HME News

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Updated: 3 hours 39 min ago

House questions CPAP bundling program

Thu, 08/17/2017 - 09:02
08/17/2017HME News Staff

WASHINGTON – A bipartisan group in the House of Representatives is circulating a congressional sign-on letter that asks CMS to delay a CPAP bundling pilot program from the next round of competitive bidding.

The letter states a number reasons for delaying the program, including the lack of evidence that it will save money or enhance care, and CMS’s lack of authorization to test alternative payment models as part of its competitive bidding program.

“Instead, we encourage the agency to work with Congress and stakeholders to prioritize efforts that bring stability to the program,” the letter states. “If the agency is interested in reforms to ensure better compliance with CPAP therapy and other home respiratory care, we stand ready to work with you on initiatives that have a greater potential to save money and improve health outcomes.”

AAHomecare encourages HME providers and other stakeholders to ask their representatives to add their names to the letter by Sept. 13.

The association has argued that bundling a CPAP device, consumable items, maintenance and service into a single monthly payment could cause disruption for providers, could provide an incentive to furnish inferior products, and could result in lower quality of care.

CMS announced earlier this year that it had added 10 new competitive bidding areas for the CPAP product category. In five of those CBAs, payment for CPAP devices, related accessories and services will be made on a bundled, non-capped monthly rental basis, while payment in the other five CBAs will be made on a capped monthly rental basis like other existing CBAs.

The sign-on letter is being spearheaded by Reps. Tim Walberg, R-Minn., Debbie Dingell, D-Mich., Cathy McMorris Rodgers, R-Wash., Scott Peters, D-Calif., and Michael Bishop, R-Mich.

CMS revamps claims review process

Wed, 08/16/2017 - 13:36
08/16/2017HME News Staff

WASHINGTON – Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.

As part of an expanding “Targeted Probe and Educate” program, the Medicare Administrative Contractors will identify these providers through data analysis.

“TPE claim selection is different from that of previous probe and educate programs,” the agency stated in an Aug. 14 announcement on its website. “Whereas previously the first round of reviews were of all providers for a specific service, the TPE claim selection is provider/supplier specific from the onset. This eliminates burden to providers who, based on data analysis, are already submitting claims that are compliant with Medicare policy.”

Per the program, the MACs will review 20 to 40 claims per provider, per item or service, per round, for a total of up to three rounds of review. After each round, providers will be offered individualized education based on the results of their reviews.

Providers with moderate and high error rates in the first round of reviews, will continue on to a second round of 20-40 reviews, followed by additional education. Providers with high error rates after the second round will continue to a third and final round of reviews and education.

Providers with continued high error rates after three rounds of review may be referred to CMS for additional action, which may include 100% pre-pay review, extrapolation, referral to a Recovery Auditor Contractor, or other action.

Providers may be removed from the review process after any of the three rounds of review, if they demonstrate low error rates or sufficient improvement in error rates, as determined by CMS.

The program began as a pilot project in one MAC jurisdiction in June 2016 and was expanded to three additional jurisdictions in July 2017. CMS will expand the program to all jurisdictions later this year.

Superior HealthPlan to make changes to Medline contract

Tue, 08/15/2017 - 10:16
08/15/2017HME News Staff

AUSTIN, Texas – Superior HealthPlan, a managed care company that’s administering part of the state’s Medicaid program, has decided to delay a contract with Medline until Oct. 1, according to the San Antonio Express-News.

The contract, which includes 244 codes for DME and supplies, was set to start Sept. 1.

Superior Health Plan, part of Centene Corp., also plans to recast the contract as “preferred provider” vs. “single source,” making it clearer that Medicaid recipients will still have their choice of provider, the newspaper reported.

The changes to the contract come on the heels of a hearing before the state’s Committee on Human Services in the House of Representatives on Aug. 9. During the hearing, lawmakers suggested that Superior HealthPlan amend its notice to patients to say they can “opt out for any reason or no reason at all,” the newspaper reported.

Prior to the hearing, a number of providers, including Respiratory & Medical Homecare and Alliance Medical Supply, had sent letters of protest to different offices of the Texas Health and Human Services Commission, as well as Superior HealthPlan.

Superior HealthPlan’s contract in Texas is only one of many such contracts between managed care companies and distributors spreading nationwide.

Invacare: Conservative short-term, bullish long-term

Fri, 08/11/2017 - 12:54
‘We want to end the year sequentially flat’08/11/2017Liz Beaulieu

ELYRIA, Ohio – Despite the excitement surrounding its recent clearance by the U.S. Food and Drug Administration to resume full operations at its Taylor Street manufacturing facility, Invacare CEO Matt Monaghan told investors Aug. 8 that the company is still trying to “report some conservatism.”

Monaghan expects Invacare’s financial results to stabilize in the second half of 2017, but there are a number of factors that are tempering a rebound right out of the gate.

“I want to end the year sequentially flat, quarter-over-quarter, so Q4 over Q3,” said Monaghan, also chairman and president, during a conference call to discuss financial results for the second quarter. “So we’ll see how close we can get on Q3 over Q2.”

For the six months ended June 30, Invacare reported net sales of $465.2 million this year vs. $532.6 million last year. It reported a net loss of $40.3 million vs. $20.2 million.

Monaghan acknowledged that it’s “hard to predict” how quickly providers will “come back” to its line of complex rehab products, which were most affected by the consent decree that limited manufacturing from its Taylor Street facility for almost five years.

“It’s a little hard for us, just 10 days into that ability to sell freely,” he said.

Additionally, Monaghan called the performance of Invacare’s respiratory product category in the second quarter “a little disappointing.” While there are signs that providers are buying more portable oxygen concentrators as they transition to non-delivery business models, POCs have been, traditionally, a small part of its product mix in the category.

“There’s really incredible growth, and I’m excited to be participating in that (with our Platinum Mobile Oxygen Concentrator),” he said. “But the challenge is, the marketplace, I think, is putting their new asset purchase dollars into that category. So for us, the decline in respiratory really reflects a mix shift to a segment of that pie that's relatively small for us. So we see the exciting startup growth, but we've got to manage that mix shift.”

“Conservatism” aside, Monaghan remains “bullish on the long term,” especially for Invacare’s lineup of complex rehab products, which includes the new TDX SP2 power wheelchair with LiNX Technology.

“I have a lot of confidence in complex rehab because of the training and talent we have in the commercial organization, and the products we’ve given them,” he said. “What we see in the book of quotes and the commercial interests for appointments to get closed going forward—I’m relatively sanguine about mobility and seating and the complex rehab part of the business.”

Invacare reported $233.5 million in net sales for the second quarter of this year compared to $275 million for the same period last year, a 15.1% decrease. For North America/HME, it reported $77.7 million in net sales compared to $110.7 million, an 86.4% decrease.

Invacare reported a net loss of $23.5 million for the second quarter this year compared to a net loss of $11.58 million for the same period last year.

Mediware taps new CEO

Fri, 08/11/2017 - 12:52
‘We want to provide the ability for our clients to absorb more technology and services from us’08/11/2017Liz Beaulieu

LENEXA, Kan. – As Bill Miller sees it, the post-acute care market is the next “pioneering space” in health care and he aims to position Mediware Information Systems as the leader in the race to settle it.

Miller, who joined Mediware as CEO in late July, knows a thing or two about where health care is headed as the former CEO of OptumInsight, a division of Optum that’s focused on data and analytics. Optum, a $90 billion company, is a subsidiary of healthcare giant UnitedHealth Group.

“I’ve watched the largest commercial payer operate, and I’ve watched what they’re trying to do, which is move care in lower theaters of cost,” he said. “If more care is moved into settings like the home, it’s not only lower cost but often more effective. Mission accomplished.”

Milller replaces Kelly Mann, who served as CEO for 10 years. The management shake up follows Mediware’s announcement in late 2016 that TPG Capital, a large private equity firm that owns the likes of Burger King and Chobani, had agreed to buy the company from Thoma Bravo.

As volume floods the post-acute care market, the need for infrastructure, software and analytics will be tantamount, Miller says.

“I want Mediware to be the company that those entities rely on as they go through those significant gains,” he said.

To get there, Mediware will double down on existing markets like HME and continue acquiring companies in ancillary markets to fill in gaps in its portfolio. Earlier this year, it finalized plans to buy Kinnser Software, a provider of software solutions to 4,000 home health, hospice an private-duty homecare professionals.

“What we did with Kinnser is a signal of things to come,” said Miller, who says he quarterbacked more than a dozen acquisitions in the nine years he was at OptumInsight. “When you’re backed by one of the largest PE firms, you’re going to stay aggressive.”

But as Miller says, “It’s great to get wide,” in terms of expanding into ancillary markets, “but you also have to go deep.”

“Mediware has been on a path of being flexible and having an all-in-one platform,” he said. “Now we want to provide the ability for our clients to absorb more technology and services from us, because we can provide scale and support them from an infrastructure perspective. We want them to rely on us for more capabilities; we want to become central to their mission.”

Diabetes advocates march forward

Fri, 08/11/2017 - 12:50
08/11/2017Theresa Flaherty

WASHINGTON – A bill that would protect access to diabetes supplies for Medicare beneficiaries is expected to get introduced in the Senate soon, say advocates.

“I’ll be back up (to Washington D.C.) and talking to congressional individuals, as well as mobilizing the patient community, to remind them this is an important issue,” said Christel Aprigliano, CEO of the Diabetes Patient Advocacy Coalition.

A bill already introduced in the House of Representatives seeks to strengthen protections requiring mail-order contract suppliers to include at least 50% of the types of testing supplies that were available before the implementation of the competitive bidding program. It would also prohibit suppliers from encouraging beneficiaries to switch brands. “The Protecting Access to Diabetes Supplies Act,” H.R. 3271, was introduced July 17 by Reps. Diana DeGette, D-Colo.; Susan Brooks, R-Ind.; and Tom Reed, R-N.Y.

“Why not enforce the rules they implemented?” said Aprigliano. “This would close the loopholes.”

Aprigliano testified at a hearing held by the House Energy & Commerce Subcommittee on Healthin July to review several bills to reform the Medicare program. Ultimately, H.R. 3271 wasn’t included in a larger Medicare package that members eventually passed, but she says it’s for the best.

“Once the Congressional Budget Office analysis comes out, I believe it will show that our bill is basically cost-neutral, which would allow it to go through easier,” she said. “It’s important to highlight this is for diabetes, specifically when so many healthcare dollars are spent on diabetes itself.”

As with other product categories impacted by the competitive bidding program, CMS has maintained there are no access issues for diabetes testing supplies. Aprigliano points to several studies that show otherwise, including a recent secret shopper survey conducted by the American Association of Diabetes Educators that showed the number of brands available under the mail-order program has fallen 50%.

“This is real life,” she said. “It’s not just numbers on a page.”

BioScrip revenues are down, but core product mix is up

Fri, 08/11/2017 - 12:47
08/11/2017Theresa Flaherty

DENVER – BioScrip’s net revenues decreased 6.2% in the second quarter of 2017, but CEO Dan Greenleaf said in an earnings call the company was hitting targets.

BioScrip reported net revenues of $218.1 million for the second quarter of 2017 compared to $232.4 million for the same period a year ago. Net loss was $29.2 million vs. $8.2 million.

Still, BioScrip increased its core product mix to 73.1%, compared to 60.3% a year ago, with an ultimate goal of 85%.

“Overall, our turnaround plan is on schedule,” Greenleaf said. “Our revenues of $218.1 million reflect our team’s focus on growing core revenues and shedding our less profitable non-core therapies, including less revenue from UnitedHealthcare this quarter as compared to the first quarter.”

BioScrip is terminating its UnitedHealthcare contract, with the exception of nutrition, by Sept. 30, 2017, and is executing a transition plan, says Greenleaf.

Not helping revenues was the 21st Century Cures Act, which reduced Medicare reimbursement for certain Part B infusion drugs on Jan. 1, without creating a payment for infusion services until 2021. The company has previously stated the act would negatively impact its earnings by $24 million in 2017.

Greenleaf lauded the recently passed Medicare Part B Improvement Act of 2017, which creates a transitional payment for infusion services starting in 2019.

“This bill is an important milestone toward improving Medicare patient access to home infusion therapies,” he said. “We have continued to work with the National Home Infusion Association and others to increase awareness in Washington, D.C., of the unintended implications of the Cures Act on the critically ill patients relying on the impacted therapies.”

For the six months ended June 30, BioScrip reported net revenues of $435.9 million this year compared to $470.9 million last year. Net loss was $48.6 million vs. $17.8 million. EBITDA, however, was $10 million for the second quarter, nearly double the first quarter.

In brief: Apria settles with MassHealth, Trump stalls sleep reg

Fri, 08/11/2017 - 12:44
08/11/2017HME News Staff

LAKE FOREST, Calif. – Apria Healthcare has agreed to pay more than $750,000 to settle allegations that it billed Massachusetts residents for services already covered by MassHealth, the state’s Medicaid program.

Under the settlement announced Aug. 9, Apria has agreed to pay $99,008 in restitution and $665,934 in penalties to settle allegations that the company improperly billed consumers between December 2011 and April 2017, according to Massachusetts Attorney General Maura Healey.

Despite the settlement, Apria denies it violated any state laws.

“We are pleased to have resolved this matter with the Massachusetts Attorney General,” said Raoul Smyth, Apria’s executive vice president and general counsel, in a statement. “Although Apria denies that it has violated any Massachusetts laws, this resolution reflects Apria’s desire to put this matter behind it so that it can continue to focus on the needs of patients.”

Apria says it addressed the processes that were the focus of the Attorney General’s investigation long before this settlement was reached.

Study: Bid program puts Medicare more in line with commercial insurers

BETHESDA, Md. – A comparison of the prices Medicare paid for certain DME under its competitive bidding program in 2010 and the average prices that commercial insurers paid that same year supports the conclusion that CMS overpaid for DME, according to a new study conducted by the Health Care Cost Institute and published this month in Health Affairs. On average, the Round 1 Rebid prices for the seven items included in the study were 34.7% lower than the prices in the Medicare fee schedule for 2010. On average, commercial payers paid 28.7% less than Medicare for the same items in 2010. “This suggests that in the nine program MSAs, the program resulted in prices that were generally comparable to but lower than the prices obtained by large commercial insurers,” the study’s authors say. Because the bid program has better lined up prices from Medicare with those of commercial insurers, the study’s authors argue it is an “effective mechanism for achieving savings,” with one caveat. “If the concerns about the program’s long-term sustainability can be resolved, competitive bidding for DME and similar items may be an effective mechanism for achieving savings in Medicare, relative to historic fee schedule prices,” they say. The Health Care Cost Institute is a non-partisan, non-profit organization that aims to provide complete, accurate, unbiased information about healthcare utilization and costs to better understand the U.S. healthcare system, according to its website.

Trump stalls sleep reg for drivers, rail workers

WASHINGTON – President Donald Trump, who has pledged to drastically slash federal regulations, has sounded the death knell for a regulation to require sleep apnea screening for commercial drivers and rail workers, according to news reports. The Federal Railroad Administration and the Federal Motor Carrier Safety Administration said late last week that they are scraping the regulation, arguing that it should be up to trucking and railroad companies to decide whether or not to screen their employees. Last year, however, the agencies announced a proposal to require screening for commercial drivers and railroad workers, and sought public input. Deadly rail crashes in New York City and New Jersey, as well as several highway crashes, have brought the issue to the forefront. In the Metro-North train crash in 2013, the engineer fell asleep at the controls because he had a severe, undiagnosed case of sleep apnea. In the New Jersey Transit train crash in September, the engineer also suffered from undiagnosed sleep apnea.

New Apria program helps reduce readmissions

LAKE FOREST, Calif. – Apria Healthcare has launched a new program for patients on non-invasive ventilation that it says significantly reduces hospital admissions.

As part of the Apria Clinical Evidence (ACE) program, respiratory therapists perform regularly scheduled home visits to help patients maintain compliance with therapy and intervene as needed to get patients back on track. During the visits, RTs monitor each patient’s progress and record their responses to a number of quality of life indicators, as well as document emergency department visits and unplanned hospital admissions.

“Apria is uniquely positioned to help these patients reduce hospital admissions by providing them with the tools and support they need for success,” said Dan Starck, CEO of Apria Healthcare. “Through the ACE program, we have seen tremendous success in reducing hospital admissions when comparing the six months prior to initiating therapy with the six months post therapy, particularly for patients diagnosed with COPD.”

Initial results from the ACE program are comparable to a recent study published in the Journal of Clinical Sleep Medicine, which demonstrated that multifaceted COPD intervention—including non-invasive ventilation, RT-led respiratory care and patient education—resulted in an 88% reduction in hospital admissions, according to Apria.

Apria is offering the ACE program nationwide through its locations in Springfield and Wilmington, Mass.

Inspired by Drive launches online community

SANTA FE SPRINGS, Calif. – Inspired by Drive has launched “Live Inspired,” an online community for special needs families. It features a weekly guest blog and other resources, and offers families a place to connect. “Our commitment to special needs families goes beyond our products,” said Matt Lawrence, vice president and general manager. “The Live Inspired community is an extension of our mission to enhance the quality of life of the people we touch and our commitment to families.”

AccessNSM taps new vice president

NASHVILLE, Tenn. – AccessNSM, the accessibility division of National Seating & Mobility, has named Kalen McKenzie vice president. McKenzie previously served as regional account manager at Dornier MedTech and vice president of national accounts at Invacare. “Kalen’s experience and expertise will be extremely valuable to AccessNSM,” said Bill Mixon, NSM CEO, in a press release. “His leadership will play an integral role in the continued strategic growth of the company.” As vice president, McKenzie will focus on integrations and organic growth for AccessNSM.

Pedors launches footwear program

ROSWELL, Ga. – Pedors Shoes has introduced a Geriatric Footwear Program that provides PTs and OTs with a discount code they can share with their patients to help offset the cost of therapeutic footwear. Pedors believes the program can help to address Medicare’s broken audit system and the emergence of e-commerce, which it says have driven orthotics fitters and pedorthists out of the market and made it harder for patients to find footwear. “The objective of the program is to keep the cost of orthopedic footwear on par with what a patient might expect to pay for a pair of sneakers,” said Stephen O’Hare, president.

AAH seeks nominations for homecare champion

WASHINGTON – AAHomecare is accepting nominations for the 2017 Van Miller Homecare Champion Award. The award, which was established in 2016 when the association renamed the AAHomecare Champion Award, recognizes a member who has made exceptional contributions to home care. Nominations can be submitted to Sue Mairena at suem@aahomecare.org until Sept. 8. The award will be presented during the Stand Up for Homecare reception at Medtrade on Tuesday, Oct. 24. Missy Cross, vice president of the homecare division of O.E. Meyer Co., received the inaugural award last year.

Aeroflow donates breast pump kits

ASHEVILLE, N.C. – Aeroflow and Ameda, a breast pump manufacturer, are partnering with Grady Memorial Hospital in Atlanta to provide breast pump kits for new mothers to use at Dekalb Detention Center. The program gives the mothers, most of whom will be in Dekalb for short periods of time, the opportunity to initiate and maintain lactation so they can continue to feed their baby breast milk once they’re reunited at home. "Many women at Dekalb believe they are not allowed to breastfeed, even in the hospital, but I encourage them to consider doing so, even if it's only for a short period of time," said Kelly Webb, the Lactation Program Coordinator at Grady Memorial Hospital. "Access to a breast pump allows a new mother to maintain supply and remain emotionally connected to her infant." Aeroflow Breastpumps, a subsidiary of Aeroflow Healthcare, is a DME provider specializing in helping pregnant and nursing women qualify for their breast pumps through their insurance and the Affordable Care Act.

Last call for HME Woman of the Year nominations

WATERLOO, Iowa – The nomination period for the HME Woman of the Year award closes Monday, Aug. 14. To nominate a woman for the award, all you have to do is complete four questions stating how the woman has made an impact on the industry. Women are also encouraged to nominate themselves. Last year’s recipient, Dr. Kirsten Davis, has used the award as a platform for networking with other women in the industry, and sharing successes and obstacles that impact their businesses. “I would encourage everyone to take a minute to really think about what they do, what they've done, and who they've touched,” said Davin. “By really sitting down and reviewing your career, we often find out that we have a greater impact than we think we do.”  The winner of the award will be announced at Medtrade in October.

QS/1 boasts QIR-certified installers

SPARTANBURG, S.C. – QS/1 has met the stringent guidelines of the Qualified Integrators and Resellers (QIR) Program, giving its pharmacy and provider customers assurance that they meet regulatory requirements to protect consumer credit card data. This Payment Card Industry Data Security Standard (PCI DSS) qualification details the procedures for a secure installation and continued maintenance of payment application systems. QS/1 integrators are PCI-certified under the QIR program to install, configure and maintain payments systems, like the company’s Point-of-Sale. “QS/1 has a history of leading the way in point-of-sale technology,” said Saul Factor, QS/1 president. “With network breaches at an all-time high last year, we want to ensure we stay ahead by taking every step possible to protect our customers and those they serve by reducing the risk of a security breach.”

EZ-Access makes improvements

ALGONA, Wash. – EZ-Access has updated its website, www.ezaccess.com, and strengthened its sales team. The company, which makes accessibility solutions, worked with VGM Forbin to update its website to improve the experience for current and prospective customers who are searching for products. The website, which was built to perform well on all devices, features products segmented by categories, a dealer contact form, a live chat and stronger security. EZ-Access has also added Scott Haisch as West Region Business Manager, reporting directly to David Heinz, director of sales for the company’s Residential Access division. Previously, Haisch was managing director of an international sales and marketing consulting company.

 

New Apria program helps reduce readmissions

Fri, 08/11/2017 - 12:20
08/11/2017HME News Staff

LAKE FOREST, Calif. – Apria Healthcare has launched a new program for patients on non-invasive ventilation that it says significantly reduces hospital admissions.

As part of the Apria Clinical Evidence (ACE) program, respiratory therapists perform regularly scheduled home visits to help patients maintain compliance with therapy and intervene as needed to get patients back on track. During the visits, RTs monitor each patient’s progress and record their responses to a number of quality of life indicators, as well as document emergency department visits and unplanned hospital admissions.

“Apria is uniquely positioned to help these patients reduce hospital admissions by providing them with the tools and support they need for success,” said Dan Starck, CEO of Apria Healthcare. “Through the ACE program, we have seen tremendous success in reducing hospital admissions when comparing the six months prior to initiating therapy with the six months post therapy, particularly for patients diagnosed with COPD.”

Initial results from the ACE program are comparable to a recent study published in the Journal of Clinical Sleep Medicine, which demonstrated that multifaceted COPD intervention—including non-invasive ventilation, RT-led respiratory care and patient education—resulted in an 88% reduction in hospital admissions, according to Apria.

Apria is offering the ACE program nationwide through its locations in Springfield and Wilmington, Mass.

Apria settles with MassHealth

Thu, 08/10/2017 - 11:34
08/10/2017HME News Staff

LAKE FOREST, Calif. – Apria Healthcare has agreed to pay more than $750,000 to settle allegations that it billed Massachusetts residents for services already covered by MassHealth, the state’s Medicaid program.

Under the settlement announced Aug. 9, Apria has agreed to pay $99,008 in restitution and $665,934 in penalties to settle allegations that the company improperly billed consumers between December 2011 and April 2017, according to Massachusetts Attorney General Maura Healey.

Despite the settlement, Apria denies it violated any state laws.

“We are pleased to have resolved this matter with the Massachusetts Attorney General,” said Raoul Smyth, Apria’s executive vice president and general counsel, in a statement. “Although Apria denies that it has violated any Massachusetts laws, this resolution reflects Apria’s desire to put this matter behind it so that it can continue to focus on the needs of patients.”

Apria says it addressed the processes that were the focus of the Attorney General’s investigation long before this settlement was reached.

New impact survey seeks ‘street level’ view

Thu, 07/27/2017 - 14:00
07/27/2017HME News Staff

WASHINGTON – AAHomecare is developing a new survey with Dobson DaVanzo & Associates to determine the impact of competitive bidding on patient access to home medical equipment nationwide.

The survey will seek input from HME providers, beneficiaries, caregivers and hospital discharge planners. Dobson DaVanzo, a leading healthcare research group, will create a report based on the survey results.

Although industry stakeholders have met with regulatory agencies to discuss improvements to the bid program, more anecdotes are needed, particularly from beneficiaries and caregivers, says AAHomecare.

“A better understanding of the experience we have every day working with beneficiaries and discharge planners to secure needed equipment in a timely manner will help policymakers come up with solutions that help providers and patients alike,” said Steve Ackerman, AAHomecare chairman in a weekly bulletin. “This independent evaluation of what is actually going on at the street level, trying to get patients home, is long overdue."
AAHomecare has formed a steering committee for the survey that includes: John Gallagher, VGM Group; George Kucka, Fairmeadows Home Health Center; and Gary Sheehan, Cape Medical Supply.  

Temporary payment for home infusion passes House

Wed, 07/26/2017 - 08:47
07/26/2017HME News Staff

WASHINGTON – A bill that reforms several Medicare benefits, including home infusion and O&P, sailed through the House of Representatives this week.

H.R. 3178, the “Medicare Part B Improvement Act of 2017,” includes a provision that would create a temporary payment for home infusion therapy to close a gap created by another bill, the 21st Century Cures Act. The Cures Act requires Medicare to pay for services associated with providing Part B drugs, but not until 2021. Meanwhile, a second provision in the act cut payments for those drugs on Jan. 1.

The provision, originally introduced by Reps. Pat Tiberi, R-Ohio, and Bill Pascrell, D-N.J., as H.R. 3163, would put a temporary payment in place for 2019 and 2020.

H.R. 3178 also includes a provision that would allow the documentation produced by an O&P practitioner to be considered part of a patient’s medical record for purposes of determining medical necessity. The provision was originally introduced by Reps. Mike Bishop, R-Mich., and Mike Thompson, D-Calif., as H.R. 3171.

The bill has moved with lightning speed: It was introduced on July 11 by Rep. Kevin Brady, R-Texas, chairman of the House Ways and Means Committee, Rep. Richard Neal, D-Mass., and nine co-sponsors.

The bill does not include a provision that would strengthen protections requiring mail-order contract suppliers to include at least 50% of the types of diabetes testing supplies that were available before the implementation of the program. That provision, which also would prevent suppliers from encouraging beneficiaries to switch brands, still exists as a standalone bill, H.R. 3271.

FDA lifts Invacare’s consent decree

Tue, 07/25/2017 - 09:50
Decree has handicapped company since late 201207/25/2017HME News Staff

ELYRIA, Ohio – Invacare has the green light to make and sell products again from its Taylor Street manufacturing facility and corporate headquarters here, the company announced July 25.

A consent decree with the U.S. Food and Drug Administration has limited Invacare’s ability to make and sell products from the facilities for nearly five years, since December 2012.

“Invacare can design, manufacture, process, pack, repack, label, hold, distribute, import into or export from the United States, the subject devices at or from corporate or Taylor Street facilities,” the FDA stated in a letter to the company dated July 24.

The letter follows the FDA’s re-inspection of the facilities in late May. Prior to the re-inspection, the FDA received and approved three certification reports from Invacare’s third-party auditor.

To ensure continuous compliance, the FDA now requires Invacare to undergo five years of audits by an auditor. The company says an auditor will inspect the facilities every six months for the first year, and then once every 12 months for the four years thereafter.

“We made significant investments in our quality system, as well as manufacturing and design processes,” said Matthew Monaghan, chairman, president and CEO, in a press release. “We are pleased to have the FDA’s recognition of our progress, and we will continue to put quality at the core of everything we do.”

Now that the FDA has lifted the consent decree, Invacare can sell wheelchairs designed and manufactured at the Taylor Street facility without having to obtain verification of medical necessity documentation. The timing couldn’t be better: The company recently received 510(k) clearance from the FDA for its TDX SP2 power wheelchair with LiNX Technology and will launch the product in the third quarter of this year.

“We look forward to expanding our rehab business over time,” Monaghan said.

ConvaTec adds distribution business

Fri, 07/21/2017 - 12:08
07/21/2017HME News Staff

READING, United Kingdom – ConvaTec, a global medical products company, has agreed to pay nearly $121 million for Woodbury Holdings, a distributor of incontinence and catheter supplies.

The Floral Park, N.Y.-based Woodbury offers a portfolio of more than 500 incontinence and 650 catheter products, and a wide array of nutritional, enteral feeding and vascular compression products through subsidiaries Woodbury Health Products and Wilmington Medical Supply.

"ConvaTec and Woodbury share a common commitment to improving the lives of people with continence issues and a dedication to providing quality products, together with distinctive service and personal support,” said Paul Moraviec, CEO of ConvaTec, in a press release. “We look forward to working with our Woodbury colleagues to bring our comprehensive end-to-end suite of services to even more customers."

With this acquisition, ConvaTec Americas will create a new distribution unit for catheter- and incontinence-related products, comprising the U.S. distribution companies of 180 Medical, Symbius Medical, South Shore Medical Supply, Wilmington Medical Supply and Woodbury Health Products.

The deal is the latest in a recent string of manufacturers acquiring disposable medical supplies companies. In 2016, Coloplast paid $160 million for Comfort Medical; and Domtar acquired Home Delivery Incontinence Supplies for $45 million.

In October 2016, ConvaTec raised nearly $1.8 billion in an initial public offering, according to news reports. ConvaTec is owned by private equity firms Nordic Capital and Avista Capital Partners, which acquired the company in 2008 for $4.1 billion.

States move to single-source more and more DME

Fri, 07/21/2017 - 12:04
‘They’re commoditizing this portion of health care, and it’s scary to think about how far they’ll take it’07/21/2017Liz Beaulieu

YARMOUTH, Maine – Distributors have been picking up Medicaid contracts for incontinence supplies in a number of states for years. Now the stakes have been raised.

In Indiana, for example, Medline has won a single-source contract to provide all DME and supplies to Medicaid patients under Managed Health Systems, a managed care company that’s administering part of the state’s program. Medline plans to drop ship aides, soft goods and supplies, and has set up a network that includes Apria Healthcare to provide “hard DME,” says George Kucka, president and CEO of Fairmeadows Home Health Center in Schererville, Ind.,

“This is completely changing the paradigm,” said Kucka, who is also the HME/Respiratory Therapy Council Chair for AAHomecare. “It’s starting to spread, and it’s not good. This points to the fact that no one respects that there’s a service aspect to this.”

Kucka got word of the contract via a letter in February. His contract with MHS will be terminated—he serves about 150 patients under the plan—and the new contract with Medline will start on Sept. 1.

Down in Texas, Medline has won a single-source contract to provide supplies—the list includes 244 codes—to Medicaid patients under Superior HealthPlan, a managed care company that’s administering part of that state’s program. That contract also starts Sept. 1.

“How is Medline going to know what to dispense to the patient?” said Victoria Peterson, an administrator for Respiratory & Medical Homecare in El Paso, Texas, which serves about 125 patients under Superior HealthPlan, representing about $75,000 in revenues per month. “When they get a script that says PediaSure, what kind are they going to provide, because there are 25 different kinds. The doc doesn’t know—we go back to the nutritionist to find the best fit. Same thing with trachs—there are six different types of tubes.”

Respiratory & Medical Homecare has filed four complaints with three difference offices of the Texas Health and Human Services Commission, as well as Superior HealthPlan. Another provider, Alliance Medical Supply, enlisted the legal team at Brown & Fortunato to also file a complaint.

“All the DME providers that have been providing services in a fabulous way for decades—now all of a sudden, they would be eviscerated,” said Pam Colbert, a member of the firm’s Health Care Group.

In a response to a request for an interview, a media relations specialist at Medline said no one was available at the moment.

“It’s a very new deal,” she said, referring to the contract in Texas. “But we may have more details to share in the coming months.”

Providers like Ben Hertz don’t begrudge Medline and other distributors like TwinMed for earning a living, but this trend is another major shift in the HME industry toward larger companies and less personal care.

“They’re all trying to maximize their own revenues, but it’s like, health care is so personal,” said Hertz, the store manager for Elmora Healthcare in Elizabeth, N.J., where the state has contracted with Medline to provide incontinence supplies to all Medicaid patients under Horizon N.J. Health. “You go to the doctor that your family has been going to for 50 years. You got to the hospital, and your nurse is your neighbor. They’re commoditizing this portion of health care, and it’s scary to think about how far they’ll take it.”

Kucka says he’s not going down without a fight, and depending on how the contract plays out, he’ll likely have Medicaid patients on his side.

“If there are service issues that creep up, the Medicaid population is more vociferous than the Medicare population,” he said. “They’re going to scream.”

Hearing drums up support for home infusion, diabetes bills

Fri, 07/21/2017 - 12:01
07/21/2017Theresa Flaherty

WASHINGTON – Bills related to home infusion and diabetes supplies were front and center during a hearing last week by the Energy & Commerce Subcommittee on Health in the House of Representatives.

At the July 20 hearing, lawmakers heard testimony on 11 bills, including a bill that would ensure Medicare beneficiaries have access to their preferred brand of diabetes supplies, and a bill that would create a temporary transitional payment for home infusion drugs to close a gap created by the 21st Century Cures Act.

“H.R. 3163, the Medicare Part B Home Infusion Services Temporary Transitional Payment Act, is bill worthy of our support,” said Rep. Gene Green, D-Texas. “The timing and payment changes for drugs and services do not line up, potentially resulting in reduced patient access. This bill solves the problem by providing a temporary bridge from 2019 to 2021, so patients don’t lose access to the care they need.”

The Cures Act requires Medicare to pay for services associated with providing Part B home infusion drugs, but not until 2021. Meanwhile, a second provision cut payments for those drugs on Jan. 1.

Other payers already recognize the value of home infusion services, testified Varner Richards, CEO of IntraMed Plus and a board chair for the National Home Infusion Association.

“Commercial insurers, Medicaid programs, and many Medicare Advantage health plans currently recognize that infusion therapy delivered at home is a cost-effective, low risk, and clinically effective treatment option,” he said. “The community supports an explicit payment for home infusion clinical services that are required to ensure effective patient care.”

Christel Aprigliano, CEO of the Diabetes Patient Advocacy Coalition, urged lawmakers to support “The Protecting Access to Diabetes Supplies Act,” H.R. 3271, which seeks to make improvements to the mail-order program for diabetes supplies. While on the surface, the program saves beneficiaries out-of-pocket costs, it comes at a high cost in terms of complications down the road, she says.

“We are on the cusp of a severe health crisis,” said Aprigliano. “Debilitating complications are common among people with mismanaged diabetes and the Medicare program bears much of this burden. The program may be hindering the ability to achieve diabetes control.”

Introduced July 17 by Reps. Diana DeGette, D-Colo., Susan Brooks, R-Ind., and Tom Reed, R-N.Y., H.R. 3271 would strengthen protections requiring mail-order contract suppliers to include at least 50% of the types of testing supplies that were available before the implementation of the program. It would also prevent suppliers from encouraging beneficiaries to switch brands. 

“(This bill) would prevent suppliers from coercing beneficiaries into changing their choice of test strips and make it easier for patients to switch and receive different testing supplies if they want to,” said Green. “I have co-sponsored this legislation in the past and will continue to support it.”

Other bills discussed at the hearing dealt with issues like furthering access to stroke telemedicine services, removing a rental cap for speech generating devices, and increasing civil and criminal monetary penalties and fines for fraud and abuse.

“Each of these policies exemplifies our shared commitment to strengthening the Medicare program for our current beneficiaries and for future generations,” said Rep. Michael Burgess, chairman, in opening the hearing.

 

 

‘What shift?’ HME industry divided over role of young professionals

Fri, 07/21/2017 - 12:00
07/21/2017Liz Beaulieu

YARMOUTH, Maine – The VGM Group gave a nod to young professionals when it hosted a meet-up for the HME Young Professionals Group at the Heartland Conference in June, but it turns out the HME industry is still very much gray.

The majority of the respondents to a recent HME Newspoll (54%) say they’re not experiencing a shift to a younger workforce.

“We have more over 65 than under 40,” wrote one respondent. “What shift?”

The majority of respondents (46%) to the poll say they only have one to five employees under 40. Five percent say they have none.

Young professionals, who are more likely not to have experience in the HME industry, can detract or add to a business, depending on the respondent, according to the poll.

“Unfortunately, we can’t afford to spend time training inexperienced staff,” wrote on respondent. “There is way too much to learn. I myself started at a young age with no experience, but that was a different time.”

On the other hand, “While experience is valuable, there are so many changes to the way we do things from five years ago that we are finding it easier to train someone with no experience,” wrote another respondent.

For the 38% percent of respondents who say they have 10 or more employees under 40, that inexperience means a fresh perspective.

“We look forward to hiring young team members,” wrote one respondent. “Most of them are not aware of what’s happened over the past 10 years in the HME industry and, therefore, they bring a welcomed attitude to our workforce.”

Other benefits of a younger workforce, respondents say: more affordable health insurance for those companies that offer it to their employees, and a higher level of tech-savviness. Detriments: less work ethic and more turnover, they say.

“Average length of employment for the younger population is two years or less,” wrote one respondent.

At some point, however, as a big portion of the workforce retires, HME companies will increasingly have to look to younger professionals. That will be a sad day, one respondent says.

“I feel that we are losing a lot of knowledge from our more senior employee base,” wrote the respondent.

 

Recently launched Upstep modernizes custom orthotics biz

Fri, 07/21/2017 - 11:58
07/21/2017Theresa Flaherty

NEW YORK – When a trio of siblings decided to launch a startup, Limor Katz’s nearly lifelong experience with foot pain led her and her two brothers to custom orthotics.

“I was in terrible pain—every day I would have to come home and rest my feet,” said Katz, co-founder and CMO of Upstep, an online custom orthotics service. “Custom orthotics changed my life. I don’t remember what foot pain is now.”

After a soft launch in 2016, Upstep announced its official launch in June. The company’s custom orthotics cost, on average, $189 to $239, compared to $300 to $500 in a podiatrist’s office.

Katz, along with her brothers Aviad and Oren Raz, spent two years working with a top podiatrist testing various orthotics and materials.

“There were many challenges to making custom orthotics without seeing the customer,” said Aviad Oren, co-founder. “The main issue is how to make foot impressions and how to fit it into the shoe.”

The process they settled on: Customers receive a footprint kit with easy instructions to make an imprint, then Upstep uses 3D technology to scan the imprint and create a custom orthotic based on the individual’s specific needs. The company stores those scans in its database so customers can order additional orthotics for up to five years.

“It’s easy—it takes five minutes,” said Katz. “It makes us happy to make a product that lets people come home with a lot of energy and enable them to focus on family and on fun things, and not on their feet.”

Katz and Oren believe a cheaper and simpler process for obtaining custom orthotics will help to upend a statistic that has only one-third of the 77% of Americans who suffer from foot pain doing anything about it.

“Custom orthotics are very expensive and the process for (obtaining them) can be very frustrating,” said Oren. “We provide a holistic solution for each customer.”

In brief: ConvaTec adds distribution business, Compass Health launches new product line

Fri, 07/21/2017 - 11:56
07/21/2017HME News Staff

READING, United Kingdom – ConvaTec, a global medical products company, has agreed to pay nearly $121 million for Woodbury Holdings, a distributor of incontinence and catheter supplies.

The Floral Park, N.Y.-based Woodbury offers a portfolio of more than 500 incontinence and 650 catheter products, and a wide array of nutritional, enteral feeding and vascular compression products through subsidiaries Woodbury Health Products and Wilmington Medical Supply.

"ConvaTec and Woodbury share a common commitment to improving the lives of people with continence issues and a dedication to providing quality products, together with distinctive service and personal support,” said Paul Moraviec, CEO of ConvaTec, in a press release. “We look forward to working with our Woodbury colleagues to bring our comprehensive end-to-end suite of services to even more customers."

With this acquisition, ConvaTec Americas will create a new distribution unit for catheter- and incontinence-related products, comprising the U.S. distribution companies of 180 Medical, Symbius Medical, South Shore Medical Supply, Wilmington Medical Supply and Woodbury Health Products.

The deal is the latest in a recent string of manufacturers acquiring disposable medical supplies companies. In 2016, Coloplast paid $160 million for Comfort Medical; and Domtar acquired Home Delivery Incontinence Supplies for $45 million.

In October 2016, ConvaTec raised nearly $1.8 billion in an initial public offering, according to news reports. ConvaTec is owned by private equity firms Nordic Capital and Avista Capital Partners, which acquired the company in 2008 for $4.1 billion.

GAO: Cover disposable devices as substitutes for DME

Health and Human Services calls move ‘premature’

WASHINGTON – The Government Accountability Office has recommended that the Department of Health and Human Services evaluates the possible costs and savings of using disposable devices as substitutes for DME and, if appropriate, seek legislative authority to cover them.

While Medicare generally doesn’t cover disposable devices, the GAO identified eight such devices that could potentially substitute for DME devices that are covered. These disposable devices fall into existing Medicare DME categories: infusion pumps, including insulin pumps; blood glucose monitors; sleep apnea devices; and nebulizers.

The GAO’s recommendation is the result of a report examining (1) potential disposable DME substitutes and their possible benefits and limitations; (2) the incentives and disincentives stakeholders identified for developing these substitutes, including the possible influence of health insurance coverage; and (3) issues related to benefit category designation, including legal authority and potential payment methodologies if Medicare coverage were expanded to include disposable DME substitutes.

In addressing issues related to benefit category designation, the GAO identified three possible options for covering disposable devices: an expansion of the current DME benefit, an expansion of the current home health benefit, or the establishment of a new benefit category.

Under the current DME benefit, disposable devices are not covered because they don’t meet CMS’s regulatory definition for “durable”: able to withstand repeated use, with an expected lifetime of at least three years.

To conduct the report, the GAO reviewed agency documents and literature on disposable DME substitutes and Medicare payment policy; interviewed CMS officials; and interviewed various stakeholders, including representatives of device manufacturers, beneficiary advocates, healthcare providers and insurers for their perspectives.
In response to the report, HHS said it was premature to evaluate disposable devices as substitutes for DME.

Ascensia, Dexcom bundle diabetes products

PARSIPPANY, N.J. – Ascensia Diabetes Care and Dexcom have hammered out a commercial agreement that they expect to increase access to the Dexcom G5 continuous glucose monitoring system. Per the agreement, Ascensia’s ContourNext One blood glucose monitoring system will be provided in the bundle of supplies for the Dexcom G5. The role of the ContourNext: to provide highly accurate readings for CGM calibration, something people who use the G5 do on a regular basis to verify sensor readings are on track. This “complete bundle” will be available to people with diabetes who are covered by Medicare and qualify for “therapeutic” CGM, according to a press release. “With this agreement, we are pleased to begin offering a complete bundle to Medicare-eligible patients, enabling access to the Dexcom G5 as efficiently as possible,” said Rick Doubleday, chief commercial officer at Dexcom. Earlier this year, CMS decided to classify certain CGMs as DME, if, among other criteria, they’re “therapeutic” and approved by the U.S. Food and Drug Administration for use in place of blood glucose monitors for making diabetes treatment decisions.

Agreement increases access to OxyGo POCs

COSTA MESA, Calif. – CareCredit will provide financing options for the oxygen patients of nearly 20,000 providers across the country under a new, multi-year agreement with OxyGo. This marks CareCredit’s first foray into the HME industry. “Entering this new market with a well-regarded partner aligns perfectly with our goal of helping people pay for the care they need when they need it,” said Greg Pierce, senior vice president and general manager of CareCredit. “Our agreement with OxyGo gives their providers a way to help people finance the equipment they need—with convenient, monthly payments.” CareCredit is a health, wellness and personal care credit card accepted through a national network of more than 200,000 healthcare provider locations and select health-focused retailers. The agreement will increase access to the OxyGo family of portable oxygen concentrators, says Dave Marquard, CEO and founder of the company, which is part of Cleveland-based Applied Home Healthcare Equipment. “This new partnership will help patients live more independent and healthier lives,” he said. “Having the freedom to be on the go while you’re on oxygen can make a big difference. Now more patients will be able to get an OxyGo and/or OxyGo FIT portable oxygen concentrator, giving them greater independence.”

Compass Health launches first product under AccuRelief line

QUINCY, Mass. – Compass Health Brands has unveiled its new AccuRelief 3-in-1 Wireless Pain Device and Bluetooth-connected mobile app, its first product under the company’s AccuRelief 2.0 line. The device, which is small enough to fit in your pocket, combines TENS, EMS and massage with the convenience of mobile technology. Additionally, the mobile app features diagrams of muscle groups, an electrode placement guide, satisfaction tracking and more. The device features 14 pre-set programs with up to 60 levels of adjustable intensity for 12 treatment zones, including the back, knee, neck, and shoulders. As an alternative to the mobile app, the device also includes a hand-held remote control.

Invacare backs vets at Wheelchair Games

ELYRIA, Ohio – Invacare is a national sponsor of this week’s 37th Annual National Veterans Wheelchair Games. The games, which run from July 17-22 in Cincinnati, feature a multitude of sporting events, including basketball, handcycling, track and table tennis. “The pure talent, tenacity and devotion to the sport demonstrated by these veteran athletes makes us honored to continue to show our support,” said Dean Childers, senior vice president and general manager of Invacare North America. Invacare associates started their supporting role on Sunday, when they met athletes at the airport to help ensure their wheelchairs were unloaded and assembled properly. Throughout the week, they’re also offering repairs and replacements. Additionally, during the event’s expo day, Invacare will display several products, including its new küschall custom manual wheelchairs; and its Invacare TDX SP2 power wheelchair with LiNX technology, which is set to launch in the third quarter of this year.

FODAC receives ‘green’ recognition

STONE MOUNTAIN, Ga. – Friends of Disabled Adults and Children was recognized by the Atlanta Better Buildings Challenge for its continuing energy consumption reduction, it announced in a press release. “We are grateful for the recognition of FODAC’s longstanding green initiative by the ABBC,” said Chris Brand, president and CEO of FODAC. “Our repurposing and recycling program has always supplied much of our inventory to supply the needs of our clients, and keeps almost 300 tons of equipment and related parts out of landfills.” FODAC is a nonprofit that has provided more than $10 million in DME and supplies to people with injuries and disabilities.

Video makes patients more likely to stick with CPAP

DENVER – Sleep apnea patients were more likely to use their CPAP machines after watching video of themselves struggling to breathe, according to a new study led by Mark Aloia, Ph.D., a sleep expert at National Jewish Health in Denver. Twenty-four patients newly diagnosed with moderate to severe OSA received education with a personalized video (PVD), education with a non-personalized video (NPV) or treatment as usual (TAU). The PVD group used CPAP devices more than two hours per night (6.5)—more than the NPV group (4.1) or the TAU group (3.5). “Sleep apnea is one of those disorders you never really notice in yourself,” say Aloia in an article in Sleep Review Magazine. “I mean, you’re asleep; you’re consciously not aware of what’s happening to you.”

TheraSkin expands VA offerings

NEWPORT NEWS, Va. – TheraSkin will now be available in all four sizes to veterans through 110 Veterans Affairs Medical Centers and 800 Community Based Outpatient Centers nationwide, distributor Soluble Systems announced July 18. "We are especially proud to offer two additional sizes of TheraSkin to the doctors and nurses treating our nation's veterans suffering with chronic wounds at the VA hospitals and outpatient centers," said Allan Staley, CEO. "Whether the wound is large or small, clinicians and veterans can know that they have more options available to them with proven clinical evidence to back it up." In the United States alone, chronic lower extremity ulcers affect an estimated 2.4 million to 4.5 million people at an estimated cost of $4,000 per month and $16,000 per episode, according to a press release.

Medtrade: 100 days and counting

ATLANTA – Advance registration rates remain in effect until Aug. 26 for Medtrade, which takes place Oct. 23-25 at the Georgia World Congress Center in Atlanta. The conference pass allows admission to educational sessions.“It’s a wise investment, because the motivation, inspiration, and product ideas from Medtrade can set the stage for future success,” said Show Director Kevin Gaffney. Show floor passes can be obtained for free from exhibitors. Show organizers announced in May that this year’s show would be shortened from four days to three. To register, go here.

NCPA names finalists for business plan competition

ALEXANDRIA, Va. – The National Community Pharmacists Association has named three teams of pharmacy students as finalists for the 2017 GoodNeighbor Pharmacy NCPA Pruitt-Schutte Student Business Plan Competition. The students hail from the University of Arkansas for Medical Sciences, the University of Pacific Thomas J. Long School of Pharmacy and Health Sciences, and the University of Southern California School of Pharmacy. They will present their business plans in a live competition on Oct. 14 at NCPA’s annual convention in Orland, Fla. They’re competing for first ($3,000 to the NCPA student chapter and $3,000 contributed to the school in the dean's name to promote independent pharmacy), second ($2,000 to the NCPA student chapter and $2,000 contributed to the school in the dean's name to promote independent pharmacy) and third place  (Third Place: $1,000 to the NCPA student chapter and $1,000 contributed to the school in the dean's name to promote independent pharmacy).

Sports clinic brings DME in house

VAIL, Colo. – The Steadman Clinic, which offers sports medicine and orthopedic surgery, has added a DME service. In the past, the clinic used third-party vendors to produce and sell DME, whether it’s braces, crutches or boots, but it wanted more influence over what its patients use to recover from their injuries, says Nick Eaton, DME manager at The Steadman Clinic. “By bringing DME in house, we can recommend products that pertain to each provider’s protocol on a patient-specific basis,” he said. The clinic’s patients often need assistance and protection before and after a procedure; others need braces to enable them to have the mobility for normal activity in their lifestyle and to help prevent further injury.

Legislation seeks to protect access to diabetes supplies

Thu, 07/20/2017 - 09:49
Although bid program already requires protections, they are not readily enforced07/20/2017HME News Staff

WASHINGTON – Reps. Diana DeGette, D-Colo., Susan Brooks, R-Ind., and Tom Reed, R-N.Y., have introduced a bill to ensure Medicare beneficiaries have access to their preferred brand of diabetes supplies.

“The Protecting Access to Diabetes Supplies Act,” H.R. 3271, would strengthen protections requiring mail-order contract suppliers to include at least 50% of the types of testing supplies that were available before the implementation of the competitive bidding program. It would also prohibit suppliers from encouraging beneficiaries to switch brands. 

“At a time when Medicare and American health care in general are topics of contentious discussions in Washington and across the country, this bipartisan effort is something everyone can support,” said DeGette in a press release. “It will ensure that seniors who have diabetes are able to get quality test strips that are compatible with their glucose monitors. Diabetic patients often rely on test strips to read glucose levels accurately and dose medication appropriately. By making sure seniors can get test strips that work, this bill will deliver better health outcomes for millions of Medicare beneficiaries.”

Although the bid program already requires protections, they are not readily enforced. A 2016 report from the Office of Inspector General found that two brands of test strips account for half of the mail-order market.

DeGette, along with Reed, is co-chair of the Congressional Diabetes Caucus.

A similar bill was introduced in the Senate in the last session.