HME News

Syndicate content
Updated: 33 min 20 sec ago

CMS rescinds proposed orthotics rule

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

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

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

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

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

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

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

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

Provider Gary Sheehan named Homecare Champion

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

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

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

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

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

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

Access survey slams bid program

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

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

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

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

Other findings from the report:

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

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

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

Permobil expands seating, positioning portfolio

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

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

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

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

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

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

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

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

Stakeholders take stock in wake of Price’s resignation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

You’ve got a right to fight

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

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

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

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

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

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

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

Numotion ramps up remote service

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

HME Woman of the Year finalists announced

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

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

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

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

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

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

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

AAH releases Q2 results for HME Audit Key

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

ResMed provides update on lawsuits in four countries

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

BOC launches new accreditation

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

CAIRE adds remote monitoring capabilities

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

NHIA leverages Citus Health to digitize provider workflow

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

Pride Mobility cuts price on power lift recliners

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

Compass Health buys Richmar

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

Permobil makes second buy in New Zealand

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

Option Care first to have accredited compounding pharmacies

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

HIDA launches homecare council

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

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

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

OIG: Enhancements needed to collect overpayments

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

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

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

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

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

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

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

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

 

HME Woman of the Year finalists announced

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

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

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

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

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

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

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

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

AAH, VGM respond to Price’s resignation

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

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

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

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

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

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

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

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

Tom Price is out at HHS

Fri, 09/29/2017 - 18:12
09/29/2017HME News Staff

WASHINGTON – Secretary of Health and Human Services Tom Price, a long-time champion of the HME industry, will resign effective 11:59 p.m. today, Friday, Sept. 29.

The resignation comes amidst growing criticism of Price’s use of charter flights instead of commercial flights to travel to government engagements. Politico, which broke the story of Price’s costly travel, estimated that the price tag for these trips was more than $400,000.

On Thursday, Price announced that he would reimburse the government for a fraction of the costs of his flights. But on Friday, he offered his letter of resignation.

“I have spent 40 years both as a doctor and public servant putting people first,” he wrote. “I regret that the recent events have created a distraction from important objectives” like reforming health care.

President Donald Trump will designate Don Wright as acting secretary, according to news reports. Wright, described by Forbes as a “more establishment” government official, currently serves as the deputy assistant secretary for health, and director of the Office of Diseases Prevention and Health Promotion.

Price’s resignation comes at an unfortunate time for the HME industry. With Price at the helm of HHS, CMS had sent an interim final rule to the Office of Management and Budget for clearance that would provide much-needed relief from Medicare’s competitive bidding program.

Already, under Price’s direction at HHS, CMS decided to stop planned bid-related cuts to accessories for complex rehab power wheelchairs, among other changes beneficial to the HME industry.

As a congressman, Price introduced bills to create an alternative to the competitive bidding program, called the market-pricing program. Tenets of MPP include requiring providers to fulfill their contracts and putting out to bid only two product categories per bid area (with the remaining product categories adopting the price submitted by contract suppliers in other areas of equal size).

Price has also introduced bills to soften the blow of the recent national roll out of competitive bidding by providing a 30% increase in reimbursement over the bidding-derived prices and a four-year phase-in period, and reinstating the bid cap at the unadjusted fee schedule amount.

Stakeholders wage protracted battle with other payers

Fri, 09/29/2017 - 12:47
09/29/2017Theresa Flaherty

YARMOUTH, Maine – A recent decision by the Washington, D.C., Medicaid program to raise reimbursement for competitive bid items was a win, but stakeholders say it’s a constant battle to keep payers from lowering payments in the first place.

“We are continuing to see the different payers, whether that be state Medicaid programs (or others), adopt Medicare rates or a discount below Medicare rates,” said Laura Williard, vice president of payer relations for AAHomecare. “In some cases, they are just lowering rates and saying it’s because of the trends they are seeing in Medicare.”

The District of Columbia Health Care Finance Office said in September it would raise the reimbursement for competitive bid items to 100% of bid rates starting Oct. 1. Previously, these items had been paid at 80% of Medicare rates, but officials reversed their decision after outreach from The Maryland-National Capitol Area Homecare Association and AAHomecare.

On the commercial payer side, Blue Cross Blue Shield, in particular, is looking at Medicare fee schedules in several of the 36 states where it operates but is not owned by Anthem.

“The big trend I am seeing with those Blues is they have a need to cut the cost of premiums to employer groups,” she said.

Following Medicare rates is nothing new, of course, but with those rates now at unsustainable levels, it’s harder, if not impossible, for providers to absorb.

“It’s going to put people out of business if they’ve held onto those contracts in the hopes that it will turn around,” said Craig Douglas, vice president of payer and provider relations at The VGM Group. “But if those payers represent 40% to 50% of a provider’s book of business, they feel like they simply can’t afford to walk away from it even if it’s—I have to believe—putting them underwater in many product categories.”

Williard has created a reference packet to help providers renegotiate their contracts. She says that being armed with data is the best way to demonstrate the implications of reducing rates, although some payers are more receptive than others.

“If they are truly in the dark about what’s going on, they are more receptive,” she said. “They understand the implications to patient access and providers going out of business.”

 

Update in Texas: Nerves rattled as contract’s start date approached

Fri, 09/29/2017 - 12:45
New twist: Superior HealthPlan posts info about forthcoming RFP for new value-based DME network09/29/2017Liz Beaulieu

AUSTIN, Texas – The state Medicaid program may have forced Superior HealthPlan to modify its contract with Medline for DME and supplies, but providers say, in reality, they fear not much has changed.

During a hearing in August that prompted the modifications, provider Barry Johnson says the state and Superior HealthPlan agreed that Medicaid recipients would be able to opt out of the contract with a simple phone call to the managed care organization.

“They’re being told they have to fill out an opt-out form specifically from Superior,” said Johnson, president of Texas Medical in Duncanville, Texas, and executive director of the state HME association. “Why are they making this more difficult than it has to be?”

In August, Superior HealthPlan, part of Centene Corp., which has more than 12 million members in 28 states, agreed to recast the contract with Medline as “preferred provider,” as opposed to “single source.” It also agreed to delay the start date of the contract from Sept. 1 to Oct. 1.

Last week, Johnson said “some” of his patients had gone through the opt-out process.

“I’m sure there will be some that never do—their caregivers work all the time; they get their mail infrequently; when they call, they’re told they haven’t filled out a personal medical information form to have a conversation,” he said. “There are a lot of barriers, and we can’t get the prior authorization unless there’s an opt-out form.”

Adding insult to injury: Johnson said he noticed way at the bottom of Superior HealthPlan’s opt-out form that it’s good for only one year.

“So a year from now, we’re going to have to go through this same exercise,” he said.

Provider Victoria Peterson said she echoes a number of providers when she says little has changed about Superior HealthPlan’s approach to the contract.

“In letters sent to patients, they are not encouraging patient choice, but encouraging patients to switch to the ‘preferred provider,’” said Peterson, an administrator for Respiratory & Medical Homecare in El Paso, Texas. “It’s their right to direct patients as they wish, but I don’t believe they’re strictly adhering to the state’s intention in demanding that Superior conserve patient choice.”

Rattling nerves further, on Sept. 22 Superior HealthPlan posted information to its website about a forthcoming request for proposal for a new value-based DME network. It says its goal is to “establish a limited network of high performing DME providers capable of delivery services and supplies in a timely, efficient and cost effective manner.” It says in the coming months an RFP will be released to interested providers who meet certain criteria.

“It’s just another way to reduce the number of suppliers and the Medicaid allowables,” Johnson said. “Medicaid is already discounted 15%, which is pretty much at or below the cost line.”

Peterson worries the RFP, like the Medline contract, will put the majority of providers at a disadvantage.

“I don’t want to speculate too much, but we are concerned that the RFP will include inane and absurd requirements that only large providers could feasibly accommodate,” she said. “This is an unusual twist in the whole Superior/Medline debacle.”

NRRTS spreads the word

Fri, 09/29/2017 - 12:29
‘We need to move beyond our little circle,’ Weesie Walker says09/29/2017Liz Beaulieu

ATLANTA – When the American Congress of Rehabilitation Medicine holds its annual event here later this month, NRRTS will be on hand to raise awareness of the CRTS and RRTS community and the issues affecting them.

The ACRM serves a global community of researchers and clinicians who deliver evidence-based rehabilitation interventions to people with disabling conditions, such as spinal cord injury.

“To accomplish what we want to accomplish in Congress, it’s going to take involvement from all around,” said Weesie Walker, executive director of NRRTS.

Among the things stakeholders are trying to accomplish is passing legislation that would reverse competitive bidding-related pricing for accessories for manual complex rehab wheelchairs. They’ve already been successful in keeping the pricing from going into effect for accessories for power complex wheelchairs.

Walker said one of NRRTS’s specific goals for the event is promoting its series of webinars, which can help educate researchers and clinicians on the issues affecting the complex rehab community.

“A couple of months ago, I got a call from a physician from a large rehab center who had participated in an advocacy webinar we hosted,” she said. “He was in charge of advocacy efforts at the center and he asked if he could share the webinar with his colleagues. I said, yes, that’s what it’s for. He was not aware of the issues.”

Walker said NRRTS will be casting a wide net at the event—the ACRM has more than 3,000 members representing more than 20 special interest and networking groups.

“We need to move beyond our little circle,” she said.

 

 

In brief: Consumers support accessories bill, VirtuOx makes buy

Fri, 09/29/2017 - 12:26
09/29/2017HME News Staff

WASHINGTON – The ITEM Coalition and 32 national consumer and clinical organizations have sent a letter to leaders in the House of Representatives, asking them to pass a bill that would halt competitive bidding-related prices for accessories for complex rehab manual wheelchairs.

“We are writing to express our strong support for this new legislation and to emphasize the importance of protecting patient access not just to accessories used with complex rehab power wheelchairs, but also to those used on complex rehab manual wheelchairs,” states the letter, which was sent to the leaders of the House Ways & Means and Energy & Commerce committees on Sept. 21.

Earlier this year, CMS stopped plans to apply bid-related pricing for complex rehab power wheelchairs. Reduced pricing for complex manual power wheelchairs, however, has been in place since Jan. 1, 2016.

Among the groups that signed on to the letter: United Spinal Association, Amputee Coalition, Christopher and Dana Reeve Foundation, Paralyzed Veterans of America and United Cerebral Palsy.

“This is a great sign of consumer/clinician support for the CRT manual wheelchair accessories fix,” said Don Clayback, executive director of NCART. “We encourage people to share (the letter) with their members in the quest to secure co-sponsors for the House bill.”

At press time, H.R. 3730, introduced by Reps. Lee Zeldin, R-N.Y., and John Larson, D-Conn., had 42 co-sponsors.

Senators introduce sleep testing bill

WASHINGTON – A bill that seeks to require the Secretary of Transportation to implement a rule to test and treat commercial transportations workers for sleep apnea was introduced Sept. 28.

The bill, S. 1883, is sponsored by Sen. Cory Booker, D-N.J., and co-sponsored by Sens. Charles Schumer, D-N.Y., Kirsten Gillibrand, D-N.Y., and Robert Menendez, D-N.J.

In August, the same group of senators sent a letter to the U.S. Department of Transportation asking why the Federal Railroad Administration and the Federal Motor Carrier Safety Administrationscrapped a proposal to require sleep apnea testing of transportation workers. The FMCSA has been working on guidelines for testing and treating commercial drivers for sleep apnea for nearly a decade and it held public comment sessions on whether to require testing in 2016.

“In the face of compelling facts that show sleep apnea is a direct cause of several tragic train accidents, the Trump administration has backed off a new mandatory testing rule,” said Schumer in a release.“This is dangerous and ill-advised. A federal law would force all rail lines to conduct these tests in perpetuity and with clear federal guidelines. Across-the-board sleep apnea testing must be law of the land for train operators and commercial drivers to help ensure us that the tragedies that happened in Brooklyn and in Hoboken will be prevented in the future.” 

VirtuOx makes buy, plans more

CORAL SPRINGS, Fla. – VirtuOx, a healthcare IT company providing diagnostic tools and services focused on sleep and respiratorydisease states, has acquired ProFox Associates and NPF, it announced Sept. 28. ProFox and NPF both offer oximetry software and technology. “This is the first of many acquisitions for us,” said Steven Lica, CEO of VirtuOx. “Our ability to create interoperability among multiple platforms will continue to drive us toward increased innovation with a goal of cost effectiveness and accuracy for healthcare providers and patients alike.” Vertess advised VirtuOx on the transactions.

Investment allows StateServ to improve software, expand network

TEMPE, Ariz. – StateServ Holdings, a DME provider to hospices and other post-acute care service providers, has received an equity investment from an affiliate of Blue Wolf Capital Partners. The investment will allow StateServ to improve and expand its proprietary software solution, DMETrack, which provides workflow automation, real-time reporting and analytics to optimize the operational, clinical and financial performance of its customers. The company also plans to use the investment to add DME providers to its network. Currently, StateServ has 1,300 DME provider locations, along with 21 company-owned warehouse facilities. It offers a full spectrum of DME benefit management solutions to more than 550 hospice providers that serve more than 80,000 patients per day in 46 states. Paul DiCosmo, CEO of StateServ, and other members of the management team will continue to lead the company and have maintained a significant equity stake. Financial terms of the deal were not disclosed.

NSM expands to Nebraska

NASHVILLE, Tenn. – National Seating & Mobility has opened a new branch in Lincoln, Neb., its first in the state. The location will provide complex rehab services across southeast Nebraska. “NSM is proud to extend our CRT expertise and offerings to clients in Nebraska, said Bill Mixon, NSM CEO. “We’re committed to growing our national network of experienced assistive technology providers to reach more individuals in need of mobility solutions.”

VGM tops best workplaces

WATERLOO, Iowa – VGM Group has been named Iowa’s Top Workplace for large employers, the member association announced Sept. 25. “This is a great honor for our company to be ranked as the Top Workplace in Iowa,” said CEO Mike Mallaro. “VGM is a family and being an extraordinary place to work is one of our important aspirations. Our unique culture helps our people serve customers with tremendous dedication and commitment.”  Approximately 300 businesses participated in the program, of which 150 were ranked on the top workplaces list. Top workplace lists are based on the results of anonymous employee survey responses. VGM, which has 900 employees, has placed in the top 10 each of the last four times they have participated in the survey. In 2015, it also placed first.

Cures update: Medicaid, CGS, Noridian

AAHomecare has learned from CMS that a provision contained in the 21st Century Cures Act will apply to all HCPCS codes covered by Medicare and Medicaid, not just the codes included in the competitive bidding program. This will allow individual states to set allowables as they choose, the association says. The provision in the Cures Act retroactively delayed a second round of reimbursement cuts in non-bid areas from July 1, 2016, to Jan. 1, 2017…CGS and Noridian are reporting Cures Act adjustments will be finalized in the coming weeks, according to a bulletin from VGM. The provision in the Cures Act allowed providers to recoup a portion of six months of payments.

CareCentrix boosts data crunching power

HARTFORD, Conn. – CareCentrix, which manages post-acute care for payers, has formed a strategic development alliance with Owned Outcomes, a developer of precision analytics. The companies say the alliance will help health plans lower costs by combining clinical expertise with next-generation analytics. “The alliance will deliver actionable insights to optimize post-acute care networks and enable personalized data-driven decisions at the point of hospital discharge,” a press release states. “Using machine learning and artificial intelligence, the organizations will leverage data to change post-acute care from being reactive to predictive, resulting in better care at a lower cost.” CareCentrix connects patients with home care through a national network of more than 8,000 credentialed provider locations. Owned Outcomes provides analytics to healthcare providers as they enter into payment agreements that include financial and performance accountability for patient care.

Caire signs on new service center
BALL GROUND, Ga. – Caire, the manufacturer of the AirSep, Caire and SeQual brands of wearable, portable and stationary oxygen concentrators, has appointed Altra Service Professionals as the authorized service center for its customers in New Jersey and New England. Altra Service Professionals will perform both warranty and non-warranty service for Caire products from its facility in Berlin, Conn. “Altra has been performing non-warranty repairs of our products for many years and were a natural fit bring on board in support of our warranty repairs,” said Miguel Cervantes, service manager. Providers have the most to gain from the relationship, the companies say. “In an industry where reimbursement continually shrinks, dealers are always looking for ways to cut costs without sacrificing quality of care,” said Robert DeChello, president and co-owner of Altra. “This relationship with CAIRE enables us to do this by providing exceptional training and processes so that we can provide efficient and affordable repair solutions.”

Hurricane relief: Preferred Homecare, Apria Healthcare step up

Phoenix-based Preferred Homecare has donated medical equipment, including wheelchairs and ambulatory aids, to the Rehabilitation Services Volunteer Project in Houston. The equipment will be used in shelters to aid victims of Hurricane Harvey, which flooded the city in August. Employees at Preferred Homecare also raised money for the American Red Cross Hurricane Harvey relief fund, with the company donating a matching amount. “Our thoughts are with everyone who has been affected by Hurricane Harvey and we are proud to make this donation in support of the relief efforts there,” said Robert Fahlman, CEO of Preferred Homecare. Preferred Homecare offers a full range of infusion, nutrition, respiratory and HME therapies and services across the West and Southwest…Lake Forest, Calif.-based Apria Healthcare says it has activated its Emergency Preparedness Plan to prepare local branches in Texas and Florida to serve hundreds of critical respiratory patients impacted in the wake of hurricanes. The company has been dispensing oxygen to patients, evacuees in shelters and others in need. Nationally, Apria has also initiated a company-wide effort to provide emergency assistance for employees who live and work in affected areas. The company says all donations raised through two GoFundMe campaigns, one for each state, will be directly distributed to affected employees. Apria has already contributed $25,000 to each campaign and has pledged to match employee donations up to $50,000 for both campaigns. So far, employees have donated almost $31,000.

Medtrade: HME Retail Product Awards, Mike Sperduti

Medtrade is looking for product submissions for its HME Retail Product Awards. Submitted products must be manufactured by companies that are exhibiting at the show. A panel of judges will select eight products that will be presented during a session on Oct. 23 at 3:30. Audience members will vote for three winners…Medtrade is offering a free workshop led by sales and marketing expert Mike Sperduti of Emerge Sales and sponsored by PlayMaker. During the six-hour workshop, Sperduti will address cold calling, closing sales and other topics. The workshop is part of the In-Depth Education Series that takes place Oct. 23 at 9 a.m.

Short takes: Computers Unlimited, Dr. Rory Cooper

Computers Unlimited launched three new mobile products at its annual users conference in September. TIMS Assistant provides real-time access to customer and prospect information, inventory pricing and availability, plus the ability to create orders and accept payments. TIMS Electronic Delivery combines routing logistics, asset pricing and tracking, and mobile payments in one application. TIMS Warehouse comprises a suite of apps designed for tracking warehouse inventory and streamlining order fulfillment. “These new mobile apps will help our customers reduce operational costs, while increasing the quality of work performance,” said David Schaer, president…Dr. Rory Cooper has been named as the recipient of the “Science and Environment Medal” as part of the this year’s Samuel J. Heyman Service to America Medals or “Sammies.” Cooper is one of seven award winners who were chosen from 26 finalists and more than 440 nominees by a selection committee that includes leaders from the government, business, the foundation and nonprofit community, academia, entertainment and the media. Cooper, who directs the Human Engineering Research Laboratories and serves as associate dean for inclusion in the School of Health and Rehabilitation Sciences at the University of Pittsburgh, was honored for designing innovative wheelchairs and other assistive technologies…Medical Service Company was recognized as a Top Workplace in Northeast Ohio. The Cleveland-based provider was honored for its employee-centric culture. It’s the sixth time the company has been recognized.

Senators introduce sleep testing bill

Fri, 09/29/2017 - 12:12
09/29/2017HME News Staff

WASHINGTON – A bill that seeks to require the Secretary of Transportation to implement a rule to test and treat commercial transportations workers for sleep apnea was introduced Sept. 28.

The bill, S. 1883, is sponsored by Sen. Cory Booker, D-N.J., and co-sponsored by Sens. Charles Schumer, D-N.Y., Kirsten Gillibrand, D-N.Y., and Robert Menendez, D-N.J.

In August, the same group of senators sent a letter to the U.S. Department of Transportation asking why the Federal Railroad Administration and the Federal Motor Carrier Safety Administrationscrapped a proposal to require sleep apnea testing of transportation workers. The FMCSA has been working on guidelines for testing and treating commercial drivers for sleep apnea for nearly a decade and it held public comment sessions on whether to require testing in 2016.

“In the face of compelling facts that show sleep apnea is a direct cause of several tragic train accidents, the Trump administration has backed off a new mandatory testing rule,” said Schumer in a release.“This is dangerous and ill-advised. A federal law would force all rail lines to conduct these tests in perpetuity and with clear federal guidelines. Across-the-board sleep apnea testing must be law of the land for train operators and commercial drivers to help ensure us that the tragedies that happened in Brooklyn and in Hoboken will be prevented in the future.”

Survey highlights broken Medicare system

Thu, 09/28/2017 - 10:17
09/28/2017HME News Staff

WASHINGTON – More than three-quarters of case managers have experienced difficulties with the discharge of patients who need home medical equipment, according to the preliminary results of a new survey from AAHomecare.

“I have been a therapist since 1991 and have never been so unable to do my job,” said one case manager. “This Medicare system is broken beyond repair.”

AAHomecare announced in July it was working with Dobson DaVanzo & Associations, a healthcare research group,to gauge the impact of competitive bidding. Survey respondents include 428 beneficiaries, 358 case managers/discharge planners and 255 HME providers from across the country.

More than half of beneficiaries (52.1%) reported experiencing difficulty with access to HME and services. More specifically, 59% of oxygen patients reported access issues.

“Fed up with trying to get a supplier in the area, paid out-of-pocket cash,” said one beneficiary.

While the study is being finalized, AAHomecare has been using preliminary results in meetings with regulators and on Capitol Hill to push for bid reform.

Bid relief letter draws 104 signatures

Wed, 09/27/2017 - 09:07
Deadline for signatures was Wednesday09/27/2017HME News Staff

WASHINGTON – A sign-on letter in the House of Representatives to pressure the Office of Management and Budget to move on a competitive bidding-related interim final rule has 104 signatures, according to AAHomecare.

The deadline for collecting signatures for the letter, spearheaded by Cathy McMorris-Rodgers, R-Wash., had been extended from the end of business on Tuesday, Sept. 26, to 2 p.m. EST today, Sept. 27.

The IFR, titled “Durable Medical Equipment Fee Schedule, Adjustment to Resume the Transitional 50/50 Blended Rates to Provider Relief in Non-Competitive Bidding Areas,” has been sitting at the OMB since Aug. 24, according to AAHomecare.

While the details of the IFR are still unknown, industry stakeholders are confident it contains relief, in some form or fashion, for non-bid areas.

CMS rolled out bid pricing to non-bid areas in two waves on Jan. 1, 2016, and July 1, 2016. The second wave, however, was retroactively delayed to Jan. 1, 2017, per a provision in the 21st Century Cures Act.