In brief: Stakeholders now await final rule on bidding, MedPAC comments on proposed changes

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Friday, September 14, 2018

WASHINGTON ­– A CMS proposed rule that, among other things, outlined changes to the competitive bidding program drew 514 comments by a Sept. 10 deadline.

“This is an incredible leap from last week, when we reported 216 submissions,” VGM stated in a bulletin. “These comments are crucial to demonstrating the need for additional relief for the non-rural areas among the other areas where CMS fell short in their proposals.”

The comments, which are public, can be read here.

In addition to the submitted comments, the Iowa delegation to the House of Representatives has joined the Ways and Means Committee and others in writing to CMS to express their concerns about the bid program and the proposed changes, VGM reported.

Reps. Rod Blum, Steve King, Dave Loebsack and David Young sent a letter to CMS Administrator Seema Verma asking the agency to take into account accessibility issues in rural areas when reviewing the public comments and before issuing a final rule, likely in November. They ask that CMS extend the 50/50 blended reimbursement rates to all non-bid areas, not just rural and non-contiguous areas.

MedPAC comments on proposed bid changes

WASHINGTON – The Medicare Payment Advisory Commission isn’t on board with all of CMS’s proposed changes to the competitive bidding program.

On CMS’s proposal to implement an “any willing provider” provision on Jan. 1, 2019, while it makes changes to the program, MedPAC comments:

“While we appreciate the fact that CMS is proposing some significant changes to the CBP, we believe that reforms can be implemented while the program continues to operate. If additional time is needed to properly implement any finalized changes, we believe the agency has better alternatives than letting the program lapse. For example, the agency could seek to extend current contracts for six months or a year.”
MedPAC commented on the proposed changes in an Aug. 31 letter to CMS Administrator Seema Verma.
MedPAC supports CMS’s proposal to use lead item pricing and maximum winning bids, though it worries that relying on maximum winning bids could result in “excessive payment rates if beneficiary demand is overestimated or supplier capacity is underestimated.” It also supports the agency’s proposal to use bid surety bonds.
MedPAC, however, does not support CMS’s proposal to continue the 50/50 blended reimbursement rates for rural and non-contiguous non-bid areas, let alone all non-bid areas:
“Using 50/50 blended payment rates results in large payment increases, often of 50% or more. While CMS presents data indicating that some supplier costs are higher in rural and non-contiguous areas, the agency also found that other costs are lower in those areas, and the agency doesn’t present data to justify the large magnitude of the proposed adjustment.”

Holding company combines Valley Healthcare, Northwest Medical

RENO, Nev. – Great Elm Capital Group has partnered with Mesa, Ariz.-based Valley Healthcare Group to acquire Portland, Ore.-based Northwest Medical and combine the two companies.

The deal creates a leading regional provider of sleep and respiratory equipment and services across Arizona, Nebraska, Washington, Oregon and Alaska serving about 70,000 patients annually, according to a press release.

“With Great Elm’s support, we believe that we will continue to grow organically, as well as be an acquirer of choice for other sleep and respiratory focused businesses that share our commitment to high-quality patient care,” said Ron Evans, co-founder and CEO of Valley Healthcare.

Northwest Medical is Valley Healthcare’s eighth acquisition since Ron and Pam Evans co-founded the company in 2006.

The combined companies, which will continue to operate under local brand names, generated $43.6 million in revenue, $2.5 million in net income, and $11.1 million in adjusted EBITDA in the calendar year 2017, according to the release.

To complete the transaction, Great Elm purchased an 80.1% equity interest in an entity formed to acquire and combine Valley Healthcare and Northwest Medical. It funded the $63.6 million transaction using $19.7 million in cash from its balance sheet, with the remainder funded using $31.3 million of secured debt, $5.3 million of qualified preferred stock and $7.3 million of equity rollover from Ron and Pam Evans and Corbel Capital Partners, a structured debt and equity fund.

Gov’t makes concessions for Hurricane Florence

WASHINGTON – Health and Human Services Secretary Alex Azar has declared public health emergencies in North and South Carolina and Virginia, giving Medicare beneficiaries and their healthcare providers there greater flexibility in meeting emergency health needs. CMS has temporarily suspended certain requirements necessary for beneficiaries who have lost or realized damage to their DME, prosthetics, orthotics and supplies as a result of Hurricane Florence. “This will help to make sure that beneficiaries can continue to access the needed medical equipment and supplies they rely on each day,” the agency stated. CMS advises beneficiaries to contact 1-800-MEDICARE for assistance. The agency’s efforts also include implementing waivers for hospitals and other healthcare facilities; making available special enrollment opportunities for beneficiaries who are victims of the hurricane; and developing a disaster preparedness toolkit for state Medicaid agencies.

House passes LCD Act

WASHINGTON – The House of Representatives has passed a bill that outlines a set of standards that MACs must adhere to before they hold meetings related to local coverage determinations. The Local Coverage Determination Act, H.R. 3635, passed by a voice vote on Sept. 12. The standards are: publishing online a proposed version of the determination and other specified, related information; convening one or more public meetings to review the draft determination, receive comments and ensure that meetings of the MAC’s advisory panel are on record; posting online a recording of the minutes from each such meeting; providing a period for submission of written public comments; and posting online specified information related to the rationale for the final determination. The bill is supported by more than 25 health and medical associations, including the American Association of Nurse Anesthetists and the College of American Pathologists. 

Essentially Women releases schedule

WATERLOO, Iowa – Essentially Women has released the schedule for its annual educational conference for HME and mastectomy service providers. FOCUS: The EW Conference will feature nearly 20 sessions covering topics like billing and reimbursement, succession planning, compliance and cyber security, compression therapy, mastectomy fitting and marketing, among others. “FOCUS is all about providing our members with education tailored to help them improve their business,” said Nikki Jensen, vice president of Essentially Women, a division of The VGM Group. “Our sessions will help attendees gain valuable insight to not only grow professionally but also adjust to the ever-evolving healthcare industry.” The conference will take place Feb. 2-4 in St. Pete Beach, Fla.

F&P responds to ResMed

IRVINE, Calif. – Fisher & Paykel Healthcare has filed a complaint with the U.S. International Trade Commission seeking an exclusion order to prevent the import and sale of ResMed’s AirFit P10 range of nasal pillows masks in the United States. The company alleges that ResMed’s AirFit P10 masks, AirFit P10 for Her masks and AirFit P10 for AirMini masks infringe on five F&P patents. “Over the last 20 years, Fisher & Paykel Healthcare has built a significant portfolio of more than 2,000 issued and pending patents,” said Lewis Gradon, managing director and CEO. “WE have developed unique mask technology that has provided improved care and outcomes for patients with OSA and we take infringement of our intellectual property rights very seriously.” Earlier in September, ResMed filed a new petition with the ITC seeking an order banning the import and sale of F&P’s Simplus full-face mask, Eson nasal mask and Eson 2 nasal mask for allegedly infringing on five ResMed patents related to mask system and cushion design.

Motivo names new exec to lead ramp up

MILWAUKEE – Motivo has named Michael Lenzie CFO and COO to help ramp up the manufacturing of its Motivo Tour Walker in response to increasing customer demand, the company announced Sept. 11. Lenzie, who will be based at the company’s headquarters in New Berlin, Wis., will also oversee accounting, supply chain and production. “Hiring Michael represents yet another important growth milestone for Motivo,” said Jeremy Knopow, co-founder. Before joining Motivo, Lenzie served in various management roles at several industrial companies, including NABCO Entrances, Aqua-Chem and Cleaver-Brooks. He is a certified public accountant. Earlier this year, Motivo rounded out nearly $5 million in funding and launched its Tour Walker nationwide.

Medtrade offers retail-focused education

ATLANTA – Medtrade has added a new retail-focused educational offering: The eRetail Experience by Health Mobius. Attendees can choose from two, one-hour sessions each on Tuesday, Oct. 16, and Wednesday, Oct. 17. “Pre-register and attend this session and we will create your e-commerce website, backed with a virtual warehouse containing more than 25,000 cash-sale products from hundreds of manufacturers, and provide a tech team to manage it all,” says Kamal Haddad, CEO of Health Mobius. “Yes, we will create and demonstrate a live, fully functioning webstore for every pre-registered attendee and allow you to take it for a free test drive.”

Growth in the sleep market continues

BOSTON – Sleep center patient volume grew 7% in the last 12 months and is expected to grow 9% in the next 12 months, according to the results of a new survey conducted by Needham & Co. ResMed looks likely to lose 2% of flow generator prescription share, but gain branded mask prescription share. For flow generators, Respironics’ share is up 1.1%, Fisher & Paykel’s share is flat and other companies’ share is up .8%. ResMed’s mask ratings are slightly above its competitors in all three mask categories. In nasal masks, its AirFit N20 was rated 5.9 (out of 7.0), compared to Respironics' DreamWear at 5.7 and F&P’s Eson 2 at 5.7. In nasal pillow masks, ResMed’s AirFit P10 was rated 5.9, compared to Respironics' DreamWear Gel at 5.7 and F&P’s Brevida at 4.7. And in full face masks, ResMed's AirFit F20 was rated 6.1, compared to Respironics' DreamWear Full at 5.9 and F&P’s Simplus at 5.8.

VMI taps new leaders

PHOENIX – Vantage Mobility International has named Mark Shaughnessy as its new president and CEO, the role previously held by Tim Baron, the company announced today. Shaughnessy’s resume includes leadership positions at Mars, Inc., Coca-Cola Company and Rubicon over a 24-year period. “Mark is a dynamic, consumer focused executive with an exemplary track record of leading small and large corporations to achieve greater employee cohesiveness and operational efficiencies,” said Barone in a press release. Barone is continuing at VMI as chairman of the board.

One Drop integrates with Apple

NEW YORK – One Drop users can now seamlessly transfer data from One Drop | Chrome to the Apple Watch, according to a press release today. Apple Watch Bluetooth connectivity is the newest of thousands of One Drop integrations that allow users to pull their data from other apps and devices. "For too long the diabetes industry has operated on point solutions and closed systems focused on the needs of healthcare providers in the clinic, rather than the needs of the people using the systems to manage their disease every day," said Jeff Dachis, One Drop CEO. With the release of iOS 12, One Drop will further expand iOS integrations by launching Apple Health Records and Siri Shortcuts. One Drop, a diabetes management solution, originally launched in 2015 as a mobile app and has since added its own blood glucose monitoring system and coaching.

Ways and Means weighs in on proposed bid changes

WASHINGTON – The Ways and Means Committee in the House of Representatives has sent a letter to CMS asking the agency to provide broader relief from competitive bidding during an upcoming transition period. “It is crucial to any fresh start that the playing field be set in a fair manner to avoid the over-correcting and re-correcting required through both regulatory and congressional action over the last seven years,” the letter states. In a recent proposed rule, CMS outlined plans to extend 50/50 blended reimbursement rates in rural and non-contiguous areas from Jan. 1, 2019, through Dec. 31, 2020, but not in all non-competitive bidding areas. It has no plans for relief in bid areas. The committee also commends CMS for its plans to move to lead item pricing but cautions the agency not to be “overly restrictive” in the amount of lead items and not to tie the pricing rations of these items to older fee schedules into perpetuity. “(That) may in the end undermine the great efforts to reduce burdens and increase access in this rule,” the letter states.

MK Battery debuts new website

ANAHEIM, Calif. – MK Battery has rolled out a newly designed and enhanced corporate website. Highlighted features include more user-friendly product searches and application cross-referencing, as well as dealer lookup and distribution center locator tools. “The aim of the website redesign was not only to modernize the look, but also to provide more comprehensive content and improved navigation and functionality,” said Rick Spiegel, vice president of sales. “We wanted to make it easier for visitors to access all the many resources that we make available online.” The new website, www.mkbattery.com, has also been designed to include mobile responsiveness for phones and tablets, and long-scroll pages to provide added content without additional clicks.