In brief: Act fast on SMART Act, Medi-Cal drops drastic cut

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Friday, November 15, 2019

WASHINGTON – Industry stakeholders are pushing providers to act fast on a bill delaying the inclusion of non-invasive ventilators in competitive bidding for five years.

They’d like to get as many co-sponsors for the bill, known as the “Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019,” ahead of the upcoming Thanksgiving recess, and they suggest focusing first on the 180 representatives who signed a letter asking CMS to drop vents from the program.

“If you are represented by one of these 180 representatives, please call and/or email healthcare staff in these offices before the Thanksgiving recess (Nov. 22 through Dec. 2), remind them of their legislator’s support for the June 2019 sign-on letter, and ask them to co-sponsor H.R. 4945,” says AAHomecare in a bulletin.

The bill, introduced Oct. 31 by Rep. Morgan Griffith, R-Va., currently has 15 co-sponsors.

Respiratory stakeholders say putting the vents out to bid could cause disruptions in patient care.

“We commend Congressmen Griffith and Welch for their dedication to ensuring vulnerable patients get the care they need,” said Dan Starck, chairman of the Coalition for Quality Respiratory Care and CEO of Apria Healthcare. “Since it is not clear how this new, untested competitive bidding program will affect home oxygen suppliers and their patients, it is inappropriate to include non-invasive ventilation in the system at this time. We applaud this pro-patient legislation, which promotes a cautious, evidence-based approach to covering critical supplies like NIV.” 

Allegheny Health tapped for Home Recovery Care

PITTSBURGH and NASHVILLE, Tenn. – Allegheny Health Network will provide DME, home infusion and other homecare products and services as part of a new joint venture between health insurer Highmark Health and Contessa.

The venture, called Home Recovery Care, will provide inpatient care in the home using telemedicine, in-home providers and Contessa’s technology for coordinating care.

“Creating a value-based experience that enables patients and families to heal in the home is a priority for Highmark Health,” said Dr. Monique Reese, senior vice president, home and community care, Highmark Health. “We are excited to expand our home-focused solutions by partnering with Contessa to provide high-quality acute-level care in the comfort of the patient’s home.”

Highmark Health is the parent company of Highmark Inc., Allegheny Health Network and HM Health Solutions. The company and its subsidiaries provide health insurance to more than 4.4 million members in Pennsylvania, West Virginia and Delaware.

Home Recovery Care is currently available to select Highmark Inc. commercial health plan members in western Pennsylvania and will be available to all Medicare Advantage members beginning Jan. 1. Highmark Health plans to extend the program to central Pennsylvania in 2020 and is exploring opportunities to also extend it to West Virginia and Delaware.

“We are laser focused on achieving the quadruple aim—to transform health care through proactively improving clinical outcomes and driving better patient and clinician experiences, thereby lowering total cost of care,” said Dr. Tony Farah, executive vice president/chief medical and clinical transformation officer of Highmark Health.

Medicaid holds off on cuts in Indiana

INDIANAPOLIS – Medicaid officials in Indiana have halted their plans to adopt the lowest Medicare rates, VGM reports. On Nov. 6, officials met in person with several members of the Great Lakes Home Medical Services association and HME providers in the state, along with representatives from VGM, AAHomecare and NCART, as a first step toward collaborating on fee schedule changes. In September, the state announced plans to adopt the lowest Medicare rates starting Oct. 1 to comply with the 21st Century Cures Act. Stakeholders responded by outlining the negative impact on access to care and the network of providers in the state.

Medi-Cal drops drastic rate cuts

SACRAMENTO, Calif. – Medicaid officials in California have agreed to implement a fee schedule for DME based on 80% of Medicare’s rural rates, VGM reports. That’s an improvement from the state’s initial plan to implement a fee schedule based on 80% of non-rural rates, a move that would have amounted to cuts of up to 60%. Under the initial plan, an oxygen concentrator (E1390), for example, would have been reimbursed at $55.19; now, it will now be reimbursed at $107.76. The California Association of Medical Products Suppliers and its members had fought back against the proposed cuts, which they said would have forced providers to drop Medi-Cal, creating access issues for beneficiaries.

ResMed enhances AirView for vents

SAN DIEGO – ResMed has upgraded its AirView for Respiratory program to include a “management by exception” feature for patients using its Astral and Stellar ventilators. The upgrade allows HME providers and physicians to more quickly access and view patient data and trends using AirView’s interactive reporting capabilities. “With management by exception and interactive reporting capabilities, AirView for Respiratory will undoubtedly help physicians and HMEs enhance the quality of care they provide to their patients,” said Steven Lubke, ResMed’s vice president of North American Respiratory Care Marketing. The Astral was first connected to AirView in 2016. AirView has long used a management by exception feature to support sleep apnea patients.

Rehab Medical employees build ramp

INDIANAPOLIS – Employees of Rehab Medical recently participated in Servants at Work, a program that builds wheelchair ramps for low-income, permanently disabled individuals. Ten staff members from the corporate office, including marketing, inside sales, IT and billing, weathered frigid temperatures on Nov. 12 to build a ramp. Rehab Medical also donated $2,500 to cover construction costs. The company offers all employees eight hours of paid time each year to volunteer in their local community.

NHIA announces 2020 conference dates

ALEXANDRIA, Va. – The National Home Infusion Association will hold its 2020 Annual Conference in Denver, April 5–9, at the Gaylord Rockies. It will be co-located with the International Academy of Compounding Pharmacists’ EduCon 2020. The NHIA conference will feature more than 100 exhibitors and a range of educational programming for the home and specialty infusion industry. “We’re excited to offer attendees an enriching experience with opportunities to study best practices, explore the latest products and services, and form lifelong professional bonds during our annual conference,” said Connie Sullivan, president and CEO. More information will be released in the upcoming months. FMI: www.bit.ly/nhia-2020-register.

Ascensia launches family focused diabetes campaign

PARSIPPANY, N.J. – Ascensia, in a nod to World Diabetes Day 2019, has launched a campaign to highlight the importance of families in helping people with diabetes manage their disease. The campaign features videos of 24 families from 22 countries that offer insight into the support they offer, from helping with daily tasks to encouraging healthy eating and exercise. “Families offer an incredible amount of support for people with diabetes,” said Michael Kloss, CEO. “By encouraging a healthy lifestyle, families can have a huge effect on managing diabetes, as well as helping to prevent type 2 diabetes.” Ascensia is a global diabetes care company with a product portfolio that includes the Contour line of blood glucose monitoring systems.

WellSky IO offers new framework for interoperability

OVERLAND PARK, Kan. – WellSky has launched WellSky IO, a new framework for interoperability that connects clients with local, regional land national patient data exchanges. This will allow clients to deliver smarter care and improve patient outcomes, the company says. “We understand that interoperability needs to be so much more than just point-to-point interfaces, faxed documents and scanned PDFs,” said CEO Bill Miller. “True interoperability has the power to make a meaningful difference in people’s lives and improve the overall health and wellness of our population.” With WellSky IO, providers can access real-time health data to make treatment decisions and participate in a nationwide electronic health information exchange.

180 Medical hands out scholarships

OKLAHOMA CITY, Okla. – 180 Medical, a provider specializing in disposable medical supplies, has named seven recipients of $1,000 scholarships. “Each year, we’re amazed at the huge hurdles so many of our scholarship applicants have overcome and still maintain an attitude of positivity and perseverance,” said Mark Jassey, COO. “It’s a true honor to be able to assist the recipients in their future career goals.” Todd Brown, the founder of 180 Medical, started the scholarship in 2012 as a way to help students with specific disabilities and conditions, including spinal cord injuries and spina bifida. Students eligible for the scholarships are often burdened with additional financial costs due to their health condition. This year’s recipients are Anissa Morrison at Southern Utah University, Benjamin Hulin at Grand Canyon University, Harrison Rose at Central Michigan University, Lauren Irving at Saddleback College, Lauren Sammons at University of Kentucky, Madison Weaver at West Chester University, and Ryan Barry at Rochester Institute of Technology.

Myndshft, Virtue partner to speed up ordering process

MESA, Ariz., and MURFREESBORO, Tenn. – Myndshft Technologies, a provider of real-time check and prior authorization technology for home infusion and specialty pharmacy, has partnered with Virtue Technologies to help its customers improve patient and physician satisfaction, increase efficiency and reduce payment denials. “Our partnership with Myndshft allows us to deliver a frictionless, automated process starting with benefits verification through to prior authorization and confirmation of delivery for both the pharmacy and the patient,” said Gibran Ameer, CEO of Virtue Technologies. Virtue Technologies is a provider of cloud-based software for ordering, refilling and receiving medications, and for tracking and reporting from order submission to delivery. It recently received an investment from private equity firm Claritas.

Aeroflow bulks up sales team

ASHEVILLE, N.C. – Aeroflow Healthcare has named Eric Mongeau as the national sales director of its sleep and respiratory divisions. Mongeau will manage outside sales teams to drive business development and growth, and oversee the expansion of the company’s patient base through referrals and strategic acquisitions. “He brings years of experience in the DME industry and specifically in sleep and respiratory equipment, as well as in the patient-first mindset that Aeroflow prides itself on,” said CEO Casey Hite. Mongeau joins Aeroflow after serving as vice president and director of strategy & operations at Reliable Respiratory, where he helped the company double its patient base and triple revenue growth in two years. He has also served as managing director of Integrated Vent Solutions and held positions at ResMed and Miele.

Carex rebrands

MIDDLEBURG HEIGHTS, Ohio – Carex, a subsidiary of Compass Health Brands, has unveiled a new logo and redesigned its website. Carex.com now features: more than 600 products, with free shipping on orders more than $75; an easy-to-use and interactive search functionality; and navigation based on health condition. “Our new Carex brand logo and website are a representation of our continued dedication to providing the best products, customer service and brand experience,” said Stuart Straus, president and CEO. Carex’s brands include AccuRelief, Bed Buddy, TheraMed, Apex, ProBasics, Roscoe Medical, Meridian, StrengthTape and TENS 7000.

Short takes: Invacare, Cardinal, ResMed

Invacare has entered into agreements to exchange $72.9 million in convertible senior notes due in 2021 for $72.9 million in senior notes due in 2024, plus approximately $6.9 million in cash. After closing these transactions, $61.1 million in aggregate principal amount of the 2021 notes will remain outstanding with terms unchanged…Cardinal Health at-Home is now a bronze-level corporate partner of AAHomecare. Cardinal is a distributor of home medical supplies to more than 12,000 commercial customers nationwide…ResMed has launched an online resource, resmed.com/COPD to host educational materials for patients and physicians. It features tips for living with COPD, the latest research and information on treatments.