In brief: AAH tallies impact of Cures provision, MACs drop revised CMN requirement

 - 
Friday, May 4, 2018

WASHINGTON – The Medicaid programs of 11 states have indicated that they will be changing their fee schedules to match Medicare’s, AAHomecare reports.

Twelve states say they will not be changing their fee schedules at this time, and 10 states say they are still analyzing data with AAHomecare and/or CMS.

“It’s gratifying to work alongside so many dedicated individuals across the country to encourage state Medicaid officials to take a careful look at their options for complying with the Cures Medicaid provisions,” said Laura Williard, AAHomecare’s vice president for payer relations. “The persistence and a team-approach exhibited by these leaders has made all the difference in our successes thus far."

A provision in the Cures Act required CMS to cap its contribution to Medicaid reimbursement for DME at Medicare reimbursement starting Jan. 1, 2018. Industry stakeholders, including AAHomecare and state associations, have been doggedly working to educate state Medicaid programs that they have options other than just adopting Medicare’s fee schedules.

The states that will be changing their fee schedules: Vermont, Montana, Washington, Colorado, Iowa, Kentucky, North Dakota, Connecticut, Maine, Massachusetts and Alabama

The states that won’t be changing their fee schedules: Florida, Georgia, Hawaii, Michigan, Minnesota, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Indiana. 

The states that are still analyzing data: New Hampshire, Illinois, New York, Kansas, Missouri, Oklahoma, Rhode Island, Wisconsin, Nebraska and South Dakota.

AAH and state associations are working with Iowa, Kentucky, Connecticut and Alabama to convince them to reverse their decisions to adopt Medicare’s fee schedules, or to limit their reductions in reimbursement using HCPCS-based utilization.

DME MACs: Revised CMNs aren’t necessary

WASHINGTON – The DME MACs have rescinded part of their updated guidance for the oxygen CMN.

Back on Feb. 15, the MACs published an article with new supplier guidance on how to use new Q modifiers on the certificate of medical necessity form. They instructed providers to report the calculated average flow rate for Question 5 on the CMN when a patient has differing daytime and nighttime prescribed flow rates. They also instructed providers to submit revised CMNs in this situation.

In an article on April 26, however, the MACs rescinded the instructions related to submitting a revised CMN.

AAHomecare applauded the change, saying requiring suppliers to create tens of thousands of revised CMNs would have created significant burdens.

“AAHomecare appreciates CMS and the DME MACs listening to concerns and rescinding the requirement,” it stated in a bulletin. “This is an example of the excellence working relations the industry has built with CMS and contractors to resolve issues that significantly impact suppliers.”

Three new Q modifiers went into effect April 1:

QA (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute);

QB (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute and portable oxygen is prescribed); and

QR (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute).

Ally Medical, Preston Wound Care merge under Acentus

TAMPA, Fla. – Principles from Tampa, Fla.-based Ally Medical Services and McKinney, Texas-based Preston Mobility Plus, dba Preston Wound Care, have merged. They’re now wholly owned subsidiaries of Acentus, also based in Tampa. Ally Medical is one of Florida’s larges providers of incontinence and medical nutritional supplies to children with special healthcare needs, and urological catheters to the neurogenic bladder patient population. Preston Wound Care is one of Texas’ largest wound care providers to patients living at home with diabetic ulcers and chronic wounds. Together, they give Acentus a robust platform that includes 24 state Medicaid licenses and a broad portfolio of commercial and managed care insurance contracts. “We believe the Acentus platform represents the future for medical supply entrepreneurs,” Ally Medical Co-founder and CEO Todd Cianfrocca said. “It allows successful, independent owners to band together and focus on building their patient revenue base quicker, more profitably and with a clear path to optimize the enterprise value of their business.”

PromptCare expands south

CLARK, N.J. – PromptCare, a regional provider of respiratory and infusion services, has acquired Hometown Oxygen, it announced today. The Charlotte, N.C.-based Hometown Oxygen specializes primarily in pediatric vent patients, serving nearly 1,100 from eight locations throughout the Carolinas. “Bringing the Hometown team on board will allow us to expand our footprint to the Southeast, an integral part of our strategy,” said PromptCare CEO Tom Voorhees. “(CEO) Scott Dinning and the Hometown team share our strong commitment to providing exemplary patient care to those we care for, and we are excited to partner with them as we continue building our platform.” Dinning will stay on as an executive. PromptCare serves more than 3,400 pediatric and adult patients through 23 locations across the Mid-Atlantic and the Northeast.

Stakeholders publish ostomy white paper

WASHINGTON – AAHomecare has partnered with several patient organizations, including the United Spinal Association, the United Ostomy Associations of America and the Spina Bifida Association, to produce a white paper on why the competitive bidding program should not be expanded to include urologicals and ostomy supplies. Both the president’s budget and the Medicare Payment and Advisory Committee have referenced such a possibility. “The danger of expanding the competitive bidding program to ostomy and urological supplies is that the minimal function of the product can take precedent over patient choice and advanced technologies, which often, and necessarily, enhances quality of life,” said contributor Anna Markiewicz of Hollister, in a bulletin.

Cork Medical inks ‘winning’ deal with GPO

INDIANAPOLIS – Medical device maker Cork Medical has signed a deal to serve as the sole provider of negative pressure wound therapy products for HPS, a group purchasing organization for 4,000 organizations in 22 states. “HPS is proud to offer Cork Medical’s Nisus negative pressure system to our members,” said Benjamin Long, contract portfolio analyst for HPS, in a release. “The exceptional pricing available through this contract, coupled with Cork Medical’s infrastructure of service centers throughout our member base, is a winning combination.” Cork Medical manufactures the Nisus NPWT system for use in hospitals, nursing homes and homecare settings.

VGM Fulfillment launches compression resupply program

WATERLOO, Iowa – VGM Fulfillment has launched a compression stocking resupply program. The new program complements its existing CPAP resupply program, which ships more than 2 million orders annually, according to a press release. “We are excited to expand our offering of services outside of CPAP fulfillment to include compression stocking fulfillment,” said Jeremy Stolz, president of VGM Fulfillment. “Similar to CPAP, the compression market is growing. This new service allows the opportunity for seamless delivery or resupply of compression stockings directly to patients or to a provider’s store.” 

Aeroflow springs into volunteering

ASHEVILLE, N.C. – Aeroflow Healthcare kicked off its spring volunteering with its employees participating in several community events. “Volunteering our time and resources to help those in need encompasses the three Cs that define Aeroflow’s culture: customers, co-workers and community,” said Ashlie Groff, director of accounting and head of Aeroflow’s Community Involvement Committee. “Along with helping others, we’re able to combine the rewarding experience of making a difference for others with the opportunity to grow stronger as a team.” So far, employees have participated in events for the Special Olympics, senior bingo and a community garden day.

MSD picked up by McKesson

STOUGHTON, Mass. – Medical Specialties Distributors has entered into a definitive agreement to be acquired by McKesson Corp., the company announced April 25. McKesson will pay $800 million for the post-acute/non-hospital patient supply chain provider, according to news reports. “We believe McKesson is the ideal partner and view this transaction as a strategic fit that will generate many benefits for our customers and their patients,” said Tom Burke, CEO of MSD. “Combining our complementary businesses will allow us to collectively bring more value to the healthcare providers across the post-acute segments MSD serves.” MSD provides more than 9,700 healthcare providers at more than 11,000 sites nationwide with a broad portfolio of medical supplies, biomedical services and technology solutions. The company has been owned by investment firm New Mountain Capital since 2013. The deal is expected to close in the first half of McKesson’s fiscal year 2019.

KCI: Data supports remote therapy monitoring

SAN ANTONIO – KCI shared data at the recent 2018 Symposium of Advanced Wound Care Spring Conference that demonstrates increased patient therapy usage immediately after patient contact using its iOn Progress Remote Therapy Monitoring. The day following an adherence call, 73.5% of patients increased therapy use, with an average increase of eight hours, the company says. Additionally, as adherence increased, the rate of daily change in wound volume reduction also increased, it says. “Patient adherence to treatment is an ever-present concern for clinicians, and we have successfully harnessed technology to alleviate that concern for more effective home care, and to provide smarter solutions for our customers and their patients,” said Ron Silverman, MD, chief medical officer, KCI. iOn Progress delivers continuous at-home monitoring for patients prescribed NPWT at home. It works in conjunction with the ACTIV.A.C system to monitor adherence and securely transmit data to the KCI iOn Progress Care Network, a group of highly trained individuals who interact with patients to driver proper utilization. The presentation is an extension of a recently published study in WOUNDS.

Short takes: VGM, Cure Medical

Waterloo, Iowa-based VGM Group has released its second playbook: “Industry Insights: How to Capitalize on Opportunities in Post-Acute Health.” The playbooks serve as a resource for HME providers adjusting to an ever-changing business climate, VGM says. This latest playbook covers a number of areas, including people, processes and business diversification…Newport Beach, Calif.-based Cure Medical has announced that its full line of ready-to-use, 16-inch hydrophilic catheters are now approved for sale in Canada. In March, the company announced that its Ultra Ready-to-Use Catheters were approved for sale in Canada.

People news: NSM, Vitalus Health

Nashville, Tenn.-based National Seating & Mobility has named Jim Noland director of clinical development. He will be responsible for developing clinical and professional relationships to support continued growth at the company. Prior to joining NSM, Noland founded Presque Isle Medical Technologies and Conduit Technology. He is also a former SMS and owner/operator of an HME, complex rehab and O&P practice in Erie, Pa…Houston-based Vitalus Health has named Karen DeJean, MSN-NI, RN, CCM, vice president of health services. She will be responsible for developing a technology based airway and heart home health program to bridge the gap between inpatient and outpatient care. DeJean has been practicing nursing for more than 30 years in Texas. Vitalus Health provides specialty lung disease management, comprehensive sleep diagnostic solutions, PAP therapy, EEG testing and home health care.