Feed aggregator

Drive DeVilbiss bows out of Medtrade Spring

HME News - Fri, 01/20/2017 - 10:52
Company says it’s rethinking its marketing strategy01/20/2017Liz Beaulieu

LAS VEGAS – Drive DeVilbiss Healthcare has had one of the busiest and liveliest booths at Medtrade Springs past, but not this year.

The manufacturer has bowed out of the HME industry’s second largest trade show and educational conference, slated for Feb. 28 to March 1 at the Mandalay Bay Convention Center in Las Vegas, HME News learned last week.

“The industry continues to change,” said Ed Link, chief marketing officer, in an email response. “It requires everyone to rethink their marketing strategy to develop the recipe for success. Our prime concern is to support our channel partners in the most beneficial way, which is changing from years past.”

It won’t be the first time a big manufacturer skips one or both of the Medtrade events. Invacare did not attend either Medtrade or Medtrade Spring in 2008, saying the two events “easily” cost them more than $1 million to attend. It has attended Medtrade since then, but with an admittedly smaller booth.

Permobil also stopped attending the two shows in 2008 and never returned.

At press time on Friday, the Medtrade Spring website listed 167 exhibitors for the upcoming event, including big names like Pride Mobility, Golden Technologies, ResMed and Philips Respironics.

“Fortunately, we have many major manufacturers signed up for Medtrade Spring, and they are enthusiastic about seeing HME providers in what we hope will be a year in which the entire industry, slowly but surely, starts to rebound,” said Kevin Gaffney, group show director for Medtrade.

Gaffney credited Drive as a “longtime exhibitor” and pointed out that the company has signed up for Medtrade in the fall in Atlanta.

The news about Medtrade Spring follows a flurry of changes at Drive, most recently a new private equity owner, Clayton, Dubilier & Rice. The company has also been busy making a number of acquisitions, most notably DeVilbiss Healthcare in 2015.

Gov’t sums up healthcare fraud and abuse control

HME News - Fri, 01/20/2017 - 10:49
01/20/2017HME News Staff

WASHINGTON – The Department of Health and Human Services and the Department of Justice have released their “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2016.”

The DME-related items in the report include:

  • In March 2016, Respironics paid $34 million to resolve civil False Claims Act allegations for paying kickbacks to DME suppliers to induce those suppliers to buy the company’s masks that treat sleep apnea.
  • In April 2016, Hollister and Byram Healthcare Centers paid $20.8 million to resolve FCA allegations that Hollister paid unlawful kickbacks to Byram with the intent to induce Byram to conduct promotional campaigns designed to refer patients to Hollister’s products.

The report also highlights findings by HHS and the Office of Inspector General that certain DME is available to CMS at a cost well below what is available to state Medicaid agencies. In audits of four state Medicaid agencies, they found that the state could have saved $18.1 million on the purchase of certain DME items if they obtained pricing comparable to pricing under Round 1 of Medicare’s competitive bidding program.

Deadline to sign infusion letter looms

HME News - Thu, 01/19/2017 - 13:39
01/19/2017HME News Staff

WASHINGTON – The National Home Infusion Association seeks signatures for a letter that urges Congress to align the effective dates of switching to an average sales price reimbursement model for Part B infusion drugs.

In the letter, addressed to Senate Majority Leader Mitch McConnell, Senate Minority Leader Charles Schumer, House Speaker Paul Ryan and Democratic Leader Nancy Pelosi, the association requests “quick action” to ensure beneficiaries have access to services, equipment and drugs.

“The disconnect between these two provisions in the 21st Century Cures Act creates a four-year gap that needs to be closed,” states the letter. “Due to the required shift in drug reimbursement…Medicare emergency department, hospital, and infusion costs may increase for this population of beneficiaries.”

The ASP language was built in to the Cures Act to help “pay for” key elements of the Medicare Home Infusion Site of Care Act, which were also included in the bill.

Deadline for signatures is Jan. 24.

Bain Capital makes bolt-on acquisition in pediatric market

HME News - Wed, 01/18/2017 - 13:45
01/18/2017HME News Staff

ATLANTA – Bain Capital Private Equity plans to buy PSA Healthcare, combining it with another recent purchase, Epic Health Services.

“The combination of these two companies promises to create a unique and highly differentiated pediatric care platform that offers the highest quality care and the best clinical outcomes for our patients,” stated Rod Windley, chairman of PSA. “Together, we have the opportunity to become the fastest growing and most efficient provider network of home care to medically fragile children in the United States.”

Per the agreement, the current equity holders of PSA Healthcare, including its senior management team and J.H. Whitney Capital Partners, its current majority owner, have agreed to roll over their current ownership interests into the newly formed affiliate.

The combined company will be led by Windley as executive chairman; current PSA CEO Tony Strange as CEO; and several members of Epic Health’s senior management team.

For Dallas-based Epic Health, the deal extends its geographic reach. PSA Healthcare, based here, has more than 75 locations in 16 states, including Florida, Georgia, Pennsylvania, Colorado, Texas and Louisiana.

Financial terms of the deal weren’t disclosed.

Epic Health announced it would be acquired by Bain Capital in December.

Both the PSA Healthcare and Epic Health deals are expected to close in the first quarter of this year.

CMS greenlights CGMs for coverage

HME News - Tue, 01/17/2017 - 14:29
01/17/2017HME News Staff

WASHINGTON – CMS classified “therapeutic” continuous glucose monitoring systems as durable medical equipment in a Jan. 12 ruling.

CMS says CGMs are considered therapeutic and meet the definition of DME if:

·      They are approved by the FDA for use in place of a blood glucose monitor for making diabetes treatment decisions (for example, changes in diet and insulin dosage);

·      They are generally not useful to the individual in the absence of an illness or injury;

·      They are appropriate for use in the home; and

·      They include a durable component (a component that CMS determines can withstand repeated use and has an expected lifetime of at least three years) that is capable of displaying the trending of the continuous glucose measurements.

“In all other cases in which a CGM does not replace a blood glucose monitor for making diabetes treatment decisions, a CGM is not considered DME,” the agency states in the ruling.

CMS says it will pay a monthly fee schedule amount of $248.38 for CGMs in 2017, plus monthly fee schedule amounts for the replacement of the sensors, transmitters and all other accessories and supplies. It says the fee schedule amount will be increased in 2018 and subsequent years based on the covered item update factors.

The ruling is effective Jan. 12.

Stakeholders streamline complex rehab fly-in

HME News - Fri, 01/13/2017 - 13:32
‘We feel that with the constraints we’re working under, a condensed version will be easier for folks,’ says Don Clayback01/13/2017Liz Beaulieu

ALEXANDRIA, Va. – NCART and NRRTS are shaking up their annual fly-in to Washington, D.C., to accommodate complex rehab providers who are strapped for time and cash.

The groups have slated the event for April 26-27—two days instead of the customary three days—at the Hyatt Regency Crystal City.

“We feel that with the constraints we’re working under, a condensed version will be easier for folks, and just as effective,” said Don Clayback, executive director of NCART. “We’ll offer the same, if not better, coverage.”

NCART and NRRTS are still working on the details of the event, but Clayback says April 26 will feature optional education in the morning and mandatory preparation for the following day’s Hill visits in the afternoon. Also slated for April 26 in the afternoon: an annual industry update from a panel of leading providers and manufacturers.

By the event in April, Clayback says NCART and NRRTS expect to have bills introduced to permanently delay CMS’s plan to apply competitive bidding-derived pricing to accessories for manual and power wheelchairs, and to create a separate benefit for complex rehab.

“We’re getting everything lined up,” he said in January. “We’re working with the same sponsors as last year on the mechanics of getting the bills introduced and we’re working on re-securing co-sponsors for them.”

Thanks to legislation passed in December, CMS’s plan to apply bid pricing to accessories has been delayed until June 30, giving stakeholders a small window to get a more permanent fix through Congress.

Last year, NCART and NRRTS hitched their event to the annual RESNA conference. Because this year’s RESNA conference will be June 26-30 at the Hilton Riverside in New Orleans, the groups decided to return to holding their own event, though Clayback says he will be attending and participating in the RESNA conference.

Also, that doesn’t mean the three groups won’t partner again in the future, Clayback says.

“Every year their event is in a different location, and every year we want to be in Washington, D.C., to carry on our message with Congress,” he said. “We’re still talking about potential plans for 2018.”
Attendees will be able to register for the fly-in through NCART or NRRTS soon.

 

 

Remedy for retail

HME News - Fri, 01/13/2017 - 13:29
Provider bets on wellness model01/13/2017Kelly Bothum

FLETCHER, N.C. – As many retailers push for a greater online presence to woo would-be customers, Remedy Health & Wellness is taking a different approach, putting the focus squarely on customers who walk through its doors.

The Fletcher, N.C., store is designed to help customer with just about any health or wellness issue, whether it’s a new mom looking for a breast pump or a weekend warrior hoping to stay active and reduce discomfort, said Marcus Suess, who co-owns the store with Jason De Los Santos.

“We’re focusing on the active community, from birth all the way to aging in place,” added Suess, CEO of All-States Medical Supply. “We have a comfortable environment where people can come in and talk about the things they need.”

Remedy Health & Wellness is stocked with traditional medical equipment like lift chairs, canes and walkers, but there’s also retail space for aromatherapy, support pillows, Vionic orthotic shoes and recovery socks for athletes. Employees are not only knowledgeable about the products they sell, but they can also educate customers about their particular health needs.

The result is an optimal shopping experience for consumers seeking “caretailing”—a hybrid blending traditional HME, retail and concern for the needs of caregivers. It’s a reflection of the needs of today’s shoppers who often want more than what is written on a doctor’s pad and are willing to pay the difference, said Maria Markusen, director of operations and development for VGM Retail, which worked with Suess on Remedy’s launch. 

“We’ve been focused on the sick for so long, but now with boomers, we have a market of consumers who are focused on the healthcare experience,” she said. “We may shop online, but if we go into the store we want the experience to be as useful as possible. We are willing to spend time and money if it’s valuable.”

Remedy is a retail venture, but it also operates a traditional pharmacy within the store that provides prescription medications and accepts insurance. Suess is confident the Remedy model will succeed because of its customer-centric approach.

“Our business plan calls for five stores in five years,” said Suess, who has operated a traditional mail-order supplies business since 2001. “As soon as this is looking strong, we plan to invest in the next one.” 

U.S. Rehab leverages outcomes tool to score big contract

HME News - Fri, 01/13/2017 - 13:28
01/13/2017Liz Beaulieu

WATERLOO, Iowa – U.S. Rehab has secured a Humana contract for its members for complex rehab and mobility products and services at higher reimbursement rates.

The key: using the Functional Mobility Assessment outcomes tool, or FMA, to show that quality products and services are worth paying more for.

“We didn’t have a contract with Humana and now we have one,” said Greg Packer, president of U.S. Rehab, a division of The VGM Group. “We were able to show them the level of quality of our independent providers and now those providers have access to that business. Those that were not in-network with Humana can become in-network.”

The contract, which carves out complex rehab and mobility products and services from other DME, goes into effect Jan. 1. VGM’s Homelink division will manage the contract, funneling business to participating U.S. Rehab members.

U.S. Rehab’s not ready to release specific data from the FMA, but Packer says it was able to use the outcomes tool to show Humana that “there are indications that a quality ATP and a quality CRT provider reduces wounds in the data set.”

“Overall, it also increases healthy days,” he said. “It has shown that if you catch possible negative effects quickly and you’re able to address them quickly, you can prevent them before there are dramatic readmissions.”

U.S. Rehab secured exclusive rights to the FMA, which measures patient satisfaction with assistive devices like walking aids, prosthetics and wheelchairs, in 2015. After piloting the tool with about 20 members that year, the group rolled it out to all members in 2016.

Packer calls leveraging the FMA to secure a big contract a “very high point in our performance here” at U.S. Rehab.

U.S. Rehab member Jerry Stalls, president and owner of Stalls Medical, a complex rehab provider based in Cary, N.C., agreed, adding that he hopes other payers take note.

“What Humana will see in the months and years to come is the predicted cost savings of supporting features on a chair that prevents more expensive procedures down the road,” he said. “They’ll see it was a good decision and a good investment.”

 

In brief: Mum’s still the word at CMS, Drive makes buy

HME News - Fri, 01/13/2017 - 13:24
01/13/2017HME News Staff

WASHINGTON – Industry stakeholders were still waiting for word from CMS at press time on Friday on how the agency plans to retroactively delay a second round of reimbursement cuts in non-competitive bidding areas.

The recently passed 21st Century Cures Act included a provision to retroactively delay the cuts from July 1, 2016, to Jan. 1, 2017.

When CMS had to delay its plans to apply bid pricing to accessories for complex power wheelchairs at the last-minute per a bill signed into law on Dec. 28, the agency didn’t come out with guidance until the third week of January, points out Cara Bachenheimer, senior vice president of government relations for Invacare.

Stakeholders have argued that CMS should bear the responsibility of re-processing the claims over the six-month period.

Drive buys U.K. bed manufacturer

PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare has already kicked off 2017 with an acquisition.

The company announced Jan. 9 that it has acquired Sidhil Group, a U.K. manufacturer of hospital and long-term care beds, pressure prevention products and a range of aids to daily living for the homecare, acute care and long-term care markets in the U.K. and throughout Europe.

“This acquisition will expand Drive’s existing manufacturing capabilities in the U.K., while adding significant manufacturing expertise to our European platform,” said Harvey Diamond, CEO of Drive, in a press release.

Sidhil Group has been manufacturing healthcare products in the U.K. for more than 130 years, with a focus on research and development. It currently operates from a state-of-the-art, 105,000-square-foot facility in Halifax, West Yorkshire, and has a nationwide service center network.

For Sidhil Group, which had its start as a small, family-run business, the acquisition allows the company to bring its product line to “new markets the world over,” said Peter Siddall, chairman of the Sidhil Group, in the release.

Drive has already made a number of acquisitions in the bed market, most recently U.K.-based Park House Healthcare in 2015.

Terms of the deal with Sidhil Group were not disclosed.

Obamacare enrollments outpace last year

WASHINGTON – More than 11.5 million people nationwide were signed up for Health Insurance Marketplace coverage as of Dec. 24, 2016, according to a new report from the Department of Health and Human Services.

That’s an increase of 286,000 compared to the same period the previous year.

Additionally, more than 700,000 residents of New York and Minnesota also signed up through the Basic Health Programs offered by those states, bringing the total to 12.2 million enrolled.

More than 8.7 million people signed up for coverage through healthcare.gov for 2017. They included:

·      8 million female and 4 million males;

·      9 million white, 584,000 African-American, 882,000 Latinos and 573,000 Asian consumers; and

·      6 million rural Americans.

“Nationwide demand for health coverage is higher than ever, as Americans prove again that Marketplace coverage is vital to them and their families,” said HHS Secretary Sylvia Burwell.

Work group expands focus on Medicaid issues

WASHINGTON – AAHomecare’s State Leaders Council has formed a work group to explore ways to address competitive bid pricing for Medicaid.

The 21st Century Cures Act, which passed in December, contained a provision that limits the federal portion of Medicaid reimbursement to Medicare’s bid pricing for DMEPOS starting in 2018.

The work group will assess what level of flexibility states have in setting Medicaid rates, and will develop approaches to educate state Medicaid directors about their options under the new law.


“We’re excited to expand the focus of AAHomecare’s partnership with our local HME associations to tackle increasing state issues facing our members as a result of the changes mandated in the Cures Act that affect Medicaid reimbursement,” said Kam Yuricich, who chairs the work group and the State Leaders Council, and is executive director of the Ohio Association of Medical Equipment Services and Great Lakes Home Medical Services Association.  

Arriva gets day in court

WALTHAM Mass. – CMS has agreed not to terminate Arriva Medical’s mail-order contract while the provider appeals to have its license reinstated.

An administrative law judge has required both parties to have initial briefings finished by Jan. 18. A hearing is scheduled for Feb. 8 before the Federal District Judge, stated Alere, Arriva Medicals’s parent company, in a press release. CMS revoked Arriva Medical’s billing privileges in November for allegedly submitting 211 claims for deceased patients between April 15, 2011, and April 25, 2016.

Bill seeks payment for pharmacy services

WASHINGTON – Sens. Chuck Grassley (R-Iowa), Bob Casey (D-Penn.) and Sherrod Brown (D-Ohio) have re-introduce a bill to help pharmacists provide healthcare services to Medicare beneficiaries in underserved areas. The Pharmacy and Medically Underserved Areas Enhancement Act, S.109, seeks to offer Medicare payment for services such as wellness screenings, immunizations and diabetes management. “Across the country and in Pennsylvania pharmacists play a critical role in helping seniors receive access to routine healthcare services like wellness checks,” said Sen. Casey in a release. “This legislation will aid those in rural communities who may not live in close proximity to the doctor but do have regular contact with their pharmacist. The National Community Pharmacists Association supports the bill. “Pharmacists are highly trained professionals and the most accessible health care providers for patients,” said NCPA CEO Douglas Hoey.The bill has 27 original co-sponsors.

ResMed set to launch travel CPAP

SAN DIEGO – ResMed has received clearance from the U.S. Food and Drug Administration for its AirMini, a device that the company says is “the world’s smallest continuous positive airway pressure (CPAP) device.” ResMed expects to launch the AirMini later this year. It is designed as a secondary CPAP, making it easier for users to continue their sleep therapy while traveling. “ResMed AirMini is the portable travel CPAP patients and home medical equipment providers have been waiting for, and we look forward to bringing it to market later this year,” said ResMed CEO Mick Farrell in a press release. “It fits easily in carry-on luggage—even in the seatback pocket on the plane.” Human Design Capital, which is owned by private investment firm PBM Capital, launched a portable CPAP device called the Z1 in 2013. It is sold direct to consumers.

AASM launches platform for HME

DARIEN, Ill. – AASM SleepTM, a telemedicine platform for board-certified sleep physicians and accredited sleep centers from the American Academy of Sleep Medicine, is now available for the HME industry. AASM SleepTM offers a secure web-based video platform to facilitate live consultations and follow-up visits between DME providers and patients, including equipment set-up and troubleshooting potential problems. “Telemedicine is changing the health care landscape by increasing connectivity between patients and health care providers, and now that convenience is available to DME providers and their at-home patients,” said Jerry Barrett, AASM executive director.

Senators take NTSB to task

WASHINGTON – Five U.S. senators have asked the National Transportation Safety Board to conduct a review of the implementation of sleep apnea testing for engineers for all passenger railroads. In a letter to NTSB Chairman Christopher Hart, Democratic Sens. Bob Menendez and Cory Booker of New Jersey, Chuck Schumer and Kirsten Gillibrand of New York, and Richard Blumenthal of Connecticut note that operator fatigue and sleep apnea have been cited in recent train crashes, including a fatal crash in Hoboken, N.J., last September, and is being looked at in conjunction with a recent crash in Brooklyn. "What's even more concerning than the slow progress railroads are making is an apparent growing trend of railroads pledging to implement sleep apnea testing and inward cameras only after a derailment has occurred on their system," the senators wrote in the letter.

Inogen expects to recoup $2M

GOLETA, Calif. – Inogen expects to recoup up to $2 million in rental revenues for the fourth quarter of 2016 as a result of a provision in the recently passed 21st Century Cures Act. The provision requires CMS to retroactively delay a second round of reimbursement cuts in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016. The company based its estimate on preliminary, unaudited financial data, it said in a press release. “We are pleased that the Cures Act reverses some reimbursement cuts in 2016 and are encouraged that it calls for a study of the impact of the competitive bidding pricing on rural areas,” said CEO Raymond Huggenberger in the release. The cuts went back into effect Jan. 1, 2017.

Aeroflow launches petition to protect breastfeeding support

ASHEVILLE, N.C. – Aeroflow Healthcare has created a petition to keep breastfeeding support as a women’s preventative care guideline available through the Affordable Care Act. Currently, pregnant and new mothers are covered for services like breastfeeding support, but these services are “on the chopping block,” the company states in a press release, under a new administration and a new Congress. “Replacement insurance plans may still include preventative care in bits and pieces, but the most vulnerable populations—young mothers and the children they support—will likely be the hardest hit by elimination of these guidelines,” the release states. Aeroflow’s Mom & Baby division provides lactation support, breast pumps and pumping supplies.

PSP Homecare sees sales increase

RANCHO CUCAMONGA, Calif. – Proto Script Pharmaceutical, doing business as PSP Homecare, has increased its sales by nearly 75% over the past year, the company announced Jan. 11. The provider has competitive bid contracts for standard mobility equipment and general home medical equipment. "I am pleased to report that during the three months ended Sept. 30, 2016, we were successful at increasing our topline sales by almost 75% over the previous year and actually turned a very small profit," said Michelle Rico, CEO and president. "As positive as this sales increase has been, we are very confident that this is only the beginning of our growth strategy taking hold and that there is much more to come."

Save the date: Essentially Women sets fall conference

WATERLOO, Iowa – Essentially Women has scheduled its annual education conference and trade show for Sept. 16-18 in Minneapolis. “We’re excited to bring our members and vendors to the Midwest next fall,” said Christa Miehe, president, in a press release. “Minneapolis was chosen as our destination for 2017 because it’s an equitably accessible location in the center of the country.” The three-day “Focus” conference will provide members with continuing education and training, resources to improve operational efficiencies, and networking opportunities. Registration will open in March. The VGM Group bought EW, a member services organization with more than 600 members in 1,000 locations, in late 2015. It has moved the annual conference from the spring to the fall.

BOC elects new members

OWINGS MILLS, Md. – The BOC board has elected its 2017 executive committee. Bradley Watson, president of Clarksville Limb + Brace + Rehab in Bowling Green, Ky., chairman; Rod Borkowski, president of Health Essentials in Calif., vice-chairman; Wayne Rosen, owner of W.R. Rosen, Inc., in South Florida, secretary; Shane Ryley, area clinic manager at Hanger Orthopedic Group in Torrance, Calif., treasurer; and Jeffrey Hedges, president of R.J. Hedges & Associates in New Florence, Pa., member-at-large. James Hewlett continues to serve as immediate past chairman. The board also named Von Homer and John Owen to the board.

Carex light therapy lamp shines bright

QUINCY, Mass. – Carex Health Brands’ Day-Light Classic Plus, was recognized by The Sweethome as the “best light therapy lamp,” the manufacturer announced in a recent press release. "At Carex Health Brands, we strive to deliver quality, innovative and affordable products that will help consumers live their best lives,” said Jeff Swain, vice president of marketing, retail, for Compass Health Brands. “We are absolutely thrilled that our Day-Light Classic Plus bright light therapy lamp has been recognized for just that.” The Day-Light Classic Plus can help consumers experience relief from seasonal affective disorder in 20- to 30-minute treatment sessions. The Sweethome, part of The New York Times Company, examined about 40 lamps.

CMS outlines qualifications for O&P

HME News - Fri, 01/13/2017 - 13:23
01/13/2017HME News Staff

WASHINGTON – CMS published a sweeping proposed rule in the Federal Register on Jan. 12 outlining the qualifications needed for practitioners and suppliers to furnish and fabricate prosthetics and custom-fabricated orthotics, and the accreditation requirements needed to bill for them.

The proposed rule also outlines the timeframe by which qualified practitioners and suppliers must meet applicable licensure, certification and accreditation requirements. Additionally, it outlines the requirements that an organization must meet to accredit qualified suppliers to bill for prosthetics and custom-fabricated orthotics.

The proposed rule also removes the current exemption from accreditation and quality standards for certain practitioners and suppliers.

The American Orthotics and Prosthetics Association has begun analyzing the proposed rule, but says at first glance it’s a move in the right direction.

“The provisions appear to be in line with what AOPA has supported with the Medicare O&P Improvements Act in defining qualified providers as those accredited with ABC or BOC and that only qualified providers can submit claims for prosthetics or custom-fabricated orthotics,” the association said in a bulletin. “That said, clearly, there are areas of the proposed regulations which will require revisions, edits and improvements, via comments to be prepared and submitted by AOPA and others in the O&P profession.” 

AOPA has long sought to have CMS enforce longstanding O&P licensure and certification requirements.

CMS is accepting comments on the proposed rule no later than 5 p.m. on March 13, 2017.

Work group expands focus on Medicaid issues

HME News - Thu, 01/12/2017 - 10:32
01/12/2017HME News Staff

WASHINGTON – AAHomecare’s State Leaders Council has formed a work group to explore ways to address competitive bid pricing for Medicaid.

The 21st Century Cures Act, which passed in December, contained a provision that limits the federal portion of Medicaid reimbursement to Medicare’s bid pricing for DMEPOS starting in 2018.

The work group will assess what level of flexibility states have in setting Medicaid rates, and will develop approaches to educate state Medicaid directors about their options under the new law.


“We’re excited to expand the focus of AAHomecare’s partnership with our local HME associations to tackle increasing state issues facing our members as a result of the changes mandated in the Cures Act that affect Medicaid reimbursement,” said Kam Yuricich, who chairs the work group and the State Leaders Council, and is executive director of the Ohio Association of Medical Equipment Services and Great Lakes Home Medical Services Association.  

Obamacare enrollments outpace last year

HME News - Wed, 01/11/2017 - 15:47
01/11/2017HME News Staff

WASHINGTON – More than 11.5 million people nationwide were signed up for Health Insurance Marketplace coverage as of Dec. 24, 2016, according to a new report from the Department of Health and Human Services.

That’s an increase of 286,000 compared to the same period the previous year.

Additionally, more than 700,000 residents of New York and Minnesota also signed up through the Basic Health Programs offered by those states, bringing the total to 12.2 million enrolled.

More than 8.7 million people signed up for coverage through healthcare.gov for 2017. They included:

·      8 million female and 4 million males;

·      9 million white, 584,000 African-American, 882,000 Latinos and 573,000 Asian consumers; and

·      6 million rural Americans.

“Nationwide demand for health coverage is higher than ever, as Americans prove again that Marketplace coverage is vital to them and their families,” said HHS Secretary Sylvia Burwell.

Drive buys U.K. bed manufacturer

HME News - Tue, 01/10/2017 - 11:33
01/10/2017HME News Staff

PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare has already kicked off 2017 with an acquisition.

The company announced Jan. 9 that it has acquired Sidhil Group, a U.K. manufacturer of hospital and long-term care beds, pressure prevention products and a range of aids to daily living for the homecare, acute care and long-term care markets in the U.K. and throughout Europe.

“This acquisition will expand Drive’s existing manufacturing capabilities in the U.K., while adding significant manufacturing expertise to our European platform,” said Harvey Diamond, CEO of Drive, in a press release.

Sidhil Group has been manufacturing healthcare products in the U.K. for more than 130 years, with a focus on research and development. It currently operates from a state-of-the-art, 105,000-square-foot facility in Halifax, West Yorkshire, and has a nationwide service center network.

For Sidhil Group, which had its start as a small, family-run business, the acquisition allows the company to bring its product line to “new markets the world over,” said Peter Siddall, chairman of the Sidhil Group, in the release.

Drive has already made a number of acquisitions in the bed market, most recently U.K.-based Park House Healthcare in 2015.

Terms of the deal with Sidhil Group were not disclosed.

AAH resolves to increase participation in HME Audit Key

HME News - Fri, 01/06/2017 - 14:34
01/06/2017Liz Beaulieu

WASHINGTON – AAHomecare is taking steps to make participation in its HME Audit Key survey easier in 2017.

The association and Brightree this month will begin beta testing a report that would give providers many of the answers to the “toughest” questions in the survey. It’s in discussions to do the same with Mediware.

“We hope to increase the motivation to participate in 2017,” said Kim Brummett, AAHomecare’s vice president of regulatory affairs.

AAHomecare expects to open its survey to the next round of data submissions—for the fourth quarter of 2016—in mid-January.

The association is also in preliminary discussions with The VGM Group’s complex rehab and O&P divisions to develop “mini-me” surveys specific to those markets.

“We want to gain momentum on rehab and O&P,” Brummett said. “We could have separate reports for each to make them feel like it’s specific to them, but then bring all the data together to say, ‘Here’s the bigger picture.’”

Additionally, AAHomecare has tweaked the survey to allow providers to pick the quarter for which they want to start entering data, instead of requiring them to start at Oct. 1, 2015, the date the survey officially launched.

“As we get further and further from that date, it gets harder and harder for suppliers to quantify the data,” Brummett said. “This also allows us to do more of an apples-to-apples comparison of the data.”

To date, providers with more than 1,500 locations have participated in the survey, Brummett said. She expects that number to rise this year, with audits likely to pick back up in 2017 due to the recent announcement of Performant Recovery as the new national RAC for DME.

“That’s going to put pressure on folks to participate after a relatively quiet 2016,” she said.

With legislation to curb audits a priority for AAHomecare in 2017, the impetus is there to have a robust set of data, Brummett said.

“If we want legislation this year, we need to state our case,” she said.

Data is currency on Capitol Hill, agreed Greg Packer, president of VGM’s U.S. Rehab.

“All decisions in D.C. are based upon, what can you give me that’s concrete to prove what you’re saying is true?” he said. “They want data-driven decisions.”

 

NRRTS promotes political activism

HME News - Fri, 01/06/2017 - 14:33
01/06/2017Liz Beaulieu

LUBBOCK, Texas – NRRTS celebrates its 25th anniversary in 2017, giving the organization and its registrants a morale boost in a year that it hopes to settle the score on an important complex rehab-related issue.

NRRTS, along with other stakeholders, has been trying to create a separate benefit for complex rehab for several years. In 2016, bills in the House of Representatives and Senate drew 146 and 25 co-sponsors, respectively.

“I’m hoping, in our 25th year, that we can finally get the CRT bill passed,” said Mike Osborn, co-owner of Alliance Rehab and Medical Equipment, who has been a NRRTS registrant since 2001. “That will give us the ability to change a lot of things and put us on a much higher level.”

NRRTS is known for putting seating and mobility specialists on the map with its registered complex rehabilitation technology supplier (RRTS) and certified complex rehabilitation technology supplier (CRTS) credentials. Today, its membership hovers at a steady 650—encouraging considering the shrinking complex rehab market.

To help the industry cross the finish line with a separate benefit, NRRTS plans to ramp up grassroots advocacy among its registrants in its 25th year. Details are still in the works, but the organization plans to give registrants tools that they can use to contact their lawmakers and “toot our horns,” not just as part of a legislative fly-in but on a regular basis, says Weesie Walker, the organization’s executive director.

“We need lawmakers at seating clinics; we need them in the shops of our registrants,” she said. “It’s sort of like, if you’re doing it right, you make it look easy, but the truth is, it’s not. We need to toot our horns more about what we’re doing, and we want to be a resource for that.”

With complex rehab such a small part of health care, it really needs all hands on deck, Walker says.

“We’re going through some tough times—I hear every day from suppliers, the companies they’re working for, it gets harder and harder,” she said. “With a separate benefit, we’ll finally get the recognition we deserve and that will alleviate a lot of the pain. If there’s only X of us across the country, we need a lot of them to be involved to be heard.”

Gerry Dickerson, a CRTS and ATP for National Seating & Mobility and the secretary of NRRT’s executive committee, says the organization’s efforts toward “political activism” are one of the things he’s most proud of.

“I’m a screaming loon when it comes to this stuff, but enough of us aren’t involved,” said Dickerson, a registrant since 1996. “If you touch one person, then there’s an exponential explosion. If someone can’t get the equipment and services they need, we have to have the wherewithal to tell them why and help fix the problem.”

Quality Medical takes total control

HME News - Fri, 01/06/2017 - 14:32
01/06/2017Liz Beaulieu

LARGO, Fla. – The new owners of Quality Medical have set the company up for a robust 2017.

The company, which offers repair and preventative maintenance services for respiratory equipment and infusion pumps, has hired a new regional director, Teresa May, to manage client relationships in south Florida; and has rented an additional 3,000-square-foot facility in Cartersville, Ga., that it plans to open in late January.

“I like to call ourselves a 13-year-old startup,” said Jim Worrell, senior vice president of corporate development, who bought the company in 2015 with two other partners, one of whom, CEO PK Bala, previously led a tech company that handled repairs for network routers and hubs.

When Worrell came on the scene, Quality Medical was still conducting business via fax and was managing its clients out of a spiral notebook. Now it has a new website with an online customer portal called Q-Connect and a CRM system.

In December, Q-Connect, which allows clients to manage and view the entire lifecycle of their equipment, already had 150 users, Worrell said.

“This cloud-based portal allows them to get RMA numbers online, approve estimates online, and access asset service tickets with a single click of the mouse,” he said. “Now when a regulator walks in and wants to see all service records for a particular asset, it’s just a click away.”

Quality Medical also rolled out a new program in the fall, called Total Equipment Control, that allows providers to outsource not only repair and preventive maintenance services, but also supply chain, warehousing and transportation activities. TEC roots in services that Quality Medical has been offering on a more customized basis. For one client, for example, Quality Medical inventoried their products and moved them from branch to branch as needed, allowing the provider to take a hands-off approach to the logistics of their vent program.

“They just call us and we ship it, and they know it’s clean and patient ready,” Worrell said.

Another component of TEC is allowing providers to sell Quality Medical their products and rent them back, as a way to boost their cash flow.

“This allows providers to better align their expenses with revenues,” Worrell said. “It changes your expenses from being fixed to variable.”

Looking forward, Quality Medical is considering another center in Florida and an additional center in the Midwest.

“This industry is in need of the kind of technology that has been in the IT industry for years,” Worrell said. “We want to be the poster child for that technology.”

CMS updates draft e-template for oxygen

HME News - Fri, 01/06/2017 - 14:30
01/06/2017Liz Beaulieu

WASHINGTON – CMS held a Special Open Door Forum on Jan. 5 to discuss the third draft of its electronic clinical template for home oxygen therapy.

This newest draft of the template includes suggested clinical data elements and visual examples for the order, face-to-face encounter and lab test results.

CMS took into account comments to:

·      provide clear headings for related sets for data elements (e.g. beneficiary information);

·      provide a visual example of each data element and its value set;

·      add elements to the F2F encounter to capture text and specific conditions;

·      add an option to order for an oxygen conserving device;

·      and verify that the suggested elements will work for pediatric patients.

The suggested clinical data elements and visual examples are not a form, CMS says, but a tool that physicians or treating practitioners may voluntarily use to create electronic medical documentation.

CMS is pursuing an e-template for oxygen in response to the 48% improper payment rate for claims in fiscal year 2015. Of the claims in error, 86.2% were found to have insufficient documentation, mostly resulting from lack of documentation in medical records to justify Medicare coverage. The agency says the impact of these improper payments was more than $541 million.

CMS reviewed the second draft of the e-template in October.

In brief: Judge keeps HHS in hot seat, Senate eyes Price hearings

HME News - Fri, 01/06/2017 - 14:28
01/06/2017HME News Staff

WASHINGTON – The U.S. District Court for the District of Columbia stands firm that the Department of Health and Human Services must implement procedures to curtail a massive appeals backlog in a timely fashion.

Judge James Broasberg on Jan. 4 refused to rescind his previous order on Dec. 5 requiring the agency to eliminate the 650,000-claim backlog before 2021. HHS had argued that it would only be able to meet such a deadline by paying for claims without regard to merit.

The court was not unsympathetic to HHS’s plight, Broasberg wrote in his decision, but “(it) must follow the instructions of the D.C. Circuit and…conclude that equitable grounds existed for (relief) and that the reductions timetable was the most appropriate form of such relief.”

Prior to Broasberg’s Dec. 5 order, HHS had asked the court not to intervene in the appeals process, citing a number of administrative and legislative actions it was taking to eliminate the backlog by 2019. One of those actions: HHS recently offered to settle disputed claims for inpatient services—a large portion of the claims at issue—for 66 cents on the dollar. A similar offer in 2014 resulted in the settlement of 350,000 claims for about $1.5 billion.

Previously, in September, the court denied HHS’s request to put litigation with the American Hospital Association on hold until Sept. 30, 2017.

Senate eyes confirmation hearings for Price

WASHINGTON – A key Senate committee will reportedly hold a confirmation hearing for Rep. Tom Price, R-Ga., the nominee for secretary of the Department of Health and Human Services, ahead of President-elect Donald Trump’s inauguration.

An aide to Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor and Pensions Committee, says the hearing could be held Jan. 18, according to news reports.

The HELP Committee is one of two committees of jurisdiction for the confirmation process. The other, the Senate Finance Committee, has not officially released dates for the hearing. The Finance Committee, chaired by Sen. Orrin Hatch, R-Utah, holds the official vote.

Industry stakeholders have cheered Price’s nomination. A longtime champion of the HME industry, he has introduced bills to replace the competitive bidding program with a market-pricing program.

Lawmakers waste no time on repeal

WASHINGTON – Republicans in the House of Representatives have set Feb. 20 as a target date to get a bill repealing Obamacare to President-elect Donald Trump.

Trump himself plans to take executive actions to undo the Affordable Care Act on his first day in office, said Vice President-elect Mike Pence in an article on The Hill.com.

Healthcare experts have warned that repealing the program without an immediate replacement would create chaos. Twenty million people are covered under the act.

HME providers are no fans of the ACA. A recent HME Newspoll showed that 28% of respondents think repealing and replacing the program should be Rep. Tom Price’s top priority as secretary of the Department of Heath and Human Services.

ResMed launches new company

SAN DIEGO – ResMed has teamed up with Dr. Mehmet Oz and Pegasus Capital Advisors to launch SleepScore Labs, a new company focused on helping people understand and improve their sleep. SleepScore’s initial focus will be to compile and analyze consumer sleep data, starting with its national sleep study on sleepscore.com. It will also license SleepScore by ResMed technology for other consumer sleep devices, to update their tracking capabilities and improve their products, according to a press release. The company has already signed R&D contracts with several global leaders, including Lighting Science Group, which plans to leverage SleepScore technology to quantitatively measure the effectiveness of its GoodNight LED pre-sleep bulb. Dr. Oz will serve as the company’s brand ambassador and liaison to patients, as well as a board member and adviser, and a co-owner. ResMed and Pegasus will serve as equity partners. ResMed and Dr. Oz partnered in late 2016 to launch a national sleep survey.

Permobil doubles down on seating

LEBANON, Tenn. – Permobil has acquired custom molded seating manufacturer Prairie Seating. The acquisition provides Permobil with a platform for innovation and growth in the custom seating business, the company stated in a press release. It also complements Permobil’s existing portfolio of ROHO seating and positioning products, it says. “The timing of this acquisition is perfect, as it aligns with our growth ambitions and with our goal of adding premium product solutions to the already strong ROHO product portfolio,” said Tom Borcherding, president of Permobil Business Unit Seating and Positioning. Prairie Seating will continue to manufacture products from its Skokie, Ill., facility. Permobil’s initial focus for Prairie Seating will be U.S. sales, with an eye toward expansion opportunities in other countries, the company says.

Numotion expands reach in Carolinas

BRENTWOOD, Tenn. – Numotion has acquired the complex rehab division of Charlotte, N.C.-based BlueDot Medical, extending its reach and capacity in the Carolinas. BlueDot has been in business for more than 14 years, serving thousands of customers annually throughout North and South Carolina. “This acquisition will provide the disabled community in the Carolinas with greater access to mobility resources and an array of products and services,” said Mike Swinford, CEO of Numotion, in a press release. BlueDot’s 11 employees responsible for serving complex rehab customers have joined Numotion’s 25 employees at its Charlotte branch.

Capitala Finance exits investment in Drive Medical

CHARLOTTE, N.C. – Capitala Finance Corp. has exited its investment in Medical Depot, doing business as Drive Medical, netting a realized gain of about $5 million with a cumulative cash-on-cash return of 4.7x, it has announced. “Our investment was a great opportunity to work with an excellent management team that was passionate about their mission, fully knowledgeable of their market space and was able to effectively execute multiple, complex, international acquisitions in a short timeframe,” stated Joe Alala, chairman and CEO of Capitala, in a press release. Drive and Clayton, Dubilier & Rice announced in August that the New York-based private equity firm would be making a “significant investment” in the company. Previously, Ferrer Freeman & Co., another New York-based PE firm, was a minority stakeholder in Drive. Capitala is a provider of capital to lower and traditional middle market companies. Since 1998, its managed funds have participated in more than 138 transactions, representing more than $1.3 billion of investments in a variety of industries in North America.

PSP Homecare makes ‘short list’

RANCHO CUCAMONGA, Calif. – Proto Script Pharmaceutical Corp., doing business as PSP Homecare, announced Jan. 6 that it is a contract supplier for standard mobility equipment and general home medical equipment and related supplies and accessories as part of Medicare’s competitive bidding program. PSP is authorized to provide these bid items in 12 areas in California and Nevada, encompassing a total population of about 32.4 million people, it says. The contract runs from July 1, 2016 to Dec. 31, 2018. “The CMS contract places us on a short list of authorized Medicare approved suppliers in our competitive bid areas,” said Michelle Rico, CEO and president of PSP, in a press release. “(It) gives PSP Homecare a strong foothold in California and Nevada, two of the largest and fastest growing mobility products markets in the country. We anticipate building our existing business within these current areas and look forward to expanding into new markets supported by a comprehensive marketing program in the near future.” PSP has specialized in power wheelchairs and orthotics since 2011. It files reports with the Securities and Exchange Commission.

AAHomecare forms tech workgroup

WASHINGTON – AAHomecare has formed a Hi Tech Work Group to explore new technology and payment models. The group, chaired by Maura Toole, director of field marketing for Philips Healthcare, will focus on how the industry can bring new technology to the market, promote operational efficiencies and make sure providers are paid appropriately for these technologies. The work group’s initial focus will be on examining new and emerging technologies that can deliver measurable benefits for both HME patients and payers, such as reduced readmissions, and strategizing how to get payer to consider increased reimbursements or new payment models that take these improved outcomes into account.

CD&R closes deal on Drive

NEW YORK – Clayton, Dubilier & Rice has completed its equity investment in Drive DeVilbiss Healthcare, it announced Jan. 4. The deal allows Drive to continue its organic growth strategy, as well as provide the company with additional capital for future acquisitions. Drive has made 25 acquisitions since 2002, including the 2015 acquisition of DeVilbiss Healthcare. The deal was first announced in September. CD&R replaces Ferrer Freeman & Co., which has been a minority stockholder of Drive since 2008. Terms of the deal were not disclosed.

GF Health Products welcomes congressman

ATLANTA – GF Health Products (Graham-Field) hosted Rep. Glenn Grothman, R-Wis., to its Fond du Lac manufacturing facility here in December. Kurt Hellman, senior vice president of manufacturing operations, led a brief tour of the plant to highlight the facility's product lines and plant capabilities. Grothman is an advocate of bringing manufacturing back to the U.S.A., a goal of GF Health Products’ “Made in USA” initiative. GF Health Products makes healthcare products for the acute care, extended care, homecare and primary care markets.

ResMed logs major milestone

SAN DIEGO – ResMed has downloaded one billion nights of sleep data on its AirView remote patient monitoring platform. “This unprecedented amount of data enables predictive analytics to help physicians and providers better manage patients’ sleep apnea and COPD therapy, and ultimately improve their overall health,” said Mick Farrell, ResMed CEO, in a press release. “Reaching one billion nights is about more than just big data; it’s a testament to how the adoption and meaningful use of technology benefits patients, physicians and providers everywhere.” ResMed first made remote monitoring of CPAP patients available in 2004.

UnityPoint at Home cracks Excelera contract

URBANDALE, Iowa ­ – UnityPoint at Home, an integrated home health services provider, has joined the specialty pharmacy network of Excelera. The network provides members with a nationally scaled infrastructure and support to help them develop best practices and gain access to limited-distribution drugs and biologics and restrictive payer agreements so they can provide continuity of care for their patients with complex and chronic conditions. “We are delighted to welcome UnityPoint at Home into our national network,” said Jim Fox, CEO of Excelera, in a press release. “UnityPoint at Home is an example of an integrated health system looking to improve continuity of care for complex patients to lower costs and advance clinical and financial outcomes.” Excelera will partner with UnityPoint at Home to develop key specialty pharmacy capabilities, including training, operations, data aggregation, reporting for drug manufacturers and payers, and revenue cycle management. UnityPoint at Home’s services include adult and pediatric nursing care, rehabilitation therapy, personal care and home support, infusion therapy, respiratory therapy, palliative care, hospice and home medical equipment services. It serves patients and communities in Iowa, Illinois and Wisconsin.

Strategic Healthcare Programs enters home infusion market

SANTA BARBARA, Calif. – Strategic Healthcare Programs, a provider of data analytics and benchmarking to home health agencies and hospice providers, has expanded its offerings to home infusion providers. SHP’s Home Infusion Pharmacy Solution allows providers to capture daily trends and insights from their clinical, financial, demographic and utilization data. “Pharmacies need these comprehensive reports to manage performance and demonstrate value as home infusion providers will need to compete based on quality outcomes and pay-for-performance reimbursements,” the company stated in a press release. The solution follows data standards recently published by the National Home Infusion Association that bring consistency to the industry and enable comparisons of outcomes and quality metrics. SHP partnered with Managed Health Care Associates (MHA), which owns The MED Group, to develop the solution.

Short takes: Pride, Etac, US Healthcare Supply

Pride Mobility has named Micah Swick director of sales. Swick was formerly national sales director for Mega/Windermere Motion, a leading supplier of power recline/lift chairs and mobility scooters. Joe Showfety has replaced Swick at Mega/Windermere…Etac CEO Torben Helbo will serve as interim president of North American sales and Convaid Products. Chris Braun, who previously held the position, departed the company this week. Convaid sold to Etac in 2015. A search is underway to replace Braun…US Healthcare Supply has received DMEPOS accreditation by the Accreditation Commission for Health Care. The Milford, N.J.-based provider offers diabetes and other medical supplies.

 

Appeals: Court keeps HHS in hot seat

HME News - Fri, 01/06/2017 - 10:17
01/06/2017HME News Staff

WASHINGTON – The U.S. District Court for the District of Columbia stands firm that the Department of Health and Human Services must implement procedures to curtail a massive appeals backlog in a timely fashion.

Judge James Broasberg on Jan. 4 refused to rescind his previous order on Dec. 5 requiring the agency to eliminate the 650,000-claim backlog before 2021. HHS had argued that it would only be able to meet such a deadline by paying for claims without regard to merit.

The court was not unsympathetic to HHS’s plight, Broasberg wrote in his decision, but “(it) must follow the instructions of the D.C. Circuit and…conclude that equitable grounds existed for (relief) and that the reductions timetable was the most appropriate form of such relief.”

Prior to Broasberg’s Dec. 5 order, HHS had asked the court not to intervene in the appeals process, citing a number of administrative and legislative actions it was taking to eliminate the backlog by 2019. One of those actions: HHS recently offered to settle disputed claims for inpatient services—a large portion of the claims at issue—for 66 cents on the dollar. A similar offer in 2014 resulted in the settlement of 350,000 claims for about $1.5 billion.

Previously, in September, the court denied HHS’s request to put litigation with the American Hospital Association on hold until Sept. 30, 2017.

CMS updates draft e-template for oxygen

HME News - Fri, 01/06/2017 - 10:15
01/06/2017HME News Staff

WASHINGTON – CMS held a Special Open Door Forum on Jan. 5 to discuss the third draft of its electronic clinical template for home oxygen therapy.

This newest draft of the template includes suggested clinical data elements and visual examples for the order, face-to-face encounter and lab test results.

CMS took into account comments to:

  • provide clear headings for related sets for data elements (e.g. beneficiary information);
  • provide a visual example of each data element and its value set;
  • add elements to the F2F encounter to capture text and specific conditions;
  • add an option to order for an oxygen conserving device;
  • and verify that the suggested elements will work for pediatric patients.

The suggested clinical data elements and visual examples are not a form, CMS says, but a tool that physicians or treating practitioners may voluntarily use to create electronic medical documentation.

CMS is pursuing an e-template for oxygen in response to the 48% improper payment rate for claims in fiscal year 2015. Of the claims in error, 86.2% were found to have insufficient documentation, mostly resulting from lack of documentation in medical records to justify Medicare coverage. The agency says the impact of these improper payments was more than $541 million.

CMS reviewed the second draft of the e-template in October.

Syndicate content