In brief: Final rule, Great Elm, Best Buy Health

WASHINGTON – The Council for Quality Respiratory Care has partnered with AAHomecare and the VGM Group to send a one-page letter to CMS urging the agency to publish the DMEPOS final rule as quickly as possible.

A proposed rule published in October outlined the agency’s plans to make permanent the 50-50 blended reimbursement rates in rural areas.

“In light of the pandemic, it is more important than ever that the Medicare payment system provides stability to suppliers to ensure that patients who require medically necessary care and treatments in the home have access to equipment and services,” the groups write in the letter to CMS Acting Administrator Elizabeth Richter. “Our organizations support the flexibilities CMS has provided during the pandemic. As important as the flexibilities are, it is also important to provide certainty in the payment system.”

In comments to the proposed rule submitted in December, CQRC also asked CMS to make permanent the 75-25 blended rates that are in effect in non-bid, non-rural areas.In its comments, AAHomecare asked CMS to also create a 90-10 blended rate for former competitive bidding areas.

CMS corrects DMEPOS fee schedule

WASHINGTON – CMS published a revised January 2021 DMEPOS fee schedule with adjustments to 919 codes, AAHomecare reported this week.

The agency says it identified errors in the original fee schedule published on Dec. 11, 2020, prompting it to make the adjustments.

On average, non-rural areas will receive 0.9% more and rural areas will receive 0.5% more than the original fee schedule, according to an analysis by AAHomecare.

A small portion of the fee schedule (8%) has more significant adjustments ranging between a 30% decrease to a 57% increase, mostly for codes with KE modifiers, the association says.

AAHomecare previously expressed its concerns to CMS that the 2021 fee schedule included rates in rural and non-rural areas that were, on average, slightly lower than the rates in the 2020 fee schedule.

Providers that submitted claims prior to Jan. 26, 2021, who were paid an incorrect amount may request the DME MAC to reprocess their claims, the association says.

Great Elm Healthcare expands Midwestern footprint

WALTHAM, Mass. – Focus Respiratory, a subsidiary of Great Elm Healthcare, has acquired Advanced Medical DME and PM Sleep Lab, adding a combined $5 million in unaudited revenues and 2,500 patients to its roster.

The acquisition of these companies expands Great Elm Healthcare’s footprint in the Midwest, adding six locations in Kansas and three in Missouri, its first in the state.

“The acquisitions of Advanced Medical DME, LLC and PM Sleep Lab, LLC fit our strategy of pursuing tuck-in acquisitions of respiratory focused companies that expand and enhance our geographic footprint, as we seek to gain scale and increase operating leverage in areas where we have an existing presence,” said Peter Reed, CEO of Great Elm Group Inc., parent company of Great Elm Healthcare. “We were attracted to the companies’ patient-centered philosophy and their talented managers and staff. We welcome these new patients and employees to the Great Elm Healthcare family and look forward to extending our offerings throughout Kansas and Missouri.”

In December, Great Elm Capital announced it had received a preferred equity investment of $37.7 million from an affiliate of JPMorgan Chase & Co., to refinance Great Elm’s DME business and to provide the business with growth capital.

Great Elm Group recently reported $14.5 million in total revenue for DME for the three months ended Dec. 31.

ACHC develops distinctions for respiratory, custom mobility

CARY, N.C. – The Accreditation Commission for Health Care has developed two new distinctions for DMEPOS-accredited organizations to help them demonstrate their commitment to patient quality of life.

The Distinction in Clinical Respiratory Patient Management allows providers to demonstrate expertise in managing respiratory conditions, and the Distinction in Custom Mobility recognizes first-rate providers of custom mobility products.

“By offering these groundbreaking distinctions, ACHC provides innovative solutions to address health care market needs of specialization and differentiation that complement accreditation,” said Tim Safley, DMEPOS program director for ACHC. “Such subspecialties are unique in their design and enhance national efforts to reduce hospital readmissions. A distinction award recognizes providers who exceed industry expectations for high-quality patient care.”

The distinction in respiratory must be earned in combination with ACHC Home/Durable Medical Equipment Accreditation, and the distinction in custom mobility must be earned in combination with the ACHC Complex Rehabilitation and Assistive Technology Supplier Accreditation.

The distinction in respiratory, which encompasses the assessment, treatment, disease management and education of respiratory conditions, helps licensed respiratory care practitioners and other qualified health care professionals distinguish their expertise in ongoing, home-based patient respiratory care, ACHC says.

The distinction in custom mobility, which addresses wheeled mobility, seating and alternative positioning, ambulation support, environmental control, augmented communication and other assistance needs, focuses on the creation and maintenance of treatment plans, goal and outcome monitoring, patient follow up and documentation to prevent complications and ensure patients maintain/improve mobility.

VGM reschedules Heartland Conference

WATERLOO, Iowa – VGM’s annual Heartland Conference will take place Sept 13-15, instead of June 14-16. The company says the conference will return to its normal summer schedule next year. “We have a responsibility to keep everyone safe, while they learn and network with their peers from around the country,” said Clint Geffert, president of VGM & Associates. “By shifting to the fall, attendees will have more time to take the precautions they need to join us in person. After all, we want to bring our community back together to celebrate 20 years of Heartland.” VGM has also decided to continue its “Heartland at Home” virtual event this year, with sessions offered for free to attendees of the Heartland Conference and $199 to members who don’t attend the in-person event. Registration for the Heartland Conference is $599 or $499 early bird for members and $775 for non-members. Registration opens May 1. FMI: https://www.vgmheartland.com/.

Best Buy Health offers safety services on Apple Watch

MINNEAPOLIS – Best Buy Health now offers health and safety services on the Apple Watch. Through a new Lively App, Apple Watch users can get assistance from trained Lively Urgent Response Agents for help in emergency and non-emergency situations. With a Live Agent Assist feature that’s coming soon, the watch can also detect hard falls, prompting an agent to call the user to make sure they’re OK and to contact family members if needed. Best Buy says it’s working with Apple closely on this new feature, which is one of the first to use Apple’s new fall detection API. “By offering these powerful safety features on Apple Watch, we’re creating a new way to achieve a greater sense of connection and independence for older adults, and added peace of mind for both them and their families,” said David Inns, Best Buy Health’s president of active aging. “It’s the perfect next step in furthering Best Buy Health’s mission to enrich and save lives through technology and meaningful connections.” Earlier this year, Best Buy and Great Call launched the new Lively App and Lively Wearable2 medical alert device. Best Buy acquired GreatCall in 2018.

Tomorrow Health partners with Geisinger Health to manage DMEPOS for members

NEW YORK – Tomorrow Health has partnered with Geisinger Health Plan to coordinate all medical equipment and supplies for Geisinger’s more than 500,000 members. Tomorrow Health says its platform will streamline the ordering, product selection and delivery process, and match patients to HME suppliers. The company says its platform will also offer reliability and value to payers and improve efficiency for HME providers. “We are excited to partner with Geisinger and to connect GHP members and their families with vital equipment and support to enable them to stay healthy at home,” said Vijay Kedar, co-founder and CEO of Tomorrow Health. “We are committed to getting patients the equipment and supplies they need as quickly and efficiently as possible, and are grateful to partner with innovative leading organizations like Geisinger to enhance their members’ care.” Industry stakeholders, including AAHomecare and PAMS, have sought more transparency on the referral process and say providers in the state have seen a significant downturn in referrals since Tomorrow Health implemented its referral program in January.

North Carolina DME company to pay fines, restitution

RALEIGH, N.C. – A Perfect Fit for You, a DME provider owned by Margaret Gibson, was ordered to pay a $2 million fine and more than $10 million in restitution to the North Carolina Medicaid program for alleged fraudulent claims submitted by employees for DME between March 2015 and November 201. In some cases, the identifying information of deceased beneficiaries was allegedly used. A civil claim under the federal and state False Claims Act was also filed against Margaret Gibson and an employee, Shelly Bandy. To resolve those claims, the company agreed to repay more than $20.1 million and Gibson agreed to pay $4 million. The United States and State of North Carolina have obtained a $34.7 million default judgment against Bandy.  The government notes that the civil claims against A Perfect Fit for You, Inc. and Gibson are allegations only and were resolved by settlement. There has been no judicial determination or admission of liability in the civil case.

Lauryn Estrella joins NEMEP team

CARY, N.C. - Lauryn Estrella has joined the NEMEP team as executive assistant. Lauryn has nearly 10 years of experience in the HME industry, working at HOMES, where she assisted with database management, organizing congressional meetings and event planning. “It will be terrific to have her on our team to assist with communications, membership growth and other projects as the board continues to increase committee work, member engagement and advocating on state and federal issues,” said Beth Bowen, NEMEP executive director. Lauryn can be reached at Lauryn@northeastmep.org.

Pandemic tailwinds boost Viemed’s revenues

LAFAYETTE, La. – Viemed Healthcare reported total revenues of $31.2 million for the fourth quarter of 2020, including $5.1 million in sales related to the COVID-19 pandemic. Net revenues for the year were $96.9 million for the company’s core business and $131.3 million overall. Adjusted EBITDA for the quarter was approximately $9.5 million, a 70% increase over the same quarter in 2019, and adjusted EBITDA for the year was $41.3 million, an increase of 117% compared to 2019. Viemed expects to generate net reveneus attributable to its core business of $25.5 million to $26.5 million in the first quarter of 2021, and revenues of $2.3 million to $3.3 million related to the COVID-19 pandemic. “I am extremely proud of the performance of our team during one of the most challenging years for the U.S. health care system,” said Casey Hoyt, CEO. “The pandemic posed more tailwinds than headwinds for us, which resulted in a record year for Viemed. We also remain optimistic about the strategic partnerships, organic growth and acquisition opportunities that we expect to contribute to our expansion in 2021.”

PromptCare acquires NBN Infusions

NEW PROVIDENCE, N.J. - PromptCare Companies, a regional provider of complex respiratory and specialty home infusion services, has acquired the assets of NBN Infusions, expanding its footprint in the Northeast. Founded in 1990 by Linda Begley, NBN is a Cherry Hill, N.J.-based provider of home infusion and respiratory therapy services with a primary focus on managing specialty infusion therapies for patients with complex and chronic conditions. “Linda has built an impressive business in South Jersey, which is a core geography for us,” said PromptCare CEO Tom Voorhees.  “NBN’s patient-first approach to providing care is well-aligned with our values and its focus on specialty infusion therapies is an excellent fit with our strategy.” Terms of the deal were not disclosed.

Study: Family docs can effectively pre-screen for OSA during pandemic

DARIEN, Ill. - Family practitioners can effectively pre-screen patients for possible obstructive sleep apnea by asking about five items from the sleep symptom checklist, according to a new study. If OSA is suspected, they can then recommend behavioral changes, such as changing sleep position, to improve symptoms. The study, published online in the Journal of Clinical Sleep Medicine, was done to assess how patients can be identified for possible OSA while clinic testing is unavailable or limited by the COVID-19 pandemic, and what measures can be suggested to improve sleep health until proper diagnosis and treatment can begin again. The study looked at 156 family medicine patients with OSA (88 women, 68 men; mean age, 57 years) and 60 control participants (36 women, 24 men; mean age, 54 years) recruited from the community. They completed the sleep symptom checklist and a range of other self-reporting measures; the primary care patients also underwent a polysomnographic sleep study. Individuals with OSA reported more symptoms related to insomnia, daytime symptoms, sleep disorders, and psychological maladjustment than the control group, and their sleep-related symptoms were significantly more severe than those of the control patients.

MCOs and Medicaid: Call for support in NY

ALBANY, N.Y. – AAHomecare is calling on providers in New York to help build support for two new bills in the state legislature that would require Medicaid managed care organizations to reimburse for DME and complex rehab at no less than 100% of the published Medicaid fee schedule for the same services and supplies. A.5368 was introduced in the State Assembly on Feb. 16 and S.5118 was introduced in the State Senate on Feb. 24. “This legislation is critically needed to ensure that New York Medicaid beneficiaries who rely on home medical equipment will maintain strong access to quality products and related services,” the association stated in a bulletin. Providers can message their representatives through AAHomecare’s Action Center. The Northeast Medical Equipment Providers Association has also created a one-pager on the need for rate stability.

New products: Invacare, Responsive Respiratory

Invacare and its subsidiary Alber USA has introduced their next generation of power assist devices: the e-motion (M25). The Alber e-motion power assist for manual wheelchairs is a push-rim activated device that features wheels with an in-hub motor and lithium io batteries. The e-motion (M25) is an upgrade from the e-motion (M15), which has been in the market since 2008. “With our second launch in less than a year, we are further strengthening our comprehensive portfolio of power assist devices,” said Joost Beltman, senior vice president and general manager, North America, for Invacare. “From our previous introductions of the SMOOV one, to the Albert ion, e-fix and now the new e-motion, we are providing the power of choice to our customers”…RRI has expanded its CPAP sanitizer offering with the introduction of the Purify O3 – the Elite Series. The Purify O3 Elite’s features include user-friendly touch-to-active controls and visual feedback through an illuminated disinfection progress ring and lighted battery life indicator. “Purify O3 Elite is the next generation of CPAP/BiPAP disinfectors,” said Thomas Bannon, president. “The illuminated interface and auditory alerts are simple, making Purify O3 Elite the choice for CPAP or reusable medical product disinfection.” Like its predecessor, Purify O3 is third-party tested for efficacy and is FDA registered.

Jackson Medical Supply named best in town

VACAVILLE, Calif. – Jackson Medical Supply has been named the best medical supply store by Daily Republic readers. The company offers a variety of products and services, and Wendy Jackson, who opened the store with her husband 20 years ago, is a certified mastectomy fitter. “It’s very fulfilling to help women get the product that makes them comfortable again,” she told the newspaper. “I have clients literally leaving in tears of joy because they are so grateful.” Jackson Medical Supply was also named “Business of the Year” for 2018-19 by the Vacaville Chamber of Commerce. The company considers among its best-sellers motorized lift and recline chairs.

Tandem names medical director

SAN DIEGO – Tandem Diabetes Care has appointed Jordan Pinsker, MD, vice president and medical director effective April 26. Dr. Pinsker joins Tandem Diabetes Care from the Sansum Diabetes Research Institute in Santa Barbara, where he has served as director of artificial pancreas technology since 2018. “Dr. Pinsker brings extensive knowledge in patient care, diabetes epidemiology and physician practice efficiency, in addition to sharing our passion for improving the lives of people with diabetes,” said John Sheridan, president and CEO of Tandem Diabetes Care. “We welcome him to Tandem’s management team, as we work together to lead in insulin therapy management using our automated insulin delivery technology and flagship pumps.” In his role at Sansum, Pinsker was a lead investigator in numerous clinical trials on automated insulin delivery systems, includes Basal-IQ and Control-IQ technology, which Tandem Diabetes Care sells.

NSM takes more ‘holistic’ approach to Las Vegas branch

NASHVIILLE, Tenn. – National Seating & Mobility is adding full-service home access options at its Las Vegas branch. Kevin McManus will join the branch to oversee home access services throughout the region. “We are proud to provide a holistic suite of solutions supporting independence for individuals in and around Las Vegas and are pleased to welcome Kevin to the team of experts serving those clients,” said Bill Mixon, NSM CEO. McManus, who has been working in the complex rehab industry since 2012, is the former owner of Nevada Mobility. To further expand the Las Vegas branch’s home access services, NSM will also bring its exclusive program to The Home Depot to the area this spring.

Össur goes green

REYKJAVIK – Össur has announced that it will be carbon neutral in 2021, its 50th anniversary. The company will be carbon neutral for energy and fuel consumption, waste generation, business travel, transportation of goods, and electricity consumption of finished goods suppliers. “We care about the environment and take our responsibility seriously,” said Jon Sigurdsson, president and CEO of Össur, who has led the company for 25 years. “We have been actively working on establishing a good overview of the company’s carbon footprint and are proud to commemorate the company’s 50th anniversary be becoming carbon neutral.” Össur has partnered with First Climate, a provider of carbon emissions management, to achieve carbon neutrality in 2021. As part of the company’s larger commitment, it is also contributing to the UN Sustainable Development Goals, with a focus on sustainable development, good health and well-being, gender equality, and responsible consumption and production.

Apria replaces Smyth with Hicks

INDIANAPOLIS – Apria Healthcare has appointed Michael-Bryant Hicks as executive vice president, general counsel and corporate secretary. He joins Apria from Elanco Animal Health, where he held the same position. Hicks previously held positions at Mallinckrodt Pharmaceuticals and The Providence Service Corporation, where he oversaw all legal functions for both companies. Hicks replaces Raoul Smyth, who most recently served as executive vice president, general counsel and corporate secretary. Smyth joined Apria in 1996 and directed the company’s legal and regulatory functions since 2015, playing significant roles in multiple milestones, including the company’s IPO in February.