WASHINGTON – A proposed electronic clinical template for power mobility devices (PMDs) is now being tested.
As part of a pilot project that kicked off in November, CMS has begun allowing physicians to use the template to collect relevant information while evaluating a patient’s mobility needs.
“It’s really important that DME and complex rehab suppliers become engaged in this process,” said Laura Cohen, executive director of The Clinician Task Force. “It’s going to be finished with or without stakeholder input—they need to get involved while their input can still be incorporated.”
Cohen is part of a workgroup that has been working for the past year to integrate the template into the electronic health record. Other members of the workgroup include CMS officials and contractors from the Office of the National Coordinator for Health IT (ONC).
While CMS officials say they are pleased with the progress of the template, Cohen is more cautious. She still worries it will become a tool only for Medicare to “auto-review” claims, instead of a tool to help patients get the mobility equipment they need.
“Making a decision about mobility comes down to a synthesis of materials—I don’t know if you can automate that,” she said.
Information about how to take part in the pilot project is available at http://wiki.siframework.org/esMD+Pilots.
DALLAS and ORANGE PARK, Fla. – A new partnership means DMEhub integrates with and supports Aprima Medical Software’s electronic health record (EHR) system, allowing physicians to order DME directly through Aprima.
“Aprima is very pleased to be able to offer this important new time-saving feature to our customers,” said Michael Nissenbaum, Aprima president and CEO, in a release. “The need to automate the DME ordering process is becoming increasingly important as we see the population age and the home healthcare market grow.”
As a result of the integration, DMEhub now pulls the patient demographic information directly from records and populates the necessary forms. It also allows physicians to attach documents.
DMEhub then electronically sends the forms to the correct supplier and incorporates the forms back into the records.
“We feel that through this partnership we are bringing a solution to Aprima’s customers that will save them time in their day-to-day workflow, therefore saving their practice money,” said Jeff Jacobs, DMEhub president, in the release.
ADDISON, Texas – Hasco Medical has received orders for $2.5 million worth of handicap accessible taxicabs, the company announced today.
The orders represent about 80 taxicabs that will be deployed in the New York City market.
“This is such a great purchase for our company,” said CEO Hal Compton in a release. “Hasco will continue to work with more taxi companies in various states to continue to provide accessible vehicles for every person that requires one.”
A court ruling has required that New York City put more handicap accessible taxicabs on the road. In mid-November, the city auctioned 200 medallions, or licenses, for handicap accessible taxicabs, and in the next three years, it will auction off another 1,800.
Currently, New York City has 233 handicap accessible taxis, representing less than 2% of its total fleet of 13,000 cabs.
Hasco sells handicap accessible vans in 18 locations from Maine to Florida. It consists of Ride-Away, Auto Mobility Sales, Mobility Freedom and Wheelchair Vans of America.
In Florida, Hasco also sells medical equipment and supplies through Certified Medical.
OREM, Utah – ActiveCare, a diabetes and chronic disease management company, has retained DelMorgan & Co. to serve as its financial adviser, it was announced today.
DelMorgan, an investment banking firm, will advise ActiveCare on strategic plans, including investments, and possible acquisitions, divestitures and joint ventures, according to a release.
“With a substantial sales pipeline and the need to fund working capital for growth, solving ActiveCare’s short-term financial challenges should unlock the opportunity for explosive future expansion and substantial profitability,” stated Neil Morganbesser, DelMorgan president and CEO, in the release. “Our goal is to help ensure that capital is available for growth and the company can execute its business plan.”
ActiveCare manages more than 30,000 diabetes patients for nearly 100 employers.
“With over 25 million diabetics and another 79 million pre-diabetics in the United States costing over $245 billion per year—33% of the nation’s total healthcare costs—there is tremendous market demand for an approach that has been shown to reduce those costs,” stated Rob Delgado, chairman of Delgado. “ActiveCare has that solution.”
ActiveCare uses “state-of-the-art” meters that allow its CareSpecialists to intervene in real time; and provides around-the-clock support.
LAKE FOREST, Calif. – CVS Caremark has agreed to acquire Apria’s home infusion business, Coram, for $2.1 billion, the companies announced today.
“CVS Caremark and Coram share a mutual commitment to provide patients with quality care,” said John Figueroa, Coram CEO.
Apria acquired Denver-based Coram for $350 million in 2007. Today, Coram has more than 4,500 employees and serves more than 20,000 patients each month through 85 locations. Third quarter revenues for the division, reported Nov. 12, were $975.3 million—about 53% of Apria’s overall revenues.
“Infusion will be a valuable component of our broad specialty pharmacy offering going forward,” said Jon Roberts, president of CVS Caremark Pharmacy Services. “Our comprehensive services will allow us to streamline care management for patients as well as their physicians.”
The deal, which is expected to close by the end of first quarter 2014, is one of the largest of its kind. The only other one to come close: Walgreen’s acquisition of OptionCare in 2007 for $850 million.
Unlike the HME and respiratory markets, the home infusion market has enjoyed relative stability, thanks to steady reimbursement and proven cost-effectiveness. Although the therapy was included in the Round 1 re-compete of competitive bidding, analysts have said they don’t expect that to have too much of an impact. Coram accepted infusion contracts in all nine competitive bid areas.
Apria plans to focus on its core respiratory business.
“The Apria Healthcare respiratory business will continue to operate as a standalone business in the future, and the company is focused on executing its strategic plan for the future,” said Lisa Getson, executive vice president, in an email to HME News.
WASHINGTON – Industry stakeholders are shaking their heads in disbelief at a final rule that makes certain complex rehab equipment capped-rental items effective April 1.
In the Nov. 22 final rule, CMS designates 78 codes as capped-rental—including codes for tilt-in-space manual wheelchair, pediatric manual wheelchair, and manual wheelchair power-assist. Medicare estimates that this equipment will only be needed, on average, for eight months—saving Medicare $130 million over five years.
“We’re extremely disappointed,” said Don Clayback, executive director of NCART. “Stakeholder input to create rational regulations that protect the program and protect beneficiaries was completely ignored.”
After publishing a similar proposed rule in July, CMS received 170 letters explaining that complex rehab equipment is for people with long-term disabilities.
Stakeholders worry that spreading payments for expensive complex rehab equipment over 13 months will be a hardship for providers—especially if state Medicaid programs and other insurers follow Medicare’s lead.
“Medicare is not the primary payer for many of these products, but as Medicare goes, so go the rest of the payers, to a large degree,” said Seth Johnson, vice president of government affairs for Pride Mobility. “If providers are unwilling or unable to transition to that model, access is going to be a problem.”
Stakeholders haven’t given up the fight. Bills in the House of Representatives and the Senate that would create a separate benefit category for complex rehab could fix the issue if passed—and prevent others like it in the future, they say.
“My hope is that people will get more fired up about the separate benefit,” said Weesie Walker, interim executive director of NRRTS. “This puts the problem in your face: CMS does not understand what complex rehab is.”
ATLANTA – Fresh off his acquisition of MedAct Software, Brightree President and CEO Dave Cormack says the pace of consolidation among software companies is only going to increase.
Brightree’s acquisition of MedAct in November is the company’s second this year and its fifth since 2008. The other acquisition this year: CareAnywhere, a software company serving home health and hospice providers.
“It’s all about interoperability,” Cormack said. “We’re talking to some of the managed care plans, and they’re looking for transparency down the supply chain. It’s a brave new world, and you need to have scale to handle this kind of interoperability.”
Brightree gains 330 customers with its acquisition of McKinney, Texas-based MedAct. Gregg Timmons, CEO of MedAct, will join Brightree as executive vice president, MedAct Division.
Another big change to health care that’s putting a premium on scale: the transition to ICD-10, a much larger set of codes that are more specific and diagnosis-driven. Brightree plans to spend $1.5 million to bring its software up to speed with ICD-10, which goes into effect Oct. 1, 2014.
“It’s a major investment for a software company,” Cormack said.
The need for scale is a big reason why MedAct hitched its wagon to Brightree, says Timmons.
“Our customers need to have access to these capabilities,” he said. “It’s not like MedAct couldn’t do it over time, but the pace of innovation had to pick up. They have a great roadmap for going forward.”
Brightree will continue to provide development and customer service support for MedAct’s software, and even update it for ICD-10, Cormack says.
“We’ll continue to give customers choice, as long as the market demands it,” he said. “But our flagship products will continue to be on the Brightree platform.”
“Health care is still a fairly fragmented market,” Timmons said. “In other markets like retail and oil and gas, they’ve already gone through supply chain integration and they’re using technology to drive efficiencies.”
YARMOUTH, Maine – HME providers struggling with decreased Medicare reimbursement are hunting for private-pay contracts, but they’re not always quick to pull the trigger.
There are providers like John Teevan, whose company, New Berlin, Wis.-based Home Care Medical inked a deal in October with Network Health to become an in-network provider of HME, respiratory, rehab and home infusion equipment. Network Health offers a range of health insurance plans to more than 135,000 plan members in northeast Wisconsin.
“We’re definitely looking for them,” said Teevan, president. “We approach networks we are not already part of or, as we go into new territories, we look for what’s there and line those up with acquisitions or expansions.”
Teevan says he’s found that, while private-pay insurers have an expectation of better discounts, they’re not “off-the-wall” compared to the Round 2 single payment amounts.
“They are more about looking for providers that can do it all,” he said.
Then there are providers like Cliff Woolard. His company, Concord, Calif.-based Home Med-Equip, has numerous major insurance contracts but recently turned down a new Medicare Advantage plan.
“They wanted me to provide service for 50% of the Medicare rates,” said Woolard, president. “I’ve never heard of anyone trying to pay that low. They didn’t even blink.”
Unfortunately, that’s a trend that’s likely to continue as more providers seek alternative payers, says Stephen Hodges, president of HME Solution, a consulting firm.
“There’s a frenzy in the marketplace to get these contracts,” he said. “There’s so much downward pressure on pricing that the payers are reluctant to negotiate price.”
Regardless, there are still plenty of benefits to working with private payers, in particular more straightforward billing procedures, say providers.
“You send the prescription information to the authorization department and they say yes or no,” said Woolard. “There’s never a guarantee, but you get some sense of authorization before you dispense a product. And they pay sooner.”
ROSEVILLE, Minn. – Among the millions of travelers to hit the road last week for the Thanksgiving holiday were young patients of Pediatric Home Service (PHS).
“These days, vents are so much smaller, and CPAP and suction machines are more compact and portable,” said Dana Akerson, marketing supervisor. “They are traveling for the holidays and are able to be with family.”
In November, PHS held one of several Facebook photo contests to draw attention to its young patients traveling with their medical equipment. Parents uploaded photos of them and encouraged friends to vote.
Of the top five vote getters, PHS selected two for $75 Visa gift cards.
“They want to show off their kids and since they are already on these platforms, it doesn’t take extra time for them to engage with our brand that way,” said Akerson.
Voters had to “like” the PHS’s Facebook page to vote. That builds traffic, says Katlyn Bourget, digital specialist.
“We’ve seen a lot of engagement and a lot of traffic growth as a result of these contests,” she said. “People see it, they share it, and they encourage their family and friends to look at it.”
PHS has been ramping up its social media presence since April, when Bourget came on board. Its Facebook page has more than 3,000 likes and its twitter handle has nearly 700 followers. The provider recently added Pinterest to its social media platform. It plans to build “pinboards” around tips for home care and ideas for crafts parents can do with their kids.
“A lot of Pinterest is about being helpful,” said Bourget. “That’s what we do on all of our platforms. There are things that may not exactly relate to our services, but it’s another way for us to be helpful and be top of mind to the consumer.”
VALDOSTA, Ga. – Numotion has purchased the custom mobility division of Barnes Healthcare Services, according to a Nov. 26 release. Barnes, which offers post-acute complex care in Georgia, Florida and Alabama, will now focus on pharmacy, respiratory, nutrition and medical supplies. “The addition of Barnes’ seven locations in Georgia and Florida greatly expands our coverage and improves access to complex rehab technology to residents throughout the region,” said Bill Boyce, regional vice president of Numotion, in the release.
Smith & Nephew makes wound care buy
LONDON – Smith & Nephew has agreed to acquire the wound management-related assets and business of Brazil’s Politec Saude, furthering its plans to build an emerging markets business, according to a Nov. 26 release. Politec Saude is Brazil’s lone distributor of Smith & Nephew advanced wound management products. “Brazil is an exciting long-term opportunity and this is an important investment which creates a significant platform from which we can grow,” said Olivier Bohuon, Smith & Nephew CEO. The acquisition comprises one-quarter of Politic’s total business; the company will continue to operate its other businesses as usual, according to the release.
Lincare offers mobile cardio telemetry
CLEARWATER, Fla. – Raytel Cardiac Services, which Lincare has sole rights over, is now offering mobile cardio telemetry services through M-Air, according to a recent release. CardioComm Solutions, which develops technology to record, view, analyze and store ECGs, developed the wireless ECG monitoring solution using TZ Medical’s Aera CT device and Raytel’s CardioCare Diagnostic Arrhythmia Service, according to the release. CardioComm released the M-Air solution to Raytel for implementation on Nov. 9.
ResMed CFO sells 15K shares
SAN DIEGO - Brett Sandercock, ResMed CFO, sold 15,000 shares of company stock Nov. 20, according to news reports. The shares were sold at an average price of $51.06, for a total of $765,900. Sandercock now directly owns 94,902 shares in ResMed, worth about $4.8 million, according to reports. ResMed recently announced its first quarter earnings for 2014, reporting slower growth versus the previous year due to Round 2 of competitive bidding.
Contractor clarifies respiratory policy
WASHINGTON – Medicare does not reimburse for home oxygen used specifically to treat obstructive sleep apnea (OSA) because it is not the primary treatment for that disease, even if beneficiaries cannot tolerate PAP devices, CGS Associates said in a recent FAQ. The DME MAC said beneficiaries who use a PAP device to treat OSA and who are in need of oxygen for other chronic pulmonary conditions like COPD, however, qualify for reimbursement if they meet the requirements of the oxygen and PAP local coverage decisions (LCDs) and have been diagnosed using a titration polysomnogram.
3B Medical releases PAP software
LAKE WALES, Fla. – 3B/BMC has released nPap Data Analyzer, a new software that works alongside the company’s line of CPAP and Auto-CPAP devices, according to a Nov. 22 release. The software allows clinicians to develop reports and graph trends in pressure, leak levels, apnea-hypopnea, flow level, tidal volume and respiration rate. The program is available to download at no cost. Also on Nov. 22, 3B Medical announced that its iCodeConnect, a web-based data management system, now features SD card functionality, the company announced Nov. 22. The iCodeConnect system allows DME providers and physicians to store patient data, generate sleep reports, exchange notes, and manage patients efficiently. The upgrade will allow the iCodeConnect patient management portal to integrate with the portable memory cards.
AABCP to launch post mastectomy awareness campaign
HOUSTON – The American Association of Breast Care Professionals (AABCP) has announced plans for several events throughout 2014 to raise political and public awareness for the need for post mastectomy services. The campaign will include basic education and explanations of what post mastectomy services are and how these medically necessary items differ from normal lingerie or aesthetic beauty products. More information about the effort is available at www.aabcp.org.
101 Mobility Tampa partnered with Harmar to donate and install a wheelchair lift as part of an effort to build an accessible home for injured Army Staff Sergeant (SSG) Alex Dillmann. Dillmann will receive the house Dec. 5…New Berlin, Wisc.-based Home Care Medical has launched a redesigned website with additional educational materials, a promotions page and a new careers page.
RALEIGH, N.C. – AmeriGlide’s online sales are going just fine, thank you, but there are only so many people who will buy lifts via the Internet, says Tim Ziehwein.
Ziehwein is a vice president at AmeriGlide, a company that manufactures lifts and, until one year ago, sold them exclusively online. Now AmeriGlide offers a distributor program (similar to a franchise program without the fees) that gives the company a physical presence and allows HME providers to tap into a $300 million home accessibility market, he says.
“What we’re really looking for are businesses that are successful now doing DME and oxygen, but they’re not doing lifts,” Ziehwein said. “We’re the perfect match.”
As part of the distributor program, AmeriGlide will, among other things, provide a customized website, after-hours sales support, an exclusive territory, and marketing guidance. Providers must have, among other things, an appropriate show room and storage space, and meet certain sales goals.
AmeriGlide decided to expand beyond the Internet because, based on its research, only 15% of accessibility products are bought online, Ziehwein says.
“There are still 85% of sales being done by brick-and-mortars,” he said. “These are the people who want to see and touch products. They also want a local company to install it and, if there’s a service issue, fix it.”
The first distributor, AmeriGlide of Lexington, was profitable in its first month, says owner Lindsay Sheffer. Her father happens to be the founder and CEO of AmeriGlide, but that didn’t mean she got preferential treatment. After seven years of installing lifts as a side job, Sheffer opened the branch in August of 2012. The key to success, she says: focusing on the local community and providing top-notch customer service.
“When something happens to you and you need this equipment, you need it yesterday,” Sheffer said. “I tell everyone they can reach me from 7:30 a.m. to 11 p.m. seven days a week. I’ve had people call me at 9:30 on a Friday night to test me. Happy customers are the best advertisement you can get.”
AmeriGlide of Lexington is one of 24 distributors that AmeriGlide has set up in the first year of the program, with an overall goal of 200, Ziehwein says.
“They see that it’s a giant market and that we have a good reputation for our products,” he says.
WASHINGTON – CMS told lawmakers during a briefing on Nov. 18 that they’re investigating reports that some contract suppliers are not servicing their entire bid areas.
Although the briefings were closed to the public, industry stakeholders heard that CMS told lawmakers it’s using secret shoppers to see if contract suppliers are willing to service Medicare beneficiaries that are living in more rural areas.
“When that happens, they begin education,” said Seth Johnson, vice president of government affairs for Pride Mobility. “If the supplier remains out of compliance, they may ultimately terminate the contract.”
CMS held the briefings for Senate staff and staff of the Energy and Commerce and Ways and Means committees.
While stakeholders agree that CMS should be monitoring contract suppliers, they’re not sure the secret shopper program will be that constructive.
“It doesn’t appear that the secret shoppers are particularly educated about the requirements of the program,” said Cara Bachenheimer, senior vice president of government relations for Invacare.
Also during the briefing, CMS told lawmakers that they’ve received only about 120 complaints from beneficiaries. That’s in sharp contrast to the number of complaints collected by the People for Quality Care (PFQC). Nearly five months into Round 2, the PFQC’s hotline still averages 35 to 40 calls per day.
“I don’t know how CMS is counting complaints but ours are quite a bit different,” said Kelly Turner, PFQC director. “We have 2,600.”
One of the most common complaints?
“They can’t get a hold of someone at Medicare to help them find a new provider,” said Turner. “They get passed around or put on hold and finally they say, ‘forget it’ and hang up.”
While CMS continues to say the program is running smoothly, recent actions taken by the agency say otherwise, says Bachenheimer.
“They said they weren’t going to issue new contracts in Tennessee, but they did,” she said. “They changed the oxygen policy because these companies are going out of business and leaving patients stranded. Those are big signs there’s a problem. CMS will never admit there’s anything wrong and they control the flow of information.”
WASHINGTON – When CMS agreed to a meeting to discuss ongoing issues surrounding power mobility device (PMD) repairs, the agency had a rude awakening, industry stakeholders say.
“CMS seemed shocked at the convoluted nature of the repair side of things,” said Peter Rankin, government affairs manager at AAHomecare. “They were also under the impression that repairs were a profit driver for providers, when they’re actually a loss driver.”
On Nov. 14, stakeholders met with the CMS ombudsman, along with other officials by phone, to share the results of repair-related surveys conducted by AAHomecare and the United Spinal Association.
Among the results from AAHomecare’s survey: The number of providers repairing PMDs fell from 75% in 2012 to 45% in 2013; 52% of providers said they would not repair PMDs provided by other companies; and 40 of 74 providers said they’ve had repair claims recouped as the result of an audit on the original wheelchair claim.
Consumers who completed United Spinal’s survey reported abandonment issues and access problems, says Alex Bennewith, vice president, government relations, for the association. A big issue: If consumers need repairs to their wheelchairs but can’t access the original provider’s documentation, they must have another face-to-face exam with their physician, adding time to the process.
“The documentation for repairs needs to be streamlined,” she said. “Even a simple repair can take weeks of waiting, and, in the meantime, wheelchair users are stuck in their homes.”
Stakeholders had the following recommendations for CMS: allow beneficiaries to attest that they’ve been abandoned (instead of the current drawn-out process); “divorce” repairs from the wheelchair so providers can feel safe doing repairs without worrying their money will be recouped if the wheelchair is audited; and carve out repairs from competitive bidding to clear up confusion about what providers can and can’t do under the program.
“This needs to be fixed immediately,” he said. “Any willing provider needs to be able to do whatever it takes to make the wheelchair operable.”
While CMS seemed open to changes, fully convincing the agency will require consumers continuing to complain, Rankin says.
“We need to make sure the drum beat continues,” he said.
YARMOUTH, Maine – Provider Brent Bradshaw says Round 2 of competitive bidding has sparked a disturbing trend: contract suppliers billing patients for brake attachments for walkers that CMS has already paid for.
CMS last month cautioned providers about “unbundling” walkers and brake attachments. When providers sell walkers with brake attachments (E0141, E0143 and E0149), reimbursement is for the whole unit, the agency stated.
Bradshaw, president of Durable Medical Equipment Inc., in Austin, Texas, welcomed the clarification.
“This makes competitive bidding winners bill at the price they agreed to,” he said. “With reimbursement for Round 2, they can bill at $70, and they’re billing the patient $95. They’re shifting the cost to the beneficiary.”
Since the clarification, however, provider Dave Mills has been leery of providing walkers to Medicare beneficiaries.
“This is something we don’t want to be in violation of,” said Mills, co-owner of Chesapeake, Va.-based First Choice in Homecare. “The reimbursement is already almost less than we’re paying.”
Billing expert Andrea Stark says the recent unbundling errors for walkers and brake attachments are probably accidental for many providers.
“This is more than likely an education issue that is cropping up,” said Stark of MiraVista. “A lot of providers are attempting to do upgrades, but this is frequently done incorrectly.”
To do it correctly, Stark says providers should offer patients equipment that suits their medical needs, and then offer different equipment with enhanced features as the upgrade.
“You have to start with what is medically necessary, and upgrade from there,” Stark said.
ATLANTA – Brightree has acquired McKinney, Texas-based MedAct, adding 330 HME providers to its customer base. “With the addition of MedAct, we are expanding our market reach to include some of the industry’s most nimble HME providers,” said Dave Cormack, president and CEO of Brightree, in a release. MedAct’s customers will join Brightree’s more than 3,000 customers. Under the terms of the agreement, MedAct CEO Gregg Timmons joins Brightree as executive vice president, MedAct Division. Brightree will continue to provide development and customer support for current MedAct solutions. In addition to MedAct’s customer base, Brightree will be able to leverage the company’s headquarters in Texas, giving it a presence in the central U.S.
OIG releases strategic plan
BALTIMORE – One of the Office of Inspector General’s (OIG’s) four goals for the next four years is to fight fraud, waste and abuse, according to a strategic plan released Nov. 21. The OIG says it plans to continue and expand existing initiatives in this area, like the Medicare Fraud Strike Force and the Health Care Fraud and Abuse Control Program. The agency also says it plans to focus on compliance issues related to fraud, waste and abuse. It plans to promote compliance, resolve noncompliance issues and help the Department of Health and Human Services (HHS) assess whether providers are qualified to take part in government healthcare programs, according to the report. Additionally, the OIG plans to take successful models, such as the Medicare Fraud Strike Force, and use them in other HHS programs, focusing on discouraging waste and promoting Medicare and Medicaid integrity. Other goals in the plan include promoting quality, safety and value; fostering financial stewardship and a high-performing healthcare system; and promoting expertise while leaning on leading-edge technology and tools.
ResMed advances patent case
SAN DIEGO – ResMed has won preliminary injunctions in Germany against two medical device manufacturers for alleged patent infringements. The initial orders prohibit Apex Medical, a Taiwanese manufacturer, and BMC Medical, a Chinese manufacturer, from selling or marketing certain products in Germany without a court order, according to a press release. ResMed has also filed lawsuits in Germany that seek damages and permanent injunctions for certain products. "We will continue to defend our investment in intellectual property and pursue all legal remedies to prevent infringement in any country where that infringement exists," said David Pendarvis, global general counsel and chief administrative officer at ResMed. Earlier this year, ResMed pursued similar legal actions against Apex and BMC in the United States. The investigation into BMC is ongoing, while the investigation into Apex resulted in a consent decree requiring Apex to stop importing and selling infringing products.
Stakeholders increase outreach for complex rehab bill
WASHINGTON – The sponsors of a bill in the Senate to create a separate benefit for complex rehab are circulating a “Dear Colleague” letter to ramp up support. With little time left in the current legislative session, the bill, S. 948, has only six supporters in the Senate. “We need to increase our Senate outreach and build on the substantive positives we have,” wrote Don Clayback, executive director of NCART, in a bulletin. Sens. Charles Schumer, D-N.Y., and Thad Cochran, R-Miss., introduced S. 948 in May. Some of those positives: Schumer and Cochran are two of the most senior senators; both Democrats (four) and Republicans (two) support the bill; and members of the Finance Committee and the Health, Education, Labor and Pension Committee are represented among supporters. NCART asks providers to contact their senators and follow up with them about the letter. A similar bill in the House of Representatives, H.R. 942, has 85 supporters, with a goal of 100. A list of the supporters for both bills, as well as Schumer and Cochran’s letter, is available at www.access2crt.org.
PFQC to providers: Encourage bennies to report problems
WATERLOO, Iowa – The number of Medicare beneficiaries calling the People for Quality Care (PFQC) hotline to report problems related to competitive bidding continues to climb. The organization recently released an updated report containing 2,614 complaints. Because the number of complaints coming into the hotline, however, has slowed, the PFQC is calling on providers to encourage beneficiaries to report problems. The organization, which shares the reports with Congress, is releasing new fliers to help providers educate beneficiaries about the hotline.
Liberator stock heads to NYSE
STUART, Fla. – Common stock of Liberator Medical Holdings began trading on the New York Stock Exchange under LBMH on Nov. 20. “We are confident that our leading market positions and strong customer relationships, combined with the increased visibility of being listed on the NYSE, will help enhance value for all stakeholders,” stated Mark Libratore, Liberator CEO, in a release. Liberator, whose products include diabetic and ostomy supplies, posted strong earnings in the third quarter of 2013.
6-4-18 Series returns to Medtrade
LAS VEGAS – The 6-4-18 Series of educational sessions, which debuted at Medtrade in October, will be part of Medtrade Spring in March, show organizers have announced. Unlike at Medtrade, however, the series will be open to all attendees. “Medtrade is committed to survival and success of the HME industry,” said Kevin Gaffney, show director, in a release. “By making these important sessions open to all, we believe a large number of providers will benefit.” Topics in the series, which is designed to provide six building blocks for success in the next 18 months, include using software as a business management tool and becoming a certified DME specialist. The early bird rate for Medtrade Spring ends Dec. 31.
Alliqua secures $13M
LANGHORNE, Pa. - Alliqua has closed a pair of deals that brings the company two new products and $13 million in investments, the Philadelphia Business Journal reports. “Alliqua now has significant capital to bring our business plans to fruition,” said CEO David Johnson in the story. In a deal with Celgene, Alliqua obtained the rights to develop and market advanced wound care products Biovance and Extracellular Matrix, and Celgene purchased $6 million in Alliqua stock. Separately, Broadfin Capital and Perceptive Advisors rounded up $7 million in investment capital for Alliqua, according to the story.
New CPAP available online only
BOSTON – Human Design Medical released Z1, a new portable CPAP machine, on Nov. 21. The palm-sized machine weighs 10 ounces and uses a lithium ion battery that works for 8 hours without backup power, according to a release. “Our goal was to make CPAP treatment more user-friendly for people with active lifestyles and I think we really nailed it,” said Steve Moore, senior vice president of sales and marketing. “I am a CPAP user myself and have taken the Z1 on business trips across the U.S. and overseas.” The Z1 machine will be available exclusively through the following Internet resellers: thecpapshop.com, cpap.com, cpapsupplyusa.com and directhomemedical.com.
NIH finds poor communication a barrier to COPD treatment
BETHESDA, Md. - To more effectively treat COPD, patients and their doctors need to have open, detailed conversations, a web-based study by the National Institutes of Health has found. Current smokers are likely to talk with their doctors about COPD symptoms (82%), but former smokers, who are also at risk, are not (37%), according to the study, which was released Nov. 15. "A good conversation between patients and providers about COPD can make a real difference for disease sufferers,” said James Kiley, director of National Heart, Lung and Blood Institute Division of Lung Diseases. “It’s no secret that early diagnosis and treatment can improve daily living for those who have COPD—but you can’t get there without an open dialogue in the exam room.” The study says continuing to increase awareness of the disease and its symptoms will help improve patient-provider communications and treatment of the disease.
Fifty children and their families attended the Nov. 22 Dallas Mavericks basketball game as part of “One Shot Away,” a diabetes recognition program hosted by Med-Care Diabetic & Medical Supplies, the Mavericks and the North Texas Chapter of the American Diabetes Association…Invacare has donated eight power wheelchairs to Youth Challenge’s new Paralympic Power Soccer program. Participants play four-on-four matches in power wheelchairs fitted with bumpers…Sunset Healthcare Solutions has launched its annual fundraising campaign to benefit the Toys for Tots Foundation. For each 6-foot long CPAP tube sold in the next two months, the company will donate a portion of the proceeds to Toys for Tots…The American Association for Respiratory Care honored Philips Respironics with the 2013 Zenith Award during the 59th International Respiratory Congress on Nov. 16. Philips received the award for the 15th time…Convaid recently volunteered at the fifth annual Strollathon in The Woodlands, Texas. The International Rett Syndrome Foundation organizes the event to raise research dollars and public awareness.
ATLANTA – Brightree has acquired McKinney, Texas-based MedAct, adding 330 HME providers to its customer base.
“With the addition of MedAct, we are expanding our market reach to include some of the industry’s most nimble HME providers,” said Dave Cormack, president and CEO of Brightree, in a release.
MedAct’s customers will join Brightree’s more than 3,000 customers.
Under the terms of the agreement, MedAct CEO Gregg Timmons joins Brightree as executive vice president, MedAct Division. Brightree will continue to provide development and customer support for current MedAct solutions.
Cormack says combining Brightree’s and MedAct’s resources, talent and industry knowledge will position the companies to better help their customers navigate declining reimbursement rates, increasing audit pressures and other challenges.
“HME providers require advanced software solutions and services that enable them to operate more efficiently, improve revenues and achieve greater profitability,” he said.
Timmons says by joining Brightree, MedAct is tapping into the company’s “significant product development investment strategy.”
In addition to MedAct’s customer base, Brightree will be able to leverage the company’s headquarters in Texas, giving it a presence in the central U.S.
BALTIMORE – One of the Office of Inspector General’s (OIG’s) four goals for the next four years is to fight fraud, waste and abuse, according to a strategic plan released Nov. 21.
The OIG says it plans to continue and expand existing initiatives in this area, like the Medicare Fraud Strike Force and the Health Care Fraud and Abuse Control Program.
The agency also says it plans to focus on compliance issues related to fraud, waste and abuse. It plans to promote compliance, resolve noncompliance issues and help the Department of Health and Human Services (HHS) assess whether providers are qualified to take part in government healthcare programs, according to the report.
Additionally, the OIG plans to take successful models, such as the Medicare Fraud Strike Force, and use them in other HHS programs, focusing on discouraging waste and promoting Medicare and Medicaid integrity.
Other goals in the plan include promoting quality, safety and value; fostering financial stewardship and a high-performing healthcare system; and promoting expertise while leaning on leading-edge technology and tools.
SAN DIEGO – ResMed has won preliminary injunctions in Germany against two medical device manufacturers for alleged patent infringements.
The initial orders prohibit Apex Medical, a Taiwanese manufacturer, and BMC Medical, a Chinese manufacturer, from selling or marketing certain products in Germany without a court order, according to a press release.
ResMed has also filed lawsuits in Germany that seek damages and permanent injunctions for certain products.
"We will continue to defend our investment in intellectual property and pursue all legal remedies to prevent infringement in any country where that infringement exists," said David Pendarvis, global general counsel and chief administrative officer at ResMed.
Earlier this year, ResMed pursued similar legal actions against Apex and BMC in the United States. The investigation into BMC is ongoing, while the investigation into Apex resulted in a consent decree requiring Apex to stop importing and selling infringing products.
WASHINGTON – The sponsors of a bill in the Senate to create a separate benefit for complex rehab are circulating a “Dear Colleague” letter to ramp up support.
With little time left in the current legislative session, the bill, S. 948, has only six supporters in the Senate.
“We need to increase our Senate outreach and build on the substantive positives we have,” wrote Don Clayback, executive director of NCART, in a bulletin this week.
Sens. Charles Schumer, D-N.Y., and Thad Cochran, R-Miss., introduced S. 948 in May.
Some of those positives: Schumer and Cochran are two of the most senior senators; both Democrats (four) and Republicans (two) support the bill; and members of the Finance Committee and the Health, Education, Labor and Pension Committee are represented among supporters.
“So while we may not have quantity right now, we do have quality,” Clayback wrote.
NCART asks providers to contact their senators and follow up with them about the letter.
“This letter can be a very powerful tool for increasing support, but will only be effective if senators are also hearing from you and other constituents,” Clayback wrote.
A similar bill in the House of Representatives, H.R. 942, has 85 supporters, with a goal of 100.
A list of the supporters for both bills, as well as Schumer and Cochran’s letter, is available at www.access2crt.org.
BALTIMORE – The financial capacities that contract suppliers submitted as part of their bids don’t hold much weight, based on new guidance from the Competitive Bidding Implementation Contractor (CBIC).
Contract suppliers must continue to provide equipment and services, even if they’re beyond their submitted capacities, the CBIC now states.
“If you are getting inundated and being asked to provide five times the products you said you could—there’s an argument for that, but it’s just not in the final rule,” said Kim Brummett, senior director of regulatory affairs for AAHomecare.
The CBIC originally stated that providers could decline referrals after they reached their capacities, with proper notice to the agency.
With so many contracts awarded to out-of-state providers, the fear is that local contract suppliers risk getting inundated with referrals, say stakeholders.
“The practical difficulty is that it’s the small local providers that are getting the calls because people don’t want to go to these long-distance firms,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “They don’t call Texas to get a walker in Ohio.”
Licensure issues with the contract suppliers for the Round 1 re-compete are starting to trickle in state by state.
“Twenty-three percent of the contracts in Ohio were awarded to firms that do not appear to be licensed or registered with the appropriate agency,” said Bachenheimer.
In Pennsylvania, it appears only 48% of contracts for the general HME category and 56% of contracts for standard mobility were awarded to providers with proper licensing, according to the Pennsylvania Association of Medical Suppliers (PAMS).
A big reason why many contract suppliers in Pennsylvania don’t meet the requirements: The state in 2012 stopped issuing disinfection licenses—required to provide beds and wheelchairs—to out-of-state providers. In both Round 2 and the Round 1 re-compete, a large number of contracts were awarded to out-of-state providers. PAMS believes those contracts will need to be voided.
“This will have a significant impact on competitive bidding contract holders and Medicare beneficiaries in both the four Round 2 bid areas and the Round 1 re-compete area in Pittsburgh,” PAMS stated a letter to CMS Administrator Marilyn Tavenner.