In brief: Data shows sharp decline, Invacare cleared for re-inspection

WASHINGTON - Nearly 41% of HME providers have dropped Medicare since July 2013, according to AAHomecare.

That was when Round 2 of the competitive bidding program kicked off in 91 cities with an average reimbursement cut of 45%.

Three states—California, New York and New Jersey—saw declines of more than 60%, while the District of Columbia saw a decline of 85.7%, according to data AAHomecare analyzed from the Medicare Supplier Directory.

Bigger picture, the association found the total number of unique companies dropped from 10,465 in July 2013 to 6,181 as of April 2017; and the number of unique locations declined 38.7%.

By comparison, the number of Medicare beneficiaries increased 8.6% from 2013 to 2016.

With the application of bid pricing to non-bid areas beginning Jan. 1, 2016, the decline has accelerated, with a 26.4% reduction in HME providers and a 23.3% reduction in total locations, according to AAHomecare.

“AAHomecare plans to highlight this data in our advocacy efforts on Capitol Hill and at CMS,” said the association in its weekly bulletin. “HME suppliers and other stakeholders are encouraged to reference both national and state data in your contacts with legislators.”

AAHomecare pulled from the Medicare Supplier Directory using counts for companies and locations providing beds, negative pressure wound therapy, support surfaces, wheelchairs and accessories, respiratory and oxygen products.

Invacare cleared for re-inspection

ELYRIA, Ohio - Invacare has complete the final milestones required to lift a consent decree with the U.S. Food and Drug Administration, paving the way for a re-inspection, the company announced April 27.

“The re-inspection is an important step before the company may resume full operations at the impacted facilities,” Invacare stated in a press release.

The decree has limited Invacare's ability to manufacture and sell certain products from its corporate headquarters and Taylor Street facilities since December 2012.

Most recently, Invacare's third-party auditor submitted a third and final certification report confirming its compliance with specified FDA regulatory requirements. Invacare also submitted its own report substantiating its compliance. Both of these steps have now been completed.

“Since I arrived at Invacare in 2015, our No. 1 priority has been to build a culture of quality excellence,” stated Matthew Monaghan, chairman, president and CEO. “Our associates have embraced this, and we have made significant progress. We look forward to demonstrating this progress to FDA during its inspection.”

Invacare says it cannot predict the length or outcome of the re-inspection.

Earlier this month, the FDA notified Invacare that it had accepted an updated second certification report submitted by the company's auditor, allowing it to resume design activities at its corporate headquarters and Taylor Street facilities.

CMS implements audit improvements

WASHINGTON - CMS has announced significant improvements to the processing of serial claims for capped rental items and certain inexpensive and non-routinely purchased items, according to a bulletin from AAHomecare.

It's an issue that has been a challenge for providers for years and contributed to the massive appeals backlog, the association says.

Improvements include:

• Instructing the DME MACs to change the process by which they adjudicate appeals of serial claims. Once the reason for denial for one claim in a series is resolved at any appeal level, the DME MACs will identify other claims in the same series that were denied for the same or similar reasons, and take that determination into consideration when adjudicating such claims.
• The DME MACs will also communicate favorable decision(s) to the DME QIC and the Office of Medicare Hearings and Appeals (OMHA) to consider when adjudicating related appeals pending at those levels.
• Instructing the DME MACs to update the CMN in the ViPS Medicare System (VMS), when appropriate, to reflect when a favorable decision has been rendered for a serial claim, allowing future claims in the same series to pay without requiring suppliers to continually resubmit evidence.
• Instructing the DME MACs to perform data analysis of all favorable serial claim appeal decisions made over the past three years, in an effort to capture all currently pending appeals in the series that could be included in this initiative. Suppliers do not need to take any action and should not reach out to the DME MAC within their jurisdiction to request that their appeal be considered for this initiative.

Med Emporium expands footprint

CHARLOTTE, N.C. - Med Emporium LLC, a home respiratory services provider, has acquired Mobile Med Inc. with locations in Greenville, S.C., and Rome, Ga. The acquisition allows Med Emporium to better serve customers in South Carolina and expands its territory into Georgia. Mobile Med has been in business for more than 10 years. Mobile Med's employees, including founders Doug Trenor and Tim Hayes, will support sales and growth efforts in those markets. As part of Med Emporium, they will have access to advanced clinical systems and support infrastructure that will help increase efficiency, according to a release.

BD accelerates offerings with Bard

FRANKLIN LAKES, N.J., and MURRAY HILL, N.J. - Becton, Dickinson and Company will buy C. R. Bard for $24 billion, the companies announced April 23.

The deal builds on BD's position in medication management and infection prevention, and increases its opportunities in fast-growing clinical areas like vascular therapy, according to a press release.

"Combining with Bard will accelerate our ability to offer more comprehensive, clinically relevant solutions to customers and patients around the globe, creating a strong partner for healthcare providers who are increasingly focused on delivering better outcomes at a lower total cost,” said Vince Forlenza, BD's chairman and CEO. “Our two purpose-driven organizations are well-aligned strategically, sharing a strong track record of performance and a deep commitment to addressing unmet needs in today's challenging healthcare environment.”

Under the terms of the transaction, Bard common shareholders will be entitled to receive approximately $222.93 in cash and 0.5077 shares of BD stock per Bard share, or a total of value of $317.00 per Bard common share based on BD's closing price on April 21, 2017. At closing, Bard shareholders will own approximately 15% of the combined company.

By combining Bard's strong leadership position and innovation pipeline in fast-growing vascular access segments—PICCs (peripherally inserted central catheters), midlines and drug delivery ports—with BD's leadership and innovation in IV drug preparation, dispensing, delivery and administration, the combined company will be better positioned to provide end-to-end medication management solutions across the care continuum, according to the release.

“Bard will expand BD's focus on the treatment of disease states beyond diabetes to include peripheral vascular disease, urology, hernia and cancer,” it states.

Following the acquisition, BD expects to create a third segment within the company called BD Interventional, where the Bard business will report both operationally and financially. Separately, BD also announced on April 23 that Tom Polen, currently executive vice president and president of the BD Medical Segment, will become president of BD effective immediately. In this new role, he will oversee BD's Medical and Life Sciences segments, as well as the new Interventional segment.

BD previously bought CareFusion, which manufacturers everything from infusion pumps and IV sets to ventilation and respiratory products, for $12.2 billion in 2014.

Bard previously bought Liberator Medical, a direct-to-consumer provider of home medical supplies, including catheters, ostomy, diabetes and mastectomy, for $181 million in 2015.

ResMed hits market with travel CPAP

SAN DIEGO - ResMed unveiled its travel CPAP, the AirMini, April 25. Weighing just 0.66 pounds and measuring just 5.4 x 3.3 x 2 inches, the company is hailing the device as “the world's smallest CPAP machine.” “CPAP is now more portable and accessible than ever before,” said Mick Farrell, CEO, in a press release. “I have been traveling all over the world with a prototype of the AirMini system, using AutoSet, humidification, and an AirFit P10 pillows mask, and it has changed my travel life. I am so excited to see that this technology is now available to many millions of sleep apnea patients.” In a recent survey, 65% of CPAP users said the size of their devices is the No. 1 reason why they don't take their CPAP machines every time they travel, breaking the cycle of adherence, according to the release. Users of the AirMini can change their comfort settings and track their usage data through an accompanying phone app. ResMed is making the AirMini, which also features portable waterless humidification, available through HME providers. It will begin taking pre-orders on May 3, and the device will begin shipping by May 31. ResMed first announced plans to launch the AirMini during a conference call in January.

ASMS launches online store for CPAP

ENCINO, Calif. - Advanced Sleep Medicine Services has launched a new online store at www.sleepdr.comto offer CPAP equipment and sleep therapy accessories. Unlike most other online sellers of CPAP equipment and accessories, ASMS also accepts health insurance, including most commercial plans and many medical groups in southern California, according to a press release. ASMA has provided diagnostic sleep testing and therapy services in southern California for more than 20 years. It has provided educational materials about sleep studies and CPAP therapy at www.sleepdr.comfor the past 10 years. “We recognize that many people prefer to do most of their research and shopping online,” said Kermit Newman, CEO of ASMS. “By offering this easy option of online shopping in addition to our brick-and-mortar sleep centers across California, we hope to reach more patients.”

Ascensia teams up with Dr. Oz

PARSIPPANY, N.Y. - Ascensia Diabetes Care has announced a partnership with The Dr. Oz Show to launch a 60-day “Take Charge” Diabetes Challenge. Ascensia is sponsoring the challenge, which is designed to increase awareness of diabetes among the general public and to help encourage better management of the condition. As part of the challenge, which launches during the April 26 episode of The Dr. Oz Show, participants who have diabetes will use Ascensia's ContourNext One Blood Glucose Monitoring System to monitor their blood glucose; and all participants will use higi, a network of self-screening health stations and an online community platform that is linked to more than 80 health devices, trackers and apps, to monitor their weight and body mass index. The April 26 episode will also highlight the experiences from some of the 60 participants who have already completed the challenge. Members of the public can participate in the challenge by joining at doctoroz.com, where they can see if they are eligible to receive one of 1,000 free ContourNext One meters.

Home mods bill returns in the House

WASHINGTON - Reps. Charlie Crist, D-Fla., and Bruce Poliquin, R-Maine, have introduced a bill in the House of Representatives that would provide tax credits to seniors who install home modifications. H.R. 1780 or the “Senior Accessible Housing Act” has six original co-sponsors and has been referred to the Ways and Means Committee. “Giving seniors the option to live more independently in their own home is less costly and can improve their quality of life,” Crist said. “Providing tax credits for home modifications is smart policy—it's better for our seniors and better for our communities.” Rep. Patrick Murphy, D-Fla., introduced a similar bill last year. The bill would provide incentives to individuals 60 years of age and older to “age in place” by providing a $30,000 tax credit for home modifications like the widening of doorways and the installation of ramps, handrails, grab bars and non-slip flooring.

Etac names new exec

TORRANCE, Calif. - Etac AB has named Ryan Williams as president, Etac NA, effective immediately. Williams has extensive experience in health care, including stints as CEO for Avera Health System in Sioux Falls, S.D., and COO of Passy-Muir in Irvine, Calif., according to a press release. As president, Williams is responsible for the Convaid and R82 brands in North America, and will report directly to CEO Torben Helbo. "Ryan is a dynamic, results-orientated leader with over 20 years of experience in healthcare and has a proven record of success in building strong teams,” stated Helbo.

Cure Medical launches new website

NEWPORT BEACH, Calif. - Cure Medical has launched a new website, curemedical.com, to highlight its expanded portfolio of intermittent and enclosed system catheters. The site will also feature customized content for customers, medical professionals and HME providers. Visitors to the site will find product videos, downloadable product flyers and a catalog, a support program for catheter users, lifestyle advice and medical research updates. “Everything we do at Cure Medical is centered on providing quality care for the people we serve,” said CEO John Anderson in a press release.

VGM ready to retail

WATERLOO, Iowa - VGM has leased a retail storefront to create a Retail Training Lab at the upcoming Heartland Conference. Located across from the convention center, the 1,100-square-foot showroom will feature healthcare products and display ideas. VGM's online marketing agency, Forbin, will also be in the showroom discussing online marketing tactics and trends to help providers reach their target audience. “We're proud to enhance Heartland Conference attendees' experience by offering this innovative, hands-on approach to learning,” said VGM's Director of Retail Programs Rob Baumhover. “The showroom will be designed as an ideal retail store, providing a unique platform to highlight opportunities for our members to strengthen their retail program.” The training lab will be open throughout the conference, which takes place June 12-15 in Waterloo, Iowa.

Fall show on 'track'

ATLANTA - Booth sales for Medtrade, which takes place Oct. 23-26 at the Georgia World Conference Center, are on track, show organizers say. Exhibitors such as Tennessee-based ramp manufacturer American Access are returning after a two-year absence, ready to tap into renewed industry optimism, according to a press release. “After the positive vibe from Medtrade Spring and renewed hope for regulatory change in Washington, we are optimistic,” said Kevin Gaffney, group show director, in the release.

Maine providers score 'win'

AUGUSTA, Maine - MaineCare will return to the 2015 Medicare fee schedule on May 1, according to a bulletin from the Home Medical Equipment and Services Association of New England (HOMES). Additionally, the rates will not be affected by the federal match reduction in the 21st Century Cures Act. "This is a huge win for our Maine members," said Karyn Estrella, HOMES President and CEO. "These companies have been struggling for the past year because of the national roll out of competitive bidding rates.”

Short takes: Studies on COPD, CPAP

When it comes to encouraging people with COPD to exercise, a mobile phone app with dialogue support works best, according to a study published in the Journal of Medical Internet Research. As part of the study, researchers reviewed three prototypes for mobile apps using different persuasive technology: dialogue support, primary task support and social support. They assessed opinions on these prototypes through 28 interviews with COPD patients, caretakers and healthcare professionals, and through 87 questionnaires completed by COPD patients. Generally, researchers found that the prototypes for mobile apps were received positively, and more specifically, they found that the prototype using dialogue support was most likely to be used or recommended by those interviewed. “Dialogue support and primary task support are considered to be both acceptable and likely to be persuasive by (COPD patients),” the study stated. “In the future, these approaches should be considered when designing apps to encourage physical activity by (COPD patients)”�Technological interventions like changes in masks, modes and pressures can help to re-initiate CPAP use, according to a study published in the Journal of Respiratory Care. Researchers found technology related problems due to mask discomfort/leaks, pressure intolerance, and residual breathing events were associated with CPAP failure in subjects seeking second opinions. But with the application of re-titration of PAP protocol (REPAP), 72% of subjects re-initiated CPAP use.