In brief: Survey results show impact of COVID-19, Spiro receives investment

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Friday, May 15, 2020

WASHINGTON – Almost all HME providers are experiencing issues accessing personal protective equipment, according to a recent survey from AAHomecare. 

In addition to problems obtaining PPE (97%), survey respondents report significant delays in getting equipment used to treat COVID-19 patients, including hospital beds (59%), CPAP/RADs (53%) and nebulizers (49%).

The survey results show how changes in operational and product costs present significant challenges for an industry already dealing with unsustainable reimbursement rates from Medicare and other payer segments. 

“The COVID-19 pandemic is creating major operational, safety, and supply chain challenges for home medical equipment suppliers,” said Tom Ryan, AAHomecare president & CEO. “These survey findings drive home the point that the HME sector is subject to a new operating environment and cost structure as a result of this pandemic, and some of the safety requirements and new business practices we are seeing are likely to be with us even after the crisis fades.”

Providers also report increased costs for PPE (85%), oxygen equipment (67%), ventilators (48%), hospital beds (47%) and complex rehab technology (19%).

Other costs include communication efforts (78%), shipping (74%), limited personnel (74%) and remote staff (65%).

AAHomecare will use the survey findings in its efforts to urge policymakers to delay Round 2021 of the competitive bidding program.

DME MACs drop CMNs for oxygen, infusion services

WASHINGTON – The DME MACs on May 7 announced that they will not require CMNs for oxygen claims during the COVID-19 public health emergency.

The update follows CMS’s decision not to enforce clinical indications of coverage for the oxygen NCDs and LCDs, as outlined in an April 6 interim final rule.

“After carefully reviewing the CMN and the related claims processing issues that would result from having missing information or having clinical information for which the form was intended, CMS has determined that requirements for a CMN for oxygen claims will not be enforced during the COVID-19 PHE,” CGS stated in a bulletin.

The same concerns apply to external infusion pumps and, therefore, the DME MACs will not require DIFs for these claims.

To file claims without CMNs, the DME MACs recommended:

“Suppliers should continue to use the appropriate modifiers, including the KX modifier where applicable, for all HCPCS codes included in the NCDs and LCDs. In addition, the CR modifier (CATASTROPHE/DISASTER RELATED) should be added to the HCPCS code(s) billed. Finally, suppliers are instructed to enter "COVID-19" in the NTE 2400 (line note) or NTE 2300 (claim note) segments of the American National Standard Institute (ANSI X12) format or field 390-BM of the National Council for Prescription Drug Program (NCPDP) format. These abbreviations may also be used in Item 19 of the CMS-1500 claim form.”

The changes are effective March 1, 2020, through the end of the PHE.

“This policy change will allow HME suppliers who provide respiratory and infusion services to provide more support to patients and family caregivers during this pandemic,” said Tom Ryan, president and CEO of AAHomecare. “We appreciate CMS’s responsiveness and collaborative approach in modifying regulations to help ensure the HME community can make its strongest possible contribution to limiting the impact of the COVID-19 crisis.”

Spiro Health receives investment

SANDWICH, Mass. – NewSpring, a private equity firm, has made an investment in Spiro Health, in partnership with Upstream Capital. 

Spiro was formed in April when America’s Healthcare at Home, Cape Medical Supply and Health Complex Medical merged to create a larger, regional company focusing on sleep and respiratory equipment and services.

“Together, this combined entity is even greater than the sum of its parts,” said Steve Hobman, NewSpring general partner. “As the number of individuals in need of home medical equipment continues to rise, we expect Spiro Health to continue leveraging its best-in-class patient and referral partner experience and market position to reach higher levels of growth.”

Spiro Health operates in seven states on the East Coast and has an active patient count of more than 50,000 patients.

The investment will be used to increase Spiro’s geographical footprint and build its technology platform.

“NewSpring’s experience growing middle-market companies makes them the perfect partner to help us unify our member companies’ operations, expand into new geographies, and improve patient experiences,” said Gary Sheehan, CEO of Cape Medical and Spiro Health.

Terms of the deal were not disclosed.

Rehab groups mark 30th anniversary of ADA

WATERLOO, Iowa – VGM & Associates, U.S. Rehab and NCART are raising awareness of the Americans with Disabilities Act, in honor of the landmark legislation’s 30th anniversary. 

The campaign kicks off with a video featuring retired Sen. Tom Harkin, a champion of the disabled and lead sponsor of the ADA.

“We are so pleased to have worked with NCART and Senator Harkin to put some great info together for the anniversary of the ADA,” said Greg Packer, president of U.S. Rehab, the complex rehab division of VGM & Associates. “We must continue to move our support to help those who are vulnerable achieve the goals they are striving for to better themselves without jeopardizing the achievements they have made.”

The ADA was signed into law by President George H. W. Bush on July 26, 1990, to ensure that any individual is not socially defined or limited in life by a disability.

“The 30‐year anniversary of the ADA is a great opportunity to bring attention to the continued improvements and changes needed to fulfill the promise of the ADA for people with disabilities,” said Don Clayback, executive director of NCART.

In the coming months, VGM, U.S. Rehab and NCART will continue to raise awareness about the ADA and what it means for stakeholders in the complex rehab industry. Visit vgm.com/ADA and Access2CRT.org/ada for updates.

Pride Mobility launches German subsidiary

HOVELHOF, Germany – Pride Mobility Products has launched its newest international standalone subsidiary, Pride Germany. Pride has had a presence in the Germany for more than 20 years and discussions for the subsidiary started in earnest in the fall of 2019. “We had to locate an appropriate facility, hire knowledgeable staff and create a top-notch sales force,” said Tim Murphy, vice president of European and Middle East operations and sales. “It has been with much help from staff at Pride Corporate, Pride Netherlands and our German management staff to see this come to fruition.” The new facility features 16,000 square feet of space, including a warehouse, showroom, repair shop and technical service area. Pride Germany has 12 employees.

Golden preps team for digital sales

OLD FORGE, Pa. – Golden Technologies’ sales team has undergone extensive digital training in recent weeks as the company prepares to adapt to the way HME retailers are doing business in the current pandemic environment. In addition to social media training, the team has been trained on conducting virtual meetings and been has been given turnkey marketing content with images for retailers to use on their social media platforms. Once states reopen for business, retailers will be able to have their lift recliner, scooter and power wheelchair programs ready to sell faster. “The goal of our digital initiative is to offer enhanced support and convenience to our retailers with safe meeting and training options, digital marketing tools, and quick ship inventory,” said Jason Davis, vice president of sales. “We strive to anticipate the needs of our retailers, so this training has equipped our sales representatives with the ability to proactively help them in their urgent effort to recover from the effects of this global health crisis.”

Somnetics repurposes Transcend CPAP

MINNEAPOLIS – Somnetics International is working to repurpose its inventory of Transcend CPAP machines for use in the fight against COVID-19. “We know we have a part to play in fighting this pandemic,” said Clarence Johnson, CEO of Somnetics. “We are working as fast as possible to boost product and convert our CPAP machines to help prevent a nationwide shortage of ventilators in health care settings.” Somnetics is taking steps to repurpose its Transcend CPAP machines into respiratory support devices to assist patients that have trouble breathing as a result of COVID-19. The company’s engineers are working on a solution that includes designing a new breathing circuit to help control aerosolization of virus particles to protect health care workers. The U.S. federal government cleared the U.S. Food and Drug Administration in late March to authorize emergency use of CPAP machines in health care settings to treat patients during the pandemic.

NABP adds home infusion accreditation

MOUNT PROSPECT, Ill. – The National Association of Boards of Pharmacy, a CMS-deemed DMEPOS accrediting organization, has added Home Infusion Therapy Pharmacy Accreditation. Starting January 2021, CMS will require accreditation for home infusion therapy services billed to Medicare. NABP is one of eight organizations that the U.S. Department of Health and Human Services has designated eligible to apply for deemed status as an accrediting organization for home infusion therapy suppliers. “We are excited to launch our new Home Infusion Therapy Pharmacy Accreditation and add it to our robust portfolio of offerings,” said NABP President Jack W. “Jay” Campbell IV, JD, RPh. “As a CMS-deemed DMEPOS accrediting organization since 2006, NABP is working with CMS on expanding our coverage to include home infusion therapy services billed to Medicare. We look forward to assisting current DMEPOS-accredited customers to realize their full potential within this space and to be recognized for the valuable services they provide.”

Paragon Ventures hires former Pacific Pulmonary exec

NEWTOWN, Pa. – Paragon Ventures has named Samantha Lincoln, formerly director of business development for Pacific Pulmonary Services, as managing director. “Our sell-side investment banking advisory business continues to grow nationally, and we are committed to having the highest caliber of talent across our team to best serve our clients,” said Marc Rose, president and managing partner. Lincoln assisted with the sale of PPS, the fifth largest home respiratory company in the country, to Teijin Ltd. At PPS, she led strategic acquisition activity—sourcing, valuing, negotiating and leading integration on 20 acquisition transactions ranging from $2 million to $30 million. Lincoln’s experience also includes corporate strategy, capital raising, and distressed turnaround and restructuring. Prior to PPS, she was vice president of Capital Works, a private equity investment firm, and was founder of Instream Partners, an NASD-registered investment bank.

ISS calls for abstracts

PITTSBURGH – The 37th International Seating Symposium is accepting abstracts for conference courses through July 12. ISS, which is scheduled to take place March 18-20 in Pittsburgh, will evaluate and score proposals based on: innovation (new topics that have not been presented at prior/other conferences), evidence and quality of references. The event will consider the following types of courses: 1-hour conference presentation, 15-minute paper presentation, poster presentation, 4-hour preconference presentation, and 8-hour preconference presentation. Presenters are limited to one submission per type. Proposed areas of consideration include pediatric seating and mobility, powered wheelchairs and funding/policy. The theme for the 2021 conference is “Showing Our Value.”

NHIA welcomes new board members

ALEXANDRIA, Va. – The National Home Infusion Association has announced new members to its board of directors: Kathleen Patrick, president of UPMC Community Pharmacies and Chartwell Pennsylvania; John Rademacher, president and CEO of Option Care Health; and Michael Zeglinkski, senior vice president of OptumRx of Avella and Optum Specialty Pharmacies. Leaving NHIA’s board are Cliff Berman of Option Care Health, Janice Wilhelm of Advanced Home Care and Ted Kramm of Optum Infusion.

DME MACs ease limits on enteral nutrition, Part B drugs

WASHINGTON – Suppliers may now dispense more than the 30-day supply for enteral nutrition and Part B drugs, according to an announcement for the DME MACs. The change is effective for claims with a date of service starting on March 1, 2020. This relief is related to CMS’s National Emergency Authority. In future potential audits, contract reviewers will determine if the amount dispensed was reasonable and necessary by reviewing the patient’s diagnosis, prospective interruptions and delays to the supply chain, and other related information.