In brief: Bills move forward, National HME makes buy, OIG reviews CGMs 

WASHINGTON – The House Energy & Commerce Committee on Dec. 6 approved an amended version of H.R. 5555 that extends the 75/25 blended rate in non-competitive bidding areas through 2024.  

The amended language does not, however, include the 90/10 blended rate adjustment for suppliers in former CBAs, according to a bulletin from AAHomecare.  

The Senate Finance Committee included similar 75/25 language from S. 1294 in a health package in November.  

“This is a very positive development for getting 75/25 blended rate relief extended for another year, but we need to keep the pressure on to make sure 75/25 relief is included in one of the upcoming appropriations bills," said Tom Ryan, president & CEO of AAHomecare. “AAHomecare will continue to engage key legislators and committee staff who will be negotiating what gets into those bills, and we’ll be letting HME advocates know when we need them to contact specific senators and representatives.” 

The Energy & Commerce Committee also passed an amended version of H.R. 5371, legislation that seeks to provide Medicare coverage for wheelchairs using titanium or carbon fiber materials. 

The amended version instructs CMS to establish new HCPCS codes for ultralight manual wheelchairs, including a separate code for titanium or carbon fiber. 

If the legislation is passed into law, this change should open up other payers other than traditional Medicare to cover these products, says AAHomecare. 

National HME buys Hospice Source 

IRVING, Texas – National HME, a provider of durable medical equipment and services to hospice and alternate sites of care, has acquired Dallas-based Hospice Source.  

The deal provides National HME with added capacity to offer best-in-class service and solutions to hospices and their patients across the United States. 

“We are thankful for the new health care provider relationships created through this acquisition and we are excited for the opportunity to provide exceptional services through our national platform and leading Hospice Cloud Pro technology,” said Jeffrey Waldman, chairman and CEO of National HME. “The entire National HME organization, along with our new team members from Hospice Source, who we are thrilled to welcome, are committed to enabling a comforting and compassionate patient experience.” 

Hospice Source, a provider of medical equipment to hospice patients and facilities, was founded in 1997. 

National HME welcomed Waldman as its CEO last year. 

Owens & Minor unveils purpose 

RICHMOND, Va. – Owens & Minor has unveiled a new statement of purpose, “Life Takes Care,” to capture the company’s approach to caring for both the business and the humanity at the heart of health care. 

This statement of purpose applies to all of Owens & Minor’s global business: the Products & Healthcare Services and Patient Direct business segments, as well as its affiliated brands, Apria, Byram and Halyard. 

“Owens & Minor has always been driven by a strong sense of the importance of the work we do behind the scenes for the patients, providers and communities we serve,” said Edward A. Pesicka, president & CEO. “Defining that sense of purpose in the statement Life Takes Care allows us to better harness the unstoppable collective strength, creativity and compassion of our teammates as we continue to move our business forward.” 

OM says it developed the new statement of purpose in response to the historic shifts affecting not only the company but also the health care industry, accelerating trends in where, when and how care is delivered. It says research shows that purpose-driven companies experience about 14% greater revenue growth and are nearly two times as likely to have above average returns. Research also shows they have reduced turnover, fewer safety incidents and increased profitability.  

The company developed “Life Takes Care” using teammate perspectives, as well as strategic insights from its leadership.  

To learn more about “Life Takes Care,” visit go here. 

• Read about the third quarter performance of OM's Patient Direct business. 

AAH backs NCART on power seat elevation 

WASHINGTON – AAHomecare has submitted comments to CMS supporting NCART’s recommendations for coding, coverage and payment regulations for power seat elevation systems. The recommendations, provided during a Nov. 30 virtual public meeting, include:  

• Adopting the code description proposed in the NCART code application. 

• Recognizing power seat elevation as a stand-alone system, the same as power tilt and/or power recline, and not merely an add on component. 

• Requiring any product that meets the description of power seat elevation to possess clinically relevant minimum performance characteristics. 

• Reconsidering the need for a separate HCPCS code for heavy-duty power seat elevation. 

“AAHomecare is proud to stand alongside NCART and other industry leaders who are working toward finally securing appropriate coverage and payment for power seat elevation,” the association stated in a bulletin. “We also appreciate the contributions of the ITEM Coalition, the Clinician Task Force and other advocacy groups who have provided input and support in securing coverage for this enabling technology.” 

See AAHomecare's complete comments here. 

Rehab Medical recognized for company culture 

INDIANAPOLIS – Rehab Medical has received a Better Business Bureau Torch Award for Ethics for building a culture of trust through clarity of purpose, empowering employees and creating opportunities for growth. As part of the recognition, the company highlighted its dedicated employee development and engagement team, which focuses on improving the lives of employees and expanding the company’s territories. “If we want to be a great business and we truly want to improve lives, it’s not just about delivering equipment, it’s about creating a great partnership with those we work with,” said Kevin Gearhart, president. “We want to create a great environment for our employees to come in and work. We want to improve their lives and we want them to be excited about working here and if we do that, we’re truly living our mission.” Since the launch of the employee development and engagement team, employees have been able to take advantage of four programs with focuses on core values, financial wellness, leadership development and mentorship. In the past three years, Rehab Medical has added a dozen new locations and landed a spot on the Inc. 5000 Fastest Growing Companies list. 

Option Care plans to complete stock repurchase in Q4 

BANNOCKBURN, Ill. – Option Care Health plans to complete the remaining $75 million of repurchases in the fourth quarter under an original authorization. In addition, the company’s board of directors approved an increase to its share repurchase program authorization from $250 million to $500 million. The program has no specified expiration date. During a call in October to discuss its third quarter earnings, Option Care said it had completed a repurchase of approximately $100 million in stock roughly equal to the $106 million breakup fee of its dissolved deal with Amedysis and had repurchased $175 million in stock year-to-date. 

OIG to review CGM payments 

WASHINGTON – The Office of Inspector General has added to its work plan a review of Medicare payments for continuous glucose monitors and sensors and how they compare to prices available to consumers. The agency will compare Medicare payments to supplier acquisition costs and prices otherwise available to consumers for selected CGMs and their sensors to determine if there are potential cost savings for Medicare and enrollees. In 2022, Medicare Part B allowed more than $1.1 billion in payments for CGMs and sensors. If the OIG finds that Medicare payments for CGMs greatly exceed their acquisition costs, then CMS has the authority to adjust payment rates for CGMs and sensors through two methods: It can adjust the fee schedule prices using its inherent reasonableness authority, or it can introduce an item into the competitive bidding program. 

Ascensia featured in film series 

PARSIPPANY, N.J. – Ascensia Diabetes Care is participating in a new film series featuring the story of patient advocate and Eversense user Troy Ita. The “Connecting the Dots” series, which brings into focus the evolution of medical technologies, includes Ascensia’s mini-documentary style video focusing on Troy’s journey with diabetes and how the evolution in continuous glucose monitoring technology has supported him to live a fuller, less interrupted life. In particular, the film highlights the transformation that Eversense, the only long-term CGM system, can deliver to people with diabetes, through the lens of Troy and his endocrinologist Dr. Rakesh Patel. “We are very proud to bring the benefits of long-term CGM system to people with diabetes and are always humbled by the impact it can have on people’s lives,” said Elaine Anderson, vice president of Global CGM and commercial operations, Ascensia Diabetes Care. “There is currently a lot to get excited about in the world of medical technology and we’d like to thank MedTech Europe for highlighting so many interesting perspectives in this film series.”  The series is presented by MedTech Europe and is produced for the organization by BBC StoryWorks Commercial Productions, the branded content studio of BBC Studios. The series is available on www.medtechconnectingthedots.com.  

Physician charged with receiving more than $13M in fraudulent payments 

SPOKANE, Wash. – Thomas Andrew Webster, M.D., of Sylvania, Ohio, has been charged by with one count of conspiracy to violate the Anti-Kickback Statue in connection with a fraudulent medical supply scheme that targeted elderly Medicare and TRICARE beneficiaries throughout Washington and in other states. According to charges announced by Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington, between May 2021 and September 2023, “Company A” allegedly engaged in a telemarketing scheme to obtain beneficiary identifying and medical information by using telemarketers to contact Medicare and TRICARE beneficiaries in the Eastern District of Washington and elsewhere. “Company A” allegedly used the information to create a fake medical record that reflected a doctor visit that never took place and medical orders for DME. Webster allegedly signed the fraudulent medical documentation and physician orders, which were then sold to DME companies that billed Medicare and TRICARE falsely and fraudulently. The charges allege that between May of 2021 and September of 2023, Medicare and TRICARE paid more than $13.7 million for DME fraudulently ordered and referred by Webster. These beneficiaries, which included many residents of the Eastern District of Washington, included individuals who had no desire or medical need for DME, individuals who had elected for hospice care and who, therefore, were not eligible to be treated for most types of illness or injury under Medicare, and individuals who lacked the limb for which the defendant placed the DME order because it had been previously amputated. 

WellSky survey: Majority of physicians don’t have established post-acute relationships 

OVERLAND PARK, Kan. – Seventy five percent of physician leaders do not have established partnerships with post-acute care providers, according to a new survey from WellSky. For those who do, communication between the clinicians and other caregivers takes place primarily over the phone, leading to a lack of visibility into their patient care. “Ambulatory care providers need a technology-driven approach to efficiently and effectively manage patients and influence their care transitions,” said Dr. Lissy Hu, president of connected networks at WellSky. “With WellSky’s comprehensive post-acute referral network, data analytics, patient choice tools, and closed loop referral capabilities, providers gain enhanced visibility into the entire patient journey enabling them to better coordinate care as patients move through the continuum.” While 86% of physicians surveyed receive an alert when their patients are admitted or discharged from a hospital, only 63% are notified when one of their patients is sent home from a post-acute facility, the survey found. This could be because 84% of respondents still rely on manual processes like phone calls to manage care transitions, WellSky says.