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CMS rescinds proposed orthotics rule

HME News - Fri, 10/13/2017 - 10:28
10/13/2017HME News Staff

WASHINGTON – CMS has announced it is withdrawing a proposed rule that would have required any practitioner or supplier who provides custom orthotics to be licensed in states where it is required.

The rule, released in January, was strongly opposed by physicians, physical therapists and occupational therapists. The rule has actually been a law since 2000, but it has never been fully implemented.

CMS said it was withdrawing the rule due to “the cost and time burdens that the proposed rule would create for many providers and suppliers, particularly the cost and burden for those providers and suppliers that are small businesses.”

The Trump administration has pledged to reduce regulatory burdens on businesses.

Industry associations like the American Orthotic & Prosthetic Association and the National Association for the Advancement of Orthotics and Prosthetics, however, supported the rule.

“AOPA is disappointed that CMS decided to withdraw the proposed rule that would finally create regulations to implement a law that was passed more than 17 years ago,” the association said in a press release. “The withdrawal of the proposed rule once again exposes the Medicare population to no regulation regarding what qualifications are required to provide custom orthotic and prosthetic services.”

In May, Sen. Chuck Grassley R-Iowa, and Reps. Glenn “GT” Thompson, R-Pa., and Mike Thompson, D-Calif., introduced The Medicare Orthotics and Prosthetics Improvement Act of 2017 in both the Senate and House that calls on CMS to enforce a law that O&P providers be certified to receive payments under Medicare. Similar bills have been introduced in previous sessions of Congress.

Provider Gary Sheehan named Homecare Champion

HME News - Thu, 10/12/2017 - 11:01
10/12/2017HME News Staff

ATLANTA – HME Provider Gary Sheehan has been named the 2017 Van Miller Homecare Champion, AAHomecare announced this week.

The award, which will be presented at the Stand Up for Homecare reception on Oct. 24 during Medtrade, recognizes AAHomecare members for outstanding service in the HME industry.

Sheehan, CEO of the 40-year-old Sandwich, Mass.-based Cape Medical Supply, has advocated for HME at both the state and regional level, building strong relationships throughout New England, as well as Capitol Hill.

Sheehan has also served in several leadership roles with theHome Medical Equipment and Services Association of New England and has presented at numerous conferences and conventions.

Missy Cross was the recipient of the inaugural award, created in 2016 when AAHomecare renamed its Homecare Champion Award to honor The VGM Group’s Van G. Miller, who died unexpectedly in 2015.

Access survey slams bid program

HME News - Wed, 10/11/2017 - 10:10
‘This report empirically validates the problems we have been experiencing with the competitive bidding program for the past several years’10/11/2017HME News Staff

WASHINGTON – More than 60% of case managers report an increase in the number of Medicare beneficiaries who have developed medical complications, received emergency care or were readmitted to a hospital due to issues related to obtaining proper and/or timely access to DME, according to a final report from Dobson DaVanzo & Associates.

“(The competitive bidding program has) negatively affected beneficiaries’ access to DME services and supplies, adversely impacted case managers’ ability to coordinate DME for patients, and placed an additional strain on suppliers to deliver quality products without delay,” states the report, completed in conjunction with AAHomecare. “If timely adjustments are not made, there is little doubt the beneficiaries, case managers and suppliers will continue to face adverse outcomes, particularly in rural areas.”

The report, “Access to Home Medical Equipment: Survey of Beneficiary, Case Manager and Supplier Experiences,” was based on a survey of more than 1,000 beneficiaries, case managers/discharge planners and HME providers.

Other findings from the report:

  • 74.3% of beneficiaries report a discontinuity or disruption in their ability to receive oxygen and supplies since July 1, 2016, when a second wave of reimbursement cuts went into effect in non-bid areas as part of a national rollout of the program.
  • 75.2% of case managers report issues accessing and coordinating oxygen therapy for their patients.
  • 85% of suppliers report beneficiaries have privately purchased DME and supplies, opting not to use their Medicare benefits to file claim.

“This report empirically validates the problems we have been experiencing with the competitive bidding program for the past several years,” said Steve Ackerman, chairman of AAHomecare’s board of directors, and president of Spectrum Medical. “The eager response to the survey from beneficiaries and discharge planners shows that these are problems adversely affecting the entire homecare community.”

AAHomecare had already shared preliminary findings from the survey with staff at Health and Human Services, CMS and the Office of Management and Budget.

Permobil expands seating, positioning portfolio

HME News - Tue, 10/10/2017 - 09:13
10/10/2017HME News Staff

LEBANON, Tenn. – Permobil continues to consolidate the seating and positioning market with its acquisition of Comfort Company.

The Bozeman, Mont.-based Comfort Company manufactures seating and postural support systems for customers with a wide range of rehabilitation needs. It joins the ROHO Group, a Belleville, Ill.-based manufacturer of seating and positioning systems, under the Permobil umbrella.

“Following the purchase of ROHO in 2015, the acquisition of Comfort Company further strengthens Permobil’s position within both the complex rehab and long-term care markets,” said Tom Borcherding, president of Permobil seating and positioning systems. “We see tremendous synergies with the addition of Comfort Company’s portfolio together with ROHO’s solutions.”

Comfort Company manufactures from a facility in New Berlin, Wis., and has more than 200 employees.

Eric Murphy, president of Comfort Company, says Permobil is a good fit, because it shares its vision of providing a high level of quality and service.

“Comfort Company has always had a strong focus and passion for the customer across the pediatric, geriatric and bariatric segments,” he said.

Permobil is on a buying spree as of late: It announced earlier in October that it was taking over operations of TiLite New Zealand and earlier this year that it had acquired Durable Medical Equipment Ltd.

Stakeholders take stock in wake of Price’s resignation

HME News - Fri, 10/06/2017 - 09:50
‘While it does slow down our momentum, it will not stop us’10/06/2017Liz Beaulieu

WASHINGTON – Tom Price’s resignation from the Department of Health and Human Services shouldn’t have an impact on a pending interim final rule, industry stakeholders say. What’s lesser known: Whether it will have an impact on a final fix for the competitive bidding program.

The IFR, which promises to provide relief from bid-related pricing in non-bid areas, is waiting to be cleared by the Office of Management and Budget—something that could happen any day now, stakeholders say.

“All the other people that Price brought into the agency with him, including CMS Administrator Seema Verma, are still there, so it’s not going to change the direction of the IFR,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “I feel optimistic that that’s still going to come out.

“The bigger question mark,” she continued, “is the longer-term fixes to the bid program. But I feel more optimistic than not on that, too.”

HHS, under Price’s leadership, was looking very closely at how it might replace the bid program with a market-pricing program. As a member of Congress, Price introduced legislation that would have done just that.

So stakeholders are doubling down on their already strong relationships with Verma, whose name has been dropped as a potential replacement for Price.

“We were able to get a meeting with her within two weeks of Price being confirmed,” said Tom Ryan, president and CEO of AAHomecare. “She certainly knows who we are and is aware of the bidding issues.”

Asked whether Price’s resignation means stakeholders and their champions in Congress need to step on the gas on legislation to reform the bid program, as well as to eliminate a “double dip” cut to reimbursement for oxygen concentrators, Ryan said, “we’re sorting that all out right now.”

“Rep. Cathy McMorris-Rodgers has been contemplating legislation—and still is,” he said.

Stakeholders say, despite Price’s resignation, the HME industry is creating a perfect storm for action that includes an IFR that recently garnered support from 104 representatives in just a handful of days, pending legislation, and a survey that highlights major access issues.

“While Price’s (resignation) does slow down our momentum, it will not stop us,” said John Gallagher, vice president of government relations for VGM, in a recent video update to members. “We have great support on Capitol Hill; we have great support in the administration; we have great support inside HHS and CMS. Keep the faith.”

Howard's Medical Supply scoops up inventory in under-served areas

HME News - Fri, 10/06/2017 - 09:47
10/06/2017Tracy Orzel

YAKIMA, Wash. - When Erik Mickelson heard fellow local HME provider Keeler’s Medical Supply had filed for Chapter 11 bankruptcy in June, he was shocked.

"They were in business for 40 years," said Mickelson, CEO of Howard's Medical Supply in Yakima, Wash. "When we started, they had 125-150 employees that did $10 million worth of business."

Howard's agreed to purchase Keeler’s inventory for $600,000 in cash, which included everything from used Group 3 wheelchairs to oxygen concentrators. The purchase didn't signify any new product lines for the company.

Founded in 2004 as a division of Howard’s Pharmacy, Howard's Medical Supply offers a full range of HME, and has locations in Yakima, Selah, Ellensburg, and Sunnyside—that last one opened last year in an underserved area.

"There's about 100,000 people down there, but there wasn't a medical supply store; they had gone out of business in 2011," said Mickelson.

This isn’t the first time Howard’s has acquired assets from his competitors:nearby Kittitas Hospital DME and Memorial DME, both hospital-based DMEs, closed their doors in 2015 and 2017, respectively. Howard's purchased Kittitas Hospital's inventory and Memorial's customer base.

While the company expects to pick up most of Keeler’s customers, Mickelson remained mum on Howard's plans for future growth. 

"We've gone from the market being over-served to under-served, so we anticipate that more companies are going to move in now," he said. "That's why we always strive to be on our A-game."

Mickelson credits part of Howard's success to the fact that the company never experienced the DME prosperity of the early 2000s. 

"And so, when everything hit the fan, we were used to running a DME in a very lean way," he said. 

And the other part? Howard's is debt-free.

"I've never heard of a company going bankrupt that did not have debt," said Mickelson.

Legal landscape: M&A, managed care top hot spots

HME News - Fri, 10/06/2017 - 09:46
10/06/2017Liz Beaulieu

YARMOUTH, Maine – With increased complexity in the HME industry, comes increased legal ground to cover, say healthcare attorneys, particularly in the areas of mergers and acquisitions, and managed care.

In M&A, Jeffrey Baird has seen an increasing number of companies selling their stakes in certain geographic markets or certain product categories, or terminating their competitive bidding contracts.

In the case of the former, providers must alert the CBIC and make plans to transition their patients to another contract provider, says Baird, chairman of the Health Care Group at Brown & Fortunato in Amarillo, Texas. While terminating a bid contract isn’t grounds for revocation, abandoning your patients is, he says.

“That’s where you have to be careful—you can’t abandon your patients,” he said.

In Baird’s experience, it’s not that difficult to transition patients, unless they’re oxygen patients, he says.

“Once you sign up to take care of an oxygen patient, you’re locked up for 60 months, so that’s trickier,” he said. “But usually there are other contractors who are willing to pick up the load.”

Also in M&A: Baird has seen an increasing number of companies closing their doors and wondering whether or not they’re liable for any outstanding audits.

“The short answer is no,” he said. “It’s an unsecured claim against a company, not an individual. Ultimately, it will end up with a government agency that serves as a collection agency, and it never goes beyond that. It may, however, prevent an individual from going out and getting another PTAN to start another company.”

You’ve got a right to fight

Another area that has increased the complexity of the HME industry is exclusive or preferred contracting between managed care companies and certain providers and distributors, says Neil Caesar, president of the Health Law Center in Greenville, S.C.

This is an area, however, where the law can be on the side of providers, rather than something they need to be worried about violating, Caesar says.

“The idea is (to use legal means) to stop it from moving forward, or help shape the contracts, or find loopholes within them,” he said. “It’s important for providers to find strength in numbers, stay on top of it and have their voice heard.”

Caesar cited Texas, where Superior HealthPlan began a preferred contract with Medline for supplies for Medicaid recipients starting Oct. 1, as an example of how providers can make a difference. The contract was originally exclusive and scheduled to start Sept. 1

“Providers were able to leverage a new policy in the state that required managed care companies to give an opt-out and clearly state that,” he said.

While instances of these contracts are popping up in a number of states, they’re likely to become more widespread, Caesar says, because managed care companies with different names in different states are often owned by the same regional or national company. For Superior HealthPlan, for example, that’s Centene Corp., which has more than 12 million members in 28 states.

“It’s not an isolated trend,” he said.

Numotion ramps up remote service

HME News - Fri, 10/06/2017 - 09:45
‘There’s always a sense of urgency for us to be faster and more efficient’10/06/2017Liz Beaulieu

BRENTWOOD, Tenn. – Numotion has updated its service model to include remote troubleshooting, diagnosing and sometimes even repairing.

The national complex rehab provider announced last month that it now offers widespread remote service through a HIPAA-compliant phone app that allows users and technicians to communicate via secure video.

“The service model in complex rehab hasn’t kept up with advancement in technology—it’s consuming and cumbersome,” said Bud DeGraff, COO. “We have a large service area and a limited number of techs, so there’s always a sense of urgency for us to be faster and more efficient. This is a way for us to make great strides in that area.”

Numotion expects it will conduct 30,000 remote service assessments by the end of this year and it has a goal of 100,000 next year. It can be used for, among other things, malfunctioning motors or actuators, and joystick lockout issues.

DeGraff says Numotion now has more than 20 techs dedicated to remote service, sitting anywhere from Connecticut and California. Even if they can’t resolve a user’s issue remotely, they can eliminate the need for an in-person assessment and can get the ball rolling by ordering parts and starting the required paperwork and documentation, he says.

“We still may have to send someone to complete the repair, but by at least getting them started, we can process more orders and take care of more customers,” he said.

Looking forward at how else Numotion can leverage technology, DeGraff says he’s most excited about the adjacencies between the company and the work of manufacturers on a more “connected wheelchair.”

“Right now, even with remote assessments, we’re still starting from square one,” he said. “With connected data, we can do preventative maintenance before a wheelchair even goes down.”

The incorporation of technology into service can’t come fast enough for wheelchair users like Brianna Rieck in Prairie Du Chien, Wis.

“I downloaded the free app and less than 10 minutes later the tech had a diagnosis,” she wrote in an online comment on the new service. “He double checked his findings with the manufacturer, then ordered the parts. It saved a ton of time and money. I’ll do it again and again—it was simple, quick and easy.”

In brief: OIG tells CMS to collect more overpayments, VGM announces Woman of the Year finalists

HME News - Fri, 10/06/2017 - 09:44
10/06/2017HME News Staff

WASHINGTON – The MACs collected only 20% of Medicare overpayments referred by ZPICs and PSCs in 2014, says a new report from the Office of Inspector General.

The ZPICs and PSCs referred $559 million in overpayments in 2014, but the MACs sought $482 million and collected only $96 million, according to the OIG.

The ZPICs and PSCs send the highest number of referrals for Part B (60%) and DME (26%). They sent the highest dollar amount of referrals, however, for home health and hospice (43%), the OIG found.

In its defense, the MACs say collecting overpayments is problematic if: the provider is no longer in business, filed for bankruptcy or was revoked from participating in Medicare.

To increase collections, the OIG says CMS should implement the surety bond requirement for home health providers and consider a similar requirement for other providers based on their level of risk.

The OIG also recommends CMS create a standard report form for all contractors and require them to use a unique identifier for each overpayment.

CMS concurred with all of the OIG’s recommendations, except the surety bond requirement. The agency says it is evaluating how to implement such a requirement without causing undue provider burden.

HME Woman of the Year finalists announced

WATERLOO, Iowa – VGM has announced the four finalists for its second annual HME Woman of the Year award.

The finalists are Lelia Wilkerson, director, Heritage Medical Equipment & Supplies; Rita Stanley, vice president of government relations, Sunrise Medical; Barbara Smith, CEO, Healthline Medical Equipment, Inc.; and Maxine Paul, director of sales and operations, NuMotion, formerly owner of Academy Medical Equipment, Inc.

“These women are trailblazers and are passionate advocates for not only the industry, but for the patients they serve,” said Clint Geffert, president of VGM & Associates. “They exemplify the dedication and innovation required to have a positive impact on their business, co-workers, customers and the communities they serve.”

The finalists, who were selected from a pool of 38 nominees, will travel to Medtrade, where the winner will be announced on Oct. 24 at 8 a.m. in room C101 of the Georgia World Congress Center.

An honorary committee that included last year’s HME Woman of the Year, Dr. Kirsten Davin, chose the finalists using criteria that included implementing new business processes, advocating on behalf of the industry, improving the lives of patients and impacting the community through volunteerism.

Mike Mallaro, CEO of VGM, notified each of the finalists personally.

“There are so many in HME that do a great job, and to be acknowledged for that is amazing,” Wilkerson told him. “I’m around a lot of great people, and it’s very humbling that I was selected as a finalist.”

AAH releases Q2 results for HME Audit Key

WASHINGTON – Seventy-one percent of MAC prepayment audits are paid upon review, and 11% of new patients are subject to MAC audits, according to the latest results of the HME Audit Key. The findings from the second quarter survey results also include: 93% of PMD MAC prepayment audits are paid upon review; 70% of completed appeal determinations for respiratory products were in favor of suppliers; 26% of new patients for hospital beds, support surfaces, and manual wheelchairs were subject to MAC audits; and 94% of SMRC respiratory audits were targeted at large suppliers. Read the complete report here.

ResMed provides update on lawsuits in four countries

SAN DIEGO – ResMed says a German court has stayed infringement proceedings against Fisher & Paykel to allow ResMed to defend the validity of its patents in the European Patent Office. The stay follows an oral hearing in late September, during which the court concluded that F&P’s Simplus, Eson and Eson 2 infringe two ResMed European Patents, ResMed says. ResMed provided additional updates on its ongoing infringement proceedings against F&P: In the U.K., it says it is proceeding to trial to defend one of three of its patents that it says F&P has challenged there, and is agreeing to revoke two other patents; In Australia, it says after it presented evidence defending a key mask patent, F&P withdrew its validity challenge and now must pay its court costs; in New Zealand, it expects to go to trial in late 2018. “ResMed will continue to stand against those we believe have unlawfully violated our patents,” said David Pendarvis, ResMed global counsel and chief administrative officer. ResMed says it has more than 5,000 patents in its portfolio, representing three decades and millions of dollars of sustained investment in R&D.

BOC launches new accreditation

OWINGS MILLS, Md. – The Board of Certification/Accreditation (BOC) is accepting applications for a new compounding accreditation for pharmacies. The new accreditation will focus on non-sterile compounding and is only available in conjunction with BOC retail or retail+ DMEPOS accreditation. “The new Compounding Accreditation program will give pharmacies the opportunity to offer their patients, referral sources and the third-party payer the assurance of safe business practices,” said Wendy Miller, chief credentialing officer for BOC. For more information, www.bocusa.org.

CAIRE adds remote monitoring capabilities

ATLANTA – CAIRE has entered a strategic relationship with SynsorMed, a mobile telehealth and remote patient monitoring company, to help its HME providers better monitor patient conditions. The multi-year agreement combines SynsorMed’s technology with CAIRE’s portable and stationary oxygen therapy devices. Available on Android and iOS platforms, SynsorMed’s technology integrates with FDA-approved devices to provide analysis on a patient’s oxygen concentrators, wherever they are. “In the first phase, our B2B customers will be able to connect and monitor a patient’s oxygen concentrator from a customized dashboard, which can remotely monitor device alarms and general diagnostics thanks to an app on the patient’s phone and Bluetooth technology,” said Dan Van Hise, vice president of marketing for Chart’s BioMedical Group. The new mobile solution will be branded as “CAIREview, powered by SynsorMed.”

NHIA leverages Citus Health to digitize provider workflow

NEW YORK – The National Home Infusion Association and Citus Health, a digital health solution provider for the post-acute care industry, have agreed to collaborate on the use of a web-based technology that will give home infusion providers greater access to clinical resources to enhance patient care. Citus and NHIA say the technology, Call Bell, will help providers transform traditional workflows into efficient digital processes, while enabling interactive communications with remote patients. “Working in the industry as a home infusion nurse for many years, I saw first-hand how the lack of automation and information flow can negatively impact an organization’s ability to deliver a high level of care,” said Melissa Kozak, RN, CRNI, founder and CEO of Citus Health. “Through the application of innovative technologies, we believe we can transform many paper-based and manual-intensive processes that can be found across the post-acute care industry.”

Pride Mobility cuts price on power lift recliners

EXETER, Pa. – Pride Mobility Products has cut the price of its power lift recliners by 10% for the fourth quarter, the manufacturer announced Oct. 2. Pride says the cut, which went into effect on Oct. 1 for all Pride branded, quick-ship power lift recliners, is meant to help HME providers compete with outside industry channels. “From e-commerce to mass merchants to discount stores to furniture stores, everyone wants to leverage a piece of this ever-important category,” Pride states in a press release. “Never has the power lift and recline chair category been more competitive than it is today, making it increasingly difficult for our HME retailers to compete.” Pride says it chose to make the price cut in the fourth quarter because it is the “height of seasonal sales” in the power lift recliner product category. The cut will remain in place through Dec. 31.

Compass Health buys Richmar

CLEVELAND – Compass Health Brands has acquired Richmar, a Chattanooga, Tenn.-based manufacturer of devices and consumables to treat patients with musculoskeletal conditions resulting from degenerative diseases, traumatic events and sports-related injuries. The two companies have complementary products in the rehab and pain management markets and, when combined, will offer a “broader go-to-market approach through multiple sales channels,” according to a press release. “This dynamic combination is expected to provide improved value and service by rapidly utilizing the existing capabilities and product portfolios of both companies.” Richmar’s products include Winner EVO electrical stimulation, combination, and ultrasound; Hivamat deep oscillation therapy; Hydratherm heat therapy products; Ionto+ iontophoresis and Superstim/Multistim stimulation electrodes; LidoFlex lidocaine patches; GelShot ultrasound coupling discs; and several laser and light therapy items. The acquisition of Richmar follows on the heels of Compass Health’s previous acquisitions of the ProBasics and Meridian Medical brands. Terms of this latest deal are not being disclosed.

Permobil makes second buy in New Zealand

LEBANON, Tenn. – Permobil will take over operations of TiLite New Zealand. Earlier this year, Permobil acquired Durable Medical Equipment Ltd, the largest complex rehab company in the country. Permobil has been a partner of TiLite New Zealand for a number of years. The two companies say they share, at their core, the same passion and mission. ““Our approach has always been to provide the highest level of service across the rehabilitation marketplace, backed by clinical expertise,” says Karl Stanisich, owner of TiLite New Zealand. “Permobil shares our values and a strong desire to provide innovative rehabilitation solutions, expanding care and helping to improve quality of life.” In 2014, Permobil bought TiLite in Pasco, Wash. Before the deal, Permobil had been selling TiLite wheelchairs in Canada.

Option Care first to have accredited compounding pharmacies

BANNOCKBURN, Ill. – Option Care Enterprises is the first national home infusion company to achieve accreditation at each of its compounding pharmacies by the Pharmacy Compounding Accreditation Board, it announced Oct. 4. The accreditation verifies all Option Care cleanroom pharmacies – in which sterile compounding of IV medications for specific physician orders is performed – meet the highest level of standards, above and beyond what is required in most states. The PCAB accreditation, offered by the Accreditation Commission for Health Care, is based on more than 40 sterile compounding standards in the U.S. Pharmacopeial Convention (USP) guidelines, or USP 797. “PCAB accreditation of all of our compounding pharmacies provides an objective, external validation of our commitment to quality,” said Brenda Wright, vice president of clinical services, Option Care.

HIDA launches homecare council

ALEXANDRIA, Va. – The Health Industry Distributors Association has formed a Home Care Channel Council, a new networking group in the home healthcare market. “The new council recognizes the importance of the home setting in health care,” said Mike Orscheln, 2017 HIDA chairman and CEO of Performance Health. “Our goal is to provide a forum for distributors and manufacturers to build and improve their channel strategies in the home care market.” Members of the council are Jackie Anderson of Key Medical Supply, Jeff Bowman of McKesson Medical-Surgical, Tom Burke of Medical Specialties Distributors, Doug Harper of NDC, Colton Mason of Supreme Medical Fulfillment Services, Pam Wedom of IMCO Health Care, Luke Whitworth of Cardinal Health, and Scott Williams of Grove Medical.

Short takes: BioScrip, Paragon Ventures, Stratice Healthcare, Invacare

BioScrip is now dispensing and administering Radicava, the first treatment option for ALS approved by the U.S. Food and Drug Administration in more than 20 years…Paragon Ventures, a healthcare M&A firm, has launched paragonventures.com. The new website features information on selling, valuing and acquiring a healthcare business…Stratice Healthcare has launched Clinician Order Entry, a portal for post-acute care settings to ensure patient orders are complete and transmitted faster…Invacare has received PDAC coding for its TDX SP2 Power Wheelchair, which launched in August. The codes are K0848, Group 3 rehab seat; K056, Group 3 single power; and K0861 Group 3 multiple power.

OIG: Enhancements needed to collect overpayments

HME News - Thu, 10/05/2017 - 11:28
10/05/2017HME News Staff

WASHINGTON – The MACs collected only 20% of Medicare overpayments referred by ZPICs and PSCs in 2014, says a new report from the Office of Inspector General.

The ZPICs and PSCs referred $559 million in overpayments in 2014, but the MACs sought $482 million and collected only $96 million, according to the OIG.

The ZPICs and PSCs send the highest number of referrals for Part B (60%) and DME (26%). They sent the highest dollar amount of referrals, however, for home health and hospice (43%), the OIG found.

In its defense, the MACs say collecting overpayments is problematic if: the provider is no longer in business, filed for bankruptcy or was revoked from participating in Medicare.

To increase collections, the OIG says CMS should implement the surety bond requirement for home health providers and consider a similar requirement for other providers based on their level of risk.

The OIG also recommends CMS create a standard report form for all contractors and require them to use a unique identifier for each overpayment.

CMS concurred with all of the OIG’s recommendations, except the surety bond requirement. The agency says it is evaluating how to implement such a requirement without causing undue provider burden.

 

HME Woman of the Year finalists announced

HME News - Wed, 10/04/2017 - 08:58
10/04/2017HME News Staff

WATERLOO, Iowa – VGM has announced the four finalists for its second annual HME Woman of the Year award.

The finalists are Lelia Wilkerson, director, Heritage Medical Equipment & Supplies; Rita Stanley, vice president of government relations, Sunrise Medical; Barbara Smith, CEO, Healthline Medical Equipment, Inc.; and Maxine Paul, director of sales and operations, NuMotion, formerly owner of Academy Medical Equipment, Inc.

“These women are trailblazers and are passionate advocates for not only the industry, but for the patients they serve,” said Clint Geffert, president of VGM & Associates. “They exemplify the dedication and innovation required to have a positive impact on their business, co-workers, customers and the communities they serve.”

The finalists, who were selected from a pool of 38 nominees, will travel to Medtrade, where the winner will be announced on Oct. 24 at 8 a.m. in room C101 of the Georgia World Congress Center.

An honorary committee that included last year’s HME Woman of the Year, Dr. Kirsten Davin, chose the finalists using criteria that included implementing new business processes, advocating on behalf of the industry, improving the lives of patients and impacting the community through volunteerism.

Mike Mallaro, CEO of VGM, notified each of the finalists personally.

“There are so many in HME that do a great job, and to be acknowledged for that is amazing,” Wilkerson told him. “I’m around a lot of great people, and it’s very humbling that I was selected as a finalist.”

AAH, VGM respond to Price’s resignation

HME News - Tue, 10/03/2017 - 08:18
10/03/2017HME News Staff

WASHINGTON – While the HME industry has lost a strong advocate in former HHS Secretary Tom Price, AAHomecare and VGM say they won’t be deterred in their fight to reform the competitive bidding program and address other issues.

They point out that in his short time in office Price, who resigned on Friday, has cleared the way for reform by, among other things, submitting a bid-related interim final rule to the Office of Management and Budget for clearance.

“We will build upon the strong engagement we have had with leadership and other professionals at these agencies since the start of the year,” the association stated.

Price resigned Friday amid growing criticism of his use of charter flights instead of commercial flights to travel to government engagements. He has been at the helm of HHS since February.

Regardless of who is HHS secretary, VGM pointed out the HME industry still has a number of champions in Congress that stand ready to help. Most recently, more than 100 members of the House of Representatives signed on to a letter pressuring the OMB to clear the bid-related IFR.

“While the DME industry has lost a strong advocate within the department, there are countless legislators on Capitol Hill that the industry can count on to craft policy that strengthens access to DME,” VGM stated. “The industry has strong support within the legislative branch of government.”

Both AAH and VGM said they look forward to developing relationships with acting HHS Secretary Dr. Don Wright, the deputy assistant secretary for health, and director of the Office of Disease Prevention and Health Promotion.

Plan for Long Term Care Before You Need It

Long Term Care Link - Sun, 10/01/2017 - 19:00
Long Term Care Planning is the process of preparing for and funding long term care.

Seniors and Retirees, Consider Using a Reverse Mortgage to Supplement Income

Long Term Care Link - Sun, 10/01/2017 - 19:00
For many seniors and retirees, the hard-earned equity in their home is their single largest asset, yet it is unavailable to use unless they take out a home-equity loan.

The Value of Geriatric Care Management Services

Long Term Care Link - Sun, 10/01/2017 - 19:00
Also known as Care Management or Aging Care Management, a Geriatric Care Manager represents a growing service offering support to adult children who need outside assistance with care and personal management for their aging parents who live close by or far away.

How the Funeral Rule Helps Consumers

Long Term Care Link - Sun, 10/01/2017 - 19:00
In 1984 the Federal Trade Commission established the Funeral Rule to give consumers of funeral services certain protections.

Caring for a Loved One at Home Can Be Challenging

Long Term Care Link - Sun, 10/01/2017 - 19:00
Informal caregivers are family, friends and volunteers who provide care and support for an aging loved one. These selfless individuals are rarely paid for their services and often endure a significant amount of stress while providing care.

Estate Planning As Part of Your Long Term Care Plan

Long Term Care Link - Sun, 10/01/2017 - 19:00
A key deficiency in the process of planning for long term care occurs when seniors fail to provide for the orderly distribution of assets after death or fail to let their family know what to do when the senior can no longer handle his or her own affairs.

Perpetrators of Elder Abuse Are Usually Family Members

Long Term Care Link - Sun, 10/01/2017 - 19:00
Many elderly rely entirely on family or other trusted individuals to help them. Whether it is physiological or psychological, as people grow older they tend to need guidance and support. Unfortunately, the dependence upon caregivers or family members makes an older person more vulnerable to abuse.

Osteoporosis - What You Need To Know

Long Term Care Link - Sun, 10/01/2017 - 19:00
Your body is constantly replacing bone, the older you are, the slower the bone is replaced. Osteoporosis is a bone disease that happens when the body loses too much bone or makes too little bone.
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