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‘Double dip’: AAHomecare increases pressure

HME News - Thu, 04/20/2017 - 13:51
04/20/2017HME News Staff

WASHINGTON – AAHomecare is asking lawmakers for relief from a “double-dip” oxygen cut in the 2017 Medicare fee schedule for stationary oxygen.

The move reinforces a letter that the association sent to previous leadership at CMS in December, asking the agency to recalculate its rates, which have dipped below competitive bidding rates in rural and non-bid areas.

“We would like to reinforce these efforts by generating congressional interest and support on the issues, as well,” the association states.

AAHomecare is also engaging the new leadership at CMS and the Department of Health and Human Services.

The association is calling HME providers to action, asking them to contact their members of Congress to educate them about the issue and have them contact CMS.

AAHomecare argues that CMS has improperly reduced payments for E1390 by applying a regulation introduced in 2006—called the budget neutrality offset—that only should be applied to unadjusted fee schedules. The association says the 2017 fee schedule for stationary oxygen must be consistent with those based on regional single payment amounts from competitive bidding areas.

Cardinal Health expands scope in home health care

HME News - Wed, 04/19/2017 - 08:42
04/19/2017HME News Staff

DUBLIN, Ohio – Cardinal Health has entered into a definitive agreement to buy the patient care, deep vein thrombosis and nutritional inefficiency business of Medtronic for $6.1 billion in cash.

Total revenues for that business, which encompasses 23 product categories across multiple market settings, were $2.3 billion for the 12 months ending October 2016. More than 70% of total sales were in the U.S., according to a press release.

“Given the current trends in health care, including aging demographics and a focus on post-acute care, this industry-leading portfolio will help us further expand our scope in the operating room, in long-term care facilities and in home healthcare, reaching customers across the entire continuum of care,” said George Barrett, chairman and CEO of Cardinal Health, in the release.

Cardinal Health says the business is complementary to its medical consumables business and, once the transaction is complete, it will become part of its medical segment, which is led by Don Casey, that segment’s CEO.

Cardinal Health expects to finance the deal with a combination of $4.5 billion in new senior unsecured notes and existing cash. It expects to close the deal in the first quarter of its fiscal year 2018.

Invacare can resume design activities

HME News - Tue, 04/18/2017 - 09:41
04/18/2017HME News Staff

ELYRIA, Ohio – Invacare has been given the green light to resume design activities, according to a Form 8-K filed with the Securities and Exchange Commission.

On April 13, the U.S. Food and Drug Administration accepted a recent second certification report submitted by Invacare’s third-party expert relating to design control requirements at its corporate headquarters and Taylor Street manufacturing facilities in Elyria, Ohio.

“The company is pleased to have achieved this milestone and believes it reflects the company’s continued emphasis on building a quality culture as part of its long-term transformation,” Invacare states in the form.

A consent decree with the FDA has limited Invacare’s ability to design and manufacture wheelchairs at the two facilities since 2012.

Invacare must still get the FDA to accept a third certification report.

Abbott Labs, Alere deal moves forward

HME News - Tue, 04/18/2017 - 09:39
04/18/2017HME News Staff

ABBOTT PARK, Ill., and WALTHAM, Mass. – Abbott Laboratories has agreed to buy Alere, but at a lower price than it previously offered.

Under amended terms, Abbott will pay $51 per common share to acquire Alere, for a new expected equity value of approximately $5.3 billion, reduced from $5.8 billion, according to a press release.

Abbott first announced plans to buy Alere in February 2016. Later that year, however, Abbott filed a complaint in the Delaware Court of Chancery, asking a judge to terminate the deal on the grounds that Alere was no longer the same company it agreed to buy.

Alere’s problems have included CMS revoking the billing privileges of its DME supply business, Arriva Medical, and allegations that it submitted claims for 211 dead patients over the past five years. Alere sued Abbott in the same court, asking a judge to enforce the deal.

CMS in January agreed not to terminate Arriva Medical’s mail-order contract for diabetes testing supplies while the provider appealed to have its licensed reinstated. A court in March denied Arriva’s motion for interim relief and denied CMS’s motion to dismiss Arriva’s complaint. Arriva says it’s considering options for appeal.

Abbott and Alere expect to close the transaction by the end of the third quarter of 2017.

Dickerson, Gunn set high watermark for complex rehab

HME News - Fri, 04/14/2017 - 11:44
‘Go big or go home, and always do the right thing,’ says Dickerson of how Simon Margolis impacted his work04/14/2017Jeff Rowe

YARMOUTH, Maine – Even as a kid, Gerry Dickerson of National Seating & Mobility was working on wheelchairs.

“I was fairly handy and my uncle had a disability,” he said recently.  “So I started working on chairs to help him get around.”

You could say that early desire to put his handiness to work helping others came full circle recently, when Dickerson was one of two complex rehab providers awarded the Simon Margolis Fellow Award at the International Seating Symposium.

Dickerson’s official entry into the complex rehab industry came when he returned from a cross-country motorcycle trip after college and met the owner of a small surgical supply company. He became an employee, then a partner, and as he nears the end of his career, he says, “the things I do now are aimed at seeing that the profession continues” and gets the recognition and support it deserves.

“I am constantly in the political process pushing for systems change,” he said. 

Political activities notwithstanding, Dickerson says the most rewarding part of his career has been the people he works with in the clinic.

“You fix a seating problem, a mobility problem, a pain problem, and you get to work with great friends all over the world,” he said. “It’s the one thing that keeps you going.”

Not surprisingly, Dickerson’s dedication has not gone unnoticed, even before the award.

“His influence and leadership has made the lives of his clients and the CRT industry better in countless ways,” observed Bill Mixon, National Seating & Mobility’s CEO. “Gerry sets a high watermark for others in our company to continually excel in everything they do every day.”

Simon Margolis played no small role in Dickerson’s unflagging dedication.

“He was a stand-up guy who was all about ethics and commitment,” Dickerson said of the late industry leader.  “Go big or go home, and always do the right thing.”

As for what’s next, Dickerson’s fascination with “handy” technology shows no sign of disappearing. 

“I want to investigate 3-D printing,” he said. “I think it’s going to change the world.”

Michele Gunn puts patients first

How do you get recognized for making an “extraordinary contribution” to your profession?

If you’re Michele Gunn of Browning’s Pharmacy & Health Care, it’s by consistently doing what you say you’re going to do over the course of a long, dedicated career. 

Gunn was one of two recipients of the inaugural Simon Margolis Fellow Award at the recent International Seating Symposium, and she thinks it’s largely because “over 25 years, I don’t believe I’ve ever lost sight of putting the client first.”

It helps, Gunn said, that what complex rehab professionals do changes people’s daily lives so they can have jobs and families.  “There are good days and bad days in this business,” she said, “but the good days are so good they far outweigh any of the bad. You do an intervention, knock it out of the park, and it keeps you coming back for more.”

In the beginning, Gunn was working with 14 college students at a center for independent living when a future colleague came and demonstrated what could be done with custom rehab technology. She joined his company and never looked back.

As for Simon Margolis, the long-time executive director of NRRTS, Gunn remembers him as “our figurehead.”

“He was a calm and good leader who always had the perfect answer,” she said.

Over her career, Gunn has come to play a similar role for her colleagues.

“To us, she is a leader, friend and mentor,” said Thana France, a RESNA seating and mobility specialist with Browning’s. “She has worked tirelessly for the past 15 years to build and grow our rehab team. Her expertise and professionalism have no bounds.”

The role of mentor is going to take up a greater part of Gunn’s time moving forward, as she recently moved from Florida to Port Angeles, Wash., to assume a managerial role with Browning’s.

“I’m hoping for more board time now,” said the longtime member of the NCART board of directors. “It’s so important that the individual vendor’s voice isn’t lost.”

Provider competes in today’s Boston Marathon

HME News - Fri, 04/14/2017 - 11:42
Business, like life, is a marathon, not a sprint, says Rick Adamich04/14/2017Kelly Bothum

WAUKESHA, Wis. – The time Rick Adamich spends running does as much for his business as it does for his body.

Lacing up for a few miles helps burn off stress, but it also gives Adamich a chance to reflect on what’s going on at Oxygen One, the home respiratory company he owns.

“It’s really when I do most of my strategic thinking about the business,” he said. “I’m working through some of the issues, and honestly, doing some goal setting.”

Lately, Adamich has had even more time than usual to contemplate work as he puts in the training miles to compete in his first-ever Boston Marathon today.

“There’s not a lot of quiet time outside of running,” said Adamich, 38, a single father of three girls. “When I’m training this hard, I have that much more time to myself. This year, the initiatives and a lot of our strategic plan—a portion of those were conceived and fine-tuned while I was running.”

Adamich has completed about a half-dozen marathons, but this is his first time competing on the venerable course of the Boston Marathon. He qualified after running the Twin Cities Marathon in Minnesota last fall in 3:06. He’s aiming to complete Boston—and its aptly named Heartbreak Hill at 20.5 miles—in under three hours. Adamich said the staff of 30 at Oxygen One will be able to keep tabs on their boss during race day.

Juggling work and family obligations with marathon training has meant lots of time spent on a treadmill, a dreaded choice for many serious runners. But Adamich recognizes many people, including some of his customers, struggle with health problems that severely restrict their mobility. 

“My dad is in a power wheelchair, so I have a direct connection to what it’s like,” said Adamich, whose father will join him in Boston. “It’s not something to take for granted.” 

Sticky situation: Home Health Depot shrinks to grow

HME News - Fri, 04/14/2017 - 11:41
04/14/2017Theresa Flaherty

INDIANAPOLIS – By divesting Genesis Healthcare Services, Home Health Depot is getting back to basics, says Nate Feltman.

HHD in February sold the Atlanta-based Genesis, a provider of HME to hospice organizations, to Richland Hills, Texas-based Hospice Cloud. In the nearly five years since HHD acquired Genesis, it doubled its patient census and added many new customers.

Still, when a buyer came along and made them an offer they couldn’t refuse, the provider accepted, so it could return its focus to its home state.

“Indiana is now our primary market and we just felt it was the right time to exit,” said Feltman president and CEO. “We have bought and sold (companies) throughout the seven years I’ve been an owner with this company. We’re more opportunistic then anything.”

In the past, HHD has dipped its toe into complex rehab, eventually selling the division to National Seating & Mobility, and bulked up its respiratory business with the 2012 acquisition of RCS Management.

Today, HHD focuses primarily on DME and respiratory services with 100 employees and nine locations across Indiana.

Feltman attributes much of the provider’s growth to two key points. The first: The implementation of the Affordable Care Act has ramped up conversations with hospital systems.

“Once the ACA started, the hospitals really began to care about anybody who touches the patients after they leave the hospital and the quality of care,” he said. “Today, a huge portion of our referrals come directly from hospital systems, and in many cases, we have preferred provider relationship liaisons at the hospitals.”

That quality of care dovetails nicely with HHD’s second growth point: the addition of providing DME to hospice organizations in Indiana, which it added after the Genesis acquisition; and the addition of invasive ventilation, which it added about three years ago.

“As a result of growing in hospice, our relationships with the hospitals are even stickier,” Feltman said. “Hospice is critical to a hospital’s reputation and when you do a good job on that side, it translates to other areas like DME, as well.”

Janet Stephens stays STEP ahead in manufacturing

HME News - Fri, 04/14/2017 - 11:39
‘Not everybody’s cut out for manufacturing, but I do think there’s a certain group of women that needs to be educated more about what manufacturing offers’04/14/2017Jeff Rowe

BOWLING GREEN, Ky. –The Manufacturing Institute has announced that Janet Stephens, director of planning & initiatives for SCA’s Global Hygiene Supply Personal Care Americas business unit, will receive the Women in Manufacturing STEP (Science, Technology, Engineering and Production) Ahead Award. HME News recently caught up with Stephens to learn more about what it’s like to be a woman in manufacturing.

HME News: How did you get your start in manufacturing?

Janet Stephens: I started out in computer science, but I didn’t like it. So I took one of those guidance aptitude tests and was told I should be an engineer. I liked chemistry, got a degree in chemical engineering, and, at my first job, found I really love the manufacturing environment. It’s a purpose-driven place to be.

HME: How has working in so many different areas of manufacturing helped you to get where you are now?

Stephens: By the time you get to the site manager level, you’re responsible for all areas, so the more you can understand all aspects of the business, the better off you are.

HME: How have you demonstrated excellence and leadership in your career in manufacturing?

Stephens: On the excellence side, I always ask how can we improve from where we are. As for leadership, I always try to put myself in the other person’s shoes, whether it’s an operator on the floor or senior management.

HME: How have you made SCA’s Bowling Green facility a benchmark in production efficiency?

Stephens: The only way to be a benchmark in anything is to engage everybody and focus on setting goals and attaining them. You have to be able to ignite the passion people have within them.

HME: Do women still need encouragement to get into manufacturing?

Stephens: There are definitely more women on the management side, but not really on the production side. Not everybody’s cut out for manufacturing, but I do think there’s a certain group of women that needs to be educated more about what manufacturing offers.

In brief: AAH submits comments on bidding, Bowen to lead NEMEP

HME News - Fri, 04/14/2017 - 11:35
04/14/2017HME News Staff

 

WASHINGTON – AAHomecare reiterated it concerns about the structure of the competitive bidding process, including CMS’s use of median bid prices instead of market clearing prices, in recent comments submitted to the agency.

CMS was mandated by the 21st Century Cures Act to take into account stakeholder input on future pricing in non-bid areas, which got their first taste of the program in 2016.

In its comments, AAHomecare also asked for more comprehensive evaluation of the bidding program’s effects on beneficiary access and the quality of equipment furnished.
 

The comments also noted significant reductions in the number of HME suppliers in recent years and echoed the feedback shared by many suppliers on a March 23 call with providers.


“The stories told by suppliers and referral sources all had the same theme: the cuts are too severe, suppliers cannot exist on the current regional SPAs, Medicare beneficiaries are not being serviced at the level they need,” AAHomecare stated. “There was a sense of urging CMS to reconsider what has been done as part of the requirement in the Cures Act.”
 


AAHomecare closed its comments by asking what process CMS will follow to respond to industry feedback from the call and the written comments provided by stakeholders, and reiterated the association’s commitment to working with the agency to arrive at a workable payment solution.

AAH makes recommendations on SMRC contract

CMS requested that AAHomecare’s Regulatory Council provide suggestions on what should be included in the next statement of work for the SMRC contractor. Strategic Health Solutions’contract is set to expire this year. Some of AAHomecare’s suggestions are:

• Change the time frame for response by a supplier from 30 days to 45 business days. 

• Limit the number of claims per letter to 20.

• Require the SMRC contractor to publicly publish error rates and overturn rates through all levels of appeal.

• Require the SMRC contractor to only look at new setups and not the random dates of service as they do now.

AAHomecare says it has previously worked with CMS on SMRC audit issues and appreciates the opportunity to continue to be involved in the process.  

Association forms Retail Work Group for complex rehab

WASHINGTON – AAHomecare has formed a new Retail Work Group within the Complex Rehab & Mobility Council. The work group will hold monthly phone calls for suppliers and manufacturers to discuss retail layouts, operational strategies, legal aspects of marketing and promotions and more. “This Work Group is a collaboration of CRMC members who are trying to supplement their cuts in reimbursement with retail cash sales,” says Work Group Chairwoman Nancy Froslie of Sanford HealthCare Accessories. “Tapping in on a solid retail sales revenue is a great way for providers to increase sales and improve their cash flow.”



Georgia passes licensure requirement

ATLANTA – Georgia’s House of Representatives and Senate have passed a bill that establishes a licensure requirement for DME suppliers. Under the requirement, a supplier must submit the appropriate forms as prescribed by the Georgia State Board of Pharmacy, submit the requisite license fee, and maintain an office or place of business within Georgia. The supplier must also meet safety standards, including ensuring all personnel engaged in delivery, maintenance and repair of DME receive annual continuing education; provide instruction to the patient or patient’s caregiver on how to use DME; receive and respond to complaints from patients; maintain patient records for all patients receiving DME; and properly manage, maintain and service DME. The bill also establishes a definition for DME that specifies it is equipment requiring a prescription, including repair and replacement parts. To be considered DME, equipment must be able to withstand repeated use; have an expected life of at least three years; be primarily and customarily used to serve a medical purpose; be generally not useful in the absence of illness or injury; and should be appropriate for use in the home. The bill now sits before Gov. Nathan Deal, who has 30 days to sign or veto it.

Rowheels names new CEO

FITCHBURG, Wis. – Rowheels, the makers of pull-based geared wheels for manual wheelchairs, has named a new CEO: Fred Mindermann. Previously, Mindermann has held executive positions at Siemens Medical and AGA Linde HealthCare, according to the Wisconsin State Journal. He replaces Rimas Buinevicius, who co-founded the company in 2011. Last year, Rowheels used $1.5 million in funding to launch a more general-purpose wheel.

Board taps Bowen to lead NEMEP

ALBANY, New York – Just months after New York and New Jersey decided to combine their state HME associations, they have announced new leadership.

The board of directors of the Northeast Medical Equipment Providers association (NEMEP) has chosen Beth Bowen, who already leads state HME associations in Florida, North Carolina, Tennessee and Virginia, as their new executive director.

“NEMEP is very lucky to have such a distinguished and energetic professional at its helm,” Kim Voelker, the former executive director of NEMEP, wrote in a letter to members on April 11.

Earlier this year, Voelker led efforts to combine the New York and New Jersey state HME associations.

Most recently, Bowen led efforts to combine the North Carolina and Virginia state HME associations.

“I look forward to serving with the board and the members of NEMEP beginning next week,” she wrote in an email on April 11.

ARJ moves headquarters

LENEXA, Kan. – ARJ Infusion Services held an open house at its new headquarters here April 13. The new location features a state-of-the-art pharmacy with compounding area; a modern infusion suite with a relaxed environment for patients and continuing education programs for clinicians. “ARJ has a lot to celebrate—a new headquarters, ranking nationally in the top 10% in home health patient satisfaction, and continued revenue growth year after year," said Lisa Sackuvich, president and owner, in a press release.

Philips launches travel CPAP device

AMSTERDAM, the Netherlands – Philips has released a compact, travel-ready CPAP device called the DreamStation Go. The device weighs just 1.86 pounds and comes in two models: a fixed-pressure unit called the Pro; and an Auto CPAP that is auto-titrating. “The new DreamStation Go is perfectly suited for every-day therapy, as well as for active, traveling lifestyles,” said Chris Vasta, president of The CPAP Shop, which began selling the device on April 10. DreamStation Go, which retails for $849, features a Federal Aviation Administration-approved automatic battery backup, a color swipe screen, and an integrated USB port, among others. It also connects to the DreamMapper sleep monitor app. ResMed, a competitor of Philips, received clearance from the U.S. Food and Drug Administration for its AirMini travel CPAP device in January. During a conference call that month to discuss its latest financial results, the company said it plans to launch the device some time before June 30. Human Design Capital, which is owned by private investment firm PBM Capital, launched a portable CPAP device called the Z1 in 2013.

VOCSN: ‘Not just another ventilator’

BOTHELL, Wash. – Ventec Life Systems has received FDA 510(k) clearance of its VOCSN, a unified respiratory systems for ventilator patients. VOCSN combines five respiratory therapies—ventilation, oxygen, cough, suction and nebulization—and is designed to improve care for patients with neuromuscular disease, impaired lung function, spinal cord injury and pediatric development complications. The system is designed for use in hospital institutional, transport and home settings, and enables caregivers to spend less time managing machines and more time caring for patients. “I’ve seen firsthand how improved ventilator technology can enhance the quality of life for patients and caregivers,” said Doug DeVries, founder and CEO of Ventec, in a press release. “Our team didn’t want to create just another ventilator, we spent the past five years focused on building a truly integrated solution.”

Smith & Nephew begins distributing patient monitoring system

LONDON – Smith & Nephew has signed a distribution agreement with Leaf Healthcare, a developer of a wireless patient monitoring system for pressure ulcer/injury prevention. “Smith & Nephew is focused on providing not just products to treat conditions, but also supporting customers through technologies designed to support prevention, as well as treatment,” said Glenn Warner, president U.S., Smith & Nephew. “The Leaf Patient Monitoring System is complementary to Smith & Nephew’s existing portfolio in this area, such as ALLEVYN Life prophylactic dressings and SECURA skin care products.” The monitoring system is comprised of a small, lightweight, wearable sensor that wirelessly monitors a patient’s position and movement, and uses that data to automate and document the management of prescribed turn protocols for patients at risk for ulcers/injuries. As a result of the agreement with Smith & Nephew, the system, which is currently in use in a limited number of hospitals, now has the opportunity to reach a nationwide customer base.

Oklahoma considers steep cuts for Medicaid

OKLAHOMA CITY, Okla. – The Oklahoma Health Care Authority has had to map out budget scenarios for the upcoming fiscal year based on a 5% to 15% reduction in state appropriations, according to Tulsa World. A cut of 15% would mean eliminating some optional benefits and reducing provider rates by up to 25%. Benefits being evaluated for elimination include pharmacy, behavioral health and DME, according to the newspaper. Past budget shortfalls have resulted in eliminating or reducing sleep studies, perinatal and dental care, and DME purchases, the newspaper reports. The authority is in charge of the state’s Medicaid program, called SoonerCare.

Action DME goes with CareTend

LENEXA, Kan. – Action DME has purchased Mediware’s CareTend Software for its durable medical equipment business. Owner Hunter Cook likes the software’s all-in-one solution. “I really look forward to using the workflow management tools in CareTend that are very intuitive to how my business operates each day-with the bonus of tracking output in real-time in a single dashboard,” he said in a press release.

Regulatory update: AAH submits comments on bidding, makes recommendations for SMRCs

HME News - Thu, 04/13/2017 - 13:48
04/13/2017HME News Staff

 

WASHINGTON – AAHomecare reiterated it concerns about the structure of the competitive bidding process, including CMS’s use of median bid prices instead of market clearing prices, in recent comments submitted to the agency.

CMS was mandated by the 21st Century Cures Act to take into account stakeholder input on future pricing in non-bid areas, which got their first taste of the program in 2016.

In its comments, AAHomecare also asked for more comprehensive evaluation of the bidding program’s effects on beneficiary access and the quality of equipment furnished.
 

The comments also noted significant reductions in the number of HME suppliers in recent years and echoed the feedback shared by many suppliers on a March 23 call with providers.


“The stories told by suppliers and referral sources all had the same theme: the cuts are too severe, suppliers cannot exist on the current regional SPAs, Medicare beneficiaries are not being serviced at the level they need,” AAHomecare stated. “There was a sense of urging CMS to reconsider what has been done as part of the requirement in the Cures Act.”
 


AAHomecare closed its comments by asking what process CMS will follow to respond to industry feedback from the call and the written comments provided by stakeholders, and reiterated the association’s commitment to working with the agency to arrive at a workable payment solution.

AAH makes recommendations on SMRC contract

CMS requested that AAHomecare’s Regulatory Council provide suggestions on what should be included in the next statement of work for the SMRC contractor. Strategic Health Solutions’ contract is set to expire this year. Some of AAHomecare’s suggestions are:

• Change the time frame for response by a supplier from 30 days to 45 business days. 

• Limit the number of claims per letter to 20.

• Require the SMRC contractor to publicly publish error rates and overturn rates through all levels of appeal.

• Require the SMRC contractor to only look at new setups and not the random dates of service as they do now.

AAHomecare says it has previously worked with CMS on SMRC audit issues and appreciates the opportunity to continue to be involved in the process.  

 

Board taps Bowen to lead NEMEP

HME News - Tue, 04/11/2017 - 10:28
04/11/2017HME News Staff

ALBANY, New York – Just months after New York and New Jersey decided to combine their state HME associations, they have announced new leadership.

The board of directors of the Northeast Medical Equipment Providers association (NEMEP) has chosen Beth Bowen, who already leads state HME associations in Florida, North Carolina, Tennessee and Virginia, as their new executive director.

“NEMEP is very lucky to have such a distinguished and energetic professional at its helm,” Kim Voelker, the former executive director of NEMEP, wrote in a letter to members on April 11.

Earlier this year, Voelker led efforts to combine the New York and New Jersey state HME associations.

Most recently, Bowen led efforts to combine the North Carolina and Virginia state HME associations.

“I look forward to serving with the board and the members of NEMEP beginning next week,” she wrote in an email on April 11.

Hurry up and wait

HME News - Fri, 04/07/2017 - 12:00
Stakeholders prep regulatory, legislative strategies04/07/2017Theresa Flaherty

WASHINGTON – When AAHomecare officials met with Seema Verma for the first time last week, they were pleased to find the new CMS administrator up to speed on key industry issues like competitive bidding.

“We had a very productive meeting,” said Tom Ryan, president and CEO. “We still have a long way to go on the road to meaningful fixes on competitive bidding and other HME policy priorities, but I’m convinced a strong working relationship with new leadership at CMS and Health and Human Services is going to help the process a great deal.”

It’s a small step forward after several months of feeling like things in Washington, D.C., are moving at a snail’s pace. Ryan says he feels providers’ pain.

“It’s April already and they want to know what’s going on,” he said.

Part of the problem is that the Trump administration’s transition has been slow and chaotic, with hundreds of key positions currently unfilled, according to a recent Washington Post article.

But that’s slowly changing at HHS, which on April 4 announced 11 new political appointments, including for its Office of General Counsel.

“There are still a number of unfilled positions, but they are moving along,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “That’s all necessary to go to the next steps to work with career staff.”

In the meantime, AAHomecare has been busy laying out its strategy. Letters in February and March asked HHS SecretaryTom Price to freezerates in non-bid areas at the 50/50 blended rate that took effect Jan. 1, 2016; and outlined several recommendations to fix the competitive bidding program.

While AAHomecare is hopeful that it can get bid relief through regulatory measures, the association is prepared to take up its fight legislatively, says Ryan.

“We think we can get legislation dropped quickly and we have the commitment from a leader who thinks that strategy makes sense,” he said. “How quickly that would move through chambers and how quickly we’ll get a Senate companion remains to be seen.”

In the meantime, HME providers need to keep up the noise, said Ryan.

“Be vocal, be loud,” he said. “CMS keeps saying there are no access issues, but I am hearing there are access issues and we’ve got to get that message out loud and clear.”

Wheelchair users lobby to protect complex rehab

HME News - Fri, 04/07/2017 - 11:57
‘Once they get the bug for advocating for themselves, they can’t really get rid of it’04/07/2017Liz Beaulieu

WASHINGTON – More than 150 wheelchair users and advocates are prepping to roll on Capitol Hill in June to lobby for improved health, independence and quality of life for people living with spinal cord injuries and disorders.

“This year is a crazy, busy year,” said Alex Bennewith, vice president of government relations for United Spinal Association, which hosts the event. “It’s the first year of a new administration, so there are a lot of things that are different than previous years. It’s very important for folks to meet with members of Congress to make sure they hear about their issues.”

Roll on Capitol Hill, in its sixth year, will take place June 11-14. The event has drawn numerous sponsors, including AAHomecare, NCART, Cure, Invacare, Numotion, Apple West Home Medical Supply and MK Battery.

The event will feature education, advocacy training and a sponsor expo on June 12, and Capitol Hill meetings on June 13. Participants typically conduct more than 200 meetings on that one day, Bennewith says.

“Who better to talk about issues than the people who are affected themselves,” she said.

Included in the reasons “why we roll” are bills in the House of Representatives and the Senate to prevent Medicare from applying competitive bidding pricing to complex manual and power wheelchairs; and a bill in the House to create a separate benefit for complex rehab.

“Congress really listens when CRT consumers weigh in on the challenges they face and what they need to be healthy and independent,” said Don Clayback, executive director of NCART, which hosts its own congressional fly-in April 26-27. “Inclusion of CRT issues in the ROCH has been a big factor in increasing CRT awareness and support in Congress.”

Users, who will include veterans, will also lobby for issues around improving community integration, preserving access to appropriate urology and ostomy supplies, and advancing research of neurological conditions.

“This is an important time for people with disabilities to feel empowered and part of the process,” Bennewith said. “Once they get the bug for advocating for themselves, they can’t really get rid of it.”

Drive has all eyes on the web

HME News - Fri, 04/07/2017 - 11:55
‘We wanted to be able to look everywhere’04/07/2017Liz Beaulieu

PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare has ramped up its minimum advertised pricing (MAP) program by contracting with Oris Intelligence.

Columbus, Ohio-based Oris offers a cloud-based platform that not only patrols and enforces MAP policies everywhere products are sold online, but also searches for unknown sellers.

“We wanted the coverage they provide—they scan the entire Internet for your MAP products,” said Ben Kwapisz, program administrator for Drive’s MAP policy. “We wanted to be able to look everywhere.”

Drive first launched its MAP program back in 2012, in response to a growing number of providers looking to diversify their businesses online.

Since then, the online marketplace has become increasingly complex to navigate for both manufacturers and providers, with large national retailers often competing aggressively to offer the lowest prices.

“When we have a MAP policy and we enforce it like we do, we’re supporting all of our customers to be able to fight that price war,” said Stephanie Treant, manager of the e-Commerce Division at Drive.

A well-enforced MAP policy not only preserves a provider’s ability to compete with large national retailers, but also ensures that the provider maintains a certain profit margin, Kwapisz said.

“We want to make sure pricing doesn’t get so eroded, providers are only making a very small percentage,” he said.

Treant declined to say how many products are protected under Drive’s MAP policy, but she says the company’s contract with Oris, a larger software company that can support an expanded and more robust program, is a good example of how it’s always looking to provide more support to providers that are selling its products online.

“We’re always evaluating our product line and how it fits into our MAP program,” she said.

With Oris, Drive has been able to stop an increasing number of violations of its MAP program, Kwapisz says.

“Absolutely,” he said when asked. “It has been able to find the exact sites, pinpoint them and get them corrected. It’s one of the things they do so well.”

 

Respiratory Services hits ‘its prime’

HME News - Fri, 04/07/2017 - 11:52
04/07/2017Theresa Flaherty

ROCHESTER, N.Y. – Rochester may be only an hour away from its Buffalo headquarters, but it’s a “different world” for Respiratory Services of Western New York.

“Most of our referrals come out of hospitals in Rochester and in Buffalo it’s mostly out of doctors’ offices,” said co-owner Michael McCartney. “Our customer service has really taken it to the next level. We guarantee that we’ll set everybody up within an hour from when we get that call from the hospital.”

The provider opened its new location—its fourth—here in March, folding in its locations in LeRoy and Honeoye, which it acquired through its acquisition of Durable Medical Equipment and Supplies in 2014. Respiratory Services, which McCartney founded in 1997, offers a full line of durable medical and respiratory equipment and services.

McCartney says his commitment to customer service has set him apart in the HME industry.

“We all have the same equipment and we all get paid the same amount,’” he said. “Other companies are trying to cut corners and save costs. I invest in my employees—I want them to stick around and be the experts when people come into the store.”

Where McCartney prefers to save money is on creating greater efficiencies, including a non-delivery model for oxygen patients and a nearly paperless office, and negotiating for better pricing from manufacturers.

“I hate paper,” he said. “With technology, there’s less paper, we can confirm orders quicker and get paid sooner.”

McCartney also negotiates with manufacturers for better pricing and buys in bulk. All four locations have a retail showroom—including a 7,000-square-foot store housed in an old Blockbuster store that accepts no insurance—he is able to offer customers “every bell, whistle and color,” they could want, he says.

With twenty years under its belt, Respiratory Services has learned to adapt to changes. Five years ago, the company was 90% respiratory; today it’s 65%—70%. Medicare has been reduced to about 11%.

“I didn’t know anything about owning my own company,” said McCartney who was a 23-year-old respiratory therapist at the time. “I haven’t looked back since. I feel like I am hitting my prime right now.”

 

In brief: SCA forms separate company, ResMed, ATS partner on grant

HME News - Fri, 04/07/2017 - 11:48
04/07/2017HME News Staff

SCA forms separate hygiene company

PHILADELPHIA – SCA will split its global hygiene and health products into a new company, Essity.

The forest products division will remain under the SCA name.

As of 2016, 86% of the company is in hygiene and health, with 14% in forest products. Synergies between the operations have diminished over time, SCA said in a press release.

Essity will develop, produce, market and sell personal care and tissue products, including the BSN Medical brands, which SCA acquired in December for $2.9 billion. Essity stems from the words “essentials” and “necessities.”

“Hygiene and health are necessities for better lives and our products and solutions play an essential role in improving well-being for everybody, everywhere,” said Magnus Groth, president and CEO of SCA.

Groth will become president and CEO of Essity.

SCA had sales in about 150 countries under global brands like TENA for incontinence products and Tork for Away-from-Home tissue products. The acquisition of BSN Medical added brands like Leukoplast, Cutimed, JOBST, Delta Cast, Delta Lite and Actimove.

The split will be completed no later than the second half of 2017.

ResMed, ATS partner on NIV grant

SAN DIEGO – ResMed has funded a new $100,000 two-year grant with the American Thoracic Society to research non-invasive ventilation for COPD patients. COPD affects 65 million people worldwide and is the third leading cause of death, according to a press release. “Through this award, the field of respiratory medicine stands to gain more valuable knowledge about the use of NIV for the treatment of COPD with the ultimate goal of improving the lives of patients and the efficiency of our health care system as a whole,” said Carlos Nunez, MD, chief medical officer for ResMed.

Study: ASV improves compliance

SAN DIEGO – Patients with obstructive sleep apnea who develop central sleep apnea are more compliant when they switch from CPAP to adaptive servo-ventilation, according to a new study. The study, sponsored by ResMed, analyzed anonymous, aggregated data from the devices of 198,890 telemonitored patients. It showed that patients who switched from CPAP to ASV went from 62.7% compliance to 76.6% compliance. “Achieving compliance through proper therapy usage is a well-recognized clinical goal in sleep apnea management, and one that is often hard to achieve, particularly in difficult-to-treat patients who may have untreated central sleep apnea,” said Carlos Nunez, M.D., ResMed’s Chief Medical Officer. “These findings underscore the importance of continuously monitoring central sleep apnea and rethinking the conventional wisdom on therapeutic options based on each patient’s disease severity.”

Option Care earns perfect accreditation score

BANNOCKBURN, Ill. – Option Care earned a perfect score on its URAC Specialty Pharmacy accreditation for its corporate as well as three specialty pharmacy centers of excellence in Chicago, Los Angeles and Panama City, Fla. The perfect accreditation score applies to all specialty areas, including immunoglobulin (IG), bleeding disorders, enzymes and infliximab. Option Care was audited on more than 200 standards, nearly 90 of them mandatory., according to a press release. “We are proud and gratified to earn independent accreditation with this unprecedented demonstration of quality,” said Paul Mastrapa, CEO of Option Care. “A perfect score is significant for us as a national healthcare services organization, as well as for the patients and providers who rely on our care.” Option Care is a leading national provider of home and alternate site infusion services.

Familiar faces, ‘fresh blood,’ encouraged to submit proposals

ATLANTA – Time is running out to submit presentation ideas for Medtrade. Potential speakers must submit presentations for review by April 27. Medtrade 2017 takes place Oct. 23-26 at the Georgia World Congress Center in Atlanta. The Medtrade educational advisory board is also on the lookout for HME providers to share their stories. “Medtrade always has the best speakers in the industry,” says Kevin Gaffney, group show director, Medtrade. “Similar to last year, we will also be on the lookout for new blood, so feel free to pass along our ‘Call for Presentations’ to suitable candidates.” Go here for more information or to submit a proposal.

AAHomecare calls for audit data

WASHINGTON – The next submission round for AAHomecare’s HME Audit Key opens April 17. The association is asking providers to use the online survey to submit their audit activity for the first quarter of 2017. To complete the survey, providers will need their NPIs and zip codes. AAHomecare reminded providers that Brightree customers now have the option of printing a report that will help them answer many of the operational questions in the quarterly survey. It also reminded them that they do not have to submit data on individual claims, only cumulative counts of pre- and post-payment audits and appeal claim outcomes under DME MAC, RAC and SMRC reviews.

NHIA publishes survey questions

ALEXANDRIA, Va. – The National Home Infusion Association has published “Uniform Patient Satisfaction Survey Questions for Home Infusion Providers.” The 12 questions will enable providers to collect consistent data to be used for research and benchmarking. “With the current focus on value-based purchasing, the delivery of high-quality home infusion care requires providers to carefully consider the patient’s experience more than ever before,” said Connie Sullivan, RPh, NHIF vice president of research. The new publication is the latest step in a multi-year initiative to establish demographic, operational, and quality benchmarks that will advance home infusion patient care.

MassHealth moves toward preferred manufacturer model

BOSTON – MassHealth has published a request for response for a preferred manufacturer/distributor for incontinence products, according to the Home Medical Equipment Services Association of New England. Tom Lane, the director of MassHealth’s Fee-for-Service Programs, told HOMES, however, that the preferred manufacturer/distributor would be required to work with the HME provider network. The bid opening date is scheduled for May 1. A number of states have explored similar models for incontinence supplies, including Illinois and South Carolina. Last year, TwinMed snagged a five-year preferred vendor contract worth $225 million to provide incontinence supplies to Medicaid beneficiaries in New York.

Short takes: Coram, Coloplast

Coram CVS Specialty Infusion Serviceshas made Functional Formularies feeding tube and oral meal replacement formulas available to its customer base. Liquid Hope and Nourish, adult and pediatric certified organic, whole foods formulas, will be available through Coram, making them even more accessible to thousands of individuals and families coping with a wide-range of challenging health conditions, from cancer to ALS, Parkinson’s and MS. “Our new partnership with Coram shows the industry, which has historically been built on sugar-filled formulas, has been flipped on its head,” said Robin Gentry McGee, founder and CEO of Functional Formularies…Coloplast’s Biatain Silicone sizes and shapes has been awarded a Red Dot award for user experience and aesthetics. The Biatain Silicone products are soft, flexible, absorbent foam dressings with a silicone adhesive used for treating chronic and acute wounds. This year, Red Dot received 5,500 submissions from 54 countries. An independent and international jury of experts assessed all products entered…B. Braun has introduced an app that offers educational content to clinicians and patients for its Easypump ST/LT Elastometric Infusion Pump System. The Easypump app, for Apple and Android devices, offers simple menus and navigation, giving infusion therapy nurses a table-top tool for teaching patients how to properly use and manage the small, lightweight pump… Quantum Rehab has launched enhancements to its iLevel technology, including 12 inches of lift and LED fender lights, to further increase the independence of users. As of May 1, the iLevel technology available on the Q6 Edge 2.0 will have two inches more lift. The iLevel technology on the Q6 Edge 2.0 will also come standard with LED headlights and tail lights integrated into the fenders.

People: Joe Lewarski, John Graham

Joseph Lewarski, vice president of Global Respiratory and Sleep for Drive DeVilbiss, will speak at the American Association for Respiratory Care’s 70th Anniversary Conference at the Dittrick Museum of Medical History April 22. He will discuss the history and evolution of home respiratory care, the impact that reimbursement challenges have on the delivery of care, the current status of respiratory homecare, therapists’ current challenges and the future of homecare respiratory therapy…John Graham, a senior fellow of the National Community Pharmacists Association, has been appointed assistant principal deputy assistant secretary for Planning & Evaluation at the Department of Health and Human Services. Graham has a record of accomplishment in many areas of health policy, including payment reform, and regulation of drugs and devices, according to a press release.

AAHomecare ‘encouraged’ after meeting with Verma

HME News - Thu, 04/06/2017 - 08:27
04/06/2017HME News Staff

WASHINGTON – Industry stakeholders had a meeting with Seema Verma, the new CMS administrator, on April 4, and they were impressed.

The top topic at the meeting: industry efforts to fix the competitive bidding program.

“Administrator Verma demonstrated impressive familiarity with HME industry concerns about the bidding program, and others in attendance were well-acquainted with the proposals in letters regarding the bidding program (that) AAHomecare recently sent to HHS Secretary Price, which provided a good baseline for discussions,” AAHomecare stated in a bulletin to members.

Tom Ryan, president and CEO of AAHomecare; Jay Witter, senior vice president of public affairs for the association; Cara Bachenheimer, senior vice president of public relations for Invacare; and Thomas Baker, an attorney recently engaged by the association, met with Verma and Deputy Administrator Demetrios Kouzoukas, as well as several HHS and CMS staffers.

At the meeting, stakeholders also discussed their support for protecting reimbursement for accessories for complex wheelchairs and for oxygen therapy.

“We believe both the tone and substance of the discussion shows that the new leadership at HHS and CMS understands industry concerns,” AAHomecare stated. “In particular, we’re encouraged by Administrator Verma and her colleagues expressing their interest in working with us to come up with solutions on these issues that will allow us to continue to meet the needs of the millions of individuals who depend on home medical equipment and related services.”

In March, AAHomecare sent a letter to HHS Secretary Price with several recommendations on how to fix the bid program, including using market clearing pricing to determine the single payment amount for any item included in the program, and using historical claims data to determine supplier capacity.

SCA forms separate hygiene company

HME News - Thu, 04/06/2017 - 08:20
04/06/2017HME News Staff

PHILADELPHIA – SCA will split its global hygiene and health products into a new company, Essity.

The forest products division will remain under the SCA name.

As of 2016, 86% of the company is in hygiene and health, with 14% in forest products. Synergies between the operations have diminished over time, SCA said in a press release.

Essity will develop, produce, market and sell personal care and tissue products, including the BSN Medical brands, which SCA acquired in December for $2.9 billion. Essity stems from the words “essentials” and “necessities.”

“Hygiene and health are necessities for better lives and our products and solutions play an essential role in improving well-being for everybody, everywhere,” said Magnus Groth, president and CEO of SCA.

Groth will transition to president and CEO of Essity.

SCA had sales in about 150 countries under global brands like TENA for incontinence products and Tork for Away-from-Home tissue products. The acquisition of BSN Medical added brands like Leukoplast, Cutimed, JOBST, Delta Cast, Delta Lite and Actimove.

The split will be completed no later than the second half of 2017.

Cures Act update: Could bill in Minnesota serve as template for relief?

HME News - Tue, 04/04/2017 - 11:49
04/03/2017Liz Beaulieu

ST. PAUL, Minn. – Minnesota could be the first state to introduce legislation to stave off a “pay for” in the 21st Century Cures Act that limits the federal portion of Medicaid reimbursement for DME to competitive bidding-influenced Medicare reimbursement starting Jan. 1, 2018.

Bills have been introduced in both the House of Representatives and the Senate that would direct the commissioner of the state’s Department of Human Services to make supplemental payments for DME that is impacted by the change. The bills state those payments should be no less than the difference between the payments before and after Dec. 31, 2017.

“Take the problems and attrition we’ve seen from the bid rates for Medicare and expand that to a whole other sector of the population—Medicaid,” said Sarah Anderson, vice president of sales and third party services for Key Medical Supply in Shoreview, Minn., and a board member of the Midwest Association for Medical Equipment Services. “It’s just unsustainable.”

Stakeholders suffered a setback in March, when omnibus bills were introduced in the House and Senate without language on supplemental payments for DME.

The omnibus bill in the House, however, includes what stakeholders call a “toehold” that keeps their efforts alive: a provision requiring DHS to study the impact of limited payment rates for DME on access. DHS must report on results by Feb. 1, 2018.

“The work is not over,” said Rose Schafhauser, executive director of MAMES, which is working on setting up meetings with Conference Committee members who are working to combine the two omnibus bills.

While cost is always a factor in getting legislation passed, stakeholders have so far successfully argued that the DME benefit has hit rock bottom. That’s something they’ll continue to argue.

“The bid rates don’t even cover the cost of acquisition,” Anderson said.

Also working in stakeholders’ favor is their good working relationship with DHS. They have worked with the agency to craft this most recent language, and they have worked with the agency in the past to prevent bid-influenced Medicare reimbursement from affecting Medicaid reimbursement for items included in the program.

“DHS and our legislature are very familiar with competitive bidding and the potential harm to providers and their patients,” Anderson said. “We’ve been working for years to continually separate (Medicaid and Medicare).”

MAMES has shared the language with other stakeholders, in the hopes that similar bills can be introduced in other states.

“We’re trying to be proactive,” Schafhauser said. “The general feedback we’re getting from state legislatures has been good. We’re not asking for an increase; we’re just asking not to go back.”

CMS eases requirements for changing providers

HME News - Mon, 04/03/2017 - 09:25
04/03/2017HME News Staff

WASHINGTON – CMS has instructed the DME MACs to accept timely orders and medical documentation whether they come from a beneficiary’s treating physician or a transferring HME provider.

The change is a big deal for providers in competitive bidding areas, where transfers of beneficiaries from non-contract to contract providers are common.

“Industry (has) suggested that competition is bolstered and provider burden limited by allowing suppliers to accept medical documentation from other suppliers who previously held responsibility for that beneficiary,” CMS states in Change Request 9886 published on March 24.

The change goes into effect April 24, 2017.

Specifically, CMS instructs the DME MACs to:

  • Accept documentation of the beneficiary’s need for an item, regardless of whether the supplier received the documentation directly from the beneficiary’s treating physician/practitioner or as transferred from his or her previous supplier.
  • Contractors shall, in those instances in which the documentation is not transferred, continue to require a new order/documentation be received by the supplier from the treating physician/practitioner.
  • Contractors shall describe any necessary workload changes in detail, including the rationale for these changes, to their Contracting Officer’s Representative and Medical Review Business Function Lead.

In an accompanying MLN Matters article, CMS put providers on notice that a new order is still required in the following situations:

  • There is a change in the order for the accessory, supply, drug and so forth.
  • On a regular basis (even if there is no change in the order) only if it is so specified in the documentation section of a particular medical policy.
  • When an item is replaced.
  • When there is a change in the supplier, if the recipient supplier did not obtain a valid order for the DMEPOS item from the transferring supplier.
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