In brief: CPI-U increase, WOY finalists, ResMed lawsuit 

WASHINGTON – CMS has announced a 3% CPI-U adjustment to the DMEPOS fee schedule for calendar year 2024, AAHomecare has reported, but the actual amount will be influenced by Medicare’s competitive bidding program. 

The adjustment varies as follows: 

   • CBP items in former CBAs (projected percentage change): +2.9% 
   • CBP items in non-CBAs (CPI-U): +3% (not directly stated in the change request) 
   • Non-CBP items (CPI-U minus productivity adjustment): +2.6% 

AAHomecare provided the following analysis: 

What this means for CBP items in former CBAs 

For items such as CPAP devices, oxygen and NPWT, where the payment is based on CBP payment rates, the 2.9% inflation adjustment should be directly reflected in the fee schedule in CY2024. 

What this means for non-CBP items 

For items that have never been part of the CBP, such as urological and ostomy supplies, the 2.6% inflation adjustment should be directly reflected in the fee schedule, regardless of location in the country. 

What this means for CBP items in rural areas 

For CBP items in rural areas, the 50/50 blended rate will continue to be applied (50% fully adjusted regional payment/50% unadjusted fee schedule from 2015), meaning the 3% increase will only be applied to the fully adjusted portion of the calculation. As such, the portion of the reimbursement calculation that is based on the static 2015 rates will remain the same, but the fully adjusted portion will increase by 3%. The 2024 rate = 50% derived from the 2015 rates, 50% derived from the current regional rates, plus 3% increase.  

What this means for CBP items in non-rural 

For CBP items in non-rural areas, the payment rate will depend on Congress passing extensions to the 75/25 relief rates. If relief is extended, the portion of the reimbursement calculation that is based upon the static 2015 rates will remain the same, but the fully adjusted portion will increase by 3%. For non-bid, non-rural areas, the 2024 rate = 25% derived from the 2015 rates, 75% derived from the current regional rates, plus 3% increase. However, if Congress fails to pass an extension, the payment rate for CBP items non-rural areas starting in CY 2024 will be 100% of the adjusted regional rate. 

VGM announces WOY finalists 

WATERLOO, Iowa – VGM Group has announced the four finalists for the 2023 HME Woman of the Year: 

• Deb Holman, chief compliance officer, Hart Medical; 

• Dana McLaughlin, president, Medical Services Company; 

• Jami Tharp, office manager, senior billing specialist, and human resource manager, Choice Medical; and 

• Heather Yi, vice president, customer success, Brightree. 

“Each of these 2023 HME Woman of the Year finalists is an impactful leader within our industry,” said Jeremy Stolz, president of VGM & Associates and VGM Fulfillment. “Their dedication truly makes a difference for their patients, their communities, and the HME industry as a whole. They are all more than deserving of this recognition for their outstanding achievements.” 

VGM will announce the winner during a free virtual ceremony at 1 p.m. CT on Dec. 21. 

The company received nominations from across the HME industry, including providers, manufacturers, association executives and other professionals. The finalists were selected based on criteria that included implementing new business processes, advocating on behalf of the industry, improving the lives of patients and impacting their community through volunteerism. 

The 2022 HME Woman of the Year was Sherry Krug of Binson’s Medical Equipment & Supplies. 

Study highlights danger of COPD in women 

SAN DIEGO – COPD prevalence among those 25 years and older is expected to increase by 23% from 2020 to 2050, with the largest growth projected among women and within low- and middle-income countries, according to a new study from ResMed published in the Journal of the American Medical Association (JAMA) Network Open. 

Other results from the study: 

• By 2050, the number of women with COPD is projected to increase by 47% compared to only 9% growth in men  

• Low- and middle-income countries forecast more than a 32% increase in COPD cases, versus nearly a 4% increase in high-income countries from 2020 to 2050  

• Increasing prevalence of COPD in women and low- and middle-income countries is driven by such factors as increases in smoking prevalence and biomass smoke during cooking in poorly ventilated homes  

"These numbers are a clear warning that we need to inspire immediate action across industries and geographies to lower the risk factors for COPD, while also increasing awareness of the symptoms of this deadly disease,” says Carlos Nunez, M.D., chief medical officer at ResMed. “The disproportionate growth of COPD among women is a critical finding as COPD has not always been as prevalent in women. As a health care community, we have a responsibility to be more vigilant in screening, testing and proactively providing COPD education to female patients, as well as communities that may not have easy access to this information. Education accompanied by action can have a positive impact by mobilizing people to get diagnosed and treated early.”  

The study projects the increased regional and global burden of COPD by 2050 through an analysis of historical prevalence and data on risk factors, such as tobacco smoking, outdoor air pollution and household air pollution.  

ResMed provides non-invasive ventilation (NIV) and other mechanical ventilation solutions tailored to the needs of COPD patients, whether in a hospital or home setting. The company says these interventions can enhance the patient's quality of life and reduce the frequency of hospital visits and the risk of death.  

To read the full study, see the publication in JAMA Network Open.  

ResMed wins patent fight 

SAN DIEGO – The U.S. Patent Trial and Appeals Board (PTAB) has invalidated the claims that New York University asserted against ResMed in a complaint for patent infringement filed in U.S. District Court, District of Delaware, in June 2021. NYU’s complaint alleged that the AutoSet and AutoRamp features of ResMed’s AirSense 10 AutoSet flow generators infringed one or more claims of seven NYU patents. “At ResMed, we’re committed to providing patients with our leading therapy solutions,” said ResMed CEO Mick Farrell. “Our sustained investment in research and development for over 30 years has culminated in more than 9,500 issued or pending patents and designs. We applaud the PTAB’s ruling and will defend our innovations, ensuring patients continue to receive our therapy solutions, empowering them to live healthier, higher-quality lives.” ResMed filed petitions with the PTAB asserting that all the claims asserted against the company were invalid. In rulings issued from Dec. 4-7, 2023, the PTAB judges, agreeing with ResMed’s arguments, found that all the challenged claims across the seven patents were invalid. “We will continue to vigorously defend our innovations,” said Michael Rider, ResMed’s global general counsel and secretary. “The fact that our intellectual property contributed to this victory is a testament to our investment in research and development, the hard work of our inventors, and the patent protection we pursue to protect our innovation.” 

Viemed focuses on NASDAQ 

LAFAYETTE, La. - Viemed Healthcare has received approval from the Toronto Stock Exchange to voluntarily delist its common shares on the TSX, in a move that will allow the company to focus on its listing on the NASDAQ Capital Market. “The company is taking strategic action to enhance market efficiency and optimize our administrative processes by consolidating trading volumes on NASDAQ, as the majority of both outstanding shares and trading volume is currently concentrated in the United States,” said Viemed COO Todd Zehnder. “The delisting from TSX will create a singular focal point and central marketplace for the company’s common shares, contributing to increased long-term liquidity on NASDAQ and increased shareholder value.” Viemed’s common shares will be delisted from TSX effective as of close of markets on Dec. 21, 2023. The common shares will continue to trade on NASDAQ under the symbol “VMD” and, following delisting from TSX, Viemed's shareholders can trade their common shares through their brokers on NASDAQ. 

Claims period opens for Philips recall 

AMSTERDAM – Counsel for the lead plaintiffs in the Philips recall lawsuit have announced that the claims filing period has opened for the previously announced settlement fully resolving economic loss claims. Patients and medical providers who purchased, rented or leased recalled devices, as well as payers who provided reimbursements for those payments, are eligible to participate in the settlement from Dec. 11, 2023, through Aug. 9, 2024. Under the terms of the settlement, users are eligible to receive device payment awards ranging from $55.63 to $1,552.25, as well as a $100 payment for each recalled device returned to Philips. Device replacement awards also are available to cover the cost of new machines purchased out of pocket prior to the settlement. Additionally, all users are eligible to receive extended warranties from Philips on remanufactured devices provided to users through the recall. Class members who registered for the recall before Sept. 7 and returned their devices to Philips or their DME providers are entitled to automatic payments of settlement benefits and will not need to file a claim. Additional information is available on the settlement website. The settlement received preliminary approval from the Honorable Joy Flowers Conti of United States District Court for the Western District of Pennsylvania on Oct. 10, 2023, and a final fairness hearing is scheduled for April 11, 2024. 

Iowa Medicaid starts paying for Firesafe Cannula Valve 

CHICAGO – Iowa Medicaid began covering the Firesafe Cannula Valve under HCPCS code E0700 on Nov. 1, making it eligible for reimbursement, Sunset Healthcare Solutions has announced. The Firesafe Cannula Valve is a thermal fuse that cuts the flow of oxygen in the event that a patient’s downstream oxygen tubing is ignited. “Prevention of home oxygen therapy related fires, and education around how they can be significantly reduced, has been an initiative of Sunset’s for years,” says PJ Ruflin, vice president of business development for Sunset Healthcare Solutions, the U.S. distributor of BPR firesafe products. “This is a huge step forward in that initiative and Sunset is proud to be part of it. We look forward to continuing to be a key asset in the program and supporting our homecare partners and their patients as it continues to progress.” The chance of an oxygen fire fatality is 20 times greater in the U.S. than in England, where firebreaks have been mandatory since 2006. Veterans Affairs mandated the fitting of thermal fuses to all 85,000 home oxygen installations for veterans in 2018 and since then, grassroots efforts have since increased across the U.S., with firefighters stepping up their efforts to educate and advocate for patients. 

Reps seek to eliminate physician cut 

WASHINGTON – A group in the House of Representatives led by Rep. Greg Murphy, R-N.C., Danny Davis, D-Ill., Brad Wenstrup, R-Ohio, Jimmy Panetta, D-Calif., Larry Bucshon, R-Ind., and Michael Burgess, R-Texas, has introduced a bill that would eliminate the 3.37% cuts to Medicare payments for physicians scheduled to go into effect Jan 1, 2024. “As of today, patients and physicians have a clear-eyed view on how to protect Medicare from injurious cuts,” said Jesse Ehrenfeld, M.D., M.P.H, president of the American Medical Association. “These cuts threaten health care access for seniors, as well as the viability of physician practices, including many in rural and underserved areas. Cancelling the cut is a good new year’s resolution.” The AMA says that after adjusting for inflation, Medicare physician payment has effectively declined 26% from 2001 to 2023—and that is before the 2024 pay cuts are factored in. 

The Wound Pros launches ‘global outreach efforts’ 

LOS ANGELES – The Wound Pros has launched its “Wound Care Without Walls” program in the Philippines, a reflection of the company’s global commitment to health care and its mission to extend its services beyond U.S. borders. The program aims to address the challenge of chronic non-healing wounds, such as pressure ulcers, diabetic foot ulcers, venous leg ulcers and others, which represent a significant and growing health burden worldwide. “The Wound Care Without Walls program in the Philippines is just the beginning of our global outreach efforts," said Junette Cacho, vice president of EMR and IT Development Department at The Wound Pros. "Our mission is to bring advanced wound care to those in need, wherever they may be. This initiative represents our dedication to global health and wellbeing." The program is designed to provide accessible and advanced wound care solutions in underserved communities around the world, providing much-needed care to stem the spate of chronic wounds and minimize lower-limb amputations. By integrating state-of-the-art technology and innovative treatment protocols, it aims to improve wound healing outcomes, reduce the risk of complications and, ultimately, enhance the quality of life for patients.