In brief: CMS increases MA payments, Resmed launches HSAT, Diabetes Atlas sparks action
By HME News Staff
Updated 8:48 AM CDT, Wed April 9, 2025
WASHINGTON – Payments from the government to Medicare Advantage plans are expected to increase, on average, by 5.06% from 2025 to 2026.
This is an increase of 2.83% since the CY 2026 Advance Notice, largely attributable to an increase in the effective growth rate.
In its April 7 Calendar Year 2026 Rate Announcement for the Medicare Advantage and Medicare Part D Prescription Drug Programs, CMS explained:
The method for setting the effective growth rate is set in statute and represents the average expected change in the benchmarks, used to determine payment for MA plans, based on the growth in Medicare per capita costs. The effective growth rate is 9.04%, which is higher than the estimate of 5.93% in the CY 2026 Advance Notice. This change is primarily due to the inclusion of additional data on fee-for-service (FFS) expenditures, including payment data through the fourth quarter of 2024, which was not included on account of the early Advance Notice publication.
Also in the payment policy update:
- In CY 2024, CMS initiated a three-year, phased-in approach for removing the medical education costs — related to services MA enrollees receive — from the historical and projected expenditures supporting the FFS costs that are included in the growth rate calculations. For CY 2026, CMS will complete the phase-in of the technical adjustment by applying 100% of the adjustment for MA-related medical education costs.
- CMS is also completing a three-year phase-in of improvements to the MA risk adjustment model that the agency finalized in the CY 2024 Rate Announcement, with the first year of the three-year phase-in starting with CY 2024. CMS is committed to expanding access to affordable, high-quality care through Medicare Advantage, while also implementing measures to safeguard beneficiaries and taxpayers from waste, fraud, and abuse. These ongoing improvements support a sustainable program that benefits both current and future Medicare recipients.
The CY 2026 MA and Part D Rate Announcement may be viewed at https://www.cms.gov/files/document/2026-announcement.pdf.
A fact sheet discussing the provisions of the CY 2026 Rate Announcement can be viewed at https://www.cms.gov/newsroom/fact-sheets/2026-medicare-advantage-and-part-d-rate-announcement.
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Related: CMS on April 4 released a final rule for Medicare Advantage.
Persante buys Sleep Management Services
MOUNT LAUREL, N.J. – Persante Health Care has acquired Sleep Management Services, which provides sleep care solutions to more than 15 hospitals in Arkansas and Texas.
As a result of the deal, Persante now operates across 85 hospital-based centers, ambulatory facilities and systems, providing in-lab and home sleep studies to more than 125,000 patients annually.
“This acquisition represents a major leap forward in our mission to deliver innovative, high-quality sleep management solutions nationwide,” said Vyto Kab, CEO of Persante Health Care. “We are reinforcing our role as the go-to partner for hospitals striving to improve patient health and streamline operations. With a strong recurring revenue model, and an expanding presence in the country’s most densely populated health care markets, Persante is poised for continued growth and innovation in the sleep management sector.”
Funding for the acquisition was provided by Peninsula Capital Partners, a Detroit-based private investment firm.
Resmed launches HSAT across US
SAN DIEGO – Resmed has announced that its home sleep apnea test, NightOwl, is now available across the U.S.
The test, which is cleared by the U.S. Food and Drug Administration, is designed to offer health care providers a simplified, accurate and efficient way to diagnose obstructive sleep apnea from the comfort of an individual’s home, the company says.
“Now more than ever, people want health care experiences that are easy, convenient, and accessible; however, navigating sleep apnea testing can be complex,” said Carlos M. Nunez, M.D., chief medical officer at Resmed. “With NightOwl, people can easily complete a sleep apnea test from the comfort of home using just a fingertip sensor and a smartphone. It also simplifies the process for providers. This is a meaningful step forward in Resmed’s mission to deliver life-changing health technology that people love.”
Resmed says NightOwl is a disposable HSAT device that:
- Records up to 10 nights of sleep data for a single patient, capturing night-to-night variability and providing clinicians with a comprehensive view of an individual’s sleep patterns.
- Sends sleep data remotely to a cloud-based diagnostic platform for physician analysis and review, enabling quick interpretation, streamlining diagnostic workflows and helping individuals receive more timely diagnoses, if applicable.
Diabetes Atlas should ‘spark action’
BRUSSELS – Nearly one in nine adults are now living with diabetes globally, and of these, an estimated 252 million are not yet aware they have the condition, placing them at higher risk of serious complications and early death, according to the International Diabetes Federation’s new Diabetes Atlas.
"The new data provides strong evidence that should spark action and promote initiatives to improve the lives of the many millions now living with diabetes and encourage more to detect diabetes in those at risk," said Professor Dianna Magliano, who chairs the IDF Diabetes Atlas Committee along with Professor Edward Boyko.
First published in 2000, the Diabetes Atlas offers insights into the impact of diabetes at national, regional, and global levels, based on the best available evidence. The 11th edition reflects new methodologies that incorporate trends in health expenditure, regional prevalence rates, and a focus on undiagnosed diabetes.
Other findings from the Diabetes Atlas, which was released at the IDF’s World Diabetes Congress in Bangkok, Thailand:
- 589 million adults (20-79 years) are living with diabetes globally, more than the population of the U.S., Canada, Mexico and the Caribbean combined.
- The estimated number of adults with diabetes is projected to reach 853 million by 2050.
- 3 in 4 adults with diabetes live in low- and middle-income countries (LMICs).
- Diabetes is responsible for more than 3.4 million deaths annually.
- 1 in 8 adults are at high risk of developing Type 2 diabetes.
- 1.8 million children and young adults under 20 are living with Type 1 diabetes.
As the number of people living with diabetes continues to rise, the Diabetes Atlas emphasizes the urgent need for improved prevention, early detection and intervention to tackle the burden diabetes places on individuals, communities, health systems and economies. In 2024, global diabetes-related health expenditure surpassed $1 trillion for the first time, up from $966 billion in 2021.
To read the Diabetes Atlas in full, go here.
Glucotrack, OneTwo Analytics AB seek to 'revolutionize’ diabetes management
RUTHERFORD, N.J., and STOCKHOLM – A new agreement with OneTwo Analytics AB will allow Glucotrack to leverage next-generation artificial intelligence and machine learning-based analytics to evaluate clinical study data from its continuous blood glucose monitors. “OneTwo Analytics are experts in simplifying complex diabetes data to generate simple, clear insights empowering clinics, health care professionals, and individuals with diabetes to make better informed decisions,” said Paul V. Goode, PhD, president and CEO of Glucotrack. “We are excited to leverage their substantial analytics experience to identify, assess and quantify the potential long-term benefits of the CBGM technology. We are committed to building on our robust suite of preclinical and in silico data by utilizing their comprehensive analytical and AI assessment tools, thereby ensuring our ability to deliver a disruptive, high-quality glucose monitoring solution to people with diabetes.” The CBGM, a long-term implantable device with no on-body external component, is designed to provide three years of continuous, accurate blood glucose monitoring. The companies say the partnership will help to develop a “truly end-to-end solution” for both health care providers and patients. “We are excited to expand our efforts through the development of a comprehensive ecosystem that combines blood glucose insights, risk stratification data, patient engagement tools, and actionable clinical dashboards,” said Steven Pusterla, chief commercial officer of OneTwo Analytics. “Together, we aim to revolutionize diabetes management and improve care for the millions of people navigating life with diabetes every day.”
Philips to lay off warehouse workers
PITTSBURGH – Philips Respironics will lay off 14 workers at a facility in Westmoreland County starting May 23, according to a Worker Adjustment and Retraining Notification Act (WARN) notice filed by the company. The positions being eliminated include warehouse operators, managers and coordinators, and an analyst. “We’re implementing this action in line with all local requirements and are supporting the impacted employees,” said Mario Fante, global external relations director, in an email to the Pittsburgh Post-Gazette. “Philips Respironics continues to have a substantive footprint in Western Pennsylvania, which remains a strong development hub for the Sleep & Respiratory Care business.” Last year, Philips Respironics cut 300 manufacturing jobs in Western Pennsylvania and relocated about 500 workers from its Pittsburgh headquarters to its two major plants in the nearby suburbs. At the time, it said it would continue manufacturing through a “third party” outside of the region.
Health-E Commerce offers CPAP alternative
DALLAS – Health-E Commerce has launched a new telehealth collaboration with Daybreak to make sleep apnea testing and treatment available at the FSA Store and HSA Store. Participants will receive a convenient at-home sleep test that is analyzed by the Daybreak’s team of board-certified physicians. If treatment is needed, the company will send an at-home impression kit and corresponding shipping materials. Once the completed impression kit is returned, it takes two to three weeks for a custom-fit, oral treatment device to be delivered. "This is a big win for individuals who experience snoring and sleep apnea and who are looking for an alternative to a CPAP device for treatment,” said Keri Kaiser, chief revenue officer for Health-E Commerce. “Quality sleep is a cornerstone to good health and wellbeing, and by adding Daybreak to our telehealth category on FSA Store and HSA Store, we are giving consumers another trusted option for improving sleep quality and their overall health – all while using tax-free FSA and HSA funds.” Individuals who purchase Daybreak through FSA Store or HSA Store will receive 50% off their home sleep test and $150 off their custom-fit sleep apnea treatment. Health-E-Commerce is the parent brand to the FSA Store and HSA Store.
Doc pleads guilty to telehealth scheme
ST. LOUIS – Dr. Scott Taggart Roethle, 47, pleaded guilty in U.S. District Court in St. Louis to one count of health care fraud for conspiring with health care companies and others to order medically unnecessary durable medical equipment, pain creams and genetic tests for thousands of patients in exchange for hundreds of thousands of dollars in kickbacks. From 2017 until 202, Roethle contracted with multiple health care companies as a telemedicine doctor. Using electronic portals to review patient information and documents, Roethle ordered health care services for patients without evaluating them or their actual medical needs. He did not have a prior doctor-patient relationship with the telemedicine patients and admitted providing no follow-up care after ordering the health care services. Roethle was typically paid about $30 for each of his fraudulent orders. He admitted receiving payments of $674,000 from five companies. He also admitted that Medicare paid out at least $1.5 million while relying on his fraudulent orders. At the time of Roethle’s sentencing, the U.S. Attorney’s Office will argue that the total loss due to the health care fraud is between $7 million and $9.5 million. Roethle was licensed to practice in 22 states during the time of his crime and worked primarily as an anesthesiologist.
BOC wins award for customer service
OWINGS MILLS, Md. – The Board of Certification/Accreditation is a winner in this year’s Stevie Awards for Sales & Customer Service, its 12th award since 2013. BOC won a Bronze Stevie Award for Sales & Customer Service in the “Best Use of Thought Leadership in Customer Service” category, which recognizes organizations that excel in leadership by sharing valuable knowledge and insights with customers, enhancing their experience through thought-provoking and educational content. “We are incredibly proud to receive this award for thought leadership in customer service,” said BOC President & CEO Judi Knott, MA, MBA, CAE. “This recognition reflects BOC’s unwavering commitment to excellence and prioritizing our customers. By staying attuned to industry trends and using feedback tools like our Net Promoter Score survey, we create content that drives our customers’ success. As a result, they can trust BOC as a dedicated partner committed to advancing their knowledge and expertise.” The Stevie Awards for Sales & Customer Service are the world’s top honors for customer service, contact center, business development and sales professionals. They organize nine of the world’s leading business awards programs, which also include the American Business Awards and International Business Awards.
Short takes: NCART, Pride Mobility
NCART hosted two days of meetings with legislators in Salem, Ore., to advocate for two bills related to right-to-repair and prior authorizations. Along with Wayne Grau, executive director of NCART, representatives from Bellevue Healthcare and National Seating & Mobility attended. “The group that attended did a great job educating members of the Oregon legislature about the issues with both bills,” Grau said. “Legislators often lack an understanding of the complexity of our industry and the services we provide to patients. We must help them understand why bills can have a positive or negative effect on their constituents. I was very proud of the group; they did a fantastic job”...Pride Mobility has launched the Victory Platinum scooter, its second in the Platinum line. Features of the scooter include EZ Turn, the company’s patented, tight-turning technology, which allows the four-wheel scooter to turn like a three-wheel scooter; Charge360, its magnetic charging technology; one-hand tiller adjustment; and full front and rear suspension. FMI: www.pridemobility.com.
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