In brief: OIG says Medicare overpaid suppliers, VGM rebrands wound care division

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Friday, December 7, 2018

WASHINGTON – Medicare improperly paid suppliers $34 million for DME and supplies that were provided during inpatient stays, according to a new report from the Office of Inspector General.

Those items should have been provided directly by the inpatient facility or under arrangements between the facility and the supplier, according to the report.

In addition, beneficiaries were improperly held responsible for deductibles and coinsurance provided during inpatient stays totaling $8.7 million.

Medicare overpaid the suppliers because systems edits that should have prevented or detected the overpayments were not adequate. If those edits had been adequate, Medicare could have saved $223.1 million since 2008, and beneficiaries could have saved $56.3 million, according to the report.

The OIG recommended that CMS direct contractors to recover the $34 million; that suppliers refund beneficiaries up to $8.7 million; and that the agency identify and recover any improper payments to suppliers after its audit period.

The OIG also recommended CMS take all necessary actions, including legislative authority, to require suppliers to refund beneficiaries and correct the system edits.

CMS concurred with all recommendations with the exception of the recommendation to seek legislative authority, stating it will consider whether to recommend the proposal for inclusion in the president’s next budget.

VGM expands, rebrands wound care division

WATERLOO, Iowa – VGM has rebranded its wound care program as VGM Wound Care. It has also expanded its tools and resources for providers currently offering wound care products or looking to get into the market. The program covers dressings, support surfaces, negative pressure wound therapy, ostomy, compression and nutrition; support materials include billing, incremental growth products, policies and educational materials. “Skin care and wound care affects each and every one of the patients HME providers work with,” said Heather Trumm, BSN, RN, CWON, director of VGM Wound Care, in a press release. “Our expanded program can help VGM members effectively offer wound care products and services to fulfill patients’ needs, all while developing another revenue stream to increase business.”  

Health spending slows year over year, CMS study finds

WASHINGTON – Overall health spending grew 3.9% in 2017, almost 1% slower than 2016, according to a study conducted by the Office of the Actuary at CMS and published this week by Health Affairs. Medicare spending grew 4.2% in 2017 vs. 4.3% in 2016. Slower growth in fee-for-service Medicare spending (1.4% in 2017 vs. 2.6% in 2016) offset faster growth in Medicare private health plan spending (10% vs. 8.1%). The trends in Medicare FFS and Medicare private health plan spending are attributed, in part, to an increased share of all Medicare beneficiaries enrolling in Medicare Advantage. Medicaid spending slowed, increasing 2.9% in 2017 vs. 4.2% in 2016. The reason: a deceleration in enrollment growth, and a reduction in net cost of Medicaid health insurance from an increase in recoveries from Medicaid managed care plans. State and local Medicaid expenditures grew 6.4%, while federal Medicaid expenditures increased less than 0.8%. Out-of-pocket spending, which includes direct consumer payments like copays and deductibles, grew 2.6% in 2017 vs. 4.4% in 2016.

Aeroflow rebrands as portfolio, footprint grow

ASHEVILLE, N.C. – Aeroflow has updated its corporate brand and identity with a new logo with a “sleeker, modern design,” according to a blog on its website. The provider also has a new trademark phrase: “Live Better Today and Tomorrow.” The rebrand is, in part, a nod to the company’s growing line of business (it started out providing oxygen but now also provides CPAP machines, breast pumps, respiratory supplies, pediatric equipment and more) and its growing geographical footprint (it most recently acquired the CPAP resupply business of Michigan-based Wheelock Home Medical). “As we continue to expand with more healthcare products and services to better assist more patients of all ages, our national footprint will also continue to grow,” the company stated in the blog. “Which is why refreshing our brand was vital toward becoming more recognizable as a source of extraordinary care.” Aeroflow enlisted the help of Percepted and its co-founder and Creative Director Chris Enock as part of the rebrand. “Aeroflow’s new brand identity, along with the brand messaging help shape the way Aeroflow is perceived and how their products and services are valued,” he said. “Our goal was to provide Aeroflow with the tools to strengthen and create enduring relationships with customers well into the future. The new brand execution promises to do just that.”

CQRC sends letter to Verma on vents

WASHINGTON – The Council for Quality Respiratory Care has sent a letter to CMS Administrator Seema Verma expressing its “serious reservations” with the proposal to include home ventilators in the competitive bidding program. “The CQRC is deeply troubled and confused by the proposal to add three types of ventilation devices, which are used by highly vulnerable Medicare beneficiaries who otherwise could not remain in their homes, to the competitive bidding program before the modified policies have been implemented,” the letter states. CMS included the proposal to include ventilators, as well as off-the-shelf back and knee braces, in a recent final rule. Comments on the proposal are due Dec. 17.

Judge presses pause on CVS-Aetna deal

WOONSOCKET, R.I. – A federal judge has told CVS Health Corp. and Aetna not to begin their integration until he has a chance to weigh in on their $70 billion merger. CVS announced on Nov. 28 that the transaction was completed. U.S. District Judge Richard Leon said, however, that the two companies have until Dec. 14 to show him why they should be allowed to continue with the integration, according to an article on modernhealthcare.com. It is unclear whether Leon has any power to forestall the integration, according to the article. A hearing has been scheduled for Dec. 18. The deal, which was first announced in December 2017, has raised anti-trust concerns.

FusionHealth to collaborate with UM

ATLANTA – FusionHealth, a sleep health technology company, will partner with the University of Michigan for Sleep SMART (Sleep for Stroke Management and Recovery Trial). The clinical trial will investigate whether OSA diagnosis and treatment improves stroke outcomes. Researchers at 110 sites will enroll 3,000 post-stroke patients while they’re still in the hospital to begin treatment right away. FusionHealth will supply the sites with sleep apnea testing and CPAP equipment, incorporating telemedicine to better monitor patient adherence and results without requiring overnight sleep apnea tests or constant clinic visits.

Bonafide integrates with Allegiance Group

THOUSAND OAKS, Calif. – Bonafide Management Systems now has full integration with Allegiance Group. The integration includes single sign on functionality, which provides seamless integration between Bonafide and the AR services provided by Allegiance Group. “This is definitely going to make it a lot easier for our customers to collect on all of their payments,” said Wayne Bailey, director of client service, Bonafide. “Utilizing this solution will enable DME providers to see exactly what is going on with their collection status real-time.” The integration also allows users to view Allegiance Group invoices, patient statements and patient activity, and collection status in the Bonafide system. Additionally, it allows users to automatically post payments in the system.

higi, Bridge Connector connect patient data

CHICAGO – A new collaboration allows for seamless integration between higi health stations using the Health Connect solution, and any EHR or hospital system using Bridge Connector technology to engage with and manage patient data. It also opens the door to connectivity of the higi platform with providers, payers, employers, retailers and others looking to connect with and manage their patient data with real-time risk identification for care intervention and ongoing preventative programs. “With over 52 million total users, higi is the leading health platform for engaging with consumers where they are,” said Jeff Bennett, CEO. “The power in our platform comes when we remove the friction between connecting the consumer with their trusted healthcare provider to allow the consumer to consent and share their data in real-time to enable additional touchpoints and timely intervention. With Bridge Connector, we continue to make it easier for consumers to be their healthiest by making healthcare better connected.” higi health stations are in 11,000 retail locations, community hubs and other points-of-care across the country, providing real-time biometric and health data nearly 1 million times per week.

Beat SmartSaver deadline for Medtrade Spring

LAS VEGAS – SmartSaver Conference Passes for Medtrade Spring, April 16-18 at the Mandalay Bay Convention Center in Las Vegas, expire on Dec. 22. The passes are $99 and allow full access to educational sessions and the expo hall. SmartSaver Expo Passes are $25 and allow full access to the expo hall. “For those who already know they are going to Medtrade Spring, these are the rates to grab,” said Sarah Varner, marketing director. “The conference pass offers a $100 savings over Early Rates and an expo pass saves $25.”