WASHINGTON – Activists who rolled into Washington, D.C., June 22-24 found that advocacy efforts are paying off, as more congressional offices are well versed in the issues facing people with disabilities, including the need for a separate benefit for complex rehab.
During the United Spinal Association’s third annual Roll on Capitol Hill, activists made 200 congressional office visits and talked about better access to health care, disability rights, employment opportunities, protection of social security benefits and accessible transportation.
“With regard to transportation and access to jobs, if you don’t have the right equipment, you can’t get out of the house and the rest doesn’t matter,” said Joe Gaskins, who participated in the event for the first time as president and CEO of United Spinal. “It’s putting the cart before the horse in some instances. If we don’t have the right medical equipment for people with disabilities, then they’re really restricted.”
Representing 26 states, Washington, D.C., and Puerto Rico, 120 activists attended the event.
“We had a lot of folks from the West Coast coming all the way over here,” said Alex Bennewith, vice president of government relations at United Spinal.
Congressional staffers were eager to hear what activists had to say, Gaskins said.
“I thought we were very well received and we have been getting good responses from congressional offices since the event that they are signing up to support our bills, including the CRT legislation,” said Gaskins.
With so many groups backing a separate benefit for complex rehab, “It’s hard to not know about it,” said Justin Richardson, director of communications and customer relations for Numotion and a member of the board of directors of the North Carolina Spinal Cord Injury Association.
For those congressional offices that didn’t—Gaskins hopes the visits will be a turning point.
“For some, it was a first-time opportunity to actually meet people that needed this equipment, so it gave them an opportunity firsthand to hear anecdotally some of the things people go through just to get through a regular day,” he said.
WASHINGTON – It’s no secret that audits are out of control, but without data it’s hard to build a case. That’s the problem AAHomecare hopes to help the industry fix with its HME Audit Key.
“We’re trying to make a stand that it’s over the top, but we don’t have any numbers to back that up,” said Kim Brummett, vice president of regulatory affairs for the association. “If we don’t have any numbers that we can share, at the end of the day, it’s all anecdotal stuff.”
With HME Audit Key, providers will use a secure electronic form to answer questions about audits, including how many they have at the redetermination, reconsideration and ALJ levels, and how many appeals they’ve won. The anonymous submissions will be compiled into a data set that AAHomecare can examine to see the impact of audits and share with lawmakers.
HME Audit Key is part of a multi-pronged effort that AAHomecare has undertaken since restarting its Audit Task Force last fall. The association has also been working closely with Rep. Renee Ellmers, R-N.C., on introducing a bill to reform the audit process.
AAHomecare’s goal is not to eliminate audits, but to reform them.
“We want smart audits,” Brummett said. “We want them to be thorough and good and make sense, and hold people accountable.”
While AAHomecare has been collecting anecdotes about audits via email, HME Audit Key is all about the numbers. And for valid statistics, it needs a large sample size.
“We need to get as many providers to participate as possible,” said Tom Ryan, president and CEO of AAHomecare. “Our goal is to get everyone to understand this is an industry-wide effort, not just an AAHomecare member effort.”
In June, AAHomecare kicked off a campaign to raise $250,00 over two years to develop HME Audit Key, and create and maintain a secure database to support it, Brummett said.
Brummett said AAHomecare expects HME Audit Key to be ready for a trial run, if not ready for use, by the end of 2014.
BALTIMORE – CMS’s Fraud Prevention System (FPS) prevented more than $210 million in improper Medicare payments in its second year of operations, more than double the previous year, according to a report sent to Congress last week. The FPS, which uses predictive modeling and other analytics to analyze billing patterns, also resulted in CMS taking action against 938 providers. “CMS is using the best of private sector technology to move beyond the ‘pay-and-chase’ approach to protect the Medicare Trust Funds,” stated CMS Administrator Marilyn Tavenner in a press release. In a report also released last week, the Office of Inspector General (OIG) concurred with most of CMS’s findings. It said, however, that the agency could increase savings further by 1.) providing contractors with written instructions on how to determine when savings from an administrative action should be attributed to the FPS and 2.) requiring contractors to maintain documentation to support how FPS information contributes to an administrative action.
Separate benefit bill lands more co-sponsors
WASHINGTON – Twenty-three additional lawmakers have signed on to co-sponsor bills to create a separate benefit for complex rehab in the past month, according to an email bulletin from NCART Executive Director Don Clayback. There are now 141 co-sponsors in the House of Representatives and 16 in the Senate, including Sen. Mike Bennet, D-Colo., a member of the Finance Committee and the HELP Committee. The bills were one of the topics of discussion at the United Spinal Association’s third annual Roll on Capitol Hill last week (see related story), where Clayback; Alex Bennewith, United Spinal vice president-government relations; and Jenn Wolff, director of Users First, hosted a panel discussion on H.R. 942 and S. 948.
Lawmakers extend deadline for letter
WASHINGTON – The deadline has been extended for the “Dear Colleague” letter asking the Office of Inspector General (OIG) to study the impact of competitive bidding before CMS expands the program in 2016. The original June 30 deadline has been extended until after the July 4 congressional recess, according to a bulletin from The VGM Group. The letter, initiated by Reps. Tom Price, R-Ga., Tom Reed, R-N.Y., and Tammy Duckworth, D-Ill., has 25 co-signers, with a goal of more than 100.
Inogen makes play in stationary market
GOLETA, Calif. – Inogen has received clearance from the U.S. Food and Drug Administration (FDA) for a home oxygen concentrator called Inogen At Home. The company, better known for its portable oxygen concentrators (POCs), plans to start selling the devices later this year. “Inogen’s release of the Inogen At Home, combined with its Inogen One family of products, positions the company with a complete product portfolio to be able to fulfill the clinical requirements of most oxygen therapy patients,” it states in a press release. “While the Inogen One product line is clinically validated for 24/7 use, the Inogen At Home gives Inogen a compelling solution for nocturnal-only oxygen therapy patients that do not yet require a portable solution, which are estimated to represent 30% of total oxygen patients in the United States.” Features of the Inogen At Home include five liter per minute continuous flow, a weight of 18 pounds and low power consumption.
MEDIchair goes private equity
TORONTO – Centric Health has entered into a definitive agreement to sell its MEDIchair and Motion Specialties retail home medical operations to Canadian-based Birch Hill Equity Partners for $50 million. MEDIchair and Motion Specialties specialize in the sale of home accessibility equipment, mobility devices and home medical supplies through a network of 47 franchised and 30 corporate stores. “We believe that working together, with not just management, but also the sales reps, store managers, franchisees and other staff, we can position MEDIchair and Motion to thrive in a fast growing industry,” stated Thecla Sweeney, a partner at Birch Hill, in a press release. Centric Health is selling MEDIchair and Motion Specialties as the first step in a strategic repositioning to focus on healthcare services businesses with low working capital requirements and low reliance on government funding, according to the release. The sale doesn’t include Performance Medical Group, which offers custom orthotics, off-the-shelf orthotics, custom bracing, and laser and shockwave therapy at 50 locations across Canada.
Binson’s provides scholarships to children with diabetes
CENTER LINE, Mich. – Binson’s Home Health Care Centers will cover all or part of the cost for 24 children to attend diabetes camp, according to a release. Scholarship applicants wrote short essays explaining why they wanted to attend a week of the American Diabetes Association Camp Midicha in Fenton, Mich. “There is no better way to give back to the community than providing opportunities to children with diabetes,” said Glen Closurdo, Binson’s director of diabetes services. “Camp is a great place for kids to gain self-confidence, while having fun and meeting other kids with diabetes.” Last July, Binson’s was awarded a contract as part of Medicare’s national mail-order program for diabetes supplies.
Use of home monitoring devices to hit 19.1M, report says
YARMOUTH, Maine – Three million patients used connected home medical monitoring devices worldwide at the end of 2013, according to a new report from Berg Insights. Researchers estimate that number will grow to 19.1 million by 2018. Driving growth: Trends in incorporating more connectivity in medical devices, and using personal mobile devices as health hubs. Connectivity is most common for implantable cardiac rhythm management devices, followed by sleep therapy. Glucose monitoring and air-flow monitoring are gaining momentum. Revenues for monitoring devices were 4.3 billion Euro in 2013 and could reach 19.4 billion Euro by 2018, according to the report.
New Charm website allows online orders
PEMBROKE, Mass. – Charm Medical Supply’s new website enables customers to place orders online. “With this new website, we intend to make our comprehensive selection of home healthcare supplies and medical equipment available to a much wider audience,” said Peter Tallas, CEO. Using the new website, customers may also enroll in the company’s DeliverEase recurring delivery program. Charm offers a range of home healthcare products, including incontinence supplies, mobility products, wound care dressings, pediatric supplies and personal care products.
NSM makes buy in Rhode Island
NASHVILLE, Tenn. – National Seating and Mobility has acquired Providence, R.I.-based Major Medical Supply. “Complex rehab products and home access solutions are our greatest areas of expertise,” said Damon Bradley, CRTS, ATP and branch manager for Major Medical Supply, which has been in business since 2005. “Specifically, we provide custom mobility and seating solutions, combined with home access solutions, lifts and ramps.” Major Medical Supply’s six complex rehab professionals are now part of NSM Providence and offer 25 years of combined experience.
Review finds 63% error rate for CPAP devices
FARGO, N.D. – A pre-payment review by Noridian found potential improper payment rates of 63% for CPAP devices from February to May 2014. The Jurisdiction D DME MAC reviewed 2,873 claims with the KH modifier (first month of billing) and 1,663 claims with the KJ modifier (4th-13th month of billing). It found most denials were due to invalid proof of delivery; no documentation in response to the additional documentation request letter; documentation submitted did not demonstrate that face-to-face clinical re-evaluation criterion were met for continued coverage beyond the first three months for KJ claims; and documentation submitted did not support that face-to-face criterion was met. Noridian says it will continue its prepayment service specific review.
Hasco’s Ride-Away to market BraunAbility vans
ADDISON, Texas and BALTIMORE – Hasco Medical subsidiary Ride-Away, a provider of handicap-accessible vans, parts and services, has secured the rights to market BraunAbility wheelchair accessible vans in the Baltimore area. Hasco expects to announce a new dealership in the Baltimore area in the third quarter of 2014. “When our new Baltimore location opens, we expect its more convenient location to attract both existing and new customers from as far as northern Delaware and southern Pennsylvania,” said Hal Compton, CEO of Hasco Medical. BraunAbility offers minivans from Dodge/Chrysler, Honda and Toyota.
Study: Pharmacists can help reduce hospital readmissions
YARMOUTH, Maine – Hospital readmissions could be reduced by 20% if high-risk patients received counseling and medication management from a community pharmacist, according to a new study from the University of Cincinnati’s James L. Winkle College of Pharmacy. The ongoing study seeks to pair 1,000 high-risk patients with community pharmacists. Researchers will focus on patients with heart failure, COPD, pneumonia, myocardial infarction or diabetes.
CareTouch offers billing system integration
WESTMINSTER, Colo. – CareTouch Communications has enhanced its CareTouch360 platform to communicate with most billing systems. The platform now supports one-way billing integration, allowing the HME provider to pull patient order reports and manually enter them; and two-way billing integration, allowing the provider to upload patient orders directly into its billing system. “CareTouch is always looking for ways to make it easier for our customers to keep their patients healthy,” commented Matthew Dolph, CEO of CareTouch. “Adding the integration element takes our solution to the next level, resulting in happy patients and increased revenues.”
BALTIMORE – CMS’s Fraud Prevention System (FPS) prevented more than $210 million in improper Medicare payments in its second year of operations, more than double the previous year, according to a report sent to Congress today.
The FPS, which uses predictive modeling and other analytics to analyze billing patterns, also resulted in CMS taking action against 938 providers.
“CMS is using the best of private sector technology to move beyond the ‘pay-and-chase’ approach to protect the Medicare Trust Funds,” stated CMS Administrator Marilyn Tavenner in a press release.
In a report also released today, the Office of Inspector General (OIG) concurred with most of CMS’s findings. It said, however, that the agency could increase savings further by 1.) providing contractors with written instructions on how to determine when savings from an administrative action should be attributed to the FPS and 2.) requiring contractors to maintain documentation to support how FPS information contributes to an administrative action.
WASHINGTON – How has the national mail-order program for diabetes supplies affected brand choice?
CMS now has a before and after picture thanks to the Office of Inspector General (OIG).
The OIG published this week the results of a study to determine the market shares of test strips for the three-month period prior to the start date of the program on July 1, 2013. It found:
· Two types of strips accounted for about 34% of the Medicare mail-order market share;
· Four types of strips accounted for 51%; and
· Ten types accounted for 75%.
In a previous study to determine the market shares of test strips for the three-month period after the start date of the program, the OIG found:
· Two types of test strips accounted for about 45% of the Medicare mail-order market share;
· Three types accounted for 59%; and
· Ten types accounted for 90%.
“CMS may choose to use the results of this report for program analysis purposes and to evaluate the effect of the competitive bidding program on brand choice,” the OIG states.
To conduct its most recent study, the OIG used a sample of 1,210 claims for a population of about 1.36 million claims for test strips provided to beneficiaries from April to June 2013.
A requirement outlined in the Medicare Improvements for Patients and Providers Act (MIPPA) prohibits CMS from awarding contracts for test strips to suppliers that don’t demonstrate that their bid covers at least 50%, by volume, of all types of test strips.
NASHVILLE, Tenn. – CGS Administrators has agreed to make two concessions that should make audits less hair-raising for HME providers in Jurisdiction C.
The first: In a June 3 bulletin, the DME MAC detailed its plans to start sending providers detailed written letters explaining why their claims were denied as part of prepayment or complex medical reviews.
“We’re encouraged that they’re taking our feedback and that we’re finding those areas where collaboration is possible,” said Andrea Stark, a reimbursement consultant for MiraVista and chairwoman of the Jurisdiction C Council.
CGS started sending the letters on May 30, but only to providers that bill for oxygen and diabetes supplies. It will expand to other providers throughout the year. In addition to the reasons for denials, the letters also contain claim-specific information, such as dates of service and submitted charges.
Typically, providers that want more information about denials have to log in to myCGS, but they say the web portal doesn’t always have what they need.
“We still find ourselves calling a lot and that’s very time consuming,” said Sylvia King, general manager of Thrift Home Care, a member of the council, and vice president of the Mississippi Association of Medical Equipment Suppliers. “Anything that will save us time getting paid, especially with reimbursement cuts, is so valuable.”
With a written record of the reasons for denials, providers will also be better positioned to train not only their staff but also their referral sources, King says.
“We can tell our referral sources, ‘This is what Medicare is telling us,’ and it’s on their letterhead,” she said. “That will be more real to them.”
Stark puts it this way: “It triggers a more direct response and intervention.”
The second concession: CGS has also started excluding providers with low error rates from service-specific audits.
“Exclusion from the edit is not forever, but it’s long enough to catch your breath, pat yourself on the back and celebrate your success,” wrote Robert Hoover, the medical director for Jurisdiction C, in a letter.
While CGS doesn’t specify what it considers a low error rate, Stark says 20% or less is a good goal for providers to have.
“That’s a good place to start and fine tune from there,” she said. “Very few providers have 0% error rates. There are going to be things that happen.”
The two initiatives together should go a long way toward empowering providers to “get in front of what’s impeding their reimbursement,” Stark says.
“A lot of times, I think providers have a high error rate because of the difficulty they have in tracking this process from start to finish,” she said. “Getting these letters is really going to allow providers to start managing this in a different way.”
As for whether or not other jurisdictions will follow suit: “I haven’t heard any talk,” Stark said.
WASHINGTON – CMS officials last week acknowledged that some providers feel “angst” about prior authorizations (PAs), but they say, given a chance, the process will prove beneficial.
“We know there is some level of angst out there about this new process,” said Connie Leonard, acting deputy director of the Provider Compliance Group, during a Special Open Door Forum June 17. “That’s understandable.”
CMS scheduled the call to provide information “on all of the prior authorization initiatives.” In the May 28 Federal Register, the agency outlined its plans to implement a PA process for certain DME.
During the call, however, officials didn’t provide any specific information on DME. They did, however, try to address some common questions, including whether there would be a form (no) and whether claims with a PA attached would be subject to audits (unlikely).
“It goes for most, if not all of the PA affirmations, that a claim that has the PA decision isn’t typically reviewed again,” said Leonard. “That’s some peace of mind for the supplier that, three years later, Medicare is not going to come looking for the claim.”
CMS officials also discussed the PMD demo project, which it will expand to an additional 12 states. They said the agency remains committed to its continued success.
“We do have frequent meetings with the MACs to be sure things are running smoothly,” said one official. “We do spot checks to make sure everything is appropriate.”
It’s the success of that project that’s pushing CMS to implement PAs for other equipment, Leonard said.
“Some of you may remember that you did not want this and thought it was the worst thing that ever happened to Medicare,” she said. “Today, CMS believes that, for the most part, most suppliers actually like the demonstration or would like to be part of it.”
CMS is accepting comments on the proposed rule until July 28.
ROCKY HILL, Conn., and FRANKLIN, Tenn. – The capped rental rule will squeeze cash flow and generate more paperwork, national mobility providers say, but it’s not altering their strategies just yet.
The rule, which went into effect in April, requires providers to send claims to Medicare and secondary payers each month of a 13-month rental period to receive full payment.
“There may be a time in the future where we have to assess what products we put out the door,” said Kevin Harmon, vice president of finance for National Seating & Mobility (NSM). “We haven’t made that decision yet as a company how we’re going to approach that.”
Another impact of the rule: Although custom chairs require adjustments and fixes over time, providers aren’t paid for repairs, and should a patient pass away, the company is only paid for the rental up to that point, Harmon said.
Though the rental rule will affect cash flow, Numotion isn’t holding back.
“We have no plans to hold off on acquisitions,” said Spokesman Justin Richardson.
The rule shows Medicare doesn’t understand the needs of complex rehab patients, Richardson said.
“The mobility systems utilized by this portion of the Medicare population are not commodity type items and should not be treated as such,” he said. “This presents an entire set of unique circumstances never before experienced by this portion of the Medicare population.”
For example: A person with a purchased Group 3 power chair could end up using a rented replacement tilt actuator, or a person could be sitting in purchased seating system paired with a rented base.
The code most affected by the rule is E1161, an adult tilt-in-space wheelchair, which CMS says is a custom code, said Harmon.
“They’ve designated it custom, it requires a specialist evaluation and ATP involvement up front, and yet CMS has determined this should be a rented item, which really doesn’t make any sense,” said Harmon.
WASHINGTON – A new bill that would increase sleep apnea screening requirements for Medicare beneficiaries is a positive step, but it overlooks problems in the program when it comes to therapy, say providers.
“I think it’s great to see so much attention placed on screening,” said Lisa Feierstein, president and co-founder of Raleigh, N.C.-based Active Healthcare.“But the other side of the regulatory framework just sets everyone up for failure by making it difficult for patients to get treated and providers to get paid.”
H.R. 4695, introduced last month by Reps. Michael Burgess, R-Texas, and Bobby Rush, D-Ill., seeks to add a screening questionnaire for obstructive sleep apnea to the initial preventive physical exam for new Medicare beneficiaries.
That could be especially helpful when a longtime CPAP user ages into the Medicare program and, not surprisingly, doesn’t have a copy of the original sleep study, say providers.
“We just had a call for a patient who’s been on CPAP since 2003,” said Debra Drillen, a respiratory therapist with Sleep Well in Brewer, Maine. “We’ve spent a lot time explaining to the doctor what needs to happen.”
Still, the legislation comes at a time when CMS is already looking to put more controls on CPAP therapy. A recent proposal seeking to implement a prior authorization process for “frequently over-utilized” DME includes CPAP. Increased utilization typically means increased audit activity, say providers.
“Would this bill raise utilization?” said Eric Parkhill, vice president of clinical operations/corporate compliance for Home Medical Professionals in Gainesville, Ga.
Overall, more and more health professionals are aware of the dangers of sleep apnea—but not everyone knows how best to treat it, say providers.
“Everybody’s asking about sleep but there’s a lot who are in the dark,” said Helen Kent, president of Progressive Medical in Carlsbad, Calif. “A lot of our doctors don’t really have much of a background in sleep.”
WASHINGTON – Reps. Pat Tiberi, R-Ohio, and John Larson, D-Conn., have introduced a bill that would require providers to obtain bid bonds as part of future rounds of competitive bidding. H.R. 4920, the Medicare DMEPOS Competitive Bidding Improvement Act of 2014, would also require providers to prove they meet licensure requirements before they submit bids. “AAHomecare is putting the full weight of the industry behind this practical piece of legislation,” stated Tom Ryan, president and CEO of the association, in a press release. “All providers and manufacturers should immediately ask their elected officials to support H.R. 4920.” Per the new bill, if a provider receives and accepts a contract from CMS, the bid bond would turn into a performance bond. If a provider receives a contract offer but does not accept it and its bid is at or below the bid price, CMS has the option to collect on the bond. AAHomecare believes the bill will “incentivize more responsible bids.” “When bids don’t have to be honored, the whole process becomes hollow,” stated Robert Steedley, president of Barnes Healthcare Services and chairman of the association’s board of directors.
SBA to take up industry issues at next hearing
WASHINGTON – The Small Business Administration (SBA) will discuss the impact of competitive bidding and audits at its National Regulatory Fairness Hearing on June 25. The meeting is an opportunity for business organizations, trade associations, chambers of commerce and related groups that serve small businesses to report unfair or excessive federal regulatory enforcement affecting their members, according to a notice from the SBA. Several members of the HME industry are scheduled to testify, including Tom Ryan of AAHomecare, Peggy Walker of U.S. Rehab and seven HME providers. The hearing will take place 9:30 a.m. to 1 p.m. at the Environmental Protection Agency, William Jefferson Clinton East Building. It’s open to the public, but advance registration is required. The SBA last took up competitive bidding a year ago.
Medtronic buys Covidien
MINNEAPOLIS and DUBLIN – Medtronic has agreed to buy Covidien in a cash-and-stock transaction valued at about $42.9 billion, the companies announced June 15. The combined company will have a comprehensive product portfolio, a diversified growth profile and broad geographic reach, with 87,000 employees in more than 150 countries, according to a press release. “We are excited to reach this agreement with Covidien, which further advances our mission to alleviate pain, restore health and extend life for patients around the world,” stated Omar Ishrak, chairman and CEO of Medtronic, in the release. The boards of directors of both companies have approved the transaction. After the transaction is completed, Medtronic and Covidien will be combined under a new entity called Medtronic plc. It will have principal offices in Ireland, where Covidien’s current headquarters reside and where both companies have a longstanding presence. Medtronic plc will be led by Ishrak and will continue to have operational headquarters in Minneapolis, where Medtronic currently employs more than 8,000. Per the transaction, each outstanding share of Covidien will be converted into the right to receive $35.19 in cash and 0.956 of an ordinary share of Medtronic plc. The per-share consideration represents a premium of 29% to Covidien’s closing stock price on June 13, the last trading day prior to the announcement. The transaction will allow Medtronic to enhance its existing portfolio, offer greater breadth across clinical areas and create entry points into new therapies. It will also allow the company to better package complementary therapies and solutions to drive value and efficiencies in healthcare systems. Finally, it will boost its capabilities in emerging market R&D and manufacturing.
More education, communication needed between COPD patients, physicians
WASHINGTON – More than half of COPD patients don’t fully understand their disease or how to manage it, according to a new survey from the COPD Foundation. The two-part Chronic Obstructive Pulmonary Experience (COPE) surveyed both patients and physicians. Nearly 62% of patients said they don’t know much about COPD exacerbations—a leading cause of hospitalization in the United States. Another 16% said they don’t know what an exacerbation is at all, and 60% said they don’t have a plan for dealing with an exacerbation. By contrast, 98% of physicians said they discuss exacerbations with patients and 92% said they develop action plans with them. The survey also found that many patients aren’t being diagnosed early enough. On this, patients and physicians appear to agree. Patients said they experience symptoms of COPD for two years and nine months, on average, before diagnosis; physicians said that 39% of their patients had reached a “severe” or “very severe” disease state by diagnosis. “COPD can be treated—but it’s crucial for doctors to diagnose it early and for patients to follow the appropriate therapeutic strategies to improve symptoms, increase activity, and reduce the chances of exacerbations,” said MeiLan Han, M.D., M.S., associate professor of Medicine in the Division of Pulmonary and Critical Care at the University of Michigan.
Does mail-order program meet requirement?
WASHINGTON – CMS may want to consider whether subsequent rounds of its national mail-order program for diabetes supplies meet a 50% requirement outlined in the Medicare Improvements for Patients and Providers Act (MIPPA). The Office of Inspector General (OIG) says 22 suppliers submitted at least 43 types of test strips for the three-month period from July to September 2013. Two types of test strips accounted for about 45% of the Medicare mail-order market share, three types accounted for 59% and 10 types accounted for 90%. The 50% requirement prohibits CMS from awarding competitive bidding contracts for diabetes supplies to suppliers that don’t demonstrate that their bid covers at least 50%, by volume, of all types of test strips. The OIG’s report is based on a sample of 1,210 claims drawn from a population of about 505,000 claims for test strips provided to beneficiaries during this period.
ResMed CEO sells 3,200 shares
NEW YORK – ResMed CEO Michael Farrell sold 3,200 shares of company stock on the open market June 16. Farrell sold the shares at an average price of $53.20 for a total of $170,240. He now directly owns 106,655 shares valued at approximately $5.7 million. Farrell is one of a number of execs at the company who has sold shares in May and June.
ASP: Brovana sees another increase
BALTIMORE – Payment increased for brand-name drug Brovana (J7605) in the third quarter of 2014 to $6.39 per dose, up 25 cents from the previous quarter, according to average sales price (ASP) figures released June 17. By contrast, Perforomist (J7606) saw payment decrease 29 cents to $6.62 per dose. Payment for budesonide (J7626) decreased 20 cents to $4.90 per dose. Payment for albuterol (J7613) stayed relatively flat at just over 13 cents per dose, and payment for ipratropium (J7644) was unchanged at just under 12 cents per dose.
Senior Medicare Patrol saves $9 million
WASHINGTON – Medicare/Medicaid recoveries attributed to Senior Medicare Patrol (SMP) projects increased 50%, to $9.1 million from 2012 to 2013, according to a report from the Office of Inspector General (OIG). However, total savings to beneficiaries decreased from $133,971 to $41,718. As part of SMP projects, 5,406 active volunteers conducted 148,235 one-on-one counseling sessions and held 14,924 group education sessions in 2013. SMP trains retired professionals and other seniors to recognize and report patterns of healthcare fraud.
HME provider faces prison time, fines
BATON ROUGE, La. – A federal court jury has found Ahaoma Boniface Ohia, owner of All-Star Medical Supplies, guilty of wire fraud, it was announced June 12. Ohia was accused of billing Medicare for durable medical equipment that was less expensive than what was provided or that wasn’t provided at all, according to a press release. Ohia, who was taken into custody after the verdict, faces up to 140 years in prison, fines of up to $1.75 million, and restitution to victims.
Wheelchair team gets replacement chairs
CEDAR RAPIDS, Iowa – It’s a happy ending for the wheelchair basketball team Iowa Chairiots. On June 14, the team received 20 new wheelchairs to replace wheelchairs that were stolen back in December. Tim Barrett, program director, told a local news outlet that the theft was actually a “blessing.” “Our equipment was outdated and unsafe, and now we have brand new equipment,” he said. In April, police arrested Rick Smith in the theft. Smith had many of the stolen wheelchairs in his home, but most of them were destroyed. The new wheelchairs have a value of about $30,000 and were paid for by donations, including a $12,000 donation from The VGM Group.
Performance Health buys TheraPearl
AKRON, Ohio – Performance Health, the manufacturer behind TheraBand, Biofreeze, Perform, Cramer, Bon Vital and Hygenic branded products, has acquired TheraPearl, a creator of hot and cold therapy products. The acquisition brings strength and scale to Performance Health’s emerging retail business, the company states in a press release. TheraPearl’s products use a proprietary Pearl Technology that allows them to be chilled or heated. They conform to the body and can be used for 20 minutes of hot/cold therapy. The products are available at most retailers throughout the U.S. and Canada, including Walmart, Rite Aid, Dick’s Sporting Goods and Target. In March, they became available in Europe at the pharmacy chain Boots. TheraPearl will continue to operate from its headquarters in Maryland.
Aeroflow updates website
ASHEVILLE, N.C. – Aeroflow has launched a new website that makes it easier for customers to find information on products and services. The website features the following new tools: patient/parent education resources; a cost savings calculator to help customers make informed decisions about whether to get equipment through insurance or buy online; a search function; a blog; a medical equipment look-up tool by zip code; and forms that make qualifying online easier. “We realized Aeroflow’s website is a first-impression to many seeking medical equipment or cost-assistance through insurance,” stated Maria Eilers, online marketing manager, in a press release. “The new website does a better job reflecting our mission to provide quality care by offering more for the convenience of those we serve.”
New Berlin, Wis.-based Home Care Medical has received reaccreditation from the Joint Commission, the provider announced June 18. Home Care Medical says it was the first accredited provider in the state in 1990.
WASHINGTON – Reps. Pat Tiberi, R-Ohio, and John Larson, D-Conn., have introduced a bill that would require providers to obtain bid bonds as part of future rounds of competitive bidding.
H.R. 4920, the Medicare DMEPOS Competitive Bidding Improvement Act of 2014, would also require providers to prove they meet licensure requirements before they submit bids.
“AAHomecare is putting the full weight of the industry behind this practical piece of legislation,” stated Tom Ryan, president and CEO of the association, in a press release. “All providers and manufacturers should immediately ask their elected officials to support H.R. 4920.”
Per the new bill, if a provider receives and accepts a contract from CMS, the bid bond would turn into a performance bond. If a provider receives a contract offer but does not accept it and its bid is at or below the bid price, CMS has the option to collect on the bond.
AAHomecare believes the bill will “incentivize more responsible bids.”
“When bids don’t have to be honored, the whole process becomes hollow,” stated Robert Steedley, president of Barnes Healthcare Services and chairman of the association’s board of directors.
WASHINGTON – The Small Business Administration (SBA) will discuss the impact of competitive bidding and audits at its National Regulatory Fairness Hearing on June 25.
The meeting is an opportunity for business organizations, trade associations, chambers of commerce and related groups that serve small businesses to report unfair or excessive federal regulatory enforcement affecting their members, according to a notice from the SBA.
Several members of the HME industry are scheduled to testify, including Peggy Walker of U.S. Rehab and seven HME providers.
The hearing will take place 9:30 a.m. to 1 p.m. at the Environmental Protection Agency, William Jefferson Clinton East Building. It’s open to the public, but advance registration is required.
The SBA last took up competitive bidding a year ago.
WASHINGTON – More than half of COPD patients don’t fully understand their disease or how to manage it, according to a new survey from the COPD Foundation.
The two-part Chronic Obstructive Pulmonary Experience (COPE) surveyed both patients and physicians.
Nearly 62% of patients said they don’t know much about COPD exacerbations—a leading cause of hospitalization in the United States. Another 16% said they don’t know what an exacerbation is at all, and 60% said they don’t have a plan for dealing with an exacerbation.
By contrast, 98% of physicians said they discuss exacerbations with patients and 92% said they develop action plans with them.
The survey also found that many patients aren’t being diagnosed early enough. On this, patients and physicians appear to agree. Patients said they experience symptoms of COPD for two years and nine months, on average, before diagnosis; physicians said that 39% of their patients had reached a “severe” or “very severe” disease state by diagnosis.
“COPD can be treated—but it’s crucial for doctors to diagnose it early and for patients to follow the appropriate therapeutic strategies to improve symptoms, increase activity, and reduce the chances of exacerbations,” said MeiLan Han, M.D., M.S., associate professor of Medicine in the Division of Pulmonary and Critical Care at the University of Michigan.
MINNEAPOLIS and DUBLIN – Medtronic has agreed to buy Covidien in a cash-and-stock transaction valued at about $42.9 billion, the companies announced June 15.
The combined company will have a comprehensive product portfolio, a diversified growth profile and broad geographic reach, with 87,000 employees in more than 150 countries, according to a press release.
“We are excited to reach this agreement with Covidien, which further advances our mission to alleviate pain, restore health and extend life for patients around the world,” stated Omar Ishrak, chairman and CEO of Medtronic, in the release.
The boards of directors of both companies have approved the transaction.
After the transaction is completed, Medtronic and Covidien will be combined under a new entity called Medtronic plc. It will have principal offices in Ireland, where Covidien’s current headquarters reside and where both companies have a longstanding presence.
Medtronic plc will be led by Ishrak and will continue to have operational headquarters in Minneapolis, where Medtronic currently employs more than 8,000.
Per the transaction, each outstanding share of Covidien will be converted into the right to receive $35.19 in cash and 0.956 of an ordinary share of Medtronic plc. The per-share consideration represents a premium of 29% to Covidien’s closing stock price on June 13, the last trading day prior to the announcement.
The transaction will allow Medtronic to enhance its existing portfolio, offer greater breadth across clinical areas and create entry points into new therapies. It will also allow the company to better package complementary therapies and solutions to drive value and efficiencies in healthcare systems. Finally, it will boost its capabilities in emerging market R&D and manufacturing.
WASHINGTON – Industry stakeholders expect Reps. Pat Tiberi, R-Ohio, and John Larson, D-Conn., to lead a group of lawmakers in introducing a bill this week that would require HME providers to obtain bid bonds as part of the competitive bidding program.
If a provider receives and accepts a contract from CMS, the bid bond would turn into a performance bond. If a provider receives a contract offer but does not accept it and its bid is at or below the bid price, the government can collect on the bond, explains Cara Bachenheimer, senior vice president of government relations for Invacare.
“That’s the beauty of it,” she said. “We believe the bill will be at least budget neutral because of this possibility of collecting on the bonds.”
The bill would also require providers to prove that they meet licensure requirements before they submit bids. A similar provision was included in the Senate Finance Committee’s version of the “doc fix” bill earlier this year.
Because the process for obtaining a bid bond would be similar to a surety bond, it shouldn’t be much of a burden for providers. An added bonus: In addition to CMS, the surety bond company would perform a financial assessment, stakeholders say.
“It’s a two-fold checks and balance,” said Jay Witter, senior vice president of public policy at AAHomecare.
The bill signals a shift in strategy for the industry. While a bill that would replace the competitive bidding program with a market-pricing program (MPP) already includes a provision requiring binding binds, it also includes a number of other provisions, which may be weighing it down, stakeholders say.
“Out of the gargantuan MPP bill, everyone understands binding bids,” Bachenheimer said. “This is non-controversial.”
The industry’s goal is to get the bill passed, on its own or as part of a larger bill, before the next round of bidding is set to take place in 2015, stakeholders say.
“This is something that Tiberi has talked about with the chairs of the relevant committees,” Witter said. “He’s run all the traps on this.”
Stakeholders are also making ground on another bill, this one to reform the audit program. It was announced at AAHomecare’s Washington Legislative Conference in May that Rep. Renee Ellmers, R-N.C., planned to introduce such a bill. Since then, she has been fine-tuning language to make sure that, like with the bid bill, it has legs, stakeholders say.
“Every time you do something like this, you want to fix all the problems, but her goal is not to fix all 100 problems,” said Beth Bowen, executive director of the North Carolina Association for Medical Equipment Services, which will host Ellmers at its summer meeting on June 27. “She wants a bill with teeth but that will pass.”
The industry continues to build its case against both the audit and competitive bidding programs. Just last week at the Heartland Conference, The VGM Group released a study that shows Medicare saves money by investing in HME. For every $1 that Medicare spends on mobility equipment, for example, it saves $16.78 in treatment for avoided falls, according to the study, conducted by Brian Leitten of Leitten Consulting.
“You always hear the drum beat from CMS about all the savings,” said John Gallagher, vice president of government relations for VGM. “We need to be able to say, ‘No, you’re losing money. You’re gutting the very entity that’s saving you money.'”
YARMOUTH, Maine – A majority of HME providers welcome the idea of prior authorizations for certain DME, but they say Medicare’s proposed timeline for returning decisions is unreasonable.
Sixty-nine percent of the 160 respondents to a recent HME Newspoll think CMS’s proposal to implement a prior authorization process for certain DME is a good idea. Eighty-four percent say they already go through a similar process with other payers, anyway.
“It would save so much time and money because it should reduce the amount of audits,” said Stan Grilliot of Hutchinson, Kansas-based Health-E-Quip.
But as always, the devil is in the details. In a proposed rule published in the May 28 Federal Register, CMS says it will make a “reasonable effort” to issue decisions on prior authorizations within 10 days.
Sixty percent of poll respondents say that’s not fast enough.
“This is yet another example of the disconnect between CMS and the real world,” said one respondent. “Medicare beneficiaries who meet the coverage criteria need the equipment now, not 10-plus days from now.”
Other providers think adding a prior authorization process is overkill.
“Current mandates, such as the face-to-face and detailed written order requirements, provide the oversight that focuses on working together to provide appropriate health care,” said Cindy Marvin of Canton, Ohio-based Aultman Home Medical Supply. “This would add an additional layer of unnecessary work on an industry already struggling with providing services to a challenging population.”
But if prior authorizations provide some protection from audits, the extra steps would be worth it, say many providers.
“I’d rather have my documents reviewed before I release the product to the patient any time,” said Lori Sears of Active Home Medical Supply in Lapeer, Mich. “I simply can’t afford to lose an audit so I support any plan that reduces that risk.”
WATERLOO, Iowa – Reimbursement may be shrinking, but the HME industry is standing on the cusp of explosive growth, The VGM Group’s Mike Mallaro told attendees at the Heartland Conference last week.
“Other industries would kill for the demand curve we are on,” said Mallaro, CFO, during his session, “HME Success: Building Your Business for the Next Five Years.” “You hear about the baby boomers and you get numb to it, but it’s a massive game changer.”
Heartland took place June 9-12. Now in its 13th year, the event drew more than 900 people, according to VGM.
While attendance was down slightly from last year, there was an increase in the number of VGM member companies that had never attended before.
“Nearly 50 new companies attended this year, which represented more than 80 individuals,” said Christa Miehe, vice president of strategic projects for VGM.
Bend the curve
The number of people age 65 and older is projected to grow 80% by 2030, said Mallaro. Unlike previous generations, they have money: In 1960, 40% of seniors were poor; today, only 8% are poor.
That’s good, because the trend of payers paying less is going to continue, Mallaro said.
“We’re not at the end of shrinking reimbursement, but you’ll have the chance to sell dramatically more units,” he said. “Patients are going to pay a bigger portion going forward and that opens the door to new products and services.”
For providers to succeed in this new normal, however, they must make changes to their business models, Mallaro said. That means expanding, increasing efficiencies, improving customer service, obtaining contracts and gathering data.
“Know your numbers,” he said. “To ignore data is to ignore opportunity.”
Get an alignment
A major opportunity for providers can be found in helping hospitals reduce 30-day readmission rates, Bob Messenger of Invacare told attendees during his session, “The Future of Hospital Oxygen Referrals: The Changing Paradigm.” During any given year, roughly half of all hospitals will be penalized, he said.
“There are $17 billion a year in costs associated with readmissions,” he said. “Don’t you think it would be wise on the part of hospitals to align themselves with those outside the hospital where the patients are?”
Keep your eye on the prize
No matter what the future brings, the reason providers keep on keeping on hasn’t changed, as keynote speaker David Wagner, author of “Living Life as a Daymaker” and a cancer survivor, told attendees.
"Know that what you do matters,” he said. “There's dramatic change in your industry. We understand that and we appreciate it. Don't take your eye off of what you do even though there is a lot of static in the way."
YARMOUTH, Maine – When provider Tammy Zelenko gets ready to close the books on her fiscal year every June, she strives to close out outstanding patient balances.
Sometimes, that means offering a discount to patients to get them to pay up.
“You’ll do whatever it takes to get that money,” said Zelenko, CEO of AdvaCare Home Services in Bridgeville, Pa. “It’s better than ending up writing it off or sending them to collections.”
With more patients paying out of pocket for needed home medical equipment—whether they have insanely high deductibles, no health insurance or simply struggle to meet their copays—it’s no surprise that providers are more willing to negotiate, says consultant Kelly Wolfe.
“We do have a lot of providers that are more adamant about collecting,” said Wolfe, CEO of Regency Billing and Consulting. “Providers are hurting so badly, sometimes that 20% copay is their profit margin.”
It’s a trend that’s likely to continue, say consultants. For consumers, along with increased financial responsibility comes an increased awareness of the cost of health care. Some are willing to forgo using insurance in exchange for reduced cost of goods and services. It’s already happening with physicians, they say.
“A lot of people will pay the doctors cash and the doctors are perfectly happy with that,” said billing consultant Sylvia Toscano. “For us, there’s such a burden with documentation. Cash is a beautiful thing.”
Most patients want to pay, but sometimes they just need someone to cut them some slack, say providers.
“If the breadwinner lands in the hospital and there’s no income coming in, you run into trouble,” said Lelia Wilkerson, a director at Heritage Medical in Burlington, Iowa. “It’s not that they don’t want to pay you, it’s just that they are in a bad place.”
WATERLOO, Iowa – The VGM Group and The van Halem Group have merged, allowing the member services organization to offer “an array of mission-critical professional services” related to audits. “They are the recognized leader in the audit defense field and our members will benefit greatly from this association,” stated Van Miller, CEO and founder of VGM, in a press release. The van Halem Group is now a division of VGM. Its headquarters will remain in Atlanta, and Wayne van Halem will continue on as president. With investment from VGM, The van Halem Group will be able to expand its capabilities, according to the release. “Together, The van Halem Group and VGM will make sure that our clients have the support that they need so they can continue providing quality care to their patients while maintaining compliance with complex regulatory issues,” van Halem stated. In addition to van Halem, the leadership team at The van Halem Group includes Carrie Nienberg, manager of clinical operations; Laura Wilson, operations manager; Kenneth Nelson, medical adviser; and Kelly Grahovac, senior consultant.
Pride Mobility, Navitas offer financing program
EXETER, Pa. – Pride Mobility Products has partnered with Navitas Lease Corp. to offer providers a new financing program. Features of the program include a simple one-page application, competitive rates, financing terms from 12 to 36 months, and credit decisions within hours. “Pride is focused on supplying our providers with the tools to grow their business and manage their cash flow,” said Andrew Pyrih, senior vice president of domestic sales for Pride Mobility, in a press release. “The program, which covers both Pride and Quantum products, offers affordable payment options to help providers best serve their clients’ mobility needs.” Ponte Vedra Beach, Fla.-based Navitas provides equipment financing to small- and medium-sized businesses nationally through referral programs with equipment vendors and through lease brokers in its RLC Funding division.
Roll up buys Care Medical Partners
LOS ANGELES – Patient Home Monitoring (PHM), a company focused on rolling up annuity-based healthcare service companies in the U.S. and Canada, has acquired Care Medical Partners, a Georgia-based HME provider, for about $5.5 million, according to a press release. Under the terms of the deal, PHM will acquire 100% of Care Medical in exchange for $144,243 in cash and 5,655,476 in shares of PHM at $0.26 per share. As part of the deal, PHM will acquire $3.15 million in medical equipment placed with patients. Care Medical, which generated more than $13.1 million in revenue from March 31, 2013, to March 31, 2014, joins other recent acquisitions by PHM in Georgia, as well as South Carolina and Florida. “We are solidifying PHM’s regional presence in the southeastern United States, while at the same time providing significant expansion opportunities for our California-based cardiology service business unit,” stated Michael Dalsin, chairman and CEO of PHM, in the release. There’s more to come: “Our M&A team is nearing the LOI stage with two additional acquisition targets and I expect to have the next deal lined up shortly,” Dalsin stated.
CDC: 9.3% of U.S. population has diabetes
WASHINGTON – The Centers for Disease Control and Prevention (CDC) released the National Diabetes Statistics Report 2014 last week and it’s not pretty. The CDC now believes 29.1 million people, or 9.3% of the U.S. population, had diabetes in 2012, up from 26 million in 2010. It believes 21 million were diagnosed and 8.1 million were undiagnosed. The CDC estimates the total costs of diabetes were $245 billion in 2012, up from $174 billion in 2010. Of that, $176 billion were direct costs (after adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than people without diabetes) and $69 billion were indirect costs (disability, work loss, premature death).
‘Dear Colleague’ letter calls for review of bid program
WASHINGTON – A “Dear Colleague” letter circulating through Congress calls on the Office of Inspector General to review the competitive bidding program before its 2016 expansion, according to a VGM bulletin. The letter, spearheaded by Rep. Tom Price, R-Ga., Rep. Bruce Braley, D-Iowa, Rep. Tom Reed, R-N.Y., and Rep. Tammy Duckworth, D-Ill., calls for a study of how competitive bidding and the national mail-order program for diabetic testing supplies are affecting senior health. Members of Congress have until June 30 to sign on.
Medtrade registration opens June 16
ATLANTA – Registration for Medtrade will open June 16. The show will take place Oct. 20-23 at the Georgia World Congress Center in Atlanta. Early rates of $25 for the expo and $99 for the conference are in effect until mid-September, according to a press release.
Special forum to address prior auth expansion
WASHINGTON – CMS will host a Special Open Door Forum on June 17 to discuss its plans to expand prior authorizations for PMDs to 12 additional states and to implement prior authorizations for certain DME nationwide. The forum will take place 2 p.m. to 3 p.m. EST. To participate, call 800-837-1935 and use the ID 41801913.
Van Miller named Entrepreneur of the Year
WATERLOO, Iowa – Van Miller, CEO and founder of The VGM Group, has been chosen as one of nine EY Entrepreneurs of the Year for the Upper Midwest. “I owe it all to the associates,” Miller said of VGM’s 630-plus employees, who own the company through an ESOP. The entrepreneurs, who are chosen by an independent judging panel, are eligible for national recognition in November. While Miller is quick to credit his associates, he deserves kudos, too, says Jim Walsh, president and general counsel of VGM, and one of its original investors. “His consummate skill in managing talent and making hard decisions is evident to all who know him,” he said.
Univita sells division, names new CEO
EDEN PRAIRIE, Minn. – Univita Health has signed an agreement to sell its Insurance Administration Services division to Stone Point Capital, a private equity firm. “The sale of the division will allow Univita to continue to expand its proven integrated home care delivery model as the single source solution for the post-acute care continuum,” the company states in a press release. “With the post-acute market size estimated at over $60 billion, there is a recognized need for expertise integrating across the care continuum.” Univita has also named Michael Muchnicki as CEO, replacing Jean Haynes. Muchnicki has 25 years of experience in health care delivery and managed care, including management positions at United Health Group and Cigna Healthcare.
AMA addresses coverage, payment for telemedicine
CHICAGO – The American Medical Association (AMA) voted last week at its annual meeting to approve a list of guiding principles to ensure the appropriate coverage and payment for telemedicine services. “The principles aim to help foster innovation in the use of telemedicine, protect the patient-physician relationships and promote improved care coordination and communication with medical homes,” according to a press release. The principles stem from a policy report developed by the AMA’s Council on Medical Service to address coverage and payment for telemedicine. “Telemedicine can improve access to receive care remotely, as medically appropriate, including treatment for chronic conditions, which are proven ways to improve health outcomes and reduce healthcare costs,” stated Dr. Robert Wah, president-elect of the AMA, in the release.
United Spinal sets date for Roll on Capitol Hill
NEW YORK – The United Spinal Association and advocates from its membership division, National Spinal Cord Injury Association, will gather in Washington, D.C., June 22-25 for Roll on Capitol Hill. The goal of United Spinal’s signature event: to shape policies that impact the health, independence and quality of life of people living with spinal cord injuries and disorders. “Roll on Capitol Hill presents a unique forum for our members and chapter leaders to constructively address disability issues that are impacting their lives, for good or bad, face to face with their representatives,” stated Joe Gaskins, president and CEO of United Spinal, in a press release. Those issues include ensuring increased access to needed DME, medical supplies and related services, prescription drugs and outpatient therapies; and expanding home- and community-based services and supports.
VGM, Brightree extend agreement
WATERLOO, Iowa, and ATLANTA – The VGM Group will continue its exclusive relationship with Brightree for business and financial management solutions for its members per a new multi-year agreement. “Effective use of modern business software solutions is vital to the success of independent HME providers,” stated Van Miller, CEO and founder of VGM, in a release. “We are excited to sign this new agreement so that our members have the opportunity to adopt a best-in-class, cloud-based solution to improve margins and optimize their businesses.” To date, more than 1,000 VGM members have converted to Brightree’s solution, according to the release.
It’s official: Gaskins becomes CEO of United Spinal
EAST ELMHURST, N.Y. – The United Spinal Association has named Joseph Gaskins its permanent president and CEO. Gaskins is an experienced Washington, D.C., lobbyist, accomplished executive in the wireless industry and wheelchair user from Seattle. Gaskins became interim CEO in December, when Paul Tobin resigned. He has been a member of United Spinal’s board of directors since April 2014. Gaskins says he looks forward to using his skills and experience to improve disability rights and help other wheelchair users achieve greater independence.
AAHomecare welcomed two new staffers in June: Melissa Perry as administrative & meeting associate, and Jess Hammett as communications associate. Perry will focus on meeting planning, and Hammett on membership and event communications.
WATERLOO, Iowa – Medicare sees significant cost savings when it preserves spending on home medical equipment, according to a new study unveiled at The VGM Group’s Heartland Conference this week.
The study, conducted by Brian Leitten of Leitten Consulting, found, for example, that for every $1 that Medicare pays for mobility equipment, it saves $16.78 in treatment for avoided falls.
“The message is clear: HME does save Medicare money and helps beneficiaries live where they want to be—at home,” said John Gallagher, vice president of government relations for VGM, in a press release.
Other examples from the study: For every $1 Medicare spends on supplemental oxygen therapy, it saves $9.62 in treatment for COPD-caused medical complications; and for every $1 Medicare spends on CPAP therapy, it saves $6.73 for the treatment of OSA-related complications.
The study is an update to a similar study in 2011.