In brief: CMS opens NCD, Philips transitions leadership, ACU-Serve makes buy

WASHINGTON – CMS has opened the National Coverage Determination for seat elevation systems used with power wheelchairs, but the agency is not reconsidering coverage for power standing systems at this time. 

CMS said in May it would commit to re-opening the NCD, nearly two years after the ITEM Coalition submitted a formal request to reconsider the NCD for mobility assistive equipment to include coverage for these systems.  

“Now is the time for Medicare – the largest health care payer in the country – to finally cover power seat elevation in power wheelchairs for the benefit of Medicare beneficiaries with 3 mobility disabilities,” said Peter Thomas, co-coordinator of the ITEM Coalition and a principal at the Powers Law Firm. “We also urge Medicare to proceed expeditiously with a separate NCA for power standing systems to ensure that Medicare beneficiaries can access these necessary systems as well.” 

A recent forum hosted by the National Council on Disability drew more than 400 participants from the disability community. 

CMS' announcement also provided an update on the NCD status for standing systems used with power wheelchairs, noting that consideration of both seat elevation and standing systems "requires evaluation of two distinct groupings of evidence." That "benefit category and coverage of standing systems will be considered at a later date," according to an announcement from AAHomecare. 
  
"While AAHomecare and mobility stakeholders are pleased to see the seat elevation NCD opened, we remain committed to the belief that both power seat elevation and standing systems deserve to be evaluated—and covered—in a timely fashion," said Tom Ryan, president and CEO. "We are disappointed that CMS has delayed the NCD for standing systems and urge CMS to expedite consideration for power standing systems as soon possible. Medicare beneficiaries with significant disabilities and their caregivers shouldn't have to continue to wait for full access to these proven, life-enhancing products.” 

The ITEM Coalition has developed Rise4Access.org to help the public advocate for coverage.  

The comment period will be open through Wednesday, Sept. 14. Comments can be made here. 

Jakobs to take reins at Philips 

AMSTERDAM – Roy Jakobs is expected to take the helm at Philips, succeeding Frans van Houten as CEO. 

Van Houten is nearing the end of his third term as CEO. 

"It has been both a privilege and a pleasure to lead the transformation of Philips, over the past 12 years, into one of the largest health technology companies in the world, bringing innovative solutions to help our customers deliver on the Quadruple Aim of better health outcomes, higher healthcare productivity and much improved patient and staff experience,” said van Houten. “While I am proud of our many accomplishments, much remains to be done to enhance the resilience of Philips to manage through current setbacks and adverse market conditions.”  

Jakobs brings a strong international, operational and transformational track record, and has been successful in turning around businesses in customer-focused growth organizations. Since taking on responsibility for the voluntary recall notification/field safety notice for specific Respironics devices on behalf of Philips, substantial progress has been made under his leadership. 

"I am delighted to have the opportunity to lead Philips to improve people’s health and well-being through innovation,” said Jakobs. “I aim to build on the company’s strong foundation as a purpose-driven health technology leader with deep innovation and clinical expertise, to serve the needs of patients and consumers today and in the future.” 

An Extraordinary General Meeting of shareholders will be held on Sept. 30, 2022, to appoint Roy Jakobs as president and CEO, effective Oct. 15, 2022. van Houten will act as adviser to the company until April 30, 2023. 

ACU-Serve acquires ECS Billing & Consulting North 

AKRON, Ohio – ACU-Serve has acquired ECS Billing & Consulting North and founder Sarah Hanna will assume a role as vice president of consulting services at ACU-Serve. 

“I am excited about ECS becoming part of the ACU-Serve team. ACU-Serve and ECS share business and client values, keeping client service as our number one priority,” said Hanna. “This move provides not only our current client base, but all healthcare providers, access to a full suite of services and technology that sets us apart in the healthcare arena and makes ACU-Serve the elite provider of revenue cycle, consulting, and training services.”  

The acquisition brings ACU-Serve more than 30 additional U.S.-based employees, advanced consulting services and strong offshore resources. 

“Staffing shortages continue to be a crisis across this country and having the opportunity to add more staff to our team in addition to bringing in Sarah Hanna to build out our consulting division is very exciting,” said Jim Knight, CEO of ACU-Serve. “We look forward to continuing to support the HME Industry, various state, regional and national associations even more with our rapidly growing speaker and consultant network.” 

180 Medical marks two decades of service 

OKLAHOMA CITY, Okla. – 180 Medical, a national supplier of catheters and ostomy supplies, celebrates its 20th anniversary this month. 

The company was founded in 2002 by Todd Brown, who was paralyzed from the chest down in a motorcycle accident in 1994 and wanted to build a medical supply company that understood the needs of its customers. 

“It’s an honor and a joy to continue Todd’s mission for this company when he founded it twenty years ago,” says Mark Jassey, chief commercial officer. “Over the years, I’ve been able to witness much of this company’s growth, and it’s very humbling to realize just how many people we’ve helped over the years, thanks to Todd’s original vision.” 

180 Medical also gives back to the community and the country through volunteering, providing two annual scholarship programs for college students, and supporting hundreds of organizations and events over the years, including the OKASA Wheelchair Basketball Tournament, the Special Olympics, Feed the Children, and many more. 

It also offers personalized peer support through a team of patient advocates who provide encouragement, resources and care using their firsthand experience of living with a disability and using catheter supplies. 

NCPA: Labor woes lead to longer wait times 

ALEXANDRIA, Va. – More than three-quarters of community pharmacists say they are having a tough time filling open positions, resulting in higher payroll costs and longer wait times for patients, according to a new survey by the National Community Pharmacists Association.  

“Community pharmacies are small businesses, and even though they are affected by the same tough conditions that are battering the rest of Main Street, the biggest threat to their ability to continue to provide health care for consumers — by far — is from the heavy-handed business tactics of insurance-owned PBMs,” said B. Douglas Hoey, pharmacist, NCPA CEO. 

The result on labor conditions is barely changed from previous NCPA surveys, when roughly 79% and 70% of community pharmacists, respectively, said they were struggling to find workers. This year and last year, applicants for pharmacy technicians are in short supply: More than 88% of respondents this year said finding pharmacy techs was their No. 1 problem, followed by front-end staff at 56%.  

Roughly 73% of respondents say they’re dealing with the labor shortage by offering higher wages and benefits. Fifty-four percent say fewer hands means it’s taking longer to fill patient prescriptions.  

An overwhelming majority (93%) of community pharmacists say inflation is affecting their businesses. Unlike most other small businesses, which can pass on higher costs to consumers in the form of higher prices, pharmacies can’t raise prices on medicines because health insurance companies dictate the pricing.  

“The cost of drugs is determined by big insurance companies and their pharmacy benefit managers,” said Hoey. “They decide how much pharmacies will be reimbursed for the prescriptions they dispense, and how much patients will pay for the drugs. Pharmacy reimbursements for most drugs is going down.”  

Indiana pauses prior auths for CPAP, BiPAP 

INDIANAPOLIS – The Indiana Health Coverage Programs (IHCP) has temporarily paused prior authorizations for continued use of respiratory assist devices, including CPAP and BiPAP, obtained through managed care programs, effective Aug. 1, 2022, to Jan. 31, 2023. The change is in response to continued impacts from a recall on Philips respiratory products. AAHomecare worked with the Great Lakes HME Association’s Medicaid committee and IHCP to make the case for pausing compliance requirements for continued use authorizations until PAP manufacturers can better meet demands for these products. Great Lakes leaders will seek an extension of the pause if it becomes clear that computer chip shortages and other supply chain constraints will still be limiting production of PAP devices—especially those with cellular compliance-tracking features—well into 2023.  

NSM launches consumer council 

NASHVILLE, Tenn. – National Seating & Mobility has formed the NSM Consumer Insights Council to provide valuable insight about trends, priorities and drivers affecting the complex rehab technology client experience. “Client experience is the heart of our business. Delivering a best-in-class client experience is as important as delivering a safe and quality mobility product or solution,” said Bill Mixon, CEO. “The mobility journey is not only unique to each person we serve, but it is also always evolving. The input from this council helps us to adapt to meet the needs and expectations of our clients.” The council is comprised of NSM clients and caregivers with personal experience in navigating the CRT industry, unique knowledge and a passion for the future of mobility solutions. Council members agree to participate in quarterly virtual meetings focused on roundtable discussions on prioritized topics.   

NCPA announces keynote speakers 

ALEXANDRIA, Va. – The National Community Pharmacists Association has announced the keynote speakers for its 2022 Annual Convention, set for Oct. 1-4 in Kansas City, Mo. The theme for this year’s convention is “Team Up! Where Teamwork Makes It All Work.” Mike Abrashoff, former commander of the USS Benfold and author of three books, is scheduled to speak during the First General Session on Sunday, Oct. 2. Abrashoff was the most-junior officer in the Pacific Fleet when he took command of the near-worst performing ship. Twelve months later, the USS Benfold was the best ship in the entire Navy – using the same crew. Will Flanary, MD, is scheduled to speak during the Second General Session on Monday, Oct. 3. Flanary is an ophthalmologist and comedian who moonlights in his free time as “Dr. Glaucomflecken” on social media to an audience of over 2.5 million. Effortlessly blending observational medical humor with biting satire, he has spent years entertaining health care professionals on a variety of topics including the horrors of health insurance. One of his latest bits skewers massive pharmacy benefit managers, the health care middlemen often condemned by independent pharmacists and many others. To learn about and register for NCPA’s 2022 Annual Convention, click here. More information is added as it becomes available.  

Quipt secures $80M in financing 

CINCINNATI – Quipt Home Medical has received a binding commitment letter from CIT Bank, N.A., a division of First-Citizens Bank & Trust Company, to provide 100% of senior secured credit facilities in the aggregate amount of up to $80 million, comprised of a term loan facility of up to $5 million, a delayed draw term loan facility of up to $55 million and a revolving credit facility in an aggregate principal amount of up to $20 million. “The commitment letter from CIT for up to $80 million of senior credit facilities is a major milestone which paves the way for us to accelerate our acquisition approach across all three tiers of our well-defined strategy. As always, we will continue to remain extremely disciplined with our capital allocation strategy maintaining a very healthy balance sheet with a conservative leverage structure,” said Greg Crawford, Chairman and CEO of Quipt. “Furthermore, we believe that the senior credit facilities further validate the strength of our business model which is yielding robust financial and operating results and will provide us the flexibility needed to be very agile as opportunities arise.” Closing is anticipated to occur within 30 days. 

Cardinal names new CEO 

DUBLIN, Ohio – Cardinal Health’s Board of Directors has elected Jason Hollar as the company's next CEO, effective September 1, 2022, succeeding Mike Kaufmann. Hollar has served as Cardinal’s CFO since May 2020. Prior to that, he held executive roles at Tenneco and Sears. “I sincerely appreciate the confidence the board has placed in me to help position the company for future growth,” said Hollar. “This is a transformational period at Cardinal Health and I am humbled to have the opportunity to lead a business that plays such a vital role in the healthcare ecosystem. I look forward to working closely with Cardinal Health's talented employees, management team, and Board as we continue to build upon our strong foundation and deliver value to our customers, communities and shareholders." Patricia English will serve as Cardinal Health's interim CFO, working with Hollar to ensure a smooth transition.  

Bradbury to succeed Pereda at IHCS 

MIRAMAR, Fla. – Integrated Home Care Services, an independent administrator of home health, DME and home infusion benefits, has named Christopher Bradbury as CEO. He succeeds Jorge Pereda, co-founder, who will now assume the role of chairman of the board. "After building successful companies throughout the last 30 years, I am excited to use my experience in a fully strategic capacity within IHCS," said Pereda. "For nearly a year, we had been searching for a dynamic leader to pass the CEO baton to and I could not be happier that we found Chris. His experience and proven track record of delivering better outcomes for patients, providers, and health plans will further position IHCS to take that next step forward and unlock our potential to serve customers on a national level." Prior to joining IHCS, Bradbury served as a senior vice president at CVS Health, where he led Aetna's commercial solutions and multi-billion dollar portfolio of specialty businesses. He also previously served as president of Aetna's North Atlantic territory, including commercial and Medicare. 

Northshore Care Supply begins clinical trial 

GREEN OAKS, Ill. – Northshore Care Supply, a provider and manufacturer of incontinence care products, has begun its first clinical trial in senior care facilities to test its premium products and challenge current care protocols that are typically in place, including required resident changes every two hours, even overnight. The constant changing of products can result in residents losing sleep. "Based on thousands of NorthShore's consumer customers with heavy to total incontinence who have experienced sound skin health while sleeping through the night over the years, we recognize that proving similar clinical outcomes in the senior living facility setting is needed and clinical trial data that will be generated is the key to NorthShore accessing the business-to-business market," says Jim Bogner, vice president of corporate strategy. Inferior incontinence products can also cause seniors to be susceptible to skin breakdown, whether those seniors reside in their own homes or in senior living facilities. 

VGM hosts latest installment in leadership series 

WATERLOO, Iowa – VGM Education will host a virtual women’s breakfast, “Preserving our Teams,” Sept. 14, featuring Amanda Schara, director of Outpatient Behavioral Health at UnityPoint-Allen Hospital in Waterloo and Kendra Richman, senior consultant in talent management and organizational development at UnityPoint. The two-hour session will provide leaders with guidance in navigating an ever-changing environment, says Cindy Diehl Yang, vice president of VGM Education. “As leaders, we need to navigate the waters of change in order to remain relevant,” she said. “Being agile and able to pivot as new opportunities arise are key components to preserving the strength of our teams.” The cost of this virtual presentation is $50 per attendee, with VGM members receiving a $10 discount. To register, go to https://live.vgmu.com and click on the Leadership Breakfast Series.  

Nexwear acquires ‘complementary’ Lily Bird 

Nexwear, a provider and manufacturer of adult incontinence products, has acquired Lily Bird, a national brand focused on women, bringing together two complementary product portfolios. “Lily Bird fits very well into our overall shared sense of purpose, securing continued access to high end innovative incontinence care products,” said Matthew Anderson, Nexwear CEO & founder. “This alliance, combining our strengths, allows us to better serve the needs of our customers and business partners bringing even more product innovation to market, faster.” Lily Bird maintains a diverse and engaged customer base, says founder Sydney Larson. “Our ‘customer first’ cultures are in superb alignment, and our teams complement each other exquisitely, too,” she said. “We are excited to join the Nexwear family and view this acquisition as a building block to better serve our customers.” The transaction was facilitated by Westbound Road, LLC, sell-side M&A advisers to Lily Bird. 

CQRC hails oxygen letter 

WSHINGTON – The Council for Quality Respiratory Care applauded the 22 bipartisan House lawmakers for urging the CMS to protect patients’ access to home oxygen. In a letter, spearheaded by Reps. Terri Sewell, D.-Ala., and Larry Bucshon, R.-Ind., to Department of Health and Human Services Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, they wrote in support of reforms to the home oxygen therapy benefit, and asked the agency to ensure that Medicare contractor documentation requirements are consistent and standardized though the use of a clear, objective template. “Particularly in the wake of a respiratory disease global pandemic, we have seen just how vital access to supplemental oxygen therapy is to keeping Medicare beneficiaries safe and stable at home,” said Crispin Teufel, Chair of CQRC. “We hope CMS takes action to protect patient access by ensuring every supplier is working from the same standardized template to confirm a patient’s medical necessity, and we thank Congress for their support.” 

Bedard Medical lands on Inc. 5000 list 

AUBURN, Maine – Bedard Medical has been named to the Inc. 5000 list of fastest-growing companies in America. The locally-owned and operated retailer ranked No. 3521. “We are honored to be recognized by Inc. as one of the fastest-growing companies in the US,” said Ben Nadeau, CEO of Bedard Medical. “Our growth is a direct reflection of our company mission statement: we care for the communities we serve. By continuing to invest in people, technology, and our market presence, we hope to meet the needs of even more communities in the years to come.” The companies on the 2022 Inc. 5000 have not only been successful, but have also demonstrated resilience amid supply chain woes, labor shortages, and the ongoing impact of Covid-19, says Inc. magazine. See the complete list here.