In brief: Audits pile up, M&A heats up, Masimo sues Apple

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Friday, September 18, 2020

WASHINGTON - CGS, the DME MAC for jurisdictions B and C, will be conducting complex post-pay reviews for surgical dressings and knee orthoses, according to AAHomecare. 

CGS will be reviewing A6196 and A6212, and L1833 and L1851. The DME MAC is conducting the reviews due to data analysis that showed “significantly above expected amounts.” 

Surgical dressings and knee orthoses also ranked No. 5 and No. 9, respectively, in total CERT improper payment rates. The reviews will include only claim dates prior to the public health emergency. 

Urological supplies 

CGS will also be conducting complex post-pay medical reviews on urological supplies, according to the van Halem Group. 

A4351, A4352, A4353, A4355 and A4316 have been selected based on data analysis that revealed the allowed dollars for these codes have been “significantly above expected amounts.” Further analysis revealed they have also received multiple CERT errors. 

Reviews will include only claim dates prior to the PHE. 

CGMs and supplies 

CMS has approved the RAC, Performant, to begin reviewing continuous glucose monitors for medical necessity requirements and CGM supplies for excessive units effective Sept. 8, according to the van Halem Group. 

Performant will be reviewing K0554 and K0553. 

PE firm buys Paragon Healthcare 

AUSTIN, Texas – An affiliate of Peak Rock Capital, a middle-market private equity firm, has completed its acquisition of Paragon Healthcare, a provider of ambulatory and home infusion services and specialty pharmacy services. 

The Dallas-based Paragon Healthcare has pharmacy and infusion operations in nine states: Alabama, Georgia, Tennessee, Louisiana, Texas, Oklahoma, Colorado, Oregon and Washington. 

“The Paragon team has an impressive track record of rapidly growing its infusion services to patients across multiple, low-cost settings of care,” said Spencer Moore, managing director of Peak Rock. “We are excited to partner with Paragon management and employees in supporting the company’s continued strong growth in high quality patient care through organic initiatives and strategic acquisitions.” 

Peak Capital acquired Paragon Healthcare, founded in 2002, in partnership with the company’s management team. 

Rick Allen, co-founder and CEO of Paragon Healthcare, says the acquisition will allow the company to “facilitate continued growth in access to lower cost care.” 

Masimo sues Apple 

IRVINE, Calif. - Masimo has filed a legal complaint in the U.S. District Court for the Central District of California claiming Apple infringes on 10 of its patents with its Apple Watch, according to news reports. The complaint charges Apple with stealing trade secrets by hiring key personnel from Masimo, including Michael O’Reilly, its former chief medical officer and executive vice president for medical affairs. Masimo claims the Apple Watch, including the Series 4 and 5 models, uses technology covered by its patents related to heart rate monitoring and other capabilities. Masimo has developed non-invasive physiological monitoring techniques to track pulse rate, arterial oxygen saturation and other parameters using transmitted light. Apple announced this week that its Apple Watch can now track blood oxygen. 

Numotion holds mid-year event 

BRENTWOOD, Tenn. - Numotion recently held its first “Mid-Year National Leadership Conference” for all employees. The goal of the conference was to reflect on the past six months and the various dynamics that have impacted the company’s customers, team and communities. The conference, which was streamed to all employees, featured opening comments from CEO Mike Swinford and updates from other members of the management team. It also included an awards presentation, a TED Talk from social psychologist Alison Ledgerwood, and a community service event. As part of the community service event, more than 750 employees raised $7,500 and completed 234 projects. The idea for the conference came from employee feedback indicating the desire to meet more than once a year. 

WellSky Foundation donates to Meals on Wheels 

OVERLAND PARK, Kan. - The WellSky Foundation has donated $50,000 to Meals on Wheels America, an organization supporting more than 5,000 community based programs across the U.S. dedicated to addressing senior isolation and hunger. Through the donation, Meals on Wheels will collaborate with the WellSky Foundation to conduct a pilot research project designed to assist health care organizations supporting older adults, particularly those transitioning from acute care settings and those facing multiple chronic health conditions. The project will explore how partnerships between health care organizations and local Meals on Wheels programs can improve senior health outcomes. It will expand upon earlier efforts by Meals on Wheels America to develop and scale a tech-based process for reporting and addressing changes in the physical or mental condition of people who receive home-delivered meals. “This latest collaboration reflects the WellSky Foundation’s ongoing commitment to helping seniors safely remain in their homes, regardless of their individual circumstances,” said Ellie Hollander, president and CEO of Meals on Wheels America. 

MIT adds ResMed to internship program 

CAMBRIDGE, Mass. – The MIT Leaders for Global Operations program announced Sept. 9 that ResMed has become the newest member of its industry partnership. The program collaborates with the MIT Sloan School of Management and the MIT School of Engineering to deliver an interdisciplinary engineering-MBA dual degree program featuring internships at partner companies. “The future of health care is digital and we need leaders with both engineering expertise and business acumen to help guide this industry and provide life-changing care to billions of people worldwide,” said Mick Farrell, CEO of ResMed and a 1998 alumnus of the program. ResMed will launch its internship program in June 2021 with projects that aim to shape the future of health care, the company says. Six-month internships in the company’s San Diego and/or European and Asia Pacific locations will focus on optimizing global supply chains to provide access to information and empower rapid decision making, using data science techniques to personalize patient therapy, and exploring machine learning solutions to improve operational efficiency. The MIT LGO program now was 25 partner companies, 18 of which are in the Fortune 500 or Global Fortune 500. 

Silverfern, One Equity Partners buys wound care provider 

NEW YORK – The Silverfern Group, an investment management firm, has partnered with One Equity Partners to buy American Medical Technologies, an Irvine, Calif.-based provider of wound care and ancillary supplies in long-term care settings, including skilled-nursing facilities. AMT manages the treatment of more than 250,000 wounds annually and offers ancillary services in ostomy, urology and tracheostomy services and supplies. “We believe AMT is well positioned to benefit from strong secular trends benefitting the U.S. post-acute health care sector as the U.S. population ages, as well as from growth opportunities through expansion within different segments of the SNF market,” said Deepak Ghosh, managing director, Silverfern. Targeting $25 million to $50 million equity per investment in partnership with qualified local investment partners, Silverfern invests in buyouts, build-ups, acquisitions, growth equity and recapitalizations. 

Short takes: Soleo Health, HomeCare Connect 

Frisco, Texas-based Soleo Health has ranked 10th among the 50 Fastest-growing Middle Market Companies in Dallas by the Dallas Business Journal. The journal ranks the 50 fastest-growing local companies that are headquartered in the Dallas-Forth Worth areas with annual revenues of $10 million to $1 billion based on their growth over the three-year period from 2017-19. Soleo Health says it achieved 79.5% growth in revenues and double-digit in its patient census over that period. The company has made the list for the third consecutive year…Winter Park, Fla.-based HomeCare Connect has welcomed Jason Luce as director of sales. His responsibilities include overseeing the daily activities of the sales team, increasing the growth of accounts and the sales team, overseeing training programs and developing accounts. Previously, Luce worked in various capacities for One Call, most recently as vice president of business development. 

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