In brief: Bid surety requirement, ostomy white paper, Inc. 5000

WASHINGTON – Medicare’s bid surety bond requirement did not have a negative impact on small supplier participation in Round 2021 of the competitive bidding, says the Government Accountability Office in a new report. 

For the report, “Effect of New Bid Surety Bond Requirement on Small Supplier Participation in the Competitive Bidding Program,” the GAO reviewed CMS’ data on supplier bids and contracts, and interviewed two DME trade organizations, including AAHomecare, and six small DMEPOS suppliers. 

The GAO analysis only includes moved off-the-shelf (OTS) back braces and OTS knee braces competitions for Round 2021, the only two categories CMS moved forward. 

In a summary from AAHomecare, the GAO found that 383 small suppliers submitted a total of 2,318 bids in all 235 competitions in Round 2021. Small suppliers represented about 60% of total suppliers that submitted bids for the two product categories and 58% of the small suppliers were awarded contracts. In the previous five competitive bidding rounds, small suppliers represented a range of 49% to 63% of bidders and 46% to 63% of the small suppliers were awarded contracts. In the previous five rounds, CMS met the small supplier participation goal in 38% to 97% of competitions.  

The GAO also found that for Round 2021, 27% of small supplier bids lost on price and about 21% were disqualified. 

AAHomecare and other industry stakeholders support the bid surety bond requirement, saying it protects the integrity of the bidding program. 

Ostomy stakeholders develop white paper 

WASHINGTON – A customized approach is needed to ensure the needs of individuals with ostomy are successfully managed, according to a new white paper published by a group of stakeholders to educate payers and state Medicaid programs. 

The white paper, developed by AAHomecare, United Ostomy Associations of America, Inc., United Spinal Association, Wound Ostomy and Continence Nurses Society, and Wound Ostomy and Continence Nursing Certification Board, addresses the variables going into managing each person’s ostomy needs, the role of the HME provider, the risks of improper management, and the value of managing ostomy with sustainable reimbursement. 

An estimated 725,000-1,000,000 individuals in the United States are currently living with an ostomy. HME providers work closely with the clinical community and end users to deliver appropriate supplies and provide education and services to people living with an ostomy in a cost-effective, homecare setting. However, continued reductions to reimbursements for ostomy supplies jeopardize access to ostomy supplies and services and increase the risk of adverse health outcomes, which increase costs to the payer and/or health system. 

“Although it is understandable that state Medicaid, as well as federal Medicare spending programs, are under extreme pressure to control costs while still providing quality outcomes, investments in quality ostomy products are crucial and will ultimately assist in controlling these costs and improving patient outcomes,” said Kate Lawrence, MSN, RN, CWOCN, public policy and advocacy coordinator for WOCN. “It is imperative that we continue to educate and advocate on behalf of patients requiring necessary life-saving products and services.” 

Lawmakers urge VA to drop finger stick requirement 

WASHINGTON – Sens. Jeanne Shaheen, D-N.H., and Susan Collins, R-Maine, along with Reps. Diana DeGette, D-Colo., and Tom Reed, R-NY., Co-Chairs of the Senate and Congressional Diabetes Caucuses, sent a letter to Secretary of Veterans Affairs Denis McDonough urging the VA to stop requiring veterans to use the medically unnecessary four finger stick tests prior to initiating continuous glucose monitoring (CGM) therapy. 

In their letter, the lawmakers highlighted their successful call earlier this year to CMS to remove the burden of this test on Medicare beneficiaries. They called on the VA to make a similar change to its criteria to ensure more veterans can access this convenient and lifesaving diabetes management and care technology. 

“We appreciate the on-going efforts of the Veterans Health Administration to provide more efficient and effective health care services to our growing veteran populations,” wrote the Co-Chairs. “While the agency has made good strides toward that end, we also are concerned about achieving greater parity between federal health programs to ensure that our veterans enjoy the benefits afforded to Medicare beneficiaries.” 

MedSupply launches full-service CRT program 

FRESNO, Calif. – MedSupply has launched MedSupply Mobility Solutions, a full-service complex rehab, seating, positioning and mobility program. 

MMS delivers custom mobility equipment, which includes manual and power wheelchairs, adaptive seating and positioning systems and devices requiring evaluation, fitting, configuration, adjustment or programming. Every piece of specialized equipment is custom-made to optimize their customers' function and independence. 

"Our goal is to provide tailored mobility equipment paired with unmatched service to our customers so they can achieve the greatest level of independence," said Verne Nielsen, ATP and director of mobility and complex rehab. "I'm excited to build and grow this special program at MedSupply, a company like no other place I've worked at. Here, the team is compassionate and always goes the extra mile for the families and facilities we serve." 

MedSupply is a provider of medical equipment and supplies specializing in negative pressure wound therapy (NPWT), low air loss mattresses, advanced wound care supplies and complex rehab mobility in the acute and post-acute market. 

MedSupply is currently focused on the West Coast, with plans to expand into additional markets in 2022. 

F&P provides FY2022 trading update 

AUCKLAND, New Zealand – Fisher & Paykel Healthcare reported revenue of $583 million for the first four months of its financial year 2022.  

Seventy-four percent of that revenue came from F&P’s hospital group during the four-month time period, which ended July 31. Constant currency revenue was 3% below the prior comparable period. This consisted of a 13% decline in hardware sales, partially offset by 2% growth in consumables.  

The company’s hospital consumables sales continue to reflect the clinical practice shift from invasive ventilation toward the use of Optiflow nasal high flow therapy, as demonstrated by new applications consumables growth of 17% in constant currency. 

In the company’s homecare product group, constant currency revenue was 4% above the prior comparable period, with 4% growth in obstructive sleep apnea masks. 

The company isn’t providing guidance for FY2022, due to continued uncertainty around the COVID-19 pandemic, say company officials. 

“With the ongoing global vaccination activity, and most countries now having experienced a COVID-19 hospitalization surge resulting in a corresponding boost in hospital treatment capacity, we do not expect our Hospital hardware revenue to continue at this elevated level for the remainder of the financial year,” said Lewis Gradon, managing director and CEO. “In our homecare product group, growth in OSA masks is dependent on new patient diagnosis rates, which we currently expect will continue to be at or above FY21 rates for the remainder of the 2022 financial year.” 

QIC demonstration to wrap by year end 

WASHINGTON – The Qualified Independent Contractor (QIC) will begin winding down the demonstration that ends December 31, 2021.  

The demonstration project allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases. Providers are being asked not to delay in returning participation forms or documentation. 

The Medicare Councils will be convening a workgroup to put together communications to CMS on the concerns over the demonstration ending that for the most part has been beneficial for all providers, according to a bulletin from MAMES. 

The demonstration was originally launched in 2016 by Jacksonville, Fla.-based C2C Innovative Solutions. 

In 2018, CMS awarded the contract to Reston, Va.-based Maximus, leading to a protest from from C2C, which it ultimately lost.  

Tomorrow Health taps former Uber exec as COO 

NEW YORK – Tomorrow Health has named Rodrigo Arévalo as chief operating officer.  

Arevalo has many years of operational experience, including a stint as general manager at Uber in Mexico where he was responsible for launching and scaling Uber’s ride sharing operations in that country. Arévalo has a wealth of knowledge on scaling complex systems and problem solving to grow quickly and sustainably, building complex technology enabled operations in multi-sided marketplaces. 

“I like to solve hard problems,” he said. “The harder it is, the more fun I tend to have. Solving healthcare in the United States has to be one of the most difficult problems out there. At Tomorrow Health, we’re re-architecting the home-based care ecosystem by building a platform to holistically streamline the coordination and management of quality home medical equipment, supplies and services.”  

Arévalo is the latest hire for Tomorrow Health from a high-profile tech company. In June, it tapped Amazon’s Krishnakumar Rajagopalan as head of engineering. Other hires include Warby Parker alum Kevin Rath as head of customer experience and Flatiron Health alum Shivani Stadvec as head of marketing. 

Inc. 5000 pros: Prochant, Proactive 

NEW YORK – Prochant, a technology-driven healthcare reimbursement firm, for the first time has landed on the annual Inc. 5000 list of fastest-growing companies. The company ranked 3,243 and had a three-year growth rate of 112%. “We are proud to be included on the Inc. 5000 list, as it’s a testament to the commitment and passion of our entire team,” said Mathew Mammen, CEO. “Non-acute care providers – including home medical equipment, specialty, and infusion pharmacy providers – are playing a critical role in transforming U.S. healthcare to improve health outcomes while also lowering costs. Our innovative, technology-driven services enable providers to outsource key revenue cycle functions, so they can enhance financial performance while improving overall patient care.”… Proactive Medical Products, a manufacturer of medical products, ranked 1978 with a three-year growth rate of 224%. “Proactive Medical Products is honored and humbled by our customers continued support, loyalty and trust to deliver high quality medical products,” said Brian Goldstein, CEO. “It is because of them that Proactive Medical has been able to achieve this prestigious honor two consecutive years. This accomplishment and recognition is shared with all the hardworking, dedicated and innovative employees at the Proactive Medical family." 

Permobil nabs top honors 

NASHVILLE, Tenn. – Permobil has been awarded top 2021 Mobility Product awards for three new products. The ROHO Hybrid Select cushion (Skin Protection & Positioning, Adjustable wheelchair seat cushion), 2021 M5 Corpus power wheelchair (Wheelchairs, Power: Group 4, All Types); and MyPermobil app (Smart Technology). As technology evolves, we are innovating alongside it, and we were thrilled to have the MyPermobil app with Voice Assistant recognized for the new award category of Smart Technology,” says Chuck Witkowski, president of Permobil Americas. “For individuals with limited use of their hands, navigating a smartphone can be a challenge. But our app now responds to a user’s voice and empowers them with real-time wheelchair insights while they at home or on the go with their Amazon Alexa or Google Assistant enabled device or app. The Mobility Product Awards, given out by Mobility Management magazine, honor exceptional product and technology development. 

Soleo Health throws support behind infusion bill 

FRISCO, Texas – Soleo Health has announced its “strong” support of S.2652, The Preserving Patient Access to Home Infusion Act. Introduced by Sens. Mark Warner, D-Va., and Tim Scott, R-SC, the legislation seeks to ensure patients’ access to life-saving home infusion therapy by providing appropriate reimbursement for such professional services. “Enactment of S.2652 would allow us to continue to deliver the high levels of quality care and deep clinical expertise to which our patients and their physicians have come to rely upon,” said Drew Walk, CEO. “We thank all parties who advocated for this bill, including the National Home Infusion Association. These efforts bode well for patient care, which is clearly of the utmost importance.” 

NCPA announces sophomore class for DPP program 

ALEXANDRIA, Va. – The National Community Pharmacists, in collaboration with the Association of Diabetes Care & Education Specialists and OmniSYS, has announced that 30 neighborhood pharmacies have been selected to receive training and financial support to become Centers for Disease Control and Prevention-recognized National Diabetes Prevention Program providers. The National DPP, launched in 2020, is a nationwide effort that created partnerships between public and private organizations to offer evidence-based, cost-effective interventions that help prevent or delay Type 2 diabetes. “Expanded pharmacy offerings show a commitment to the well-being of your patients and your community; they can quite literally change the trajectory of peoples’ health journey,” said Brian Caswell, NCPA president and owner of Wolkar Drug in Baxter Springs, Kan. “It’s great that so many pharmacies are eager to participate in the National Diabetes Prevention Program and make these important lifestyle change services accessible to their patients.” 

VA employee pleads guilty to CPAP scheme 

ATLANTA – Kevin Rumph Jr., a Department of Veterans Affairs employee, has pleaded guilty to using his department-issued credit card to buy more than $1.9 million worth of CPAP equipment between 2013 and 2021, which he then stole and sold. Rumph worked in the VA’s Prosthetic Department at its Community Based Outpatient Clinic (CBOC) located at Fort McPherson in Atlanta, where his duties included purchasing a wide variety of medical equipment. Rumph used his government-issued purchase card to make unauthorized purchases of CPAP supplies from a supplier in Alabama which he then sold to a vendor located in Ohio. “As a VA employee, Rumph’s job was to serve those who served and protected our nation,” said Acting U.S. Attorney Kurt R. Erskine. “His greed was a betrayal of trust that deprived veterans of the scarce resources needed by them to live productive lives.” Sentencing is scheduled for Nov. 17. 

No joy for provider who pled guilty to fraud 

HATTIESBURG, Miss. – Joy Beth Harden has pleaded guilty to one count of health care fraud. She was charged with submitting bills to Medicare and other health benefits programs since 2016 for DME that was neither prescribed nor delivered to patients, for her business, BZB LLC, doing business as Duracare Home Medical Equipment. Harden, who will be sentenced Nov. 23, 2021, faces a maximum penalty of 10 years in federal prison and a $250,000 fine.  

CMS updates: TPEs to restart, comments sought on enteral NCD 

CMS announced last week that DME MACs will be restarting the Targeted Probe and Education (TPE) program but did not provide a start date or any other information at this time…CMS is accepting public comments on removing the Enteral and Parenteral Nutritional Therapy National Coverage Determination, published in July in the 2022 Physician Payment proposed rule. The announcement comes after the DME MACs published a new Enteral Nutrition LCD and Parenteral Nutrition LCD that will go into effect Sept. 5.