital Health Technologies.” 

The groups recommend that CMS create a regulatory pathway under the DME benefit for software or an application that is “primarily and customarily” used to serve a medical purpose but can be used on any device that can satisfy the durability requirements, including home computers, smartphones and iPads. This would, effectively, divide the regulatory requirements for DME between the software and the home device used to display the software/application.  

“Our most important finding is that coverage can be modernized through Medicare’s existing benefit structure,” said Lu Zawistowich, president and founder of CapView Strategies, a health policy consulting firm. “No new structures need to be created.” 

The groups recommend that all other non-software components should be covered and coded independently as DME and/or supplies and not bundled into the software supply allowance/payment rate. If software is covered as DME, then major or clinically meaningful updates should be covered as supplies. Currently, routine updates are considered normal/routine servicing of digital health technologies.  

The white paper’s origins go back several years, when a number of digital health companies joined AdvaMed and spoke with the association about exploring possible pathways for Medicare coverage for their technologies. 

“They anticipated challenges in getting Medicare coverage,” said Richard Price, senior vice president of payment and health care delivery policy at AdvaMed. 

And rightly so. The groups point to a broken system that, on the one hand, covers insulin pumps and CGMs, for example, but on the other hand doesn’t cover the algorithm that allows the two devices to speak to each other. 

“(Under the current structure), it’s unclear how the algorithm would be covered, or at all,” Price said. 

The groups point out that digital health has a proven track record. ResMed and their provider partners, for example, have increased the adherence rate for CPAP therapy to 87% and, as a result, reduced costs to the health care system by 50%. 

“Digital health has an incredible return on investment,” said Mick Farrell, CEO of ResMed and AdvaMed board member. 

RICHMOND, Va. – Virginia Gov. Ralph Northam has signed into law a state budget that includes an amendment requiring Medicaid managed care organizations to reimburse at no less than 90% of the state Medicaid fee schedule for DME.  

The Atlantic Coast Medical Equipment Services Assocation, VGM and AAHomecare worked on the effort for more than year. “Virginia providers stepped up to the plate when called upon to get the job done which is an illustration of the power of a state association at work,” said Beth Bowen, ACMESA executive director. “What a great win for Virginia’s DME community and the patients they serve.”  

It’s the latest win for providers across the country working to stabilize Medicaid rates, says David Chandler, director of payer relations for AAHomecare. 

"This win for DME in Virginia is another great example of what we can achieve when we develop a game plan and work together,” he said. 

LUCI named ‘Best Invention’ 

NASHVILLE – LUCI, a mobility technology platform, has been named to Time Magazine’s annual list of the 100 Best Inventions. “This is an incredible honor, and one we would have never considered when my brother Jered and I started tinkering with my daughter’s wheelchair in the kitchen three years ago,” said Barry Dean, CEO of LUCI. “The most exciting part of being included in this list is having the opportunity to bring more attention and, hopefully, more innovation to the world of power wheelchair users.” For 2020’s list, Time solicited nominations from its editors and correspondents around the world, and through an online application process. It then evaluated them on factors including originality, effectiveness, ambition and impact. LUCI’s hardware mounts onto a power wheelchair between the power base and the seat, and helps users avoid collisions and dangerous drop-offs while maintaining personalized driving control. The patented sensor-fusion system combines data from cameras, ultrasonic sensors and radar into a single, 360-degree view of the world, giving riders independence and safety. 

Study: Power mobility devices empower kids 

LEBANON, Tenn. – Power mobility devices can help young children with mobility impairments develop cognitive, reasoning and spatial skills, according to a new study published in “Physical & Occupational Therapy in Pediatrics.” The study, which was funded by Permobil, looked at 33 children aged between 6 months to 36 months who experience mobility limitations. It found that young children demonstrated self-initiated mobility through the use of a powered mobility device, in this case, the Explorer Mini from, Permobil, and that the device was instrumental in promoting exploratory behaviors. “The pediatric chair helps young children develop a sense ofs independence and the desire to explore, learn, and challenge their existing skill set,” said Dr. Teresa Plummer, lead author of the study.  “Once they discover that the world exists beyond their outstretched arm, they are set on a trajectory of rapid advancement of spatial skills, learning depth perception, directionality and laterality. These are all essential skills for visual development, reading and understanding how they fit into the world around them.” The Explorer Mini received 510k clearance from the U.S. Food and Drug Administration in February 2020.   

Dentists, sleep docs differ on HST 

YARMOUTH, Maine ­– The American Academy of Dental Sleep Medicine has issued a position statement that says dentists should be allowed to order or administer home sleep tests, something the American Academy of Sleep Medicine disagrees with, according to an article published in the Sleep Review. The AADSM states: “It is within the scope of practice for a qualified dentist, defined by the American Dental Association (ADA) as a dentist treating sleep-related breathing disorders who continually updates his or her knowledge and training of dental sleep medicine with related continuing education, to order or administer home sleep apnea tests (HSATs).” The AASM, for its part, states that a home sleep apnea test is used as a medical assessment and its use must be preceded by a comprehensive sleep evaluation by a medical provider. This medical evaluation should include an assessment for chronic diseases and conditions that are associated with increased risk for obstructive sleep apnea, including hypertension, stroke, and congestive heart failure. 

AAHomecare asks feds to prioritize DMEPOS suppliers 

WASHINGTON – AAHomecare is asking government officials to include DMEPOS suppliers in the first group of health care professionals to get vaccinated for COVID-19.        

In letters to officials at the Department of Health and Human Services and leadership at Operation Warp Speed, AAHomecare stressed the close contact that suppliers have with patients in home-based settings and highlighted the important role the industry plays in meeting the challenges posed by the pandemic.  

“DMEPOS suppliers are in patients’ homes every day and play a central role in helping individuals infected with COVID-19 manage their health care needs at home so that hospitals and acute care facilities have the capacity to handle those requiring more intensive care,” the letter states. “In addition to directly interfacing with infected individuals, many of the products and services provided by DMEPOS suppliers require their staff to enter homes with other caregivers or family present to set up the equipment for use.” 

AAHomecare pushes sequestration, budget neutrality 

WASHINGTON ­– AAHomecare is asking members to use its Action Center to register support for extending a moratorium on Medicare sequestration cuts, which is set to expire Dec. 31. AAHomecare is also urging them to register support for H.R. 8158, a bill introduced by Reps. Cathy McMorris Rodgers, R-Wash., and Dave Loebsack, D-Iowa that would remove the budget neutrality requirement for oxygen in rural areas. In September, the House Energy & Commerce Committee approved H.R. 8158. The association would like to see both measures advance before Congress adjourns in December. 

OMHA reduces ALJ backlog 

WASHINGTON – The Office of Medicare Hearings and Appeals is back to operating at full capacity and is making its way through a backlog of appeals at the Administrative Law Judge level, AAHomecare reports. As of Oct. 31, 2020, there are about 85,000 DMEPOS appeals pending at the ALJ, a decrease of 51% compared to nearly 173,000 in 2019. OMHA also reported that the average wait time for an ALJ hearing is still four years, but it believes that should decrease as judges work their way through the backlog. OMHA is required to eliminate the backlog by 2020. 

Quality Biomedical launches supply chain program 

BOULDER, Colo. – Quality Biomedical has developed an integrated supply chain management program for respiratory equipment across its eight warehouse facilities. Critical services available include pick-up and delivery, preventative and corrective maintenance, storage, cleaning, and same-day deployment using its web-based portal, Q-Connect. “Although this program has broad industry appeal in general, the benefits of maintaining and deploying patient-ready equipment via a national network of distributed service centers and warehouses has been highlighted due to COVID,” said Jim Worrell, chief commercial officer. “COVID underscored the need for rapid deployment of critical respiratory equipment getting to hot spots or other areas where demand for equipment is spiking.” 

What’s your financial score? 

WASHINGTON – HME providers that submitted bids for Round 2021 of competitive bidding now have the ability to view their financial score in Connexion. As part of the bid process, the competitive bidding implementation contractor evaluated a bidder’s financial health by reviewing financial documents and calculating a financial score. The financial score is available to all bidders, even those that bid on the 13 product categories that were recently removed from the bid program. AAHomecare encourages providers to review their financial score to see how they performed during the bid process. “The financial score will also be helpful for bidders in submitting bids in future rounds,” the association wrote in a recent bulletin. 

ATS makes recommendations on home oxygen therapy for COPD 

NEW YORK – The American Thoracic Society has posted online its latest clinical practice guideline on home oxygen therapy, addressing long-term and ambulatory therapy for adults with COPD. 

The guideline makes the following recommendations: 

• In adults with COPD who have severe chronic resting room air hypoxemia, we recommend prescribing long-term oxygen therapy at least 15 hours per day. 

• In adults with COPD who have moderate chronic resting room air hypoxemia, we suggest not prescribing LTOT. 

• In adults with COPD who have severe exertional room air hypoxemia we suggest prescribing ambulatory oxygen. 

“Oxygen is a common, yet burdensome, equipment-laden therapy, so if we are going to prescribe it, there should be enough evidence that we can tell our patients what they should expect in terms of improving their symptoms, and the quality and quantity of their lives,” said Susan Jacobs, MS, RN, co-chair of the guideline committee and a research nurse manager in pulmonary, allergy and critical care medicine at Stanford University. 

The guideline, also published in the Nov. 15 issue of the American Journal of Respiratory and Critical Care Medicine, was borne out of an ATS workshop in 2017 on Optimizing Home Oxygen Therapy data, which “identified the lack of evidence-based clinical practice guidelines for appropriate use of home oxygen as a critical gap,” wrote the committee. 

The guideline also includes recommendations for liquid oxygen. In patients with chronic lung disease who are mobile outside of the home and require continuous oxygen flow rates of less than 3L/minute during exertion, the ATS suggests prescribing portable liquid oxygen. 

Additionally, the guideline makes recommendations for adults with interstitial lung disease. 

Gov’t takes down scheme involving kickbacks, straw companies 

NEWARK, N.J. – The ownhttps://oig.hhs.gov/oei/reports/OEI-03-21-00050.asper of a group of DME companies has admitted his role in a conspiracy to pay kickbacks in exchange for DME, the U.S. Attorney’s Office for the District of New Jersey has announced. Albert Davydov, 28, of Rego Park, N.Y., has pled guilty by videoconference before a U.S. district judge to an indictment charging him with conspiring to violate the Anti-Kickback statute. Davydov, the owner of nine DME companies, participated in a scheme to pay kickbacks in exchange for orders from doctors for medical unnecessary orthotic braces. Once Davydov and his conspirators received the completed orders, they billed Medicare and other federal and private health care benefit programs for the braces. Davydov concealed his ownership of the DME companies by falsely reporting to Medicare that various straw owners owned the companies. As part of his plea agreement, Davydov has agreed to pay back more than $16 million. 

OIG provides latest pricing update on Part B drugs 

WASHINGTON – Seven codes for Medicare Part B drugs met CMS’s price substitution criteria by exceeding the 5% threshold for two consecutive quarters or three of the previous four quarters, according to a new report from the Office of Inspector General. The OIG is providing the seven codes to CMS for its review. It says CMS should review this information to determine whether or not to pursue price substitutions that would limit excessive payments for Part B drugs. The OIG conducted its study by obtaining second quarter ASP and AMP data for Part B drugs, and calculating the volume-weighted AMP for each drug, consistent with CMS’s methodology for calculating volume-weighted ASPs. It then compared the volume-weighted ASPs and AMPs, and identified all drugs with complete data for which the ASPs exceeded the AMPs by at least 5%. The OIG also identified drugs that met CMS’s duration criteria for price substitution, meaning they exceeded the threshold in the two previous quarters or three of the previous four quarters. 

CMS touts decreased improper payment rate 

WASHINGTON – CMS says its aggressive corrective actions have led to an estimated $15 billion reduction in Medicare fee-for-service improper payments since 2016. 

The Medicare fee-for-service estimated improper rate decreased to 6.27% in fiscal year 2020, compared to 7.25% in FY 2019, the fourth consecutive year the rate has been below the 10% threshold for compliance established in the Payment Integrity Information Act of 2019. 

“We must ensure that fraud and abuse doesn’t rob the program of precious resources,” said CMS Administrator Seem Verma. “From the beginning, this administration has doubled down on our commitment to protect taxpayer dollars and this year’s continued reduction in Medicare improper payments is a direct result of those actions.” 

CMS says the reduction is the result of efforts to identify root causes of improper payments, implement action plans to reduce and prevent improper payments, and extend the agency’s capacity to address emerging areas of risk through work groups and interagency collaborations. 

One example of activities that have helped to reduce the improper payment rate: home health improvements, including clarifying documentation requirements and educating providers through the Targeted Probe and Educate program, which resulted in a $5.9 billion decrease in estimated improper payments from FY 2016 to FY 2020. 

CMS has developed a five-pillar program integrity strategy to modernize its approach to reducing improper payments, it says: 

• Stop bad actors: CMS works with law enforcement agencies to crack down on “bad actors” who have defrauded federal health programs. 

• Prevent fraud: Rather than the expensive and inefficient “pay and chase” model, CMS prevents and eliminates fraud, waste and abuse on the front end by proactively strengthening vulnerabilities before they are a problem. 

• Mitigate emerging programming risks: CMS is exploring ways to identify and reduce program integrity risks related to value-based payment programs by looking to experts in the health care community for lessons learned and best practices. 

• Reduce provider burden: To assist rather than punish providers who make good faith claim errors, CMS is reducing the burden on providers by making coverage and payment rules more easily accessible to them, educating them on CMS programs and reducing documentation requirements that are duplicative or unnecessary. 

• Leverage new technology: CMS is working to modernize its program integrity efforts by exploring innovative technologies like artificial intelligence and machine learning, which could allow the Medicare program to review compliance on more claims with less burden on providers and less cost to taxpayers. 

Great Elm shows improvement 

WALTHAM, Mass. – Great Elm Capital Group has reported first quarter revenue for DME grew 10.4% year over year and 5% sequentially, results that show the company’s ability to grow despite the negative impact of the COVID-19 pandemic, officials say. Great Elm reported a net loss for DME of $500,000 vs. $800,000 year over year, and an adjusted EBITDA of $2.8 million vs. $3 million year over year. “We made significant progress toward achievement of our strategic goals for both our DME and Investment Management businesses during the quarter,” said Peter Reed, CEO. “DME added key management talent, continued to improve operationally and is actively pursuing attractive add-on acquisition opportunities.” During the first quarter, Great Elm’s PAP supply rates remained strong, while rental revenues continued to be negatively impacted by suppressed referral pipelines for new equipment setups during the pandemic. Looking forward, company officials remain focused on exploring ways to lower the cost of capital and obtaining additional funds for potential future acquisitions. 

Philips survey shows respiratory health is more of a priority 

AMSTERDAM, the Netherlands – The COVID-19 pandemic has created unique challenges for the COPD community, but it has also increased awareness of the condition and pushed patients to pursue alternative care options, according to the first ever World COPD Day survey by Royal Philips. “Despite impacting millions of people around the world, COPD isn’t talked about as often as other chronic conditions like heart disease,” said Huiling Zhang, head of medical office for connected care at Philips. “We conducted this survey to shed light on the unique burdens and stresses that COPD patients face every day, intensified during this time. The survey results show that more than ever, respiratory health – and taking action to improve it – is a priority, but that the impacts of the pandemic have been especially felt by the COPD community, whom we work so hard to support with our respiratory solutions.” Philips surveyed more than 4,000 adults in China, India, Russia and the U.S. Fifty six percent of COPD patients report COVID-19 has made it difficult for them to get treatment, 58% report that managing their COPD during the pandemic has been completely overwhelming, and 68% report they worry much more than they used to about their chronic condition because of the pandemic, according to the survey. The number of respondents familiar with COPD increased from 52% prior to the pandemic to 72% today, according to the survey. Other highlights: The willingness for telehealth visits has been on the rise due to the pandemic, particularly for wellness visits (56% to 62%), regular check-ins for chronic health issues (57% to 64%) and new health issue (57% to 63%); and COPD patients have looked for better ways to manage their condition due to the pandemic (75%). 

York Schwab to lead Medtrade shows 

ATLANTA – Medtrade officials have named York Schwab their new show director. Schwab, who was formerly an account executive, replaces Mark Lind, who left to pursue another opportunity. Schwab says he is hopeful about the opportunities in the HME industry, including for Medtrade’s two flagship events, Medtrade East and Medtrade West. “Coming out of COVID, face-to-face trade shows have never been more important,” he said. “You don’t know what you’ve got ‘til it’s gone. Ultimately, showing is always more powerful than telling.” Schwab has served major clients like Pride Mobility and VGM as an account executive for Medtrade for the past four years. He has a bachelor’s degree in political science from East Carolina University, and an extensive background in manufacturing and distribution. 

RICHMOND, Va. – Virginia Gov. Ralph Northam has signed into law a state budget that includes an amendment requiring Medicaid managed care organizations to reimburse at no less than 90% of the state Medicaid fee schedule for DME.  

The Atlantic Coast Medical Equipment Services Assocation, VGM and AAHomecare worked on the effort for more than year. “Virginia providers stepped up to the plate when called upon to get the job done which is an illustration of the power of a state association at work,” said Beth Bowen, ACMESA executive director. “What a great win for Virginia’s DME community and the patients they serve.”  

It’s the latest win for providers across the country working to stabilize Medicaid rates, says David Chandler, director of payer relations for AAHomecare. 

"This win for DME in Virginia is another great example of what we can achieve when we develop a game plan and work together,” he said. 

WASHINGTON – CMS has finalized a number of changes to the Stark Law, including new permanent exemptions for value-based arrangements, in a 627-page final rule set to be published in the Federal Register on Dec. 2. 

The exemptions will allow physicians and other health care providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law, CMS says. 

“When we kicked off our Patients Over Paperwork initiative in 2017, we heard repeatedly from front-line providers that our outdated Stark regulations saddled them with costly administrative burdens and hindered value-based payment arrangements,” said CMS Administrator Seema Verma. “That sound you hear is the mingled cheers and exclamations of relief from doctors and other health care professionals across the country, as we lift the weight of our punishing bureaucracy from their backs.” 

CMS published a request for information in June 2018 seeking input from stakeholders about how to address regulatory barriers to a value-based health care payment and delivery system under the Stark Law. The agency then published a proposed rule in October 2019 proposing sweeping reforms of the regulations that interpret the Stark Law. 

Other changes to the Stark Law include: 

• Finalizing additional guidance on key requirements of the exceptions to the physician self-referral law to make it easier for physicians and other health care providers to make sure they comply with the law. 
• Finalizing protection for non-abusive, beneficial arrangements that apply regardless of whether the parties operate in a fee-for-service or value-based payment system, such as cybersecurity technology that safeguards the integrity of the health care ecosystem. 
• Reducing administrative burdens that drive up costs by taking money previously spent on administrative compliance and redirecting it to patient care. 

Unless specified in the rule, all of the changes go into effect 60 days from the rule being published in the Federal Register. 

WASHINGTON – CMS has finalized a number of changes to the Stark Law, including new permanent exemptions for value-based arrangements, in a 627-page final rule set to be published in the Federal Register on Dec. 2. 

The exemptions will allow physicians and other health care providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law, CMS says. 

“When we kicked off our Patients Over Paperwork initiative in 2017, we heard repeatedly from front-line providers that our outdated Stark regulations saddled them with costly administrative burdens and hindered value-based payment arrangements,” said CMS Administrator Seema Verma. “That sound you hear is the mingled cheers and exclamations of relief from doctors and other health care professionals across the country, as we lift the weight of our punishing bureaucracy from their backs.” 

CMS published a request for information in June 2018 seeking input from stakeholders about how to address regulatory barriers to a value-based health care payment and delivery system under the Stark Law. The agency then published a proposed rule in October 2019 proposing sweeping reforms of the regulations that interpret the Stark Law. 

Other changes to the Stark Law include: 

• Finalizing additional guidance on key requirements of the exceptions to the physician self-referral law to make it easier for physicians and other health care providers to make sure they comply with the law. 

• Finalizing protection for non-abusive, beneficial arrangements that apply regardless of whether the parties operate in a fee-for-service or value-based payment system, such as cybersecurity technology that safeguards the integrity of the health care ecosystem. 

• Reducing administrative burdens that drive up costs by taking money previously spent on administrative compliance and redirecting it to patient care. 

Unless specified in the rule, all of the changes go into effect 60 days from the rule being published in the Federal Register. 

Hospice Source buys Superior Healthcare 

CARROLLTON, Texas – Hospice Source, a provider of DME to the hospice market, has acquired Superior Healthcare in Marinez, Calif. The deal furthers Hospice Source’s position as the largest provider of DME to the hospice market in California, the company says. “The acquisition of Superior Healthcare allows us to extend our passion for service to a greater number of northern California hospice patients and hospice partners,” said Jeff West, CEO of Hospice Source. “We welcome our new team members, hospice partners and patients to the Hospice Source family.” Hospice Source currently provides service to patients and hospice providers in multiple states from 62 locations. It is a portfolio company of Transition Capital Partners, a Dallas-based private investment firm. 

Sleeplay takes ‘unconventional approach’ 

MIAMI – Sleeplay is a new CPAP shop for all things sleep, wellness and comfort. The company says it provides customers with an easy-to-use website, and convenient features like complimentary equipment troubleshooting and digital prescription uploads. “Sleeplay’s unconventional approach to a somewhat archaic industry is exactly what this market needs and truly distinguishes us from other organizations in the space,” said Liliane Fuhrman, owner of Sleeplay. The website features hundreds of curated products for those with and without sleep apnea, including travel-size CPAP machines, CPAP cleaners, eye masks, weighted blankets and travel pillows. Top products include ResMed AirMini AutoSet Travel CPAP Machine, Philips Respironics DreamStation Auto CPAP Machine with Heated Humidifier, Fisher & Paykel Evora CPAP Mask, Snugell Ergonomic CPAP Pillow and SoClean Device Disinfector. 

DarioHealth hits milestone in B2B market 

NEW YORK – DarioHealth has signed a contract to provide its digital therapeutics solution to eligible employees of a Fortune 500 technology company. Dario will be available to eligible employees and dependents effective Jan. 1, 2021. “This contract, awarded through an RFP process that included Dario’s largest competitors, represents an important milestone in our strategic shift toward the business-to-business-to-consumer market comprised of self-insured employers, health care provider networks and insurance plans,” said Rick Anderson, president and GM of North America. Dario says employees will benefit from a therapeutic approach that delivers adaptive, personalized experiences designed to drive behavior change through intuitive, clinically proven digital tools and coaching.  

Oventus Medical becomes ‘preferred supplier’ for VGM members 

BRISBANE, Australia – Oventus Medical has signed a marketing agreement with VGM & Associates. Per the agreement, VGM has named Oventus Medical as a preferred supplier of oral appliance therapy and will promote the company’s “lab-in-lab” program to its 2,500-plus members with 7,000-plus locations. “The difficulties associated with CPAP therapy and optimum patient care are well understood,” said Scott Owen, senior vice president of contracting for VGM & Associates. “By working with Oventus, the introduction of a program that offers oral appliance therapy as alternative to CPAP enables our members to better support both their patients and referral sources, while strengthening their revenue base.” The agreement is initially for a one-year term, with an automatic annual renewal, unless a party elects not to renew 90 days prior to the end of that term. Oventus Medical expects to start the process of launching its LIL program to VGM members in January. It believes the agreement will make “a large contribution to growth” next year. Under Oventus Medical’s LIL l program, dentists take scans of the mouths of patients within hybrid sleep facilities, which also offer DME, to fit them for oral devices. 

American Medical Depot auctions inventory 

NEW YORK – Tiger Capital Group, a financial services firm providing assets appraisal, liquidation exits and inventory auctions, will conduct online auctions in December for the remaining $7 million in inventory, plus other assets, from two East Coast facilities operated by American Medical Depot, a distributor of medical equipment and supplies that is closing. Tiger Capital will conduct auctions for the assets of the company’s 30,500-square-foot facility in King of Prussia, Pa., and 77,500-square-foot facility in Tampa on Dec. 2 and 16, respectively. These auctions follow a previous auction on Nov. 13 for AMD’s assets from a facility in Vernon, Calif. Items up for bid range from PPE to medical gloves to catheters from manufacturers like 3M, Medline and Becton Dickinson. 

Aeroflow donates to inclusive playground 

ASHEVILLE, N.C. – Aeroflow Healthcare has donated $10,000 to help make a playground at Lake Tomahawk Park in Black Mountain, N.C., inclusive to children with physical disabilities. Aeroflow partnered with Noah Lewkowicz, a local Eagle Scout and high school junior, on the project. “Noah began his Eagle Scout project two years ago, just a few years prior to a close family friend being in a near-fatal crash, which left him unable to walk,” said Wendy Lewkowicz, Noah’s mother. “The community rallied behind Noah to raise a few thousand dollars but was left with a gap of $10,000 to meet necessary ADA requirements. That’s when Aeroflow swooped in to offer their support.” The project entailed replacing mulch with a poured surface, creating ADA-approved concrete ramps for entry, and adding a hardback swing. The playground re-opened the weekend of Nov. 20. 

WASHINGTON – CMS permanently expanded certain telehealth services, leveraging an “explosion of innovation” during the COVID-19 pandemic, in a final rule released Dec. 1. 

In in its annual Physician Fee Schedule final rule, the agency adds more than 60 services to the Medicare telehealth list that will continue to be covered beyond the end of the public health emergency. 

“During the COVID-19 pandemic, actions by the Trump Administration have unleashed an explosion in telehealth innovation, and we’re now moving to make many of these changes permanent,” said HHS Secretary Alex Azar. “Medicare beneficiaries will now be able to receive dozens of new services via telehealth, and we’ll keep exploring ways to deliver Americans access to health care in the setting that they and their doctor decide makes sense for them.” 

Before the pandemic, only 15,000 fee-for-service beneficiaries each week received a Medicare telemedicine service. But between mid-March and mid-October of this year, more than 24.5 million out of 63 million beneficiaries and enrollees have received a Medicare telemedicine service. 

CMS has covered 144 telehealth services, such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, through the end of the PHE. 

AMARILLO, Texas – CMS’s recent reforms to the Anti-Kickback Statute and the Stark Law will benefit HME providers, but “not a whole lot,” says healthcare attorney Jeff Baird. 

The agency in late November published two final rules, culminating a years-long process of modernizing regulations to better support coordinated and value-based care, but they mostly impact physicians and hospitals. 

Baird, chairman of the Health Care Group at Brown & Fortunato, drilled down to how the reforms impact HME providers, specifically. 

Anti-Kickback Statute 

One new safe harbor under the Anti-Kickback Statute that will impact HME providers is the “care coordination” safe harbor, which now allows providers to receive or provide something of value to another provider without violating the Anti-Kickback Statute, if certain conditions are met, Baird says. 

Other safe harbors that will impact HME providers, he says: the “cybersecurity” safe harbor, which now allows providers to donate certain technology and services “that are necessary” to referral sources; and the “personal services and management contract” safe harbor, which now allows providers to set a methodology, but not necessarily a specific compensation, for contracts in advance. 

“We’ve had this confluence of forces coming together, where value-based care, for that to be successful, providers have to work together,” Baird said. “So you have value-based care pushing providers to work together, but at the same time, you have the Anti-Kickback Statute saying if you work together and share something of value, it’s a kickback. That is a problem. You’ve got two opposing forces. Finally, they’ve come out and said, ‘OK, let’s relax the statute.’”  

Stark Law  

There are three new exceptions under the Stark Law and only one of them really applies to HME providers, Baird says. This exception allows providers to spend up to $5,000 to a physician for services rendered in a 12-month period. 

“It’s important that (the services) can’t be made up,” he said. “But if XYZ wants to pay up to $5,000 to Dr. Jones for legitimate services, there aren’t going to be any questions. If XYZ pays more than $5,000, those may be questioned. There’s a risk CMS may come in and say, ‘Wait, why did you pay more than $5,000,’ and you’ll need to justify what the physician has done for you. But basically, you’ve got real protection.” 

Baird noted that there is a modification to an existing exception that applies to HME providers. CMS has modified the definition of commercially reasonable to say that an arrangement between an HME company and a physician is commercially reasonable if it furthers the legitimate business purposes of those two entities, but it doesn’t have to produce a profit. 

“It can be at a loss for one or both parties, as long as patients are being taken care of,” he said. “It used to be that you couldn’t have a loss. You had to break even or make a profit.” 

DARIEN, Ill. – The American Academy of Sleep Medicine has created a Congressional Sleep Health Caucus to promote healthy sleep and the importance of high-quality, patient-centered care for patients.  

The caucus is co-chaired by Reps. Zoe Lofgren, D-Calif., and Rodney Davis, R-Ill. 

 “As we deal with the unique challenges and added stress brought on by the COVID pandemic, the necessity of good, quality sleep is all too clear,” said Lofgren. “Insufficient sleep has been associated with various mental and physical health challenges, and it’s clear that sleep hygiene is a matter of public health. I look forward to working with my colleague, Rep. Rodney Davis, to highlight and promote sleep research at a federal level through the Congressional Sleep Health Caucus.”  

The caucus will help improve sleep health by highlighting the: 

• Importance of healthy sleep for overall health, well-being, productivity, and public safety 

• Prevalence of sleep disorders, such as obstructive sleep apnea, and effectiveness of treatments, such as positive airway pressure (PAP) therapy 

• Availability of expertise from the sleep team at accredited sleep facilities 

• Discoveries generated by sleep and circadian research 

The caucus will host congressional briefings on topics such as the elimination of daylight saving time, student sleep health and school start times, and sleep health disparities. 

“The establishment of the Congressional Sleep Health Caucus is an important milestone for the field of sleep medicine, and I am grateful to Rep. Lofgren and Rep. Davis for their leadership,” said AASM President Dr. Kannan Ramar. “The caucus will amplify our messages and strengthen our advocacy efforts on Capitol Hill.” 

Sullivan Health buys Progress Mobility  

ORLANDO, Fla. - Sullivan Health Holdings has closed on its first acquisition: Progress Mobility, an Orlando, Fla.-based provider of scooters, wheelchairs, hospital beds and lift chairs. 

Sullivan Health Holdings is building a network of HME providers, with a goal of closing on five or more acquisitions in the next 12 to 18 months. 

“Progress Mobility is a very unique company that is one of the country’s leaders in online mobility sales,” said Asim Akhtar, CEO and principal of Sullivan Health. “They have a phenomenal staff, great technology and a unique position in the market that we hope to grow alongside their team in coming years. With the way the world is going, we here at Sullivan believe the ability to purchase mobility online versus in-store will be paramount to success in 2021 and beyond.” 

Progress Mobility buys equipment “by the container full” and keeps more than $2 million worth of inventory on hand, it says on its website, allowing the company to pass on savings to customers. 

Sullivan Health Holdings already has LOIs with other acquisition targets. 

“Our goal at Sullivan Health Holdings is to embrace forward-thinking companies and leaders,” Akhtar said. 

CMS finalizes telehealth expansion 

WASHINGTON – CMS permanently expanded certain telehealth services, leveraging an “explosion of innovation” during the COVID-19 pandemic, in a final rule released Dec. 1. 

In in its annual Physician Fee Schedule final rule, the agency adds more than 60 services to the Medicare telehealth list that will continue to be covered beyond the end of the public health emergency. 

“During the COVID-19 pandemic, actions by the Trump Administration have unleashed an explosion in telehealth innovation, and we’re now moving to make many of these changes permanent,” said HHS Secretary Alex Azar. “Medicare beneficiaries will now be able to receive dozens of new services via telehealth, and we’ll keep exploring ways to deliver Americans access to health care in the setting that they and their doctor decide makes sense for them.” 

Before the pandemic, only 15,000 fee-for-service beneficiaries each week received a Medicare telemedicine service. But between mid-March and mid-October of this year, more than 24.5 million out of 63 million beneficiaries and enrollees have received a Medicare telemedicine service. 

CMS has covered 144 telehealth services, such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, through the end of the PHE. 

FSB’s Pinnacle Medical sells to AdaptHealth 

CHICAGO – FSB Companies has sold its portfolio company Pinnacle Medical Solutions, a provider of diabetes management supplies, to AdaptHealth. 

Pinnacle, which will continue to operate under its current name and location in Southaven, Miss., primarily serves patients in the Southeast, offering CGMs, insulin pumps and other diabetic supplies. 

“It was an honor to be part of the Pinnacle team and build something special,” said Frank Brumfield, CEO and owner of FSB. “The Pinnacle-FSB teams were able to work together to create an exceptional company that provides outstanding quality service to patients, payers and manufacturers. We were able to leverage technology, perfect workflows and build an incredible culture that we are proud to transition to AdaptHealth.” 

AdaptHealth announced earlier this week that is it acquiring AeroCare Holdings. 

Allina Health sells to AdaptHealth 

ST. PAUL, Minn. - Allina Health is selling its HME division to AdaptHealth, according to ABC Newspapers. The purchase includes Allina’s Home Oxygen & Medical Equipment Division, also known as HOME. “We are extremely proud of the work and commitment of our Home Oxygen & Medical Equipment staff,” said Lisa Shannon, president and COO of Allina Health. “We are excited about AdaptHealth’s deep industry expertise and resources to grow and invest in the division.” HOME has a showroom in St. Paul, Minn., and a presence in seven other cities in Minnesota. 

Medtronic launches discount program 

DUBLIN - Medtronic has launched a CGM Access Discount program that allows users without insurance coverage or those who switched insurance or lost coverage to access discounted out-of-pocket costs for a Medtronic CGM. The discount enables eligible patients to pay $180 for a Medtronic CGM (with a 12-month warranty) and $60/month for sensors. For more information on the program, click here. In October, CMS announced proposed changes that, if finalized, would expand Medicare coverage for CGMs. Earlier this year, Medtronic expanded its Medtronic Assurance program for U.S. customers who lose their jobs and health insurance due to the COVID-19 pandemic. Current eligible customers can receive a three-month supply of sensors, infusion sets and reservoirs at no cost.  

Stratice, Kno2 partnership eliminates barrier to information flow 

CARMEL, Ind. - A new partnership connects Stratice Healthcare’s eOrdersPlus with Kno2’s Interoperability as a Service. Health care professionals will be able to seamlessly create and receive complete, compliant medical orders, enabling rapid fulfillment of orders and integrating those orders into patient charts. By partnering with Kno2, Stratice is removing barriers to the flow of information between a care provider’s EHR and existing clinical workflows in eOrdersPlus. Additionally, Kno2’s network will offer real-time access to millions of patient records, allowing for a complete order with the back and forth of phones and faxes. “Our partnership with Kno2 greatly accelerates Stratice’s mission to serve as the industry’s sole open, completely neutral care coordination hub filling the gap between ‘eReferral’ platforms and the transmission of complete, compliant orders for a wide array of patient care needs based on true patient and prescriber choice,” said Jason Farmer, CEO of Stratice. 

NRRTS partners with Canadian association 

LUBBOC, Texas - NRRTS has partnered with the Canadian Assistive Devices Association to develop a Canadian standard for complex rehab technology services. “The complex rehabilitation technology industry in Canada is thriving and our partnership with NRRTS will enable us to ensure that we can provide the highest levels of service to our clients and partners while maintaining a level of professionalism and knowledge that having a NRRTS designation requires” said Erin Roberts, executive director, CADA. The program was formally introduced at the CADA AGM on Nov. 17. NRRTS provides a mechanism for consumers, clinicians and third-party payers to identify qualified suppliers who provide high-quality complex rehab technology and related services to people with physical disabilities. “NRRTS promotes the highest standard of ethical conduct by its registrants,” said Weesie Walker, executive director of NRRTS. “We are extremely proud to be working with CADA on launching a Canadian standard that upholds these mutual beliefs.” 

Nonin recognized by Inc. Magazine 

MINNEAPOLIS – Nonin Medical has been named to Inc.’s inaugural Best in Business list in the health products category. The list is meant to honor companies that have gone above and beyond to make a difference. "I couldn't be prouder of what the incredible employees at Nonin have done to address the needs of the health care industry during these trying times,” said Dave Hemink, CEO of Nonin Medical, a manufacturer of pulse oximeters. “Having Nonin named to Inc.'s Best in Business for Health Products is a reflection of the agility and dedication Nonin employees have to helping improve patient outcomes and quality of life worldwide."  

180 Medical names scholarship recipient 

OKLAHOMA CITY, Okla. – 180 Medical, a provider of intermittent catheters, incontinence products and ostomy supplies, has announced that Yousra Mohamed has become the first student to receive their new Caregiver Scholarship. The scholarship aims to help college students who are currently unpaid caregivers of a family member or loved one with a chronic disability. “We’re so proud to be able to assist Yousra with her goals through our new Caregiver Scholarship program,” said Mark Jassey, chief commercial officer. “We’re sure her experience as a caregiver from such an early age will influence her dedication to care and compassion both at school, among her peers, and in her future career.” Mohamed began her freshman year at the University of Southern California this fall with the help of the 180 Medical Ron Howell Caregiver Scholarship of $1,000. The scholarship is named after 180 Medical’s former president, Ron Howell, who retired from the company after nearly 15 years. 

Baxter buys SleepGlad 

COLUMBIA, Tenn. - Baxter Management has bought SleepGlad, a cloud-based CPAP mask fitting and initial CPAP management platform for HME providers. The technology, which only requires patients to take a “selfie,” is manufacturer neutral, meaning providers can customize and add preferences from ResMed, Philips Respironics, Fisher & Paykel Healthcare or 3B Medical. “We are excited to have SleepGlad join our family of companies,” said David Baxter, owner. “We look forward to the continued growth of this phenomenal product, while contributing to positive outcomes in sleep health and patient care.” Akhil Raghuram, MD, formed SleepGlad this year with the goal of optimizing mask fittings during sleep studies in his sleep lab. The acquisition allows for a “complete and seamless” remote CPAP setup and replenishment through Baxter’s sister company, S3 Resupply, according to a press release. 

Virtis Health expands into Illinois 

WOODRIDGE, Ill. - Virtis Health, an alternate site of care company offering treatment, clinical management and administration of specialty infusion and injectible medications in an ambulatory infusion center (AIC) setting, has opened its first site in the Chicagoland area. The site, staffed with licensed infusion-specialist nurse practitioners, offers a range of therapy management services, including immunoglobulin treatments for primary immunodeficiencies and autoimmune disorders. Concurrent with the opening, Virtis Health has appointed Stacey Boetto as a nurse practitioner to oversee the company's AIC. She founded Faire Health, where she served as a full-practice authority nurse practitioner at several locations throughout Illinois. Virtis Health currently operates six locations, with four AICs in Arizona (Glendale, Scottsdale, Tempe and Tucson), one in Dallas/Fort Worth and now one in Chicagoland. 

Protech Home Medical highlights growth 

CINCINNATI – Protech Home Medical has reported preliminary revenue in the range of $26.1 million to $26.5 million for the quarter ended Sept. 30, driven by “robust organic growth.” It reported preliminary adjusted EBITDA in the range of $5.6 million to $6.1 million. “We have seen our sleep business pick up in the back half of the year, approaching levels seen early in 2020 and are optimistic the sleep business will return to and surpass pre-pandemic levels in 2021,” said Greg Crawford, CEO and chairman. “As a whole, our business remains robust into our fiscal first quarter of 2021, our M&A pipeline is full, and we are well capitalized with our balance sheet to capture the significant opportunities at our front door.” Company officials noted that CMS’s recent decision to drop 13 product categories from Round 2021 of its competitive bidding program “is extremely bullish for our current business.” “It provides us with a significantly clearer outlook on the margin for our overall product mix,” said Hardik Mehta, CFO. 

Numotion grows in Texas 

BRENTWOOD, Tenn. – Numotion has expanded into Amarillo, Texas, with the acquisition of the complex rehab division of BritKare. “Numotion is proud to continue to grow our reach in Texas with this investment in BritKare,” said Mike Swinford, Numotion CEO. Founded in 1995, BritKare has been serving the mobility needs of customers in the areas surrounding Amarillo and Lubbock, Texas, for more than 25 years. The company’s employees, including four assistive technology professionals, will join Numotion. BritKare represents the eighth branch for Numotion in Texas and only the most recent example of Numotion’s growth in the region. It also recently acquired Northland Rehab Supply in Sioux Falls, S.D. Numotion’s existing locations in Texas are in Fort Worth, Waco, Austin, San Antonio, Dallas and Athens.  

NorthShore offers free trial, discount 

GREEN OAKS, Ill. – NorthShore Care Supply has launched a program for ICU nurses and other COVID-first responders in the U.S., including a free trial of two bags of adult diapers, as well as a 20% discount on all absorbent adult diapers, protective underwear, bladder control pads and cleaning wipes available at its NorthShore.com website. “We want to show our appreciation for the dedication of our medical providers and their heroic work during this pandemic,” said Adam Greenberg, president and founder, NorthShore Care Supply. “We’ve been contacted by a number of ICU nurses this year treating COVID patients who are struggling to meet the needs of their patients during extended shifts while managing with overactive balder or bladder or bowel incontinence.” The free trial and discount program for ICU nurses and COVID-first responders is available through March 31, 2021, while supplies last.