Home Article In brief: CMS to end CHOPD, Lincare CEO to lead CQRC 

In brief: CMS to end CHOPD, Lincare CEO to lead CQRC 

In brief: CMS to end CHOPD, Lincare CEO to lead CQRC 

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By HME News Staff

Updated 10:05 AM CDT, Wed June 19, 2024

WASHINGTON – CMS has announced that payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will conclude on July 12, 2024.  

Launched in early March, the CHOPD payments were designed to ease cash flow disruptions experienced by some Medicare providers and suppliers, such as hospitals, physicians and pharmacists, due to the unprecedented cyberattack that took health care electronic data interchange Change Healthcare offline in February.  

“In the face of one of the most widespread cyberattacks on the U.S. health care industry, CMS promptly took action to get providers and suppliers access to the funds they needed to continue providing patients with vital care,” said CMS Administrator Chiquita Brooks-LaSure. “Our efforts helped minimize the disruptive fallout from this incident, and we will remain vigilant to be ready to address future events.” 

CHOPD accelerated payments have been issued to more than 4,200 Part A providers, totaling more than $2.55 billion; CMS also issued 4,722 CHOPD advance payments, totaling more than $717.18 million, to Part B suppliers. 

Providers of services and suppliers are now successfully billing Medicare, and to date, CMS has already recovered over 96% of the CHOPD payments. After July 12, 2024, CMS will no longer accept new applications for CHOPD accelerated or advance payments. Any providers of services or suppliers that are having difficulty billing or receiving payment should contact Change Healthcare, owned by UnitedHealth Group, by visiting https://www.unitedhealthgroup.com/ns/changehealthcare.html and/or their Medicare Administrative Contractor (MAC). To find your MACs contact information, please visit https://www.cms.gov/mac-info. All new CHOPD program applications must be submitted from eligible providers and suppliers prior to that date. 

CMS will continue to monitor for other effects of the cyberattack on Medicare providers and will continue to engage industry partners to address any remaining issues or concerns. CMS encourages all providers of services and suppliers, technology vendors, and other members of the health care ecosystem to double down on cybersecurity, with urgency. Please visit the HPH Cyber Performance Goals website at https://hphcyber.hhs.gov/performance-goals.html for more details on steps to stay protected. 

CMS report: Health spending will rise 

WASHINGTON – CMS's Office of the Actuary projects that average annual growth in national health expenditures (5.6%) will outpace average annual growth in GDP (4.3%), resulting in an increase in the health spending share of GDP from 17.3% in 2022 to 19.7% in 2032. 

The NHE estimates discussed in the office’s new report contain expected effects from the Inflation Reduction Act of 2022 (IRA), including anticipated effects associated with the law’s provisions regarding the redesign of Medicare’s Part D drug benefit, negotiations on certain high-cost drugs under Medicare Parts B and D, and expected enrollment and spending trends related to its temporary extension of enhanced subsidies for Marketplace plans. 

The 5.6% growth rate in national health expenditures over 2023-32 is lower than in 2023 when NHE growth was projected to have been 7.5%, faster than GDP growth of 6.1%, reflecting broad increases in the use of care associated with an insured share of the population of 93.1% (an unprecedented high). 

Selected highlights on NHE spending by major payers include: 

  • Medicare: Average annual Medicare expenditure growth is projected to be 7.4% for 2023-2032. Over 2030-2032, Medicare spending growth is expected to be somewhat lower (7.0%), reflecting projected slowing enrollment growth after the last of the baby boomers (those born between 1946 and 1964) enroll in 2029.   

  • Medicaid: For 2023-2032, the average rate of growth for Medicaid spending is projected to be 5.2%. State eligibility redeterminations resumed in 2023 following the expiration of the Families First Coronavirus Response Act’s continuous enrollment provisions, and many individuals were disenrolled in 2023 (and more in 2024) as a result. After 2024, Medicaid enrollment is expected to stabilize as eligibility processes return to normal. 

  • Private health insurance: The average rate of growth for private health insurance spending over 2023-2032 is projected to be 5.6%. Enrollment gains in direct-purchase plans (which include Marketplace plans) are expected through 2025 related to the temporary extension of enhanced Marketplace subsidies and the Special Enrollment Period. Enrollment is projected to fall in 2026 when the enhanced subsidies expire under current law. 

  • Out-of-pocket: The growth rate for out-of-pocket spending is projected to average 4.7% during 2023-2032, impacted in part by the implementation of the $2,000 cap on Part D covered Part D enrollee prescription drug out-of-pocket expenses and lower gross prices on drugs subject to the IRA’s negotiation provisions that serve to lower out-of-pocket payments for people with Medicare prescription drug coverage. 

The report is published annually and is often referred to as the “official” estimates of U.S. health spending and health insurance enrollment. 

CQRC names Lincare CEO as new chairman 

WASHINGTON – The Council for Quality Respiratory Care recently named Jeff Barnhard, CEO of Lincare, as chairman of the board. “It is an honor to serve as the next chairman of CQRC,” said Barnhard. “In this role, I look forward to advocating for reforms to protect the delivery of care to home respiratory patients and the stability of our profession. I am excited to engage with stakeholders across our diverse community to promote a greater understanding of our patient population and advance policies that align with their clinical needs, including access to supplemental oxygen.” In addition to Barnhard, CQRC elected Perry Bernocchi, executive vice president of Owens & Minor and CEO of the company’s Patient Direct segment, as treasurer. It named Tim Pigg, formerly CEO of Rotech, as secretary. One of CQRC’s top priorities is the Supplemental Oxygen Access Reform (SOAR) Act (S. 3821/H.R. 7829), bipartisan legislation to remove supplemental oxygen from Medicare’s competitive bidding program and permanently extend Medicare’s blended payment rates, ensuring accessibility in rural and less densely populated urban areas. 

Braze Mobility named to Hub to accelerate innovation 

TORONTO – MaRS Discovery District and the Toyota Mobility Foundation has announced the seven Canadian startups, including Braze Mobility, selected to participate in the Mobility Unlimited Hub inaugural cohort in Toronto. After receiving over 50 applications from across the country, MaRS and Toyota Mobility Foundation, along with their advisory committee, chose the seven promising startups, all of which have at least one member from their management team identifying with underserved groups (persons with disability; BIPOC; female, non-binary, gender neutral; 2SLGBTQ+ community). “It’s inspiring to see such strong interest from startups eager to tackle pressing mobility challenges showcasing the Canadian spirit of innovation and determination to create impactful solutions,” said Alison Nankivell, CEO, MaRS Discovery District. “We are thrilled to help the Mobility Unlimited Hub cohort accelerate their innovations and bring transformative mobility solutions to market through our partnership with the Toyota Mobility Foundation.” Braze Mobility is an Ontario-based startup that offers blind spot sensors for wheelchairs, providing audio, visual, and vibration alerts to help users avoid obstacles. This solution enhances safety and confidence for wheelchair users by preventing accidents and injuries. The Mobility Unlimited Hub is launched with the support of several community members, including Access to Success, ClusterBridge, George Brown College, Global Startups, Linamar iHub, KITE UHN, Sheridan College, Sixty Degree Capital, Toronto Global, University of Toronto, and Woven Capital, all united under the mantra, "Nothing about us without us.” This community-driven approach is fundamental to the Hub's mission, ensuring that solutions are developed with direct input from those they aim to serve. 

Belluscura shares performance update 

LONDON and PLANO, Texas – Belluscura says sales of the X-PLOR portable oxygen concentrator in the United States were $820,000 in the three months to May 2024. The company says it recorded sales of $450,000 in May alone, its highest recorded monthly sales figure, across both direct-to-consumer and business-to-business channels. Belluscura says testing and validation of its DISCOV-R POC remains on schedule to ship in June. The company plans to initially sell the device through its DTC channel, then initiate sales through its B2B channel late in the third quarter. The company expects to announce audited results for the year ended Dec 2023 on or before June 28. 

HHS addresses ‘urgent need’ to plan for aging population 

WASHINGTON – The U.S. Department of Health and Human Services, through its Administration for Community Living, has released “Aging in the United States: A Strategic Framework for a National Plan on Aging.” The report lays the groundwork for a coordinated effort – across the private and public sectors and in partnership with older adults, family caregivers, the aging services network and other stakeholders – to create a national set of recommendations for advancing health aging and age-friendly communities that value and truly include older adults. The framework will advance best practices for service delivery, support development and strengthening of partnerships within and across sectors, identify solutions for removing barriers to health and independence for older adults, and more. “The rapidly growing population of older adults creates an urgent need for thoughtful planning and coordinated action to strengthen the systems that support health and wellbeing as we age,” said Alison Barkoff, who leads the Administration for Community Living. “ACL was proud to lead the development of this strategic framework, and we are excited to work with our partners at every level of government, across sectors, and with older adults to develop a national plan on aging.” Developed by leaders and experts from 16 federal agencies and departments working together through the Interagency Coordinating Committee (ICC) on Healthy Aging and Age-Friendly Communities, the report also reflects input from community partners and leaders in the aging services network. It captures the opportunities and challenges created by the aging of the U.S. population and defines goals and objectives for addressing critical aging issues. Additionally, it considers the many factors that influence the aging experience, as well as things all people need as they age, such as coordinated housing and services, aligned health care and supportive services, accessible communities, age-friendly workplaces, and high-quality long-term services and supports. ACL hosted a public webinar on June 10 to provide an overview of the Strategic Framework and in the coming months, the ICC will engage with stakeholders across the nation to explore the opportunities and issues in the framework and inform the development of the national plan on aging. 

ITEM Coalition presses for Medicare coverage of standing coverage 

WASHINGTON – The ITEM Coalition has reaffirmed its request for CMS to open a National Coverage Analysis (“NCA”) for Medicare coverage of standing systems in power wheelchairs. The ITEM Coalition submitted its original national coverage determination request for coverage of both seat elevation and standing systems in 2020. CMS bifurcated the original NCD request and granted coverage of power seat elevation in May 2023. “While the ITEM Coalition applauds CMS’s decision in 2023 to cover power seat elevation, we have waited nearly four years for CMS to open the NCA for standing systems coverage, and the time is now for CMS to finally act,” said Peter W. Thomas, J.D., ITEM Coalition co-coordinator and managing partner of Powers law firm. The ITEM Coalition is requesting that CMS formally open an NCA as expeditiously as possible to: 

Establish a benefit category determination (“BCD”) that standing systems in power wheelchairs are “primarily medical in nature” and, therefore, covered durable medical equipment (“DME”) under the Medicare program, and 

Explicitly recognize coverage of these systems as reasonable and necessary for beneficiaries with a medical or functional need for standing systems in Group 3 power wheelchairs in order to perform or participate in MRADLs in the home. 

Parachute Health embeds authorization process 

NEW YORK – Parachute Health has launched a partnership with Optum and Walgreens/CareCentrix to embed prior authorization workflows directly into the prescribing process, liberating providers from what’s typically a back-and-forth process. “I am excited to be streamlining the ordering and authorization process by partnering with payers and building the necessary cost-controls to eliminate the current administrative burden that all stakeholders face," said David Gelbard, CEO and founder of Parachute Health. “As Parachute continues to scale our revolutionary open e-prescribing platform nationally, it is exciting that we are now able to embed prior authorizations into the point-of-care ordering process. Our platform is a mission-driven solution that benefits all stakeholders – reducing costs for payers, liberating clinicians from burdensome processes, and freeing providers to focus on what matters most: caring for patients.” Parachute Health says it empowers more than 220,000 clinicians and 3,000 supplier locations to deliver exceptional patient care. 

1 True Health, Advanced Homecare form partnership 

SAN DIEGO – 1 True Health – Care Management (1TH-CM), which offers patient care management and coordination solutions, has partnered with Advanced Homecare, a provider of sleep therapy services, to bring services to a broader audience, in a deal facilitated by M3M Group. "We knew there was an exceptional synergy between these two companies,” said Mark Prescott, CEO of M3M Group. “By joining forces, 1TH-CM and Advanced Homecare have the opportunity to revolutionize the way healthcare is delivered, reaching even more patients suffering from chronic and acute conditions on a larger scale." 1TH-CM has established itself in fostering effective communication and collaboration between patients and healthcare providers, enabling individuals to receive care within complex medical systems with ease. Advanced Homecare is dedicated to delivering solutions that address the unique needs of patients suffering from sleep-related disorders.

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