In brief: Letters urge CMS to drop vents from bid program, NSM boosts home access biz

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Friday, May 24, 2019

WASHINGTON – Reps. Morgan Griffith, R-Va., and Peter Welch, D-Vt., and Sen. Bill Cassidy, R-La., are leading a pair of congressional sign-on letters asking CMS and HHS to drop non-invasive vents from Round 2021 of competitive bidding.

Industry stakeholders and their champions in Congress argue that vents are life-supporting, service-intensive medical devices and that including them in the program will negatively impact medically fragile patients.

“Congress has never specifically directed the secretary to competitively bid ventilators and Medicare has never attempted to bid any items within its entire DME category of devices requiring frequent and substantial servicing,” the letter states. “CMS has never proposed including ventilators in the program through rulemaking and we would encourage you to solicit such input on the record before doing so. We urge you to reconsider these plans.”

CMS announced in March that non-invasive vents were one of the 16 product categories to be included in Round 2021. The bid window for the program opens July 16.

NSM builds up home access biz

NASHVILLE, Tenn. – National Seating & Mobility has acquired Living Free Home, expanding its presence in the Northeast. The acquisition adds branches in Madison, N.J., and Boston, and allows the company to now serve clients throughout New Jersey, New York City and Massachusetts. Since launching in 2003, Living Free Home has become the largest home accessibility provider in the Northeast, NSM says, specializing in stair lifts, vertical platform lifts, ramps, auto lifts, ceiling track lifts, incline lifts and bathroom modifications. The company specializes in serving veterans through multiple Veterans Affairs facilities. The owners of Living Free Home, Tom Krieck and Rich Kantor, will transition to the NSM team. AccessNSM, a division of NSM, has dozens of locations across the United States. NSM launched the division in 2015.

NHIA publishes position paper on infusion reimbursement

ALEXANDRIA, Va. – The National Home Infusion Association has published a position paper that makes the case that reimbursement for home infusion must include essential professional pharmacy services. Without it, “Medicare patients will not be able to access home infusion services and will have to seek care in other, more expensive, settings,” says the NHIA. A final rule, passed in November 2018, included a temporary transitional payment for home infusion services, but limited it to only those days a “skilled professional” is in the home. In February, the association filed a lawsuit against the U.S. Department of Health and Human Services over the matter.

Regulatory: Peformant, CGS

WASHINGTON – Reformant Recovery, the National DMEPOS RAC Contractor, has added upper limb orthoses to its approved issues list. Performant will review claims for upper limb orthoses with dates of service within five years of the date of service of a previously paid upper limb orthoses for the same beneficiary. HCPCS codes identified as same, for the same anatomical site, will be denied as the reasonable useful lifetime requirement has not been met…The Jurisdiction B and C councils met recently to discuss a recent publication, “Correct Billing – Continued Coverage for Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea,” that outlines the proper use of the KX modifier. The councils say the publication is not a policy update, just a clarification of existing policy, but stakeholders are concerned that’s not the case and that suppliers won’t have enough time to implement changes, according to a MAMES bulletin.

Studies: Remote, self-monitoring improves CPAP adherence, don’t overlook female, younger patients

DALLAS – Remote monitoring and patient self-monitoring can boost CPAP adherence to as high as 85%, according to a new study from ResMed. Average adherence using legacy technology with no cloud connectivity or remote monitoring capabilities is 50%. The study evaluated patients using 100% cloud-connected devices, including 4.1 million Americans (85% compliance); 31,000 Brazilians (83%); and 17,000 Mexicans (81%). “These results equate a strong endorsement for remote and self-monitoring technology,” said study coauthor and ResMed Chief Medical Officer Carlos M. Nunez, M.D. “Despite different healthcare systems, financial and social issues, patients in all three countries have reached above-average adherence rates when treated with 100% cloud-connectable PAP devices.” … Men with sleep apnea are 8.5% more likely to stay adherent on CPAP therapy than women, according to a study presented by ResMed. Other findings of the study: people over age 60 were 7.3% more adherent than the entire study cohort (77.7% vs. 70/4%); and people with self-reported severe sleep apnea were 78% adherent at the one-year mark, compared to 70.5% of those with self reported moderate sleep apnea and 65.2% of those with mild sleep apnea. “Sleep specialists, pulmonologists and primary care physicians should heed these results and ensure that their younger, female and more mildly diagnosed patients have the proper supports to stay on therapy,” said Adam Benjafield, study coauthor and ResMed’s vice president of medical affairs. “Regardless of why these gaps exist, we know they do, signaling the need to keep in close contact with patients in these populations.” To conduct the study, medXcloud, a ResMed assembled group of healthcare key opinion leaders, examined de-identified data of more than 1 million CPAP users from ResMed’s remote monitoring network, AirView, who were registered for its myAir patient engagement tool.

Both studies were presented at the American Thoracic Society’s ATS International Conference in Dallas.

Gemco receives VAWD accreditation

HUDSON, Ohio – Gemco Medical has received VAWD accreditation by the National Association of Boards of Pharmacy. VAWD (verified-accredited wholesale distributor) is awarded to pharmaceutical wholesale distributors in compliance with state and federal laws, and NABP’s VAWD criteria. The accreditation plays a vital role in in preventing counterfeit drugs from entering the U.S. drug supply, protecting the public from drugs that have been contaminated, diverted or counterfeited, the company says. Wholesale distributors that have been VAWD accredited have undergone a rigorous review of their operating policies and procedures, licensure verification, survey of facility and operations, background checks and screening through the NABP Clearinghouse. Accredited facilities are reviewed annually and undergo a site survey every three years.

Domtar launches new product line

RALEIGH, N.C. – Domtar Corp.’s Personal Care Division has launched its new Attends Premier product line in North America. The line, available both online and in-store, offers briefs, underwear and a premium underpad. Innovations in the new line include the Dry-Lock Containment Core, SmartCool Breathability and ConfidenceCuff Elastics.

People news: Liz Cole, Jan De Witte

NRRTS has selected Liz Cole to receive a Distinguished Service Award. The award, one of the highest honors the organization presents, recognizes individuals for their outstanding contributions to the complex rehab community. “Award recipients have gone above and beyond to promote, protect and advance CRT and the mission of NRRTS,” the organization said. Requirements for winning the award include passion, commitment, integrity and an unwavering ethical compass, NRRTS says. Cole, who was most recently the director of clinical applications for the ROHO Institute for Education, is now retired…ResMed has elected Jan De Witte to fill a newly created position on its board of directors. De Witte is currently CEO and board member of Barco NV, a company that designs and develops visualization and collaboration technology solutions for health care, enterprise and entertainment markets. Prior to Barco, he was president and CEO of General Electric’s Global Healthcare IT business. Jack Wareham will be retiring from the board in November.