In brief: AAH meets with Humana Military, accessories issue clears another committee

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Thursday, July 18, 2019

WASHINGTON – AAHomecare has requested that Humana Military waive the requirement for documentation submission with each subsequent rental month after the initial documentation is received.

Humana Military, which manages the Tricare East contract, is currently evaluating the request, the association says.

The development comes after Laura Williard, vice president of payer relations, and David Chandler, director of payer relations, met with executive leadership at Humana Military and Wisconsin Physician Services, its claims processor.

AAHomecare says the problem stems from the WPS’s claims system not being able to connect documentation to claims.

“With the volume of documentation being received, the indexing of these items has been in a backlog situation and is creating inaccurate claims denials,” the association wrote in a bulletin.

Humana says it is aware of the issues and has made the following fixes: claims are being put into a suspended status instead of being denied; claims are automatically being checked for documentation each day and are paid when the documentation is available; and documentation indexing and claims processing have been combined. Additionally, Humana expects to complete a project this month to bring indexing of medical documentation up to date.

Accessories issue clears another committee
WASHINGTON – The Energy and Commerce Committee in the House of Representatives has approved a bill that includes language to suspend bid pricing for accessories for complex rehab manual wheelchairs for one year, according to AAHomecare. The committee’s Health Subcommittee endorsed the bill, H.R. 2328, last week. The bill would also permanently exempt complex rehab manual wheelchairs from the competitive bidding program. H.R. 2328 is one of two larger bills with similar language. The House Ways and Means Committee approved H.R. 3429 on June 26. That bill could be headed to the floor for a full vote before the August recess, stakeholders say.

ResMed completes $500M debt offering
SAN DIEGO – ResMed has completed a $500 million private placement debt offering, with proceeds used to pay down current borrowings on the company’s senior unsecured revolving credit facility. “We are pleased to complete this U.S. private placement offering on attractive terms,” said Brett Sandercock, CFO. “The transaction significantly lengthens our average debt maturity profile and provides improved visibility on our long-term funding costs.” The company has closed a private placement offering of $250 million principal amount 3.24% senior notes due July 10, 2026, and $250 million principal amount 3.45% senior notes due July 10, 2029. Net proceeds will be about $498 million, after ducting estimated fees and expenses related to the offering.

NC waives tax for incontinence supplies
RALEIGH, N.C. – The North Carolina General Assembly has passed a bill that exempts medically prescribed diapers and incontinence products covered under the Medicaid program from the state sales tax starting Oct. 1, according to AAHomecare. “This is a great win for the industry that was accomplished by the collaborative work of our lobbyist working with AAHomecare, ACMESA and other provider lobbyists,” said Gayle Devins, CEO of ActivStyle. The bill, S. 523, now moves to Gov. Roy Cooper for his signature. ACMESA and other stakeholders plan to continue pushing for retroactive relief for providers of incontinence supplies in the state.

Jackson Medical Supply hits 20 years
VACAVILLE, Calif. – Jackson Medical Supply celebrated its 20th anniversary with a party at its store in Vacaville, Calif., on July 17, according to the Daily Republic. “I love it,” Dallas Jackson, who owns the company with his wife Wendy Jackson, told the newspaper. “We are selling products that help people.” The company provides a variety of DME but considers power lift-and-recline chairs its biggest seller. The Jacksons were working for a medical supply company in the Bay Area and were getting requests from people in upper Solano County for DME, prompting them to open the store at 506 Main Street 20 years ago. Jackson Medical Supply also has locations in Woodland and Vallejo.

NCPA names student finalists
ALEXANDRIA, Va. – The National Community Pharmacists Association has announced that three teams of pharmacy students have been named finalists in the 2019 Good Neighbor Pharmacy NCPA Pruitt-Schutte Student Business Plan Competition. Teams of pharmacy students from the University of Georgia College of Pharmacy, the University of Oklahoma College of Pharmacy, and the University of Texas at Austin College of Pharmacy will present their business plans in a live competition on Oct. 26, 2019, at the NCPA Annual Convention in San Diego.

NHIA denounces new proposed rule
ALEXANDRIA, Va. – A proposed rule published last week fails to address a “deeply flawed policy” that reimburses home infusion services only on days when a nurse is present in the patient’s home, says the National Home Infusion Association. “This policy fundamentally misunderstands how home infusion is delivered, could jeopardize patient safety and creates barriers that have already inhibited patient access to these services,” said Logan Davis, PharmD, chairman of NHIA’s board of directors. The association has pushed CMS to revise the policy, finalized last year, and even filed a lawsuit in federal court earlier this year. The proposed rule would group home infusion drugs into three payment categories in preparation for the new home infusion benefit that starts in 2021. Each category would have a single unit of payment in accordance with specified infusion codes under the physician fee schedule. In the rule, CMS also proposed higher payment amounts for the first home infusion therapy visit, along with a small decrease in the payment amounts for each subsequent visit to make the adjustments budget neutral. The 21st Century Cures Act, passed in 2016, requires Medicare to pay for home infusion services associated with Part B infusion drugs.

RRI revamps website
ST. LOUIS – Responsive Respiratory has launched a revamped website offering online pricing and ordering for HME providers. “We recognize that a high percentage of the population utilizes Internet portals to place orders,” said Tom Bannon, president. “It is important that our new site embraces this growing segment and technology.” The website, www.respondo2.com, also has a streamlined design that aligns with the company’s core markets: home care, emergency medical services, and industrial filling and distribution. Additionally, a user-friendly format allows easy access to product specifications, manuals, multiple images and product demo videos. “By restructuring our website into core markets, the user experience becomes more efficient and intuitive,” Bannon said. “Customers are able to quickly locate their target product more efficiently than ever before.”

Prochant study details keys to back-office success
CHARLOTTE, N.C. – Driving a culture of innovation is one of the best practices for improving back-office efficiency, especially in businesses hit by reimbursement cuts, according to a recent study by Prochant. “With close to 600 employees and 20 years of experience, we have a vast pool of knowledge in this area,” said Joey Graham, executive vice president and general manager at Prochant, a billing and process outsourcing company based here. “Prochant has found that providers who improve their standards of work, hold their team accountable, and turn to technology are usually the most successful.” The study, “Best Practices for Managing Your Back Office,” covers: front-office operations, back-office processes, tools to standardize work, tips to improve standards and technologies for better business.

People news: RESNA, Glooko
Julie Piriano will be chair of RESNA’s Professional Specialty Board effective Aug. 1. Piriano, director of rehab industry affairs at Pride Mobility, is highly active on legislative and regulatory issues for the complex rehab industry and has been a member of RESNA for more than 20 years…Stephen Lien has been named CFO at Glooko, a diabetes data management company. Lien has extensive experience in senior leadership roles, most recently as CFO of PipelineRx, a healthcare SaaS technology company offering pharmacy solutions.