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Home infusion: Stakeholders arm themselves with data

HME News - Fri, 09/26/2014 - 12:30
“We are looking at any and all avenues’09/26/2014Theresa Flaherty

WASHINGTON – The stars could align for the latest iteration of a bill to require Medicare to cover home infusion therapy, say industry stakeholders.

Similar bills have been introduced over the past several years, but stakeholders have a few things working in their favor this year. The first: a new study by Avalere, a non-partisan healthcare policy firm, that found Medicare could save $80 million over a 10-year period if it covers home infusion therapy. The National Home Infusion Association (NHIA) commissioned the study at the behest of lawmakers.

“It’s never been a question of convincing congressional staff members that this is valuable,” said Russ Bodoff, executive director of NHIA. “I think everyone accepts that home infusion is a valuable service. The question always was, ‘Is it a savings or is it a cost?’ Now there’s data.”

Reps. Eliot Engel, D-N.Y., and Pat Tiberi, R-Ohio, introduced The Medicare Home Infusion Site of Care Act on Sept. 10. The bill would require Medicare to pay for home infusion services and related supplies under Medicare Part B. The drugs are already covered under Part D. 

The second thing working in the industry’s favor: a growing recognition of the potential of the post-acute care market to not only reduce costs but also increase the quality of care.

“Patient care is getting more and more important and what the appropriate site of care is seems to be something that’s right up Congress’ alley right now,” said Ken Van Pool, vice president of legislative affairs for NHIA.

With the current legislative session rapidly winding down, stakeholders are focusing on building a coalition of support around the bill to get it attached to a larger vehicle.

“It doesn’t look like there’s going to be a lame duck doc fix or Medicare bill, but if there is, we want to be prepared for that,” Van Pool said. “Longer term, there are several vehicles that will move. We are looking at any and all avenues.”

Vents: Providers should be on alert

HME News - Fri, 09/26/2014 - 12:30
09/26/2014Liz Beaulieu

HINGHAM, Mass. – Industry stakeholders worry what a recently announced widespread prepayment review for non-invasive ventilators in Jurisdiction A may mean for coverage and reimbursement going forward.

The NHIC, the DME MAC for that jurisdiction, says it has initiated the review due to a spike in billing for E0464, a product that costs Medicare about $1,500 a month on a rental basis.

“We knew it was only a matter of time,” said Wayne van Halem, president of the van Halem Group. “The volume for this code has increased dramatically.”

Why the spike? The popularity of non-invasive vents (they’ve had “amazing results,” van Halem says); an increase in the use of non-invasive vents over Bi-Level devices; and the lack of specific coverage criteria.

While the National Coverage Determination (NCD) outlines general criteria for the provision of vents, there are no Local Coverage Determinations (LCDs) with specific criteria, stakeholders say.

“It has given providers a false sense of security—there’s no coverage criteria, so it can’t be audited,” van Halem said. “That’s just not the case.”

What could happen next: The other jurisdictions could follow suit, and depending on what they all find, a new policy with more specific coverage criteria and a modified payment methodology could be implemented.

“Providers will want to be very proactive that their documentation not only supports the clinical need but also that Bi-Level was tried and ruled out,” van Halem said.

When it comes to providing non-invasive vents vs. Bi-Level devices, the DME MACs began laying out their case in a bulletin in April. After stating the conditions for which vents are covered, they stated: “Each of these disease categories are comprised of conditions that can vary from severe and life-threatening to less serious forms. These disease groups may appear to overlap conditions described in the Respiratory Assist Devices LCD, but they are not overlapping. Choice of an appropriate device i.e., a ventilator vs. a bi-level PAP device is made based upon the severity of the condition.”

Brian Simonds, a provider in Jurisdiction A, isn’t opposed to more specific coverage criteria for non-invasive vents—in Massachusetts, where he’s located, the Medicaid program requires prior authorizations—but he says any attempt to, say, cap reimbursement is unacceptable.

“We’re taking a huge risk in getting these patients home,” said Simonds, director of Baystate Home Infusion & Respiratory Services. “There’s a tremendous amount of education for the patient and the family. Then there are the preventative maintenance requirements. It’s not just like regular equipment. You have to be very vigilant.”

In brief: AAH honors champions, Philips Respironics snags gov’t contract

HME News - Fri, 09/26/2014 - 11:45
09/26/2014HME News Staff

WASHINGTON – AAHomecare has named Cara Bachenheimer of Invacare and Joel Mills of Advanced Homecare as its 2014 Homecare Champions. The award recognizes AAHomecare members who have made exceptional contributions to the homecare community throughout their careers. AAHomecare officials lauded Bachenheimer, senior vice president of government relations for Invacare, as a “consensus builder who sees the big picture.” AAHomecare officials praised Mills, CEO of Advanced Homecare and one of the association’s original members, for his long-time commitment to the industry. AAHomecare will present awards to Bacheheimer and Mills during the Stand Up for Homecare reception at Medtrade on Oct. 21. 

Philips Respironics to develop vent for gov’t

MURRYSVILLE, Pa. – Philips Respironics has snagged a three-year, $13.8 million contract to develop a next-generation portable ventilator for the U.S. Department of Health and Human Services (HHS). The ventilator will help fill the need for portable, low-cost, user-friendly and flexible ventilators in a pandemic or other public health emergencies, according to a Sept. 17 press release from HHS. “An affordable portable ventilator will help us meet the needs of critically ill patients during a public health emergency, whether due to a naturally occurring pandemic or an act of bioterrorism,” stated Robin Robinson, director of the Biomedical Advanced Research Institute and Development Authority, which will over see the project. Per the contract, Philips Respironics must develop a ventilator that will meet the needs of everyone from infants to the elderly. It must also be low cost: Currently, ventilators with all the required features cost anywhere from $6,000 to $30,000 per unit. The contract includes an option for HHS to purchase 10,000 completely kitted, initial production ventilators from Philips Respironics for $32.8 million.

CAMPS co-locates at Medtrade Spring

LAS VEGAS – The California Association of Medical Product Suppliers (CAMPS) will co-locate its annual meeting with Medtrade Spring in 2015. The events will take place March 30-April 1 at the Mandalay Bay Convention Center in Las Vegas. “This co-location agreement saves CAMPS members time and money by allowing them to go to one trade show instead of two,” stated Kevin Gaffney, group show director, Medtrade, in a press release. CAMPS and Medtrade had a similar agreement a decade ago. CAMPS expects to provide California-specific topics and speakers to the event. The association will also hold a membership update meeting and a small reception for California attendees.

#Pharmacists ready to tweet

ALEXANDRIA, Va. – Pharmacists from around the world will take part in a tweet-a-thon Oct. 2. The second annual event will allow pharmacists to highlight the positive impact pharmacist have on patients, communities and the healthcare system, according to a release from the National Community Pharmacists Association (NCPA). Last year m ore than 7,100 tweets with the hashtag #Pharmacist were sent. “From preventing potentially adverse reactions, to teaching newly diagnosed diabetic patients how to use their glucose monitor, to administering 40 flu shots in three hours—last year’s stories were diverse and inspiring,” according to the release.

AbleNet secures reimbursement for 100-plus products

ST. PAUL, Minn. – AbleNet has secured Medicare reimbursement for more than 100 assistive technology products, including speech generating devices (SGDs), accessories and mounting solutions, the company announced Sept. 24. The funding “opens opportunities for people with communication disabilities to participate in daily activities and lead more fulfilling and productive lives,” AbleNet stated in a press release. To see the products that have been approved for funding, visit http://www.dmepdac.com/dmecsapp/do/search, and under “Search DMEPOS Product Classification List: Manufacture/Distributor” enter “AbleNet.”

Are diabetes rates slowing?

YARMOUTH, Maine – The incidence and prevalence of diabetes appears to have plateaued between 2008 and 2012, according to an article published Sept. 24 in the Journal of the American Medical Association. However, there appear to be continued increases in diabetes among subgroups, including non-Hispanic black and Hispanic subpopulations, and those with a high school education or less, the article states. The basis for the article: an analysis of data from the National Health Interview Survey for 664,969 adults ages 20 to 79 years old from 1980 to 2012 to measure the annual percentage change in rates of the prevalence and incidence of diagnosed diabetes (Type 1 and Type 2 combined).

180 Medical ups scholarship program

OKLAHOMA CITY – 180 Medical will give nine young adults $1,000 to help overcome their medical hardships and pursue their goals of higher education. “Our scholarship committee could not pick just five, so we are awarding nine individuals this year,” stated Kieranne Nelms, marketing manager, in a press release. The 180 Medical College Scholarship is for students with spinal cord injuries, spina bifida, transverse myelitis and/or a neurogenic bladder who plan to attend a two-year, four-year or graduate school program full time in the fall. In addition to eligibility documentation, winners submitted brief essays about the importance of college to their goals, lessons learned from a failure or qualities that set them apart. The founder and CEO of 180 Medical, Todd Brown, created the scholarship program. Brown was left paralyzed from the chest down by a motocross accident in 1994.

DeVilbiss revamps website

SOMERSET, Pa. – DeVilbiss Healthcare’s www.intellipap.com now has a refreshed look and improved usability. In addition to a softer appearance that the company believes makes it more welcoming, the website allows users to view pictures and instructions more readily. The website also has a simplified format: Users see only the input fields for items necessary to obtain compliance information. They can enter patient, device, provider and physician information as needed.

Inogen execs sell shares

NEW YORK – Inogen CEO Raymond Huggenberger sold 25,722 shares on Sept. 22 for an average price of $20.25 in a transaction valued at $520,870. He now owns 6,808 shares valued at $137,862. Inogen Director Timothy Petersen sold 46,865 shares on Sept. 22 in a transaction worth nearly $1 million. The shares sold at an average price of $21.05 for a total of $986,508. Peterson previously sold 39,135 shares on Sept. 17 in a transaction worth $850,012.

Short takes: Apria, ActiveCare, Essentially Women, Inogen

Apria Healthcare has secured a $100 million credit facility from Wells Fargo Capital Finance. “Wells Fargo Capital Finance provided us with a creative and flexible financing package that helps leverage our existing asset base for future growth,” stated Debra Morris, CFO of Apria, in a release. “Our sector of the healthcare industry continues to experience significant change. It is important for us to have a lender that understands these dynamics.” Wells Fargo’s healthcare finance portfolio has now surpassed $1 billion in commitments…Essentially Women will host its annual “Focus on the Future” event March 8-9 at the Rosen Plaza Hotel in Orlando. This year’s theme: “Heat Up Your Business: Facing Challenges – Expanding Opportunities.”

People news: Jones, Holm

ActiveCare, a provider of diabetes management and wellness services, has appointed Michael Jones president and interim CEO effective Oct. 1. Jones will replace David Derrick, who is stepping down for personal reasons. Previously, Jones founded or ran several fast-growing technology companies, including Interactive Care and RemedyMD, according to a press release… Ottobock has named Aaron Holm manager of consumer marketing and engagement. The goal of the newly created position: strengthen the company’s connection to consumers and impact product development processes and patient outcomes. Holm is a consumer himself—he lost both of his legs when he was crushed between two cars on the side of a freeway while helping a friend change a tire, and he has been using Ottobock’s microprocessor-controlled knees since 2007.

 

DeVilbiss responds to demand

HME News - Fri, 09/26/2014 - 01:26
09/26/2014Liz Beaulieu

SOMERSET, Pa. – DeVilbiss Healthcare has ramped up the workforce at its manufacturing facility here by 20% to meet increased demand for its products, the company announced Sept. 25.

DeVilbiss has also increased its manufacturing hours from 12 to 16 hours a day with two eight-hour shifts.

“This is certainly the biggest increase in workforce that DeVilbiss has made in the past 10 years,” said Ed Murphy, president and CEO.

DeVilbiss has hired 33 assemblers and a manufacturing supervisor, three manufacturing engineers and a technician, and three quality engineers and two technicians. The hourly workforce now stands at about 110.

Behind the increase in demand for DeVilbiss products: A movement in the HME industry toward more expensive, but higher quality products, Murphy says.

“Where dealers are squeezed so hard on reimbursement, they’re looking more at the total costs of the products they buy,” he said. “The cost of product failure is astronomical. Even if a product is under free warranty repair, it will cost the provider $75 to $100 to pick up the equipment, bring it back to the warehouse, ship it to the manufacturer. It costs a lot, and it’s a pain.”

Since 2013, DeVilbiss has been manufacturing all of its products in the United States, a move that has allowed the company to not only keep closer tabs on quality but also increase its overall efforts in this area, Murphy says.

“In China, if you have someone put a meter on a product, read it and put the information into a computer, you introduce five potential sources of error,” he said. “In the U.S., we can have an automatic testing station that eliminates the labor component of the test and the sources of error, and increases reliability.”

So how much of an issue is reliability for, says, concentrators, anyway?

“Concentrators are complicated,” Murphy said. “A few years back, all of the manufacturers went too far trying to cut cost out of the product in reaction to what the market was looking for. At a certain point, you can’t reduce the cost anymore. You need to make sure you’re maintaining the quality and safety factors that allow the product to withstand a little more abuse.”

Murphy says DeVilbiss’ concentrators are a good example of the increase in demand the company has seen.

“When we moved our concentrators back from China, we originally set up two product lines,” he said. “We quickly had to add a third line and now that third line is almost all fully utilized, as well.”

In another recent move to drive demand for its products further, DeVilbiss has added an inside sales force to focus on smaller customers.

“We wanted them to hear from us on a more regular basis.”

 

AAH honors consensus builder, passionate leader

HME News - Thu, 09/25/2014 - 09:08
09/25/2014HME News Staff

WASHINGTON – AAHomecare has named Cara Bachenheimer of Invacare and Joel Mills of Advanced Homecare as its 2014 Homecare Champions.

The award recognizes AAHomecare members who have made exceptional contributions to the homecare community throughout their careers.

AAHomecare officials lauded Bachenheimer, senior vice president of government relations for Invacare, as a “consensus builder who sees the big picture.”

“Bachenheimer is a regulatory, legislative and government relations expert who has been on the front lines of defending the HME industry for almost 20 years,” stated Tom Ryan, president and CEO of the association, in a press release. “Her strategic advice and counsel have helped guide the industry through some of its biggest challenges.”

AAHomecare officials praised Mills, CEO of Advanced Homecare and one of the association’s original members, for his long-time commitment to the industry.

“From starting in home care at 16 and learning the business from the ground up to revamping and becoming CEO of Advanced Homecare, Mills is well known for his passion for the industry, patient and employees,” Ryan stated.

AAHomecare will present awards to Bacheheimer and Mills during the Stand Up for Homecare reception at Medtrade on Oct. 21.

Philips Respironics to develop vent for gov’t

HME News - Tue, 09/23/2014 - 10:18
09/23/2014HME News Staff

MURRYSVILLE, Pa. – Philips Respironics has snagged a three-year, $13.8 million contract to develop a next-generation portable ventilator for the U.S. Department of Health and Human Services (HHS).

The ventilator will help fill the need for portable, low-cost, user-friendly and flexible ventilators in a pandemic or other public health emergencies, according to a Sept. 17 press release from HHS.

“An affordable portable ventilator will help us meet the needs of critically ill patients during a public health emergency, whether due to a naturally occurring pandemic or an act of bioterrorism,” stated Robin Robinson, director of the Biomedical Advanced Research Institute and Development Authority, which will over see the project.

Per the contract, Philips Respironics must develop a ventilator that will meet the needs of everyone from infants to the elderly. It must also be low cost: Currently, ventilators with all the required features cost anywhere from $6,000 to $30,000 per unit.

The contract includes an option for HHS to purchase 10,000 completely kitted, initial production ventilators from Philips Respironics for $32.8 million.

Face-to-face rule: Clarifications provide ‘breathing room’

HME News - Fri, 09/19/2014 - 12:45
09/19/2014Liz Beaulieu

WASHINGTON – Recent clarifications from CMS and its contractors have loosened the noose that is the face-to-face requirement, industry stakeholders say.

Stakeholders have learned that 1.) CMS and its contractors won’t audit providers for compliance with the face-to-face requirement until they start enforcing it (the written order prior to delivery requirement, however, is fair game); and 2.) CMS won’t require providers to obtain a new face-to-face evaluation when a state requires a new order on a periodic basis.

“They have been slow to come, but every clarification is a bit more breathing room,” said Andrea Stark, a reimbursement consultant with MiraVista.

CMS implemented both the face-to-face and written order prior to delivery (WOPD) requirements July 1, 2013. The agency started enforcing the WOPD requirement on Jan. 1; it planned to start enforcing the face-to-face requirement some time this year, but it has since pushed back its plans indefinitely.

There is a minor glitch in CMS’s plan to prohibit the DME MACs, RACs, ZPICs and PSCs from auditing providers for compliance with the face-to-face requirement: It doesn’t apply to the CERT. But stakeholders don’t see that as a “giant risk.”

“The CERT audits a small number of claims on a post-payment basis,” Stark said. “I don’t envision them doing a mass audit to catch providers.”

The clarification that CMS and its contractors will require providers to obtain new face-to-face evaluations only for orders for Medicare payment came from one of the four DME MACs, but stakeholders expect the others to follow suit.

“A lot of states have annual prescription requirements for oxygen,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “If you had to get a new face-to-face for every patient, every year, that would be crazy.”

Of course, there are still numerous gray areas that stakeholders would like to see CMS clarify. Among them: Do providers really need to obtain a new face-to-face evaluation when a beneficiary changes providers (due to personal preference, an acquisition, or competitive bidding), or when a beneficiary switches insurance plans?

“We’re not trying to be unreasonable,” Brummett said. “We continue to try to work with CMS to find a solution. Every little thing counts.”

Separate benefit: ‘Our hope is to get it done this year’

HME News - Fri, 09/19/2014 - 12:44
09/19/2014Leah Hoenen

WASHINGTON – Armed with a growing number of co-sponsors, industry stakeholders hope to get bills to create a separate benefit for complex rehab in both the House of Representatives and the Senate passed this year. 

The plan is to get the bills attached to a larger piece of Medicare legislation, stakeholders say. 

"The most difficult thing about this bill, like all of our stuff, is getting a legislative vehicle that's moving through the House and Senate sooner rather than later," said Cara Bachenheimer, senior vice president of government relations for Invacare.

The bills—H.R. 942 and S. 948—have 159 and 21 co-sponsors, respectively, including influential members of the House Ways and Means and Senate Finance committees with jurisdiction over Medicare.

Although the bills are complicated, technical and detailed, signing on is a "no brainer" once lawmakers understand its objectives and what it will do, stakeholders say. 

"Adding co-sponsors is really critical because it shows there's huge support for it, so when a vehicle does come along, it's much easier to attach it,” Bachenheimer said.

While stakeholders are optimistic about the chances of the bills passing, they say it's unlikely anything will happen until after the November elections.

"Depending on the outcome, Congress will decide whether to take on Medicare legislation in the lame duck session, or whether to pick it up in January or February in the new session," said Don Clayback, executive director of NCART.

Should the latter be the case, the current bills would die, but they can be re-introduced, stakeholders say.

"We know what we need to do that we have control over, and that's what we're working on now," said Clayback said. "We can pick up on our momentum in January if we need to. Our hope is to get it done this year."

Special report: HME industry forges a new identity

HME News - Fri, 09/19/2014 - 12:42
Sneak peek at October issue09/19/2014John Andrews

YARMOUTH, Maine – In an industry that has become accustomed to incremental changes through the years, external forces are now combining to greatly accelerate the shift away from the old fee-for-service (FFS) Medicare system to a value-based payment model that places more accountability on providers.

Though there are many external forces directing this metamorphosis, there are three major catalysts: consolidation, change in scope and information technology.

Consolidation is resulting in strategies for increased leverage and scalability; changing scope, in new business opportunities in post-acute care; and information technology, in improved operational  efficiencies.

‘Tech will make it all possible’

Alan Morris, director of business development for Crown Point, Ind.-based HealthCall, which provides communications solutions for chronic care, says these three catalysts are intertwined, but each is stamping its own imprint on the industry.  

“Reduced reimbursement and growing demand are driving change in HME,” he said. “The dynamic shift from volume-based to value-based purchasing models, paired with the rapidly growing elderly population, is beginning to drive a massive spike in demand for post-acute services. Data and technology are empowering HME to do more with less. The market is growing and the HME provider community is consolidating, but technology will make it all possible.”

New players, new money

In terms of influence, Mike Mallaro, CFO of Waterloo, Iowa-based The VGM Group, believes consolidation—throughout health care—is having the deepest impact on the changing industry.

“Consolidation is occurring on multiple fronts—dramatic payer consolidation has been occurring over the past several years and will continue,” he said. “With fewer, larger payers, the balance of power between payer and supplier is skewed and puts the supplier in a vulnerable position. Payers are able to drive lower reimbursement, narrow panels and demand supporting services that they, otherwise, could not compel providers to supply.”

Consolidation will also create a new economic environment, Mallaro says, as large providers seek to leverage their scale to create points of differentiation over smaller competitors.

“This leveraging of scale creates advantages in insurance contracting, cost efficiency and ability to invest in expansion and technology,” he said.

Consolidation is also bringing new players into the market, Mallaro says, pointing to “a tremendous amount” of European money and private equity investment in the HME market over the past several years.

“This new money has different perspectives on our market and new ways of looking at our business—that will drive changes and will affect the entire industry,” he said.

Risk is the only option

Jettisoning previously successful methods in favor of new, unproven and unfamiliar practices takes nerve, dedication, aptitude and faith—yet this risky approach may be the only option for survival, says Gregory LoPresti, CEO of Upstate Home Care in Syracuse, N.Y.

“It has been a long gradual change from FFS to what is now being contemplated with accountable care organizations and patient-centered medical homes,” he said. “But if you don’t move away from FFS, you will never cut your way to profitability. You have to add new lines of business.”

Part 2 next week: Technology gives Geneva Woods a leg up

 

Provider to wheelchair users: What pushes you?

HME News - Fri, 09/19/2014 - 12:39
09/19/2014Theresa Flaherty

CUMMING, Ga. – Provider Chris Malcom says his new foundation for wheelchair users, iPush, doesn’t have to be the biggest or the best. It just has to make a difference.

“I want to create an avenue that gives people information and resources,” said Malcom, vice president of At Home Medical Products, a provider specializing in urological, incontinence, ostomy, personal care and skin care supplies. “We’re not looking for a cure, we’re looking for a better quality of life.”

Malcom, himself a wheelchair user for 23 years, launched the foundation in July.

Malcom says he benefited from rehabilitation therapy and the right equipment after an accident left him paralyzed, but he knows other wheelchair users aren’t always so lucky, in many cases due to insurance companies that are more focused on their bottom lines than on patient care.

“From what I hear, people aren’t exposed to all the different things that are out there these days for people in chairs,” he said. “I learned so much in rehab but rehab stays and recreational therapy are getting shorter and shorter.”

The foundation’s website, www.ipush.org, offers articles and resources on a variety of topics like accessible travel, adaptive sports and parenting. The foundation also offers wheelchair users a place to connect online via its Facebook page, which is averaging 500 new followers a week, mostly in the 24- to 45-age range.

Malcom’s future goals for iPush: achieving non-profit status so it can fundraise, and conducting extreme makeovers for adaptive equipment.

“As we grow, I want to have campaigns where you submit your story to us and we’ll help you,” he said. “If you want to be a better gardener or a Paralympic athlete, we’ll help you. Tell us what drives you, what pushes you.”

 

In brief: Bills get bump, CMS touts MA plans

HME News - Fri, 09/19/2014 - 12:37
09/19/2014HME News Staff

WASHINGTON – A legislative fly-in on Sept. 10 spearheaded by The MED Group and supported by AAHomecare resulted in 100 meetings with lawmakers. The topics of discussion at the meetings: bills to reform the competitive bidding and audit programs, H.R. 4920 and H.R. 5083, respectively. “These bills are gaining momentum and our presence on the Hill should make a difference,” said Jeff Woodham, senior vice president and general manager of The MED Group, in a press release. Currently, the bid bill has 49 co-sponsors; the audit bill, 36. AAHomecare officials helped to manage the appointment process, provided briefing materials and joined in on the meetings. “Working together on our HME legislative priorities—through back-home meetings, letters to Capitol Hill, and face-to-face meetings in D.C.—will ultimately be what makes the difference in getting these bills passed and enacted into law,” said Tom Ryan, CEO of AAHomecare, in the release. Congress was expected to recess Friday until after the elections.

CMS touts popularity, value of MA plans

WASHINGTON – Enrollment in Medicare Advantage (MA) plans in 2015 is projected to increase to a new all-time high, CMS announced Sept. 18. Premiums are expected to remain affordable, as well, the agency says. “Seniors and people with disabilities are benefiting from a transparent and competitive marketplace for Medicare health and drug plans,” stated CMS Administrator Marilyn Tavenner in a press release. The annual open enrollment period for Medicare and drug plans begins Oct. 15. Between 2010, when the Affordable Care Act was enacted, and 2015, enrollment in MA plans is expected to increase 42% and premiums are expected to decrease 6%. For 2015, MA plans submitted average premiums that were $2.94 higher, but CMS estimates premiums will be only $1.30 higher because more beneficiaries are expected to enroll in lower cost plans.

CMS releases performance results for ACOs

WASHINGTON – Accountable care organizations (ACOs) in the Pioneer ACO Model and Medicare Shared Savings Program generated more than $372 million in savings in their second and first years, respectively, CMS reported Sept. 16. The Pioneer ACOs generated estimated total savings of more than $96 million and qualified for shared savings payments of $68 million. They saved the Medicare Trust Fund about $41 million. Broken down, 11 Pioneer ACOs earned shared savings, three generated shared losses and three elected to defer reconciliation until after the third year. Fifty-three Shared Savings Program ACOs held spending to $652 million below their targets and earned performance payments of more than $300 million. One ACO overspent its target by $10 million and owed shared losses of $4 million. They will save the Trust Fund about $345 million.

NSM makes buy in Pennsylvania

FRANKLIN, Tenn. – National Seating & Mobility (NSM), has acquired Oakdale, Pa.-based Able Mobility Center and renamed it NSM Pittsburgh. The provider will serve the entire Three Rivers region. “We were known as the ‘friendly mobility store’ and always considered the client the most important part of our job,” said Marci Kennedy, branch manager, in a release. “We look forward to continuing our mission with NSM.” NSM Pittsburgh will have seven complex rehab technology professionals on staff, all from Able Mobility. Two are also certified rehab technology suppliers (CRTSs).

Drive Medical becomes AAH corporate partner

WASHINGTON - Drive Medical is now one of AAHomecare's corporate partners. "Drive and its CEO Harvey Diamond have been actively involved in AAHomecare for much of the company's 14-year history," the association stated in a bulletin. Support from corporate partners allows AAHomecare to increase its work advocating on behalf of the HME industry. Partners increase their financial commitment to the association and many of their senior executives take part in its councils, committees and work groups.

Inogen execs, shareholder sell shares

NEW YORK – Two Inogen executives sold off some of their company stock this week. Vice President Byron Myers sold 22,333 shares Sept. 15 at an average price of $21.33 for a total transaction of $476,362. Director Timothy Peterson sold 39,135 shares Sept. 17 at an average price of $21.72 for a total value of $850,012.  In addition, Versant Ventures, a major shareholder of Inogen, has sold 7,388 shares of the company’s stock at an average price of $23.25 for a total of $171,771

New e-commerce website ranks products

PORTLAND, Maine – A new e-commerce website makes it easier for users to select the best home medical equipment for their needs by creating top 10 lists of the best/most useful equipment as ranked by physicians and consumers. Users can search the site, 10bestmedical.com, by product category or by condition. The products featured on the website are available for purchase for cash. “Based on our extensive experience in the field, we know that many baby boomers and those with chronic conditions are not willing to accept decreased product quality due to insurance cutbacks and often decide to purchase a second or higher quality product on their own,” said Tyrrell Hunter, co-founder and vice president, in a release. 

ResMed integrates with health system

SAN DIEGO – ResMed’s AirView compliance management platform (formerly EasyCare Online) is now securely connected to the Epic EHR system of Fairview Health Services. The integration means Fairview’s medical staff can view up-to-date outcomes data on sleep apnea patients without logging in to multiple patient management systems. “The healthcare system is under significant pressure to drive down the cost of care while still delivering exceptional patient outcomes," said Raj Sodhi, vice president, healthcare informatics at ResMed, in a press release. "Sleep apnea represents one area where technology integration can play a key role in making that happen.” Fairview is a Minneapolis-based nonprofit academic health system with 21,000 employees and 2,300 aligned physicians.

Cailor Fleming, AOPA renew partnership

YOUNGSTOWN, Ohio – Cailor Fleming Insurance has renewed its partnership with the American Orthotic & Prosthetic Association (AOPA). Per the partnership, Cailor Fleming will continue to provide the association’s members with a wide range of custom designed insurance products, including broad property, umbrella and workers compensation. The new partnership becomes effective Jan. 1 and will last five years. Cailor Fleming also has exclusive relationships with the National Association for the Advancement of Orthotics & Prosthetics (NAAOP) and the Board of Certification (BOC), among others.

Mediquip pursues gov’t contracts

BETHPAGE, N.Y. – Mediquip has expanded its reach to service federal agencies by applying for a GSA Schedule and pursuing contracts. “The opportunity to service government accounts opens up significantly more markets throughout our region as our goal of expanding our services to various healthcare agencies becomes a reality,” stated William Hill, co-founder of Mediquip, in a press release. Mediquip is a full-line HME provider that specializes in clinical respiratory services, including ventilation.

Short takes: Brightree, SCA, Michael’s Pharmacy

Brightreehas released the latest version of Brightree HME, which features new capabilities for prior authorization requests (PARs), electronic purchasing, document management and electronic eligibility checking…SCA has refreshed its line of Tena Skincare cleansing, washing and protective cream products. The line, targeted to those suffering from incontinence, features milder formulations, easy-to-identify packaging and design updates…Michael’s Pharmacy, a compounding pharmacy and DME supplier, has achieved accreditation from the Healthcare Quality Association on Accreditation (HQAA).

Good works: Dr. Comfort, Hasco

Dr. Comfort will offer Tonya, a tall stylish pink slipper, for a limited time in October in honor of Breast Cancer Awareness Month. A portion of the sales from each slipper sold will be donated to the Susan G. Komen Foundation...Hasco subsidiary Mobility Freedom has delivered accessible vans to the Rentas family and to Aura Alfaro, both of Orlando, Fla., as part of its We Deliver Freedom Program. The program uses crowdfunding and social media to raise awareness of families in need. 

CMS touts popularity, value of MA plans

HME News - Fri, 09/19/2014 - 10:06
09/19/2014HME News Staff

WASHINGTON – Enrollment in Medicare Advantage (MA) plans in 2015 is projected to increase to a new all-time high, CMS announced Sept. 18.

Premiums are expected to remain affordable, as well, the agency says.

“Seniors and people with disabilities are benefiting from a transparent and competitive marketplace for Medicare health and drug plans,” stated CMS Administrator Marilyn Tavenner in a press release.

The annual open enrollment period for Medicare and drug plans begins Oct. 15.

Between 2010, when the Affordable Care Act was enacted, and 2015, enrollment in MA plans is expected to increase 42% and premiums is expected to decrease 6%.

For 2015, MA plans submitted average premiums that were $2.94 higher, but CMS estimates premiums will be only $1.30 higher because more beneficiaries are expected to enroll in lower cost plans.

“The vast majority of MA enrollees will face little or no premium increase for next year, with 61% of beneficiaries not seeing any premium increase at all,” the agency states.

The quality of MA plans continues to improve, as well, CMS says. About 40% of plans will receive four or more stars for 2015, an increase of about 6% from 2014.

CMS releases performance results for ACOs

HME News - Fri, 09/19/2014 - 10:05
09/19/2014HME News Staff

WASHINGTON – Accountable care organizations (ACOs) in the Pioneer ACO Model and Medicare Shared Savings Program generated more than $372 million in savings in their second and first years, respectively, CMS reported Sept. 16.

The Pioneer ACOs generated estimated total savings of more than $96 million and qualified for shared savings payments of $68 million. They saved the Medicare Trust Fund about $41 million.

Broken down, 11 Pioneer ACOs earned shared savings, three generated shared losses and three elected to defer reconciliation until after the third year.

Fifty-three Shared Savings Program ACOs held spending to $652 million below their targets and earned performance payments of more than $300 million. One ACO overspent its target by $10 million and owed shared losses of $4 million. They will save the Trust Fund about $345 million.

Additionally, 52 Shared Savings Program ACOs reduced costs compared to their benchmark, but they did not qualify for shared savings.

While CMS characterized the savings as “encouraging,” Kaiser Health News characterized them as “teensy sums in the context of a program that spends half a trillion dollars a year on care for the elderly and disabled.”

Bills get bump from fly-in

HME News - Tue, 09/16/2014 - 10:49
09/16/2014HME News Staff

WASHINGTON – A legislative fly-in on Sept. 10 spearheaded by The MED Group and supported by AAHomecare resulted in 100 meetings with lawmakers.

The topics of discussion at the meetings: bills to reform the competitive bidding and audit programs, H.R. 4920 and H.R. 5083, respectively.

“These bills are gaining momentum and our presence on the Hill should make a difference,” said Jeff Woodham, senior vice president and general manager of The MED Group, in a press release.

Currently, the bid bill has 40 co-sponsors; the audit bill, 24. At least 9 and 10 co-sponsors, respectively, were added to the bills just this week.

AAHomecare officials helped to manage the appointment process, provided briefing materials and joined in on the meetings.

“Working together on our HME legislative priorities—through back-home meetings, letters to Capitol Hill, and face-to-face meetings in D.C.—will ultimately be what makes the difference in getting these bills passed and enacted into law,” said Tom Ryan, CEO of AAHomecare, in the release.

Provider Jackie Semrad, who attended the event, said even though stakeholders have been touting bidding and audit reform for some time now, the industry’s message needs constant reinforcement.

“They understand that the bidding program is flawed and that this bill will address one of the biggest issues—the fact that current bids are not binding,” said Semrad, the compliance officer for Reliable Medical Supply, in the release. “Most were not aware of this part of the bid program until we educated them. This is one reason why we need to continue to talk to our members of Congress.”

Providers on denied claims: ‘We’ll fight to the end’

HME News - Fri, 09/12/2014 - 13:20
09/12/2014Liz Beaulieu

YARMOUTH, Maine – A defiant 60% of the respondents to last week’s HME NewsPoll say they wouldn’t take up CMS on an offer to settle pending appeals in exchange for partial payment.

“I would rather go out of business than give CMS another 32% discount with all the hoops they make us go through,” said Jody Wright of Rocky Mountain Medical Equipment in Lakewood, Colo. “It’s insulting and I’m going to fight them to the end for every dollar they own my company.”

CMS on Aug. 29 offered a settlement to acute care hospitals and critical care access hospitals to resolve pending appeals of patient status denials in exchange for timely partial payment of 68% of the net payable amount.

A good number of respondents asked why they should help CMS get out of a sticky wicket that the agency itself has created, one where about half a million appeals are tied up at the administrative law judge (ALJ) level.

“Medicare has set the allowables; they should pay their portion of the allowable plus interest if the claim is not paid within 30 days,” said Kevin Jones of All American Medical Equipment & Supplies in Oklahoma City. “They are dragging this out. They should be charged late fees and interest.”

Another reason not to take CMS up on its offer, respondents say: The agency might get the wrong idea that providers can make due with 68% of reimbursement.

“Beware of giving them another tool to use against us,” said Ed Huyke of Anything Medical in Bullhead City, Ariz. “It may be used to show that we are currently being overpaid and are willing to accept and can survive with 68%. The offer is not good.”

Some providers said they would accept CMS’s offer—but not without strings attached.

“As long as this settlement wouldn’t affect the timely payment of future claims, I would accept 68% of my audited claim files at this time,” said Ronnie Sleeper of Med Supply Plus in Corinth, Miss. “Also, any settlement would have to stipulate that the claims in question are legitimately filed claims in the first place.”

For the 40% of respondents who say they would accept CMS’s offer, it would be largely a financial decision.

“The administrative cost alone of winning 100% of my over $100,000 of appeals would cost me at least $30,000,” said Mike Coughlin of CVI Medical in Dallas.

Heard at the Summit: Branch out and mind your data

HME News - Fri, 09/12/2014 - 13:18
09/12/2014Theresa Flaherty

MINNEAPOLIS – With the explosion of interest in post-acute care, it’s time for HME providers to get off the sidelines, said the speakers at last week’s HME News Business Summit.

“I can’t think of a more meaningful time for the HME industry to stand up and shine than right now,” said speaker Tom Sayre, vice president of strategy and business development for CHI Health at Home, the national home health services division of Catholic Health Initiatives. “It’s time for the industry to reach out in meaningful ways—that’s what population health management is.”

The Summit, held Sept. 7-9 in Minneapolis, featured sessions that ran the gamut from healthcare reform to investment in HME.

But a common thread throughout: data’s role in helping HME providers secure their rightful position in the post-acute care lineup.

“You have to be a data freak,” said panelist and provider Gregory LoPresti, senior vice president and CEO of Upstate HomeCare. “It’s out there—you just have to collect it.”

Be accountable—to the right patients

It’s time to stop fixating on the 5% of Medicare beneficiaries who consume 60% of Medicare dollars, mostly in the last 18 months of their lives, speaker and consultant Andy Edeburn told attendees.

“Our inability to manage our own behavior will be our demise,” said Edeburn, vice president of continuum strategies for the Health Dimensions Group. “If we manage behavior more efficiently, we can reduce the number of people who get to that 5%.”

Prove your value

In the past, hospitals didn’t care about penalties, but now, hospital admissions and margins are going down, and penalties are going up. That’s an opportunity for HME providers to capitalize on what they have to offer—as long as they have the data to back it up.

“Show them what their readmission rate is, show them what your readmission rate is, and over time,” said speaker Alan Morris, director of business development for HealthCall. “Then tell them, ‘Here’s the evidence to prove it and let’s talk about what this means for your bottom line.’”

Here to stay

As if to underscore the value of home care, a panel of private equity investors told attendees that, despite its challenges, HME is an exciting market to be in.

“This is a market that is not going away,” said panelist Jeff Lipsitz, managing partner with Cortec Group, which has investments in Harmar and 101 Mobility. “No matter what the government tries to do, there is a wave of older folks that want your products and to stay in their homes.”

Demo set to arrive in 12 new states

HME News - Fri, 09/12/2014 - 13:16
09/12/2014HME News Staff

YARMOUTH, Maine – CMS’s PMD demo is set to arrive in 12 new states in just a few weeks and, for the most part, providers are welcoming it with open arms.

“One of our primary vendors is doing some education on it,” said James Rogers, CEO of Phoenix Rehab and Mobility in Hixson, Tenn., one of the states being added to the demo. “The feedback we’ve received from them is this has been a positive development in the industry and should help out as far as the audits.”

The demo, which requires providers to submit prior authorizations for PMDs, started in seven states in 2012 and is expanding to Pennsylvania, Ohio, Louisiana, Missouri, Washington, New Jersey, Maryland, Indiana, Kentucky, Georgia, Tennessee and Arizona.

Two big reasons for the comfort level of providers in these new states: First, they’re used to submitting prior authorizations for other payers; second, they figure CMS has gotten any bugs with the demo worked out by now.

“We’re not the guinea pigs, so we should be able to flow right into that,” said Bob Miller, president and CEO of Hackettstown, N.J.-based Bach’s Home Health Care.

There are some providers, however, that have heard mixed reviews of the demo, depending on the region. They’re taking a wait-and-see approach before rendering a verdict.

“I think that as long as the process can happen quicker than advanced determination of Medicare coverage, I’m all for it,” said Peter Norman, owner of Bellevue, Wash.-based Bellevue Healthcare. “I’m cautiously optimistic about it, with cautious probably the right emphasis.”

Reporter’s notebook: Loyal customers, the ABN and creativity

HME News - Fri, 09/12/2014 - 13:13
09/12/2014Liz Beaulieu

YARMOUTH, Maine – Suppose you were an HME provider supplying a Medicare beneficiary with oxygen therapy through a competitive bidding contract. Suppose the beneficiary also needs non-prescription items like a hospital bed, mattress and other HME for which you don’t have contracts.

Suppose the beneficiary and his or her children want to continue doing business with you, even though you don’t have the contracts. What are your options?

“You can’t sell the equipment to the patient, so we sell the equipment to the daughter or son,” said Tom Inman, president of Virginia Home Medical in Newport News, Va. “They can put a bow on the foot of the bed and call it a present. They’re as happy as can be.”

While industry consultants concede this is a gray area—there are “a ton of different cash arrangements out there,” said one—they recommend providers always get an advance beneficiary notice (ABN).

“When you have knowledge that a piece of equipment is subject to insurance, you’re required to get an ABN,” said Andrea Stark, a reimbursement consultant with MiraVisa. “That protocol is in place to protect the beneficiary and the family, and to make sure everyone knows how the transaction will be treated.”

Here’s one reason why that’s necessary: It’s not uncommon, for example, for the children of a beneficiary not to be on the same page, turning a simple transaction into a complicated one, says Sylvia Toscano, owner of Professional Medical Administrators.

“What we see a lot is that one of the kids will make an arrangement and then another will get involved later on and say, ‘That’s a Medicare-covered item; I don’t know why you took our money,’” she said. “If they go to Medicare, it becomes our word against theirs and refund requirements could come into play.”

This is almost a nice problem to have, says Rob Baumhover, director of retail programs for The VGM Group.

“The nice thing is that it means you’ve built that relationship with the children, and they’re the ones that want mom and dad to be taken care of by you,” he said. “Then, when the time comes for them to need your services, they’ll stick with you, too.”

Inman says he’s comfortable selling non-prescription equipment to the children of his patients without an ABN.

“If you have an ABN, you’re admitting that the Medicare patient is your customer,” he said. “They’re not my customer; I’m not getting anything from them. I’m selling for cash to the public.”

Inman says Medicare is making it so hard to get equipment that many families with loved ones in need are saying, “Screw it.”

“You have to be creative,” he said.

In brief: CMS responds to AAH, complex rehab bill adds sponsors

HME News - Fri, 09/12/2014 - 13:12
09/12/2014HME News Staff

WASHINGTON – Contractors conducting pre-pay audits and prior authorizations are required to load that information into the RAC Data Warehouse, CMS has said in response to an AAHomecare inquiry. “Contractors conducting pre-pay audits are required to load that information into the RAC Data warehouse,” CMS said. “Claims that are paid through one of the prior authorization programs have a unique tracking number that follows the claim and is included in all data shared with the Recovery Auditors. Claims with a unique tracking number are excluded from Recovery Auditor review.” AAHomecare said in a bulletin that it was pleased with CMS’s statement and plans to work with DME MACs provider outreach and education groups to ensure such processes are in place.

Twelve lawmakers sign on to separate benefit bill

WASHINGTON – Twelve more lawmakers have lent their support to H.R. 942 and S. 948, bills that would create a separate benefit for complex rehab. With the 11 representatives who signed on in August, there are now 159 co-sponsors in the House, NCART Executive Director Don Clayback wrote in a bulletin. There are 21 co-sponsors in the Senate. “It shows that the ongoing communication between CRT stakeholders and their members of Congress is paying off,” Clayback wrote. “The additions maintain solid bipartisan support and include members of the key congressional committees that have jurisdiction over the Medicare program.”

Dick’s Homecare buys assets from Walnut Medical Services

ALTOONA, Pa. – Dick’s Homecare has purchased certain assets of the Lewistown, Pa., facility of Walnut Medical Services. The deal provides operational efficiencies to both companies in the central Pennsylvania market, according to a press release from Duckridge Advisors, which served as the M&A adviser for Walnut Medical Services. Dick’s Homecare is one of the largest providers of HME and related products and services in the rural Pennsylvania market with eight locations. It will consolidate Walnut Medical’s facility into its own facility there. Terms of the deal were not disclosed.

Active Controls, Quantum Rehab expand strategic alliance

SEWELL, N.J. – Active Controls alternate drive controls are now available pre-assembled on Quantum Rehab power wheelchairs as part of an expanded strategic alliance between the two companies. The line of midline specialty controls includes head arrays, chin controls and mini-proportional joysticks. “All of them are fully compatible with our Q-Logic line of electronics, so the expansion of our alliance makes applications even more seamless for our providers,” stated Jay Brislin, vice president of Quantum Rehab, in a press release. Active Controls and Quantum Rehab first formed an alliance earlier this year. To order, providers must request a quote for the desired control using the quote generator on the Active Controls website. Once approved, the company will convert the quote to an order. Providers must then place an order for the power wheelchair with Quantum Rehab and request shipment to Active Controls. The turnaround, once there, is 48 hours.

Lawmakers: Medicare should cover infusion at home

WASHINGTON – Reps. Eliot Engel, D-N.Y., and Pat Tiberi, R-Ohio, have introduced a bill that would allow patients fighting severe infections, cancer or chronic diseases to receive infusion treatments in their homes instead of in a site of care. The Medicare Home Infusion Site of Care Act, H.R. 5435, would pave the way for Medicare Part B to cover infusion-related care and services, including equipment and supplies, provided in a patient’s home. The lawmakers, citing research by Avalere, a non-partisan healthcare policy firm, say the move would save an estimated $80 million over a 10-year period.

AAH comments highlight NWPT code confusion    

WASHINGTON – Commenting on code changes in CMS’s proposed CY 2015 Hospital Outpatient Prospective Payment System, AAHomecare says there is significant confusion among providers about the use of G0456 and G0457 with mechanical and electrical disposable NWPT devices. Confusion also surrounds the variance in components billed with distinct products, according to the association. Three manufacturers, through the Alliance of Wound Care Stakeholders, are working to provide CMS with detailed information on the costs of devices so the agency can establish non-facility practice expense relative value units for the new CPT codes for disposable NPWT, the association says. “AAHomecare recommended that CMS review those paid invoices and consider the costs of these devices when setting APC assignment of disposable NPWT and that any APC reassignment would be premature at this time and CMS should continue to place disposable NPWT APC 0016,” the association stated in a bulletin to members.

Disposable Medical Express adds auto ship

SPRING LAKE PARK, Minn. – Online retailer Disposable Medical Express, which specializes in incontinence products, now offers automatic shipment. Customers can sign up for the program during checkout. “This program will make it easier than ever for our customers to get the supplies they need to manage their incontinence,” the company stated in a release. “Now, instead of having to remember to place their order, we’ll do the work for them and their shipment will show up at the front door every month.” Customers receive a $2 discount on every case in their first order, and can alter or cancel at any time. Autoship is available for almost every product in the online store.

Shield HealthCare announces caregiver contest

VALENCIA, Calif. – Shield HealthCare has announced its 14th annual caregiver story contest. The contest recognizes the role of both family and professional caregivers, and the rewards and challenges they face, the company announced in a press release. The top three story winners and the five runners-up of the “What Makes Caregiving Rewarding?” story contest will each receive a monetary prize and a one-year subscription to Today’s Caregiver Magazine. All entries must be one page and submitted or postmarked by Nov. 30. Full contest details and official rules are available on Shield HealthCare's website at www.shieldhealthcare.com/caring.

Inogen cleared for reimbursement in France

GOLETA, Calif. – The Inogen One G3 portable oxygen concentrator has received coverage for reimbursement in France, the company announced Sept. 9. The Department of Social Affairs and Health has added the concentrator to its list of reimbursable oxygen therapy products and services as published in the Official Journal of the French Republic. The Inogen One G2 received similar coverage in 2013. France is estimated to be the third largest market in Europe, according to Global Industry Analysts.

Breathe device approved for European sales

IRVINE, Calif. – Breathe Technologies has received CE Certification for its Non-Invasive Open Ventilation System (NIOV), paving the way for the company to sell the device in the European Union. "We are now exploring potential commercialization partners for the EU and developing a European advisory board," said Larry Mastrovich, president and CEO, Breathe Technologies, in a press release. NIOV has also been recognized by the European Respiratory Society with a Product of Outstanding Interest (POINT) Award for 2014.

ResMed exec sells stock

SAN DIEGO – ResMed CFO Brett Sandercock on Sept. 3 sold 10,000 shares of stock at an average price of $53.23 for a total value of $532,3000. Sandercock now owns 70,913 shares valued at about $3.7 million. ResMed on July 31 reported revenues of $1.56 billion for fiscal year 2014, an increase of 3% over fiscal 2013.

Do-gooders: DeVilbiss, Med-Care, Ottobock, Convaid

Somerset, Pa.-based DeVilbiss Healthcare has announced a partnership with Team Fisher House, a program benefitting the Fisher House Foundation. The foundation is best known for its network of comfort homes where military and veteran families can stay at no cost while a loved one is receive medical treatment. As part of the partnership, DeVilbiss will champion the finish line tent for the Army Ten-Miler Oct. 12 in Washington, D.C…Boca Raton, Fla.-based Med-Care Diabetic & Medical Supplies has donated $100,000 to support Best Buddies, a nonprofit organization dedicated to creating opportunities for friendship, employment and leadership training for people with intellectual and developmental disabilities. Med-Care has also signed on to raise additional funds through vendors and partners, and to participate in the Best Buddies jobs program in Palm Beach...Ottobock Healthcare will provide technical service for the Rio 2016 Paralympic Games, it announced Sept. 8. The manufacturer has played this role for 13 games. As the Official Prosthetic, Orthotic and Wheelchair Technical Services Provider, Ottobock, which has offices in Brazil, will provide a team of prosthetists, orthotists, wheelchair technicians and welders from across the region and from its network worldwide…Torrance, Calif.-based Convaid recently donated a Cruiser wheelchair to Environmental Travelling Companions (ETC), a national pioneer in the field of accessible outdoor adventures for people with disabilities. The ETC will use the Cruiser at its camp location at the South Fork of the American River to assist people with disabilities to and from the river’s edge for an adaptive whitewater rafting program.

People in the news

Ottobock has hired Chris Wintenburg to fill the newly created position of director of e-commerce and inside sales for North America. Wintenburg will be responsible for managing the company’s e-business relationship; driving the overall success of North America online sales; increasing throughput and online sales for all business units and product categories; and managing inside sales efforts. He comes to Ottobock after a 13-year career at Dell.

Bidding and bundling: Providers heed call to comment

HME News - Fri, 09/05/2014 - 13:07
09/05/2014Theresa Flaherty

WASHINGTON – Industry stakeholders say a large number of providers answered the call to submit comments by Sept. 2 on a proposed rule to, among other things, expand the competitive bidding program nationwide.

More than 4,000 comments were submitted on the overall rule, and stakeholders believe a good number of them pertained to the bid expansion and another HME provision to create bundled monthly payments.

“The feedback we’ve gotten from providers spoke to rural healthcare access,” said John Gallagher, vice president of government relations for The VGM Group. “The comments were diverse—from the guy who can no longer go out to islands off of Cape Cod to the guy in Montana who covers a 400-mile radius and can no longer cover Indian reservations.”

CMS published the rule in the July 11 Federal Register.

Stakeholders planned to sift through the comments as a strategic exercise, looking to see where they agree and don’t agree with other commenters.

“We like to analyze comments, to see if there’s a theme and to maybe reach out to other associations whose comments didn’t align with ours to get feedback,” said Kim Brummett, senior director of government affairs for AAHomecare.

Of course, it’s one thing to comment en masse, it’s another thing for CMS to take notice. Brummett pointed to the *advance notice of proposed rule, published in February, as an example.

“Not one comment on that ANPR said that bundling enterals was a good idea and they listed the reasons why,” she said. “CMS went ahead and included it anyway.”

 

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