In brief: F&P’s expectations, insulin affordability, Power 500 list

AUCKLAND, New Zealand – Fisher & Paykel Healthcare expects full year operating revenue for the 2023 financial year to be within the range of about $1.55 billion to $1.6 billion, the company announced on Jan. 19. 

In F&P’s Homecare Product Group, sales of obstructive sleep apnea masks have remained strong, said Lewis Gradon, managing director and CEO. 

“Our mask sales growth rate is currently tracking above that of our first half as global supply of CPAP hardware improves and our Evora Full continues to perform well,” he said. 

In the Hospital Hardware Group, revenue continues to exceed pre-pandemic levels, as F&P responds to various COVID-19 surges, including in China, Gradon said. 

“For the second half of this financial year, we currently estimate the relative proportion of our Hospital sales between hardware and consumables will be similar to the first half,” he said. 

F&P doesn’t expect any material impact on its full year constant currency operating expense growth target that it guided to in November. 

• Read how F&P’s Homecare Product Group was a bright spot in the company’s financial results for the first half of the 2023 financial year, with revenue up 10% over the prior comparable period.  

Report: Insulin cap to generate millions in savings for Medicare beneficiaries 

WASHINGTON – If the Inflation Reduction Act’s provision capping the cost of insulin at $35 for a month’s supply had been in place in 2020, 1.5 million Medicare beneficiaries across the country would have saved an average of $500, according to a new report from the U.S. Department of Health and Human Services. 

Starting July 1, under Medicare Part B, beneficiary cost sharing will be limited to $35 for a month’s supply of insulin, which will result in an estimated $27 million in total savings, says the report*. 

“The Biden-Harris Administration is committed to lowering health care costs and increasing access to high-quality, affordable health care, and the Inflation Reduction Act is helping us do just that,” said HHS Secretary Xavier Becerra. “Thanks to this historic law, people who get their insulin through Medicare won’t have to pay more than $35 for a month’s supply. No one should have to skip or ration their insulin because they can’t afford it.” 

The provision already went into effect on Jan. 1 for Medicare Part D, kicking off an estimated $734 million in total savings. 

Produced by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), the report includes selected findings from a recent report* to Congress that examined the critical role that insulin plays in the treatment of diabetes, reviewed evidence on how insulin affordability affects adherence to insulin treatment and downstream health consequences, and described policy efforts to improve the affordability of insulin. 

The report also provides information on savings by state and by demographic characteristics, including gender, race and ethnicity, and age. The states with the most beneficiaries projected to benefit from the insulin cost savings are Texas (114,000 beneficiaries), California (108,000) and Florida (90,000).  

Prior to the provision, about 37% of insulin fills for beneficiaries required cost-sharing that exceeded $35 per fill, including 24% that exceeded $70 per fill. Nationally, the average out-of-pocket cost was $58 per insulin fill, typically for a 30-day supply. Patients with private insurance or Medicare paid about $63 per fill on average. 

The full HHS report, “Insulin Affordability and the Inflation Reduction Act: Medicare Beneficiary Savings by State and Demographics”, is available at https://aspe.hhs.gov/reports/insulin-affordability-data-point and the report to Congress is available at: https://aspe.hhs.gov/reports/insulin-affordability-rtc. 

Popularity of EVs squeezes access to compound used in concentrators 

BOULDER, Colo. – As the demand for electric vehicles has grown, the price of lithium, which, when combined with zeolite, allows oxygen concentrators to generate oxygen at purity levels of 90% or higher, is experiencing significant increases, according to a bulletin from Quality Biomedical. 

Lithium is a key component of the batteries used in EVs and certain sieve beds of oxygen concentrators. 

“As the demand for EVs has increased, the price of lithium is experiencing significant increases, nearly 4x from the end of 2021 to now,” wrote CEO PK Bala in an email to customers. “Hence, the cost of sieve beds containing zeolite and lithium is rising.” 

Quality Biomedical says the largest U.S. supplier of zeolite has announced a 40% increase in prices for the compound, effective immediately, prompting the company to analyze and negotiate with sieve bed vendors to minimize the impact on providers. 

“We will work hard to be the best service partner we can be to you,” Bala wrote. “You may recall in 2021 and 2022, when gas and labor costs increased substantially, we did not adjust pricing but instead absorbed those cost increases and drove internal productivity improvements to mitigate those increases. While this 40% cost increase is very substantial, we will do our very best to minimize its impact on your business.” 

Quality Biomedical plans to contact providers to discuss the impact on them. 

ResMed, AdaptHealth make tech list 

YARMOUTH, Maine – Several HME companies have made the Power 500 Technology Companies list, a nod to their commitment to improving the health of people around the world. In the Medical Devices category, ResMed, Dexcom, Insulet Corp., AdaptHealth and Masimo were all listed as leaders. The list includes companies that demonstrate product or service leadership, technical depth in their specific fields, consistent organizational growth or evolution, operational excellence and high-caliber management teams, among other criteria, according to The Healthcare Technology Report, which publishes the list. Other categories are biotechnology, health care software and consumer health tech. The Healthcare Technology Report also publishes the Top 50 Healthcare Technology CEOs and other lists. 

ACMESA, AAH push for rate stabilization in VA 

RICHMOND, Va. – The Atlantic Coast Medical Equipment Services Association (ACMESA), along with AAHomecare, is asking stakeholders in Virginia to contact their lawmakers in the House and Senate to pass a budget amendment that would direct the state Medicaid program, the Department of Medical Assistance Services, to set reimbursement for DME at 100% of the Medicare rate in rural areas. “In recent years, the DME industry has seen significant cost increases due to supply chain issues, higher prices from manufacturers, and new operational requirements brought on by the current COVID-19 public health emergency (PHE),” the association states. “In this environment, it is important that Medicaid programs protect patient access to critically needed products and services by making sure DME reimbursements reflect the market realities facing suppliers. By supporting access to vital DME in the home, any additional cost to the state would be offset by decreasing utilization of emergency rooms and unnecessary hospitalization.” ACMESA and AAHomecare have set up an action center with information on Item 304 #14h in the House and Item 304 #28s in the Senate that includes a tool for sending a pre-populated message to lawmakers. The two organizations, along with the United Spinal Association of Virginia, are also asking stakeholders to contact their lawmakers to pass another budget amendment in the House, Item 304 #30h, that would direct DMAS to cover complex rehab wheelchair equipment and accessories for Medicaid recipients who live in a nursing facility in the state. 

Green Prosthetics sells to Mobility Ideal Health Care 

DALLAS – Generational Equity has announced that its client Green Prosthetics and Orthotics has sold to Mobility Ideal Health Care. "This was a deal where all the stars aligned perfectly,” Faraaz Ali, senior M&A advisor for Generational Equity. “Our client was a niche custom fabricator of prosthetic and orthotic devices that checked all of the investment criteria boxes of a strategic acquisition party that was consolidating in this space. Outside of the mutually beneficial structure of the deal, what brought both parties together was their mutual passion for human mobility solutions and the commitment to bettering the lives of those that have been impacted." Green Prosthetics, located in Erie, Pa., has multiple locations in Pennsylvania and New York, offering custom fabricated prosthetic and orthotic devices. Mobility Ideal Health Care, located in Edison, N.J., has nine locations, offering prosthetics, orthotics and diabetic footcare, physical and occupational therapy, DME and PPE. 

CMS announces largest participation in Marketplace 

WASHINGTON – A record-breaking more than 16.3 million people have selected a health plan through the Affordable Care Act Marketplace during the recent open enrollment period from Nov. 1, 2022, to Jan. 15, 2023, according to CMS. Total plan selections include 3.6 million people (22% of total) who are new to the Marketplace for 2023, and 12.7 million people (78% of total) who had active 2022 coverage and made a plan selection for 2023 coverage or were automatically re-enrolled. “Since President Biden took office, the number of people who have signed up for an affordable health care plan through HealthCare.gov has increased by nearly 50%,” the agency stated in a press release. “Because of the President’s plan, millions of working families saved an average of $800 on their health insurance premiums last year.” Over 1.8 million more people have signed up for health insurance, or a 13% increase from this time last year. The 3.6 million plan selections from people who are new to the Marketplace represent a 21% increase in new-to-Marketplace plan selections over last year. Individuals benefited from a highly competitive Marketplace this year, according to CMS, with 92% of enrollees having access to options from three or more insurance companies. Also, new standardized plan options were available in 2023 through HealthCare.gov, which helped consumers compare and select plans, the agency says.  

Mobility City joins U.S. Rehab 

BOCA RATON, Fla. – Mobility City Holdings, a franchisor with locations in 34 of the top metro areas in the U.S., has joined U.S. Rehab, a division of VGM & Associates. Joining U.S. Rehab means Mobility City’s franchise owners will have access to more products at discounted rates, as well as more networking and education opportunities, company officials say. "Having joined VGM's U.S. Rehab community, we look forward to our location owners meeting with their local U.S. Rehab salesperson one-on-one,” said Diane Baratte, CEO of Mobility City. “We hope to extend our product offering and reduce pricing to benefit our consumers. We believe that networking with other U.S. Rehab community members and vendors enables us to extend our service network to the benefit of these community members and the end consumer.” Mobility City expects to extend its involvement with U.S. Rehab to include other VGM divisions like Homelink and VGM Live at Home. The company's business model, which includes repair, rental and sales services for mobility products, and focus on patient care “is what we are all about,” says Tyler Mahncke, vice president of U.S. Rehab. “VGM and U.S. Rehab are excited to welcome Mobility City to our network of provider partners,” he said. “Their 40-plus locations are a great addition to our membership.” 

Dr. Cooper named to Hall of Fame 

ARLINGTON, Va. – RESNA Fellow Dr. Rory Cooper is one of 16 innovation pioneers who will be honored as part of the 50th class of National Inventors Hall of Fame (NIHF) inductees, the organization has announced. The 2023 class was announced at the recent Consumer Electronics Show in New York. Cooper is the founder and director of the Human Engineering Research Laboratories (HERL), a collaboration between the U.S. Department of Veterans Affairs and the University of Pittsburgh. A biomedical engineer, he holds 20 U.S. patents in wheelchair technology innovations that have improved manual and power wheelchairs. His inventions have advanced the health, mobility, and social inclusion of people with disabilities and older adults. A RESNA member since 1988, Cooper has served on numerous RESNA committees, on the board, and as president and treasurer of the organization. He was inducted into the RESNA Hall of Fellows in 2002 and was named the 2023 Colin McLaurin Distinguished Lecturer at the organization’s conference last year. A ceremony for the 2023 class will be held on Oct. 26, 2023, at The Anthem in Washington, D.C. It will mark the 50th anniversary of the NIHF. 

NorthShore Care Supply recognized by Newsweek 

GREEN OAKS, Ill. – NorthShore Care Supply was recognized by Newsweek as one of the Best Online Shops of 2023. NorthShore Care Supply, a provider of adult diapers and incontinence supplies, ranked No. 1 in the Medical Supplies category, surpassing leading brands such as CVS, Walgreens, RiteAid and AllegroMedical. "It's a great honor to be recognized as the No. 1 online shop in the medical supplies category this year," says Adam Greenberg, president and founder of NorthShore Care Supply. "Our website has evolved from a diverse catalog to a patient-centered, educational shopping experience featuring our own NorthShore brand. It's now easier than ever for people to shop for premium absorbent products that stay confidently dry for even the heaviest control problems." Rankings are based on criteria online shoppers value like website usability and security, and how likely they are to purchase at a particular shop. NorthShore’s e-commerce brand has undergone site updates and added interactive tools to help consumers find a product that meets their needs. The Product Finder Tool and Sample Program provide customized product recommendations to consumers within seconds. NorthShore's website also offers Auto-Ship ordering options to help consumers save on orders and stay stocked with their needed products.  

Pedors launches ‘umbrella’ directory of foot care professionals 

MARIETTA, Ga. – Pedors Shoes has launched Let’s Walk, a directory to help patients find a local health care professional that specializes in foot and ankle care, mobility and therapy. “In an era where search browsers monetize search results by returning paid-for page rankings, letswalk.com provides practitioners a complementary tool that lists their services as a foot health care provider specifically targeted to their local patient population – at no charge,” said Stephen O’Hare, president of Pedors Shoes “The foot health care professional associations each have their own member directories, which are accessible to the public but are not marketed to the public and only present practitioners from their discipline. What we saw was a need to provide a service under one umbrella that invites all of the allied foot health care professionals that wish to participate. Participating health care professionals include pedorthists, orthotists, podiatrists, orthopedists, physical therapists and occupational therapists. To register on Let’s Walk please visit https://www.letswalk.com/add-your-facility 

Encore names new director 

NASHVILLE, Tenn. – Encore Healthcare has named Sarah Brundidge - MSc, RRT, AE-C, CPFT, as director, quality & innovation. She brings vast experience in respiratory care from multiple perspectives, including the hospital, the HME provider and the medical device company, most recently at Propeller Health, where she served as a senior customer success manager. “Sarah brings a whole new level of clinical expertise to an already clinically-focused organization,” said Zach Gantt, CEO of Encore Healthcare. Prior to Propeller, Brundidge served as the director of lung health for the Wisconsin chapter of the American Lung Association, as well as president of the Wisconsin Society for Respiratory Care.   

Rx Redefined raises $8M 

OAKLAND, Calif. – Rx Redefined, a tech-enabled provider of medical supply services for group practices, has raised $8 million in Series A funding. The round was led by Crosscut Ventures Management, with participation from Tusk Venture Partners, Silverton Partners, Pisgah Fund and Jeff Immelt, former CEO of General Electric. The platform allows physicians to directly order and fulfill the supplies they believe are in the patient's best interest, thereby reducing handoffs and improving the patient experience. "Today, when a patient is prescribed recurring use of medical supplies, like a catheter to empty their bladder or a glucose monitor for diabetes, the purpose of this device is to support a failing organ," said Brandon Boots, CEO and founder of Rx Redefined. "This is intimate and time-sensitive, yet the current standard of care is to fax a prescription off to a big box distributor in the hope that they will support the patient's insurance and fulfill the product timely. Unfortunately, the reality is unnecessary hoops, insurance complications, and product switching in the name of increased margin. Ultimately this delay leads to the patient suffering." Rx Redefined, which launched in 2018, has enabled physicians to distribute millions of medical products to their patients. In the last year, Rx Redefined increased its physician population by 450%. 

Witkowski pleads guilty to Medicare fraud 

NEW YORK – Matthew Taylor Witkowksi has pled guilty to conspiracy to commit health care fraud and will be sentenced April 20, according to the Department of Justice. From at least August 2019 through the date of his arrest in July 2022, Witkowski and a co-conspirator engaged in a scheme to defraud Medicare by illegally obtaining and selling fraudulent written orders for goods and services paid for by Medicare, including for durable medical equipment.  Using a call center that he owned and operated in the Dominican Republic, he illegally generated and purchased fraudulent written orders for DME and then sold those fraudulent orders to pharmacies and DME suppliers who submitted more than $8 million in fraudulent claims to Medicare. Witkowski received more than $4 million in kickbacks from suppliers, who made payments to True Prospects Marketing, Inc., a company controlled by Witkowski and his co-conspirator, and to Sales Drive Marketing LLC, a company owned and controlled by Witkowski. 

NCPA preps for fly-in 

ALEXANDRIA, Va. - The National Community Pharmacists Association (NCPA) has opened registration for its 2023 Congressional Pharmacy Fly-In scheduled for April 26-27 in Alexandria, Va., and Washington, D.C. It’s the association’s first in-person fly-in since April 2019, prior to the COVID-19 pandemic. “Through the NCPA Congressional Pharmacy Fly-In, community pharmacists will be able to talk with policymakers about the important role independent pharmacies play in their communities, the many ways that pharmacy teams help patients, and challenges facing the industry,” the association stated. “In addition to helping foster existing relationships, it’s an opportunity to build rapport with those new to Congress who are now making decisions central to the future of pharmacy.” Prior to the fly-in, NCPA staff will update attendees on the congressional agenda for 2023 and the association’s ongoing advocacy efforts, which include working to stop unfair practices by pharmacy benefit managers and protecting and expanding patient access to community pharmacy services. Register here.