In brief: AdaptHealth leadership, Philips vents, catheter billing

PLYMOUTH MEETING, Pa. – Josh Barnes will step down as president of AdaptHealth on Aug. 31 and from the board of directors on Dec. 31, the company has announced. 

“Founding Adapt and helping it become the leading provider of HME is a source of immense pride,” said Parnes. “With Suzanne (Foster) as CEO, I am confident the company is in excellent hands and will continue to innovate, grow and deliver patient-focused best-in class care.” 

AdaptHealth also appointed Dale Wolf as chairman of the board effective July 1. Wolf has served on the company’s board since November 2019 and will assume the role from outgoing Chairman Richard Barasch.  

"I am thrilled to assume the role and look forward to working alongside Suzanne and her team to leverage the momentum in our business as we continue to improve the lives of millions of people who rely on us,” said Wolf. 

Additionally, Foster, who became CEO on May 20, has joined the board effective July 1. 

FDA, Philips address potential vent malfunction 

WASHINGTON – The U.S. Food and Drug Administration on June 27 highlighted updated use instructions from Philips Respironics for its BiPAP V30, BiPAP A30 and BiPAP A40 ventilators due to potential interruptions and/or loss of therapy. 

Philips has updated the use instructions for the vents due to a potential failure in the ventilator inoperative alarm, which can cause therapy interruption or loss. 

New instructions 

• If interruptions of therapy can be tolerated and the ventilator inoperative (vent inop) alarm occurs, the patient/caregiver will have instructions to remove the patient from the device and to place them on an alternative device. 

• If interruptions of therapy cannot be tolerated, the patients and caregivers are instructed to provide alternate ventilation AND contact the equipment supplier for immediate device alternative. 

The potential issue 

The vents may reboot intermittently for five to 10 seconds then restart with the same patient settings; reboot intermittently then restart with factory default settings; and enter a ventilator inoperative state after three reboots within 24 hours, or without a preceding reboot. These issues can result in therapy interruptions or loss, potentially leading to hypoventilation, hypoxemia, hypercarbia, respiratory failure or death in vulnerable patients, the FDA says. 

The impact 

There have been 952 reported injuries and 65 reports of death, it says. 

Philips statement 

Philips noted that, while there have been reports of potential patient harm, investigation of these reports could not conclusively determine the cause. The company also noted that customers may continue to use their system in accordance with instructions for use and the field safety notice. 

The company says it is currently investigating the issue and will implement appropriate actions. 

CMS seeks to exclude cath codes from program 

WASHINGTON – CMS has published a proposed rule to address significant, anomalous and highly suspect (SAHS) billing activity within the Medicare Shared Savings Program in response to an observed increase in DMEPOS billing for selected intermittent urinary catheter supplies in calendar year 2023. 

The agency says SAHS billing activity for codes A4352 and A4353, if not addressed, could adversely impact the accuracy, fairness and integrity of the program’s financial calculations. 

In the proposed rule, CMS proposes to exclude payment amounts for the two codes on DMEPOS claims submitted by any supplier from expenditure and revenue calculations used for: 

• assessing performance year (PY) 2023 financial performance of Shared Savings Program ACOs 

• establishing benchmarks for ACOs starting agreement periods in 2024, 2025 and 2026, and 

• calculating factors used to determine revenue status and repayment mechanism amounts in the application and change request cycles for ACOs applying to enter a new agreement period beginning on Jan. 1, 2025, or continue their participation in the program in PY 2025, respectively.  

CMS will accept comments on the proposed rule, “Medicare Program: Mitigating the Impact of Significant, Anomalous and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023,” until July 29, 2024. 

Comments can be submitted at: https://www.regulations.gov/. Refer to file code CMS-1799-P). 

Aeroflow Health launches telehealth nutrition counseling service 

ASHEVILLE, N.C. – Aeroflow Health has launched Aeroflow Nutrition Services, a telehealth service for personalized and group-based sessions with qualified dieticians. Aimed at patients with Type 2 diabetes, the services will help to simplify and support nutrition counseling and use the power of food to manage diabetes and reduce the risk of complications, the company says. “Food should always be a part of the discussion for patient treatment plans,” said Sophie Lauver, registered dietitian for Aeroflow Health. “What we eat is directly tied to our health outcomes. There is a lack of understanding about what foods are detrimental to our health, and this is where Aeroflow’s Nutrition Services will make a significant impact with education for patients, especially those looking to effectively manage type 2 diabetes. Nutrition education is paramount for patients managing any type of chronic disease. With individualized sessions and personalized treatment plans, patients can quickly make changes that will positively impact their health.” Aeroflow Health will offer the services virtually so patients can participate from the comfort of their homes. The company says the services will be available as a preventative care benefit, with little to no cost for most patients through insurance.  

BOC honors Chris Casteel 

OWINGS MILLS, Md. – The Board of Certification/Accreditation (BOC) has named Chris Casteel, BOCO, BOCP, co-owner of Anew Life Prosthetics and Orthotics in Detroit, as the recipient of this year’s Certificant of the Year Award. After overcoming his own obstacles following limb loss at the age of 24, Casteel has made it his mission over the past two decades to "pay it forward" by empowering others to live fulfilling lives with the help of O&P devices. "I am deeply honored to receive BOC’s Certificant of the Year Award,” said Casteel. “This recognition is a testament to the incredible support I have received from my colleagues, patients and community. My journey through limb loss and rehabilitation has been profoundly personal, and it has driven my passion to help others regain their mobility and independence. This recognition encourages me to continue advocating for O&P advancements and to remain dedicated to providing the best care possible for my patients and community.” In addition to his experience as a practitioner, Casteel has been a peer counselor for many years and hosts a monthly amputee support group that he initiated at the University of Michigan – a model that has now spread to other local hospitals. In 2010, he also volunteered in Haiti, where he donated his time, energy and knowledge of O&P to assist children and adults with disabilities who needed help following the region’s catastrophic earthquakes. The nomination period for BOC’s next Certificant of the Year award will open in the fall of 2024. Those eligible for the award include BOC-certified durable medical equipment specialists, mastectomy fitters, orthotic fitters, orthotists, pedorthists and prosthetists who have made outstanding contributions to their profession, including commitments to service, research and outreach. 

CMS to implement small increase for seat elevation systems  

WASHINGTON – CMS has agreed to increase reimbursement for seat elevation systems for power wheelchairs by $13.62 to $2,013.96, according to NCART. The agency will implement the change and provide instructions on submitting previously submitted claims for adjustment as part of its July DMEPOS fee schedule update, the organization says. Reimbursement of $2,000 for the new code E2298 went into effect April 1, 2024. On an interim basis prior to April 1, providers were being paid about $2,800, on average, for seat elevation systems. Stakeholders had recommended a rate of $3,450, on average. The change follows a meeting between CMS and stakeholders. Click here for CMS’s letter to Wayne Grau, executive director of NCART, about the change. 

Dynarex opens flagship warehouse 

MONTVALE, N.J. – Dynarex Corp. has opened an expansive new warehouse in the Town of Wallkill (Middletown), N.Y.  With easy access to New York State Route 17 and Interstate Highway 84 and just 14 miles from Stewart International Airport, the facility will serve as the company’s distribution center for the Northeast region. "This new warehouse is a shining example of our commitment to excellence and growth," said Dynarex CEO Zalman Tenenbaum. "The Town of Wallkill facility is more than just an addition to our network — it's our flagship warehouse and our e-commerce hub that will significantly boost our fulfillment capabilities across the Northeast region." The 450,000-square-foot facility, which features 36-foot ceilings and 22 high-level bay doors with full van access, is nearly quadruple the size of the company’s previous facility. It also features an advanced automated conveyor system to assist in receiving, selecting and shipping and to increase worker safety. Dynarex held a formal ribbon-cutting ceremony at the facility on June 24 that was attended by local dignitaries. 

Honest Medical incorporates ADA standards in updated website 

OCEANSIDE, Calif. – Honest Medical has updated its e-commerce website with thousands of health care products to make it more accessible for people with disabilities. The company made the updates in accordance with new Americans with Disabilities Act accessibility standards. “At Honest Medical, we believe everyone deserves equal access to the medical supplies they need to live healthy lives,” said CEO Mike Greenan. “That’s why we’re thrilled to announce these significant enhancements that ensure our website is fully compliant with ADA accessibility standards.” Features of the website include tagging elements with button functionality to aid assistive technology like text-to-speech screen readers; adding alt text to images and fields that describe meaning and context so those with visual impairments can enable assistive technology; improving menus and dropdowns to coordinate assistive technology; and scaling font sizes and increasing letter spacing to aid those with learning disabilities like dyslexia. The ADA standards outline best practices for making web content more accessible, including ensuring users can navigate a website using the keyboard rather than a mouse; having heading structure that enables users with accessibility tools to easily navigate a site; and making sure all images have captions. 

State update: Carelon transition delayed 

WASHINGTON – Carelon Medical Benefits Management will not review Medicaid prior authorization requests for DMEPOS in Maryland (Wellpoint), Missouri (Healthy Blue) and Wisconsin (Anthem) on July 1 as planned, AAHomecare reports. The transition has been postponed until further notice, according to the association. “Suppliers in Maryland, Missouri and Wisconsin should continue to follow the current process when requesting authorizations for DMEPOS services under Medicaid,” AAHomecare stated in a bulletin. The transition was originally announced on April 1. For state-specific announcements, please go to: 

Maryland 

Missouri 

Wisconsin 

Trella Health enhances CRM platform 

ATLANTA – Trella Health, a provider of market intelligence and CRM solutions to the post-acute care industry, has launched several new features in its Marketscape platform to streamline workflows, improve goal tracking and minimize administrative tasks. The company says this enables sales reps to maximize their field time, strengthen referral relationships and drive significant growth for their organizations. “We’re thrilled to unveil these new enhancements in our CRM; through continuous improvement and consistent innovations, we are dedicated to delivering solutions that boost efficiency, save valuable time and drive cost reductions,” said Kathy Ford, chief product officer at Trella Health. “Our mission is clear: to empower our customers and their go-to-market teams with the tools they need to strategically grow and achieve unparalleled success.” The enhancements include goal creation to track objectives more effectively; event templates to align strategy; enhanced calendar functionality to optimize workflow and market and sales spotlight to improve accessibility. Trella Health says the new meeting and event scheduling feature, for example, has resulted in a 41% decrease in time spent creating events and a 27% increase in saving events. 

Chiropractor admits to $14.9M Medicare scam 

NEWARK, N.J. - A Georgia chiropractor who owned or operated multiple DME companies and a cancer genetic testing (CGx) company has admitted her role in a health care fraud and illegal kickback conspiracy. Tefylon Cameron, 57, of Powder Springs, Ga., pleaded guilty on June 20, 2024, before U.S. District Judge Michael E. Farbiarz in Newark federal court to an information charging her with conspiracy to commit health care fraud and conspiracy to violate the Federal Anti-Kickback statute. According to documents filed in the case and statements made in court: 

Cameron and her conspirators owned, operated and had a financial interest in DME companies through which they obtained doctors’ orders for durable medical equipment, namely orthotic braces, for Medicare beneficiaries without regard to medical necessity. Cameron and her conspirators obtained DME orders using marketing call centers and telemedicine companies (including multiple Florida-based companies), caused the submission of false and fraudulent claims to Medicare and paid illegal kickbacks.   

Cameron and her conspirators also owned, operated and had a financial interest in a CGx company through which she agreed to provide a clinical laboratory with leads of beneficiaries who were qualified to receive federal health care benefits for cancer genetic tests. Cameron submitted invoices to the clinical laboratory seeking payment on a per-lead basis but entered into a sham agreement to disguise kickback and bribe payments. 

In total, Cameron and her conspirators caused a loss to Medicare of more than $14.9 million.