In brief: CMS releases adjusted rates, ResMed buys another software provider

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Friday, June 1, 2018

WASHINGTON – CMS on May 25 published the adjusted reimbursement rates that will go into effect for seven months in rural areas.

The adjustments, called for in a recently released interim final rule, means reimbursement for oxygen concentrators, for example, will go from $77.16 to $121.46 per month from June 1 through Dec. 31 in rural areas.

Per the IFR, CMS is reverting to 50/50 blended reimbursement rates in rural areas, but not in all non-bid areas, as stakeholders had hoped.

Other examples include from $43.95 to $73.87 per month for CPAP devices; $703.16 to $1,184.12 for negative pressure wound therapy pumps; $36.73 to $66.62 for lightweight manual wheelchairs; and $205.41 to $438.56 for low-air loss mattresses.

VGM called the adjustments a step in the right direction, but pointed out they fall short of broader reform.

“VGM will continue to fight for CMS to implement sustainable rate methodologies and apply them to all non-bid areas, as well as high-level competitive bidding reforms to ensure that process are truly reflective of the market,” the company stated in a bulletin.

ResMed buys another software provider

SAN DIEGO – ResMed has entered into a definitive agreement to acquire privately held HEALTHCAREfirst, a provider of software solutions and services for home health and hospice agencies. HEALTHCAREfirst offers electronic health record software, billing and coding services, and advanced analytics that allow home health and hospice agencies to optimize their clinical, financial and administrative processes, ResMed says. “The home health and hospice segments are large and growing fast, due to the rising prevalence of chronic conditions and an aging population shifting to homecare and other lower-cost care settings,” said Raj Sodhi, president of ResMed’s SaaS business. “HEALTHCAREfirst’s solutions suite enables ResMed to help efficiently and effectively manage this growing population, benefiting patients, their families, agencies and payers.” HEALTHCAREfirst will complement the company’s existing software solutions offered by Brightree, a software provider for primarily the HME market, which it acquired in 2016.

CMS to implement O&P provisions

ALEXANDRIA, Va. – The American Orthotics & Prosthetics Association has received word that CMS has issued instructions to the DME MACs to immediately implement provisions that require the notes of orthotists and prosthetists to be recognized as part of the medical record. In early May, the MACs retired the “Dear Physician” letter for artificial limbs. The letter, originally published in 2011, dramatically changed the standards for approving a prosthetic claim, leading to higher denial rates. AOPA has been pressing CMS officials to implement the provisions, it said in a bulletin on its website.

Homecare Medical excels as small business

AUBURN, N.Y. – Homecare Medical Supply, Inc. has received a 20th Annual Small Business Excellence Award from the U.S. Small Business Administration for its “longevity, innovation, sales growth, increased employment, ability to overcome adversity or community contributions,” according to The Citizen and auburnpub.com. Homecare Medical Supply is a family owned business that offers home oxygen, CPAPs, nebulizers, hospital beds, wheelchairs, walkers, lift chairs urological supplies and orthopedic soft goods. Joseph and Joan Manning started the company in 1983 and their son Joe Manning purchased it in 1997 and now runs it with his wife Donna and their daughter Cynthia. Homecare Medical Supply received the award during a luncheon on May 2 during National Small Business Week.

Apria Healthcare salutes veterans

LAKE FOREST, Calif. – Apria Healthcare has launched Apria Salutes, a program that offers active duty military, veterans and other eligible family members an ongoing 25% discount and free shipping on qualifying purchases made on ApriaDirect.com, the company’s retail HME and supplies website. “We are proud to do our part to help the men and women who are actively serving or who have served our country by providing a convenient way to shop for over 7,000 health-related retail items, ranging from CPAP accessories to mobility devices,” said Dan Starck, CEO of Apria Healthcare. “These products help people improve their quality of life.” As part of the Blackstone Veterans Initiative, Apria, along with a portfolio of companies, has also adopted a goal to hire 50,000 veterans and spouses by 2022. This is in addition to the 50,000 veterans and spouses that were hired between 2013 to 2017 under the same initiative. Additionally, Apria belongs to the Department of Defense Military Spouse Employment Partnership, which works to connect military spouses with partner employers.

Growth was off for F&P Healthcare’s masks

IRVINE, Calif. – Fisher & Paykel Healthcare reported operating revenue grew 10% to a record NZD 980.8 million, or 9% in constant currency terms, for fiscal year 2018. Split up, that’s 13% constant currency growth in the company’s hospital product group and 4% growth in its homecare product group. F&P reported that its operating profit grew 12% to NZD 269.8 million and its net profit after tax few 12% to NZD 190.2 million in FY 2018 vs. 2017. In the homecare product group, OSA mask constant currency revenue growth was 5% for the first half of FY2018, and 2% for the second half. “This is lower growth than we have experienced over the last few years as competitors introduced new masks to market,” said Lewis Gradon, managing director and CEO. F&P says it plans to expand its range of masks later this year. OSA flow generator revenue declined 8% for the full year, but it saw 10% growth in constant currency terms for the second half of the year.

ADA: Improve insulin access, affordability

ARLINGTON, Va. – The American Diabetes Association on May 24 released a public policy statement outlining both long- and short-term recommendations for improving insulin access and affordability. The recommendations in “ADA Public Policy Statement: Insulin Access and Affordability” include increasing transparency across the entire insulin supply chain; streamlining the approval process for biosimilar insulins; lowering or removing patient cost-sharing for insulin; and increasing access to healthcare coverage for all people with diabetes. The statement follows a white paper, “Insulin Access and Affordability Working Group: Conclusions and Recommendations,” published on May 8 in Diabetes Care. The ADA’s Chief Scientific, Medical & Mission Officer William T. Cefalu, M.D., also testified that day before the U.S. Senate’s Special Committee on Aging to share the findings and conclusions in the white paper. A recent survey by the ADA confirmed that individuals who face high out-of-pocket costs for insulin are not adhering to their diabetes care plan by either rationing or forgoing insulin doses to reduce costs. The statement is the latest milestone in the ADA’s Make Insulin Affordable strategic initiative, which launched in November 2016 and includes a petition that has been signed by nearly 350,000 individuals.

Option Care nurses receive infusion certification

BANNOCKBURN, Ill. – Option Care, a provider of home and alternate treatment site infusion therapy services, recognizes 19 of its nurses for passing the Certified Registered Nurse Infusion (CRNI) examination this spring. The bi-annual exam, facilitated through the Infusion Nurses Certification Corporation, is the only accredited and nationally recognized certification for infusion nursing. Option Care says its newly certified clinicians make up nearly 20% of the total number of clinicians to receive the credential this March and will join an elite group of only 3,000 active certified clinicians worldwide. The exam tests the knowledge and expertise of nurses in eight core areas of infusion therapy practice: technology and clinical applications, fluid and electrolyte balance, pharmacology, infection prevention and control, special populations, transfusion therapy, antineoplastic/biologic therapy, and parenteral nutrition.

CQRC questions OIG findings

WASHINGTON – The Council on Quality Respiratory Care criticized a recent report from the Office of Inspector General, saying it underestimates the negative impact of the competitive bidding program on access for oxygen patients. The CQRC states that the “limitations in the report’s methodology signal significant flaws in the OIG’s conclusions.” It points out that the OIG, itself, acknowledges that continued Medicare payment “is not a direct measure of continued access to oxygen equipment and contents” and that “the response rate for our survey was too low to project the results to all beneficiaries for whom claims did not continue.” The CQRC in March released its own report citing lost or limited access due to the bid program. “It is past time for CMS to correct the competitive bidding methodology with a set of rules that ensures access to oxygen and home therapies for Medicare patients in need of respiratory care as well as adequate reimbursement to providers dedicated to the delivery of high quality home oxygen care,” said Dan Starck, chairman of the CQRC. 

NSM goes in-network with MedCost

NASHVILLE, Tenn. – National Seating & Mobility has a new provider agreement with MedCost, a Winston-Salem, N.C.-based benefit solutions company. As an in-network provider, NSM’s branches in North Carolina and South Carolina are authorized to provide rehab solutions to MedCost members with mobility challenges. NSM currently operates branches in Charlotte, Asheville, Valdese and Raleigh, N.C.; and Charleston, Greenville and Columbia, S.C. MedCost, jointly owned by Carolinas HealthCare System and Wake Forest Baptist Medical Center, helps employers lower their health plan costs and provider more affordable benefits for their employees, according to a press release. NSM also has provider agreements with Geisinger Health Plan and the Visiting Nurse Service of New York Choice Health Plans.

Lisa Wells launches Naturally Able

LAS VEGAS – There’s a new website for people with disabilities that aims to provide free resources and news to them lead healthier lives. Naturally Able, published and founded by Lisa Wells, also offers a free magazine vie email subscription signup and an online discussion group. “By offering these resources, Naturally Able is serving an existing need for more natural, healthy lifestyle options in the disability community,” said Wells, who is also the vice president of marketing at Cure Medical, a manufacturer of intermittent catheters and closed catheter systems. “We received more than 2,000 visitors in our first week of service online with no paid advertising and that speaks to the ongoing desire for more help in this area from our audience.” Some of the resources on the website include financial planning for parents and caregivers; Amazon Prime perks; ways to explore the great outdoors on wheels; the risk of sleep apnea for quadriplegics; and low-cost hacks for better home accessibility. Naturally Able also aims to financially support non-profits within the disability community by donating 10% of all net income received from advertising to local chapters of the United Spinal Association and the Spina Bifida Association. Wells is the founder of several social communities for wheelchair users, including Wheel:Life, which she sold to Comfort Medical in April 2016.

VGM, HME News join forces on benchmarking survey

WATERLOO, Iowa – The VGM Group and HME News have partnered to administer one HME Financial Benchmarking Survey, rather than two separate surveys. The two entities say the move will mean an increase in responses and more consistent data. “We’re excited to work with our friends at VGM on this project,” said Rick Rector, publisher of HME News. “We look forward to increased participation and can’t wait to dig into the data and share it with the respondents, as well as HME Business Summit attendees.” Businesses that complete and submit the online survey by July 13 are eligible to win a free registration to the Summit, scheduled for Sept. 16-18 in Savannah, Ga.