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Plaintiff reaches proposed settlement with Invacare

HME News - Fri, 08/28/2015 - 12:50
08/28/2015HME News Staff

NEW YORK – The lead plaintiff in a class action lawsuit against Invacare has reached a proposed settlement of $11 million in cash, according to a statement from lead counsel Bernstein Litowitz Berger & Grossman.

A hearing for Government of Guam Retirement Fund et al vs. Invacare will be held Nov. 9 before Christopher Boyko in the U.S. District Court, Northern District of Ohio, Eastern Division in Cleveland.

Boyko will determine whether the proposed settlement should be approved as fair, reasonable and adequate; whether the action should be dismissed with prejudice against defendants and the releases specified and described in the stipulation and agreement of settlement should be granted; whether the proposed plan of allocation should be approved as fair and reasonable; and whether the application for an award of attorneys’ fees and reimbursement of litigation expenses to be filed on behalf of lead counsel Bernstein Litowitz Berger & Grossman and local counsel Climaco, Wilcox, Peca, Tarantino & Garofoli should be approved.

The lead plaintiff in the lawsuit alleges that the defendant made false and misleading statements about violations of FDA regulations and current Good Manufacturing Practices.

Analysis reveals worsening appeals backlog

HME News - Thu, 08/27/2015 - 12:50
08/27/2015HME News Staff

WASHINGTON – The wait time for DME appeals at the administrative law judge level has increased by nearly 25% during the first half of 2015, according to an analysis released by AAHomecare.

“It is painfully obvious that this system is broken, but no measures are being taken to fix the root of the problem,” said Kim Brummett, vice president of regulatory affairs at AAHomecare, in a release.

Despite reports from the Office of Medicare Hearings and Appeals indicating improvement, the average processing time at the ALJ level was 725 days in June, according to data that AAHomecare analyzed from the OMHA website.

              

By law, providers who file an appeal at the ALJ level must receive a decision within 90 days. However, due to the sheer number of appeals received, OMHA has suspended the assignment of hearings for appeals.

The result: the number of claims held at the ALJ level has gone from 38,506 in 2006 to 364,634 in 2015, a 947% increase.

The number of appeals for DME at the ALJ level has skyrocketed from 6,305 in 2006 to 133,839 in 2014, a whopping 2122% increase.

That’s in part due to the specific nature of providing DME products and services, Brummett says.

“Home medical equipment providers are dealing with the same patient and same service/item on an ongoing basis over a period of time,” she said.  “When the first claim is denied, all of the subsequent claims for the same patient and service are denied. However, when the previous claim is overturned, it does not mean that any other claims for the same patient and same service will be paid/overturned at any level. This cycle traps a large volume of claims in a system that cannot handle them properly.”

If this trend continues, OMHA will have 3 million appeals by the end of 2016, AAHomecare says.

Prosthetic community rallies

HME News - Wed, 08/26/2015 - 14:23
08/26/2015HME News Staff

BALTIMORE – Hundreds of amputees and prosthetic stakeholders converged on CMS Wednesday to protest drastic proposed changes to the local coverage determinations for lower limb prostheses.

About 300 people attended a public comment hearing, hosted this morning by the four DME MACS, with another 400 calling in.

“What we (as health care providers) want...is the ability to prescribe the right device for the right patient and do that at the right time and make sure that they do reach the full potential that they have,” said Dr. Marlis Gonzalez-Hernandez, medical director of Outpatient Physical Medicine and Rehabilitation Clinics for Johns Hopkins Hospital, according to an article on healio.com.

After the hearing, protesters held a rally in front of the Health & Human Services building, holding signs that read “Get your hands off my legs,” and “Honk if you like your limbs. We do too!”

The rally is the latest in a groundswell of support that has grown since the draft LCDs were released in July. A petition calling on the White House to rescind them has garnered more than 107,000 signatures.

The deadline to submit comments to CMS on the proposed changes is Aug. 31.

United Health dominates Medicare Advantage market

HME News - Tue, 08/25/2015 - 13:14
08/25/2015HME News Staff

NEW YORK – There is little or no competition in the Medicare Advantage market in 97% of U.S. counties, according to a new study from the Commonwealth Fund.

Among the nation’s 2,933 counties, only one—Riverside, Calif.—qualified as a competitive market and only 80 qualified as moderately competitive.

“Allowing private health insurers to play a larger role in Medicare is often suggested as a way to control Medicare costs and improve quality of care,” said Stuart Guterman, senior scholar in residence at AcademyHealth and coauthor of the study, in a press release. “The idea is if there are more insurers, they’ll fight for customers by lowering premiums and improving quality. For that to happen, however, we need to have enough insurers in a given market—and this study shows that, overwhelmingly, that isn’t the case.”

The Commonwealth Fund found that six insurers dominate the markets in the 100 counties with the most Medicare beneficiaries. United Health had the greatest number of Medicare Advantage enrollees in 38 counties, while Blue Cross affiliates had the greatest enrollment in 13 counties and Humana in 12 counties.

While both urban and rural markets lack competition, rural markets are the least competitive, the Commonwealth Fund found.

The Commonwealth Fund is a private foundation that aims to promote a high-performing healthcare system that achieves better access, improved quality and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children and elderly adults.

Pieces fall into place for O2 Concepts

HME News - Fri, 08/21/2015 - 12:54
08/21/2015Liz Beaulieu

OKLAHOMA CITY – It’s turning out to be a banner year for O2 Concepts.

The manufacturer has been around for five years, but it pocketed its first outside investment in July and plans to launch a new POC by 2016.

“We’re in the middle of launching DNA Technology right now,” said CEO Rob Kent of the software platform that allows HME providers to access usage and other data from a Verizon modem in the company’s POC.

Currently, O2 Concepts has one flagship product: the Oxlife Independence, a POC with both pulse dose and continuous flow. It’s a feature that allows the OxLife to be used 24/7, eliminating the need for a stationary oxygen concentrator, Kent says.

O2 Concepts will use the investment from the Bank of Oklahoma to support new product development, as well as enhance its manufacturing facility in Newtown, Conn., and expand its presence overseas. The company recently received CE certification for the Oxlife, clearing it for use in Europe and other foreign countries, Kent says.

“Now we’re lining up key partners,” he said. “For that kind of growth, you need a healthy amount of capital.”

Also by year’s end, O2 Concepts plans to double its sales force in a calculated move to ramp up sales of Oxlife, which has been on the market for about three years, as well as the new POC coming down the pike, Kent says.

“We really want to coach the business model of non-delivery,” he said.

In a busy POC market, O2 Concepts is staking a claim not only for its smart and dual-mode POC but also for its five-year warranty. The company shifted to a five-year warranty in 2014 after learning the biggest concerns providers have with POCs are reliability and out-of-warranty repair costs, Kent says.

“Even though our cost to manufacture may not be the lowest, we have the lowest long-term service costs,” he said. “If your business is going to be around for the next five years, we’re the product you should buy.”

Providers left holding the bag in Florida

HME News - Fri, 08/21/2015 - 12:51
‘They’re saying it’s between us and Univita’08/21/2015Theresa Flaherty

MIRAMAR, Fla. – HME providers are scrambling to get paid and to get in-network with health plans three weeks after the collapse of Univita Health.

Provider Ken Steber, who Univita contracted with to provide products and services to recipients in northern Florida, says he's owed nearly $500,000. 

“We’re fighting with the insurance companies to get some sort of resolution, but it’s not going too well,” said Steber, president of Pensacola-based Gulf Medical Services. “They are saying that’s between us and Univita, but they are ultimately responsible for these patients.”

Univita gained control of the Florida Medicaid market in 2014, when the Agency for Health Care Administration contracted with the provider to administer the program for 10 of the 14 participating health plans. Less than a year later, however, AHCA announced Univita was no longer processing prior authorizations and told providers to contact health plans directly.

Provider Ivonne Gonzalez, who assumes she won’t be able to collect on her outstanding claims with Univita, has been working with several health plans. She’d like to get in-network, but she’s heard they’re only offering short-term arrangements—about 60 days, in most cases.

“So far, they aren’t proposing to let us into their networks after the transition,” said Gonzalez, president and CEO of Health Medical Equipment in Miami. “What are we supposed to do? Pick up our equipment?”

Providers hope the state will intervene, but AHCA has traditionally been hands off with how health plans handle their business, says attorney Dan Leyton.

“You can see where the MCOs might resist the idea of making good on Univita’s obligations,” said Leyton, a partner with Kravitz, Talamo & Leyton in Hialeah.

However things shake out, AHCA needs to think long and hard about how it wants to move forward, Leyton says.

“You have to wonder whether providers are going to want to continue to participate if they know that someday, a situation like this is going to happen again,” he said.

Templates ease documentation burden, respondents say

HME News - Fri, 08/21/2015 - 12:49
But misconception that they’re not allowed remains08/21/2015Theresa Flaherty

YARMOUTH, Maine – Template has long been a dirty word in the HME industry, but as health care shifts toward paperless, HME providers are now playing catch up.

“Virtually all physicians are using electronic templates for everyday exams, surgeries, etc.,” said one respondent to a recent HME NewsPoll. “They get frustrated with the lack of HME capabilities in their systems.”

Forty-five percent of respondents to the poll say they use electronic templates vs. 55% who don’t.

One of the biggest obstacles to more widespread use of templates: Many providers believe they’re a no-no. In 2013, however, CMS issued a clarification to its Program Integrity Manual that stated, “CMS does not prohibit use of templates to facilitate recordkeeping,” as long as they are not what it calls “limited space templates.”
Still, the misperception remains.

“Do we use templates? No,” said one respondent. “Do we use one or more of the various electronic medical record systems that facilitate ordering? Yes.”

But with increasingly complex requirements, coupled with an onslaught of audits, templates can make it easier to document need.

“The templates walk the doctor through each question making sure they address all the notes that are needed,” said one respondent. “We don’t need to go back to the physician two or three times. It’s more efficient.”

Of the poll respondents that do use electronic templates, 70% cite increased efficiency as the biggest benefit. Other benefits include improved patient care (18%) and decreased denials (12%).

Templates are only as good as the people using them, however.

“We are finding that templates are not the answer because humans are not willing to update and understand the importance of this process,” said Starla Barlie, billing coordinator at Center Home Health Care in Enterprise, Ala.

 

MobilityWorks consolidates accessible van market

HME News - Fri, 08/21/2015 - 12:48
08/21/2015Tracy Orzel

AKRON, Ohio – MobilityWorks, a national chain of wheelchair accessible van providers, has entered into a merger agreement with Hasco Medical, significantly strengthening its presence on the East Coast.

MobilityWorks has 35 locations in 13 states, while Hasco has 22 locations in 11 states, including Connecticut, Massachusetts, New Hampshire, Vermont and Maine, as well as nine locations in Florida.

“MobilityWorks is currently the largest supplier in the United States of wheelchair accessible vehicles and Hasco is No. 2,” said Chris Paczak, vice president of marketing at MobilityWorks. “We joined forces to cover more of the United States and different markets, and to provide our service to people in need of our products.”

Under the terms of the agreement, Hasco will become a wholly owned subsidiary of MobilityWorks. 

Hasco’s locations in Florida are an especially big coup.

“Hasco covered parts of the country that we did not—New England all the way down to Florida,” said Paczak. “Florida is a very strong market for our products.”

Also acquired through the merger: Ride-Away, a wheelchair van and adaptive equipment provider. Hasco acquired the New Hampshire-based company in March, along with its 11 East Coast locations.

“As our customers travel to vacation areas, relocate or visit family they’ll have a larger MobilityWorks/Hasco footprint for service and rental vehicles,” said Paczak, on the acquisition of Ride-Away.

The merger is expected to be finalized within 60 days, about the time it takes for the FTC to complete a business review. 

Founded in 1997 and based in Akron, Ohio, MobilityWorks is an Inc. 500|5000 company with more than 460 employees nationwide. In April, the company acquired Miami, Fla.-based Sunset Mobility.

In brief: Apria goes big for PERS, Drive buys HurryCane

HME News - Fri, 08/21/2015 - 12:41
08/21/2015HME News Staff

LAKE FOREST, Calif. – Apria Healthcare has expanded an agreement to offer PERS devices.

Apria has worked with Tunstall Americans for nearly six years, but under an expanded agreement, the provider will make the company’s products available to the general public under its Apria Medical Alert brand.

“This expanded relationship demonstrates our commitment to providing enhanced services, such as Tunstall’s cellular base unit and automatic fall detection, combined with 24/7 personal support, to help individuals continue to recover and live safely in their own homes," said Chris Gorciak, senior director of marketing & e-commerce for Apria.

Tunstall will support order intake and fulfillment, and design custom branded products and materials for Apria.

“Our two companies share a passion for improving patient outcomes, safety, and quality of life through innovative healthcare technology and high-touch personal health monitoring services,” said Casey Pittock, president and CEO of Tunstall Americas.

Drive Medical buys HurryCane

PORT WASHINGTON, N.Y. – Drive Medical has entered into an agreement to buy HurryCane from the Marketing Architects portfolio of companies.

Drive Medical believes HurryCane’s brand recognition means a “huge market” for its products.

“With Drive’s extensive manufacturing and distribution capabilities, these products will soon be sold all over the world, as will the many new HurryCane products soon to be introduced,” said Harvey Diamond, CEO Of Drive Medical, in a press release.

The HurryCane cane employs a patented design that allows for maximum mobility on all terrains, along with continuous balance and stability, according to the release. It is sold direct-to-consumer, but last year, HurryCane relaunched a retailer program to also sell through HME providers.

Kirsten Newquist, vice president of channel development at Drive Medical, will oversee the marketing, sale and promotion of all HurryCane products, under the leadership of Jeffrey Schwartz, co-founder and executive vice president of Drive Medical.

The deal is scheduled to close by Aug. 25.

HurryCane is only the latest in a string of acquisitions for Drive Medical. Most recently the manufacturer bought DeVilbiss Healthcare.

AOPA pulls out all the stops

Ads, meeting, protest and petition all part of efforts

WASHINGTON – The American Orthotic and Prosthetic Association is organizing stakeholders to fight proposed changes to coverage requirements to prostheses.

AOPA has commissioned print and TV advertising in the Washington, D.C., area; it’s arranging for top officials and a Boston Marathon survivor to attend, and hopefully speak at, a DME MAC open meeting on Aug. 26; and it’s organizing more than 100 amputees to converge at CMS headquarters for a protest later that same day.

Also part of the fray: a petition organized by the National Association for the Advancement of Orthotics and Prosthetics asking the White House to rescind the proposed changes. The petition has more than 100,000 signatures.

All of these activities lead up to an Aug. 31 deadline to submit comments to CMS on the proposed changes.

InfuSystem says it’s ‘well positioned’

MADISON HEIGHTS, Mich. – InfuSystem Holdings on Aug. 13 reported net revenues of $17.2 million for the second quarter ended June 30, 2015, compared to $16.4 million for the same quarter in 2014, a 5% increase.

It reported a net income of $800,000, an 11% decrease.

"This was an important quarter for InfuSystem as we made substantial progress in integrating the acquired Ciscura assets, gained traction in the expansion of our EMR initiatives, continued expanding our base of payer contracts, decreasing bad debt by 21% compared to last year's second quarter, and we operated profitably for the 11th out of the last 12 quarters, said CEO Eric Steen, in a release. “InfuSystem is well positioned to generate solid financial results for the second half of 2015 and beyond."

The infusion pump and services provider has completed the acquisition of all the assets of Alpharetta, Ga.-based Ciscura, including 1,600 infusion pumps in 100 facilities throughout the Southeast. The acquisition will open up InfuSystem’s full portfolio of infusion products, including its InfuSystem EXPRESS EMR software, to its newly acquired customers.

Brightree, VGM Fulfillment remove fees

ATLANTA – Brightree and VGM Fulfillment, a consignment-based CPAP resupply service, have made available a no-fee integrated interface. “This new agreement allows providers to realize additional reductions in operating costs by removing any transaction fees,” stated Rob Boeye, executive vice president of Brightree, in a press release. The interface allows Brightree customers to reduce inventory cost and speed up the billing process with direct shipments of CPAP supplies to patients. Brightree and VGM have been partners since 2008.

VGM creates cost calculator as part of bid fight

WATERLOO, Iowa – The VGM Group has created a delivery cost calculator to help show Congress and CMS that rural areas will take a significant hit in 2016 if competitive bidding pricing is applied nationwide. VGM is asking HME providers to fill out and submit delivery cost calculator forms. The group will file the data it receives by state and send it to the appropriate members of Congress. Questions that VGM hopes to answer with the data include: Does CMS realize how much it costs to deliver medical equipment and service patients? Is it considering the cost of gas, and the wear and tear on your vehicle? How about the time it costs to send a delivery person 50-100 miles away round trip?

PRO2 bets on POC

LUBBOCK, Texas – PRO2 Medical Supplies has started carrying the LifeChoice ActiVox Portable Oxygen Concentrator. The provider says it has added the product in response to “customers wanting an overnight, portable oxygen concentrator that reduces cylinder deliveries and eliminates the trouble of changing and carrying multiple oxygen bottles,” according to a press release. The POC comes complete with AC/DC power supplies, carrying bag and cannula. PRO2 has stores in Lubbock and Big Spring. It also carries urological equipment, incontinence briefs, knee scooters, walkers, CPAP masks, wheelchairs, catheters and other health and medical necessities.

Wanted: Individuals making an impact on HME

WASHINGTON – AAHomecare seeks nominations for its “Homecare Champion Award.” The annual award represents an opportunity to honor and thank someone in the HME industry for his or her hard work and dedication. Last year’s recipients: Cara Bachenheimer, senior vice president of government relations for Invacare, and Joe Mills, chief executive officer of Advanced Homecare. The recipients of this year’s award will be announced at AAHomecare’s “Stand up for Homecare” reception at Medtrade. The reception will take place from 5:30 to 7 p.m. on Oct. 27 on the rooftop deck at the Metro Atlanta Chamber of Commerce. The reception is also a fundraiser for consumer-related initiatives and groups, like the National Council on Independent Living.

Video commemorates ADA

EAST AMHERST, N.Y. – NCART has released a seven-minute video honoring National CRT Awareness Week and commemorating the 25th anniversary of the ADA. “Complex Rehab Technology: 25 Years after the Americans with Disabilities Act” includes historical footage, as well as commentary from former Sen. Tom Harkin, D-Iowa, highlighting the importance of preserving access to complex rehab products. “While the passage of the ADA was a great achievement, if people with disabilities can’t access the CRT they require, the ADA can be a big unfulfilled promise,” wrote Don Clayback, executive director of NCART, in an email to stakeholders. To view the video, click *here.

Move over Movember, here comes Sleeptember

WASHINGTON – The American Sleep Apnea Association and numerous partners will launch Sleeptember next month. The year-long, patient-led, patient-supported campaign will create online and community events to raise awareness of the public health impact of sleep loss, and will raise funds for medical research and advocacy efforts, according to Sleep Review. The campaign will center around the soon-to-go-live website www.sleeptember.org. The association modeled the campaign after Movember, a campaign where men grow moustaches during November to raise awareness of men’s health issues.

Missouri providers meet senator

PERRYVILLE, Mo. – Provider Patrick Naeger hosted a meeting with Sen. Roy Blunt, R-Mo., Aug. 12. Naeger is executive vice president of Healthcare Equipment & Supply Co., and president of the Midwest Association of Medical Equipment Services. "This was a great opportunity to meet with Senator Blunt and to share with him industry concerns,” said Naeger in a release. “In particular, we asked for support of our efforts to curb the competitive bid national price roll-out, which is slated to take place Jan. 1, 2016.” Also in attendance: Justin Decker, CRTS and ATP with Alliance Rehab and Medical Equipment; and Tom Powers from The VGM Group.

Paralympian partners with Melio maker

LIVERPOOL, England – Albert Medical Devices has partnered with Paralympian Bert Burns to create a new educational video. Earlier this year, Albert Medical Devices launched Melio, a self-emptying leg bag system for catheters. The video features Burns demonstrating the system and the positive impact it can have on wheelchair users. “Melio answers one of the biggest inconveniences of using the restroom when you’re away from home,” said Burns in a release. “It never fails—every time you visit a public restroom, the handicap stall is occupied by someone who is not a wheelchair user.”

Drive, DeVilbiss hammer away at integration

PORT WASHINGTON, N.Y. –Drive Medical has completed a significant portion of its restructuring plan to integrate DeVilbiss Healthcare, the company announced August 14. “Over the next few months, we will be focused on the operational aspects of the integration plan with a renewed focus on innovation and the development of new products,” said Harvey Diamond, CEO of Drive, in a release. The two companies will operate independently in the Americas until the integration is competed, which is expected to happen by the end of October. At that time, customers will be able to order Drive and DeVilbiss products together on one purchase order, through a centralized customer service support center. Drive DeVilbiss Healthcare will have more than 2,000 employees and distribute in more than 80 countries.

More list makers: Aeroflow, PlayMaker CRM

Aeroflow Healthcarehas landed at 3089 on the Inc. 5000 list list of fastest growing companies. “We are extremely proud to receive this recognition, but we are even more excited about the future of the company and our employees,” said Casey Hite, CEO and founder, in a press release. It’s the provider’s first time on the list…PlayMaker CRM, a cloud-based customer relationship management software provider for the post-acute care industry, has ranked 722 on this year’s list. It’s the third year in a row that PlayMaker has made the list: It ranked 956 in 2014 and 451 in 2013. “Our continued growth is a testament to the tremendous amount of work our team puts in to deliver a purpose-built sales acceleration platform to the post-acute healthcare industry,” stated John Griscavage, CEO, in a press release. “I am delighted to see clients of all sizes embracing our innovative technology.” 

Drive Medical buys HurryCane

HME News - Fri, 08/21/2015 - 08:40
08/21/2015HME News Staff

PORT WASHINGTON, N.Y. – Drive Medical has entered into an agreement to buy HurryCane from the Marketing Architects portfolio of companies.

Drive Medical believes HurryCane’s brand recognition means a “huge market” for its products.

“With Drive’s extensive manufacturing and distribution capabilities, these products will soon be sold all over the world, as will the many new HurryCane products soon to be introduced,” said Harvey Diamond, CEO Of Drive Medical, in a press release.

The HurryCane cane employs a patented design that allows for maximum mobility on all terrains, along with continuous balance and stability, according to the release. It’s sold direct-to-consumer, but last year, HurryCane relaunched a retailer program to also sell through HME providers.

Kirsten Newquist, vice president of channel development at Drive Medical, will oversee the marketing, sale and promotion of all HurryCane products, under the leadership of Jeffrey Schwartz, co-founder and executive vice president of Drive Medical.

The deal is scheduled to close by Aug. 25.

HurryCane is only the latest in a string of acquisitions for Drive Medical. Most recently the manufacturer bought DeVilbiss Healthcare.

AOPA pulls out all the stops

HME News - Thu, 08/20/2015 - 11:27
Ads, meeting, protest and petition all part of efforts08/20/2015HME News Staff

WASHINGTON – The American Orthotic and Prosthetic Association is organizing stakeholders to fight proposed changes to coverage requirements to prostheses.

AOPA has commissioned print and TV advertising in the Washington, D.C., area; it’s arranging for top officials and a Boston Marathon survivor to attend, and hopefully speak at, a DME MAC open meeting on Aug. 26; and it’s organizing more than 100 amputees to converge at CMS headquarters for a protest later that same day.

Also part of the fray: a petition organized by the National Association for the Advancement of Orthotics and Prostheticsasking the White House to rescind the proposed changes. The petition has more than 100,000 signatures.

All of these activities lead up to an Aug. 31 deadline to submit comments to CMS on the proposed changes.

Apria goes big for PERS

HME News - Wed, 08/19/2015 - 10:13
08/19/2015HME News Staff

LAKE FOREST, Calif. – Apria Healthcare has expanded an agreement to offer PERS devices.

Apria has worked with Tunstall Americans for nearly six years, but under an expanded agreement, the provider will make the company’s products available to the general public under its Apria Medical Alert brand.

“This expanded relationship demonstrates our commitment to providing enhanced services, such as Tunstall’s cellular base unit and automatic fall detection, combined with 24/7 personal support, to help individuals continue to recover and live safely in their own homes," said Chris Gorciak, senior director of marketing & e-commerce for Apria.

Tunstall will support order intake and fulfillment, and design custom branded products and materials for Apria.

“Our two companies share a passion for improving patient outcomes, safety, and quality of life through innovative healthcare technology and high-touch personal health monitoring services,” said Casey Pittock, president and CEO of Tunstall Americas.

InfuSystem is ‘well positioned’

HME News - Tue, 08/18/2015 - 10:19
08/18/2015HME News Staff

MADISON HEIGHTS, Mich. – InfuSystem Holdings on Aug. 13 reported net revenues of $17.2 million for the second quarter ended June 30, 2015, compared to $16.4 million for the same quarter in 2014, a 5% increase.

It reported a net income of $800,000, an 11% decrease.

"This was an important quarter for InfuSystem as we made substantial progress in integrating the acquired Ciscura assets, gained traction in the expansion of our EMR initiatives, continued expanding our base of payer contracts, decreasing bad debt by 21% compared to last year's second quarter, and we operated profitably for the 11th out of the last 12 quarters, said CEO Eric Steen, in a release. “InfuSystem is well positioned to generate solid financial results for the second half of 2015 and beyond."

The infusion pump and services provider has completed the acquisition of all the assets of Alpharetta, Ga.-based Ciscura, including 1,600 infusion pumps in 100 facilities throughout the Southeast. The acquisition will open up InfuSystem’s full portfolio of infusion products, including its InfuSystem EXPRESS EMR software, to its newly acquired customers.

CMS shortens Round 1 contracts

HME News - Fri, 08/14/2015 - 11:36
08/14/2015Tracy Orzel

BALTIMORE – CMS announced the timeline for Round 1 2017 last week, with one noticeable difference from previous rounds: The contract period is two years instead of three.

Stakeholders say CMS most likely reduced the contract period to two years so that Rounds 1 and 2 would both end Dec. 31, 2018.

“There’s a good chance CMS could scrap the bid program in its entirety and do something to update the fee schedule or do some kind of national bid program,” said Seth Johnson, vice president of government affairs for Pride Mobility Products. “I’m not sure what their rationale is in bringing these two bid programs into sequence. We’ll find out as we get closer to that date."

By law, CMS is required to recompete competitive bidding contracts at least once every three years.

The change in contract length could impact the number of providers who submit bids, says Kim Brummett,vice president of regulatory affairs at AAHomecare.

“It’s a lot of work for a shorter contract,” she said. “We may see less bidders because of this.”

However, Johnson says the two-year contract could be a blessing for some providers.

“If the rates are lower and/or a supplier did not win a contract then that could be viewed as a good thing,” he said. “It’s all about where the single payment amounts come in and whether the supplier was offered or not offered a contract.”

As for what those rates will be, stakeholders say it’s hard to predict what will happen. In the Round 1 re-compete, the average reduction in reimbursement was 37%. In the original Round 1, it was 32%.

“With the bid prices being where they are right now, it’s difficult to even fathom that they would be lower,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Inogen predicts growth in sales will stick

HME News - Fri, 08/14/2015 - 11:31
One reason: There’s plenty of runway left for growth in the POC market, says President and CEO Ray Huggenberger08/14/2015Liz Beaulieu

GOLETA, Calif. – Four moving parts helped Inogen grow domestic business-to-business sales a whopping 80.5% in the second quarter this year compared to the same period last year, making it the company’s fastest growing channel.

CEO Ray Huggenberger credited investments the company has made in its sales force and consumer marketing; investments its provider customers have made in marketing; the industry picking up, in “tiny little steps,” on a non-delivery business model; and the initial pay off of a private label program with Applied Home Healthcare Equipment.

“None of this individually is a reason why we would see 80% growth, but all of them combined make for a good year-over-year comparison,” he said during an Aug. 11 conference call to discuss earnings.

Overall, Inogen reported net revenues of $44 million for the second quarter compared to $30.4 million for the same period last year. Net income was $3.5 million vs. $2.3 million. The company reported net revenues of $77.8 million for the first half of the year compared to $54 million for the same period last year. Net income was $5 million vs. $3.2 million.

The first half of 2015 has gone so well for Inogen that the company has increased its guidance for the year to between $145 million-$149 million in revenues, growth of 28.8%-32.4% compared to 2014. Previous guidance was $133 million-$137 million.

When asked whether Inogen could sustain this level of growth in its business-to-business sales, Huggenberger said, “We’re increasing our guidance because we do believe it’s going to stick.”

One reason for that stickiness: There’s plenty of runway left for growth in the POC market, Huggenberger says.

“I see the journey of the POC becoming the default of how oxygen is delivered as a long and grinding one with steps made each quarter and each year,” he said. “I foresee it to take a long, long time and the reason for that is there are existing infrastructures that are not easily changed.”

Huggenberger predicts the “tipping point” everyone is waiting for to be “several years in the future.”

“POC is a cheaper way and so we see DME businesses establishing fleets of POCs for temporary rental,” he said. “We also see some businesses seriously looking at the POC as a more default means of providing oxygen therapy, but in general, the bigger the company, the bigger the infrastructure and the harder it is to make that decision.”

NHIA’s Bodoff recollects and predicts

HME News - Fri, 08/14/2015 - 11:27
08/14/2015Theresa Flaherty

ALEXANDRIA, Va. – When Russell Bodoff took the reins at the National Home Infusion Association, the organization was near bankruptcy and there was no Medicare benefit for home infusion therapy.

Today, NHIA is a vibrant organization with strong finances—but there’s still no Medicare benefit. Bodoff retired this month after eight years and will be replaced by Tyler Wilson. He spoke with HME News about the state of home infusion.

The association

In less than a decade, the once struggling NHIA has built itself into a powerhouse with “tremendous support” from the home infusion industry, says Bodoff.

“We have a very active and strong presence on the Hill and with the regulatory agencies,” he said. “We’ve built a strong membership base. Every major home infusion provider is a member, not just the large ones, but the small mom-and-pops, the hospital systems—we have tremendous support. I am also very proud of our staff.”

The benefit

Infusion stakeholders have been working on a benefit for 25 years through multiple pieces of legislation, but Bodoff says he’s optimistic it will happen.

“We’re getting closer now,” he said. “No one questions the benefit of home infusion. There’s no question this will provide savings in the Medicare system. Back when John Kerry was still a senator and sponsored our legislation, he said, ‘This is healthcare insanity.’”

The future

All areas of health care are undergoing massive changes and providers must change right along with them, says Bodoff.

“There are consolidations, payers are reevaluating reimbursement, and reimbursements are becoming tighter,” he said. “Providers in home infusion and other areas are going to have to learn how to operate efficiently in the new models of the future.”

In brief: Settlement dampens Liberator Medical's earnings, senators ask CMS to backpedal on accessories

HME News - Fri, 08/14/2015 - 11:24
08/14/2015HME News Staff

STUART, Fla. – Liberator Medical Holdings has reported net revenues of $20.4 million for its fiscal third quarter ended June 30, 2015, a 9.7% increase compared to the same period last year.

It reported a net income of $1.7 million vs. $2 million, a 15.8% decrease.

The increase in revenues was due primarily to Liberator Medical’s continued emphasis on its direct response advertising campaign to acquire new customers.

The decrease in income was due to a one-time expense of $600,000 associated with an agreement to settle a civil qui tam lawsuit in which the company, among others, was charged with violating the False Claims Act for engaging in illegal kickback arrangements with Coloplast. The other defendants named in the lawsuit are Hollister, 180 Medical, A-Med Health Care Center, Byram Healthcare Centers, CCS Medical, RGH Enterprises, d/b/a Edgepark Medical Supplies, and Shield California Health Care Center.

Liberator Medical has reported net revenues of $60.3 million for the first six months of 2015, a 9.9% increase over the same period last year. It reported a net income of $5.8 million vs. $5.7 million, a 1.2% increase.

Senators ask CMS to backpedal on accessories

WASHINGTON – A bi-partisan group of 23 senators sent a letter to CMS last week asking the agency to rescind its plan to apply competitive bidding pricing to accessories for complex rehab wheelchairs. The letter was lead by Sens. Thad Cochran, R-Miss., and Chuck Schumer, D-N.Y. “The conversations with these offices over the past week, and with those who were not able to sign on at this time, have created an important increase in Senate awareness and support on this issue,” said Don Clayback in a bulletin to members. “We will need that as we move ahead.” In the House of Representatives, Rep. Lee Zeldin, R-N.Y., has introduced a bill that would provide technical correction to prevent CMS from applying competitive bidding pricing to accessories for complex rehab.

NHIA seeks feedback on outcomes elements

ALEXANDRIA, Va. – The National Home Infusion Association is accepting stakeholder comments on newly revised Definitions for Patient Outcomes Data Elements to be used in the collection of data to assess the safety, effectiveness and efficiency of home and specialty infusion care. Providers, nurses, physicians, pharmacists, payers, accreditors and other healthcare professionals can submit feedback on NHIA’s website. The revised definitions are part of the association’s ongoing efforts to establish field-specific demographic, operational and clinical quality benchmarks. The latest iteration of definitions builds upon and updates previous definition established in 2012. Revised definitions include adverse drug reaction, ER use, unscheduled hospitalization, access device events, medication error and therapy complete.

ACHC gets accepted by Highmark Health

CARY, N.C. – The Accreditation Commission for Health Care’s sleep accreditation program has received acceptance by Highmark Health, an independent licensee of the Blue Cross Blue Shield Association. Effective this month, the approval allows ACHC-accredited sleep providers in Pennsylvania, Delaware and West Virginia to access Highmark Health’s network. Highmark Health and its diversified businesses and affiliates operate health insurance plans serving 53 million members in those states.

RESNA revises position on tilt and recline

ARLINGTON, Va. – RESNA has released an updated position paper on tilt, recline and elevating legrests. “Since the original publication in 2010, there’s been additional scientific evidence for various functional uses for tilt, recline and elevating legrests,” said lead author Brad Dicianno, medical director at the University of Pittsburgh. RESNA states that these features are often medically necessary, allowing users to realign posture, improve respiration, bowel and bladder function, redistribute and relieve pressure, and manage edema. To keep up with changing technology, research and clinical best practice, RESNA’s position papers are reviewed every five years.

MedForce, Universal Software integrate

SUFFERN, N.Y., and DAVISON, Mich. – MedForce Technologies and Universal Software Solutions have developed an interface that enables automated transfer of patient demographics, documentation and other information. The integration streamlines workflows, eliminates duplicate data entry and ensures instant access to information at all times, according to the companies. “In health care, it is critically important that software systems work together for providers to realize the improvement in productivity they’ve been promised,” said Nathan Apter, chief technology officer at MedForce, in a press release. MedForce provides document and process management solutions; Universal Software provides a practice management solution known as Healthcare Data Management System or HDMS.

Attendance at AZMESA event tops charts

PHOENIX – The Arizona Medical Equipment Suppliers Association saw record attendance at its annual conference held Aug. 6 in Phoenix, according to a press release. The association has also seen its ranks grow for the fifth consecutive year. It now represents 44 companies in the state with 80 member contacts. “We are still a small association, but we are seeing more and more interest and recognition here,” said Rose Schafhauser, executive director of the association. “We are aggressively moving to attract a larger number of providers in the state.” More than 65 people attended the conference to hear sessions from VGM’s John Gallagher, AAHomecare’s Jay Witter and others.

HME industry leaves imprint on Inc. 500 list

Brightreehas ranked on the Inc. 5000 list of fastest growing private companies in the U.S. for the sixth year in a row. “This achievement recognizes the talent, dedication and passion of our employees in creating innovative solutions for the post-acute healthcare market,” said Dave Cormack, president and CEO, in a release. The list ranks companies according to percentage revenue growth between 2011 and 2014. In that timeframe, Brightree has grown 128%, reporting a revenue of $96.6 million in 2014…Carolina’s Home Medical Equipment also made the list for the fourth consecutive year. The company ranked in the top 15 healthcare companies in North Carolina. “Having experienced a 50% reimbursement cut from most payers over the last three to four years, it is clear to me that the relationships we have with our customers and referral sources made this possible,” said Frank Trammell, president and CEO, in a press release. “This could not have happened without an extremely proficient staff that is dedicated to the notion of extreme customer service.”…Cape Medical Supply also made the list for the sixth time. Claiming No. 4,003 this year, the company has experienced 73% revenue growth over the past three years, has added 25 new jobs and has continued to expand its geographic reach.

Inogen gets new board member

GOLETA, Calif. – R. Scott Greer has been appointed an independent director to Inogen’s board of directors. Greer has also been appointed to the company’s Audit Committee. He will serve as a Class I director, with a term expiring at the annual meeting of stockholders on Oct. 14, 2015. Greer, who is a director of Sientra and numerous biopharmaceutical companies, replaces Timothy Petersen, who served on the board since 2010. Previously, Greer was chairman of Inogen’s board of directors from 2005 to 2007.

Rotech announces layoffs

HME News - Thu, 08/13/2015 - 10:25
08/13/2015HME News Staff

ORLANDO, Fla. – Despite “momentum” from a string of acquisitions, Rotech Healthcare plans to lay off 90 employees by Oct. 9.

The provider, one of four “nationals” in the HME industry, filed a Worker Adjustment and Retraining Notification with the state on Aug. 12, according to news reports.

The layoffs will take place at Rotech’s 3600 Vineland Road location, a billing center.

Rotech has a total of 3,500 employees in 450 locations in 48 states.

Since late last year, the provider has made at least six acquisitions, including the respiratory equipment assets of Alert Medical in Fort Meyers and Naples, Fla., in July.

“The momentum continues,” said CEO Tim Pigg in a press release about the acquisition.

Rotech has also bought assets from Specialized Medical Services in Cody, Wyo., and assets from unnamed companies in Arkansas, Louisiana, Mississippi and Florida.

Of the Cody, Wyo., acquisition, Pigg said in a press release: “Unlike many of our smaller distressed competitors, we have the staying power to ride the current market difficulties and capital available to invest in our core products and target healthcare markets.”

Rotech emerged from Chapter 11 bankruptcy in September of 2013. As part of a reorganization plan, the provider reduced its debt from about $600 million to just under $300 million. Its annual cash interest payments were reduced from $60 million to $20 million.

 

CMS announces bidding timeline for Round 1 2017

HME News - Wed, 08/12/2015 - 11:18
08/12/2015HME News Staff

BALTIMORE – Registration for Round 1 2017 opens Aug. 25, and the bid window opens Oct. 15, CMS announced yesterday.

“CMS is achieving additional savings as part of the Affordable Care Act’s expansion of the competitive bidding program,” stated CMS Deputy Administrator Sean Cavanaugh in a press release. “Data used to monitor the effectiveness of the overall competitive bidding program show that implementation is going smoothly, with few inquiries or complaints and no adverse changes to beneficiary health outcomes.”  

Due to lower payments and decreased utilization, the Round 1 recompete has saved Medicare more than $580 million over three years (January 2011-December 2013), according to CMS. Round 2, which spanned 91 cities, and the national mail-order program have saved Medicare $2 billion in the first year, the agency says.

The complete Round 1 2017 timeline:

Aug. 25
Registration for user IDs and passwords begins

Sept. 14
Authorized Officials are strongly encouraged to register no later than this date

Oct. 5
Backup Authorized Officials are strongly encouraged to register no later than this date

Oct. 15
CMS opens bid window for Round 1 2017

Oct. 23
Registration closes

Nov. 16
Covered document review date for bidders to submit financial documents

Dec. 16
Bid window closes

Winter 2016
Preliminary bid evaluation notification

Summer 2016
CMS announces single payment amounts, begins contracting process

Fall 2016
CMS announces contract suppliers, begins contract supplier education campaign and begins beneficiary, referral agent and supplier education program

Jan. 1, 2017 
Implementation of Round 1 2017 contracts and prices

The seven product categories included in the Round 1 2017 are: enteral nutrients and equipment; general home equipment; nebulizers; negative pressure wound therapy pumps; respiratory equipment; standard mobility equipment; and transcutaneous electrical nerve stimulation devices.

Liberator’s revenues up, income down

HME News - Tue, 08/11/2015 - 12:00
08/11/2015HME News Staff

STUART, Fla. – Liberator Medical Holdings has reported net revenues of $20.4 million for its fiscal third quarter ended June 30, 2015, a 9.7% increase compared to the same period last year.

It reported a net income of $1.7 million vs. $2 million, a 15.8% decrease.

The increase in revenues was due primarily to Liberator Medical’s continued emphasis on its direct response advertising campaign to acquire new customers.

The decrease in income was due to a one-time expense of $600,000 associated with an agreement to settle a civil qui tam lawsuit in which the company, among others, was charged with violating the False Claims Act for engaging in illegal kickback arrangements with Coloplast. The other defendants named in the lawsuit are Hollister, 180 Medical, A-Med Health Care Center, Byram Healthcare Centers, CCS Medical, RGH Enterprises d/b/a Edgepark Medical Supplies, and Shield California Health Care Center.

Liberator Medical has reported net revenues of $60.3 million for the first six months of 2015, a 9.9% increase over the same period last year. It reported a net income of $5.8 million vs. $5.7 million, a 1.2% increase.

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