In brief: Hurricane waivers, NIV advocacy, CRT lobby

WASHINGTON – CMS will permit people with Medicare who have lost or had damage to their DMEPOS products because of Hurricane Helene to receive replacements of such items and services, according to a bulletin from AAHomecare.  

Specifically, CMS waivers for Florida, Georgia, North Carolina, South Carolina, and Tennessee state that: 

When DMEPOS is lost, destroyed, irreparably damaged, or otherwise rendered unusable, CMS is allowing DME MACs to have the flexibility to waive replacement requirements such that the face-to-face requirement, a new physician’s order, and new medical necessity documentation are not required. Suppliers must still include a narrative description on the claim explaining the reason why the equipment must be replaced and are reminded to maintain documentation indicating that the DMEPOS was lost, destroyed, irreparably damaged, or otherwise rendered unusable or unavailable as a result of the emergency.  

The full list of CMS determinations, declarations and waivers by state can be found here.   

Florida, North Carolina and Tennessee have also shared information to help protect access to HME for their Medicaid beneficiaries: 

• Florida: FL AHCA and Sunshine Health 

• North Carolina: NC DHHS 

• Tennessee: TennCare 

AAHomecare will provide additional details, resources, and support as they become available. 

Cascade Orthopedic Supply goes independent 

CHICO, Calif. – Cascade Orthopedic Supply has announced that it will redeem Ottobock’s ownership interests in the company in a deal that was finalized Sept. 27. Cascade is now an independently held company. "I am elated to have the opportunity to redeem all outstanding ownership interests of Ottobock by Cascade,” said Jeff Collins, CEO, Cascade Orthopedic Supply. “Our time at Ottobock allowed us to strengthen the core competencies of the business and achieve growth despite challenging market conditions. I am grateful for those who have worked with us along the way and excited to bring independent innovative solutions to our customers." Throughout their partnership, Cascade says the company and Ottobock operated autonomously and, therefore, their working relationship as supplier and distributor will remain unchanged. Cascade says it will maintain distribution of Ottobock's orthotic and prosthetic devices and uphold a strong supplier partnership.  

Cascade has posted an FAQ about the transaction. 

AAH strengthens NIV, CGM advocacy 

WASHINGTON – AAHomecare has expanded its relationship with legal and public policy firm Foley Hoag to strengthen its advocacy work on significant coverage issues for non-invasive ventilators and continuous glucose monitors. “Foley Hoag’s expertise in Medicare and Medicaid policy is already helping us sharpen our arguments by identifying established laws and regulations that support our advocacy goals,” said Tom Ryan, president and CEO of AAHomecare. “In addition, their relationships with leaders at CMS and in Congress will help us reach the most important decision-makers on these issues.” AAHomecare began working in earnest in July 2021 to prevent Medicare Advantage plans from applying overly restrictive coverage criteria for NIVs. Its efforts have included directly engaging with CMS on the issue, enlisting members of Congress to help make its case, outreaching to medical directors at major payers and generating media coverage, often with support from the ALS Association and CHEST. 

• Related: AAHomecare has launched two portals to collect end user and family caregiver stories about the impact of policy changes for NIVs and CGMs. 

• Related: Industry stakeholders are concerned that a recommendation to require COPD patients to try and fail on RADs before they can qualify for NIVs will impede access for patients.   

AAH, Medtrade collaborate on new track 

WASHINGTON – AAHomecare has collaborated with Medtrade on a new Managed Care track that includes sessions for both beginner and advanced payer relations strategies. The association’s Payer Relations Council developed six classes for the track. “The AAHomecare Payer Relations Council has some of the brightest and most respected payer relations experts in the industry,” says Laura Williard, senior vice president of payer relations for AAHomecare. “By learning from these experts, companies can expect to come home from Medtrade better equipped to advance their companies in contract negotiation, technology, relationships with payers, and overall payer strategy.” For those new to payer relations, the first track will provide information on what are the regulatory bodies, how to build and maintain effective relationships with payers, and how to engage the most important stakeholders in this space. The second track will delve into sophisticated negotiation techniques, complex contract negotiations, advanced technologies including AI, emerging trends, and the future landscape. To see the full conference agenda for Medtrade, Feb. 18-20 in Dallas, go here. 

CRT advocates wrap successful lobbying day 

WASHINGTON – U.S. Rehab and NCART hosted about 70 meetings with various members of the House of Representative and the Senate on Sept. 24 to advocate for enhanced accessibility and support for individuals with disabilities. During the meetings, stakeholders urged members of Congress to support H.R. 5371 and the newly released S. 5154, which would allow consumers the choice to upgrade to a titanium or carbon fiber manual wheelchair, ensuring they have access to the best possible mobility solutions for their specific lifestyle. "It was truly exciting to see so many U.S. Rehab members in attendance, as well as national providers, manufacturers and technology companies coming together to support our industry,” said Tyler Mahncke, president of U.S. Rehab. “We made a significant difference in D.C., and we are already seeing progress with our ask on the carbon and titanium consumer choice upgrade bill.” Additionally, the organizations called on Congress to contact CMS Administrator Brooks-La Sure to expedite the coverage process for power standing systems. “The focus on meeting with representatives and senators on committees of jurisdiction will provide benefits for the industry in 2025 and beyond,” said Wayne Grau, executive director of NCART. “This is just the first step, as the CRT industry will continue to educate legislators about the incredible value they bring to constituents with CRT products and services.” 

Respiratory organizations reiterate call for support of SOAR Act 

WASHINGTON – In honor of World Oxygen Day today, 30 leading patient, provider and professional organizations have united to call on Congress to pass the Supplemental Oxygen Access Reform or SOAR Act (S. 3821/H.R. 7829). This legislation seeks to ensure that individuals enrolled in Medicare who rely on supplemental oxygen can access the proper type and level of oxygen they need to live full, healthy lives. Among the organizations endorsing this reform are the American Association for Respiratory Care (AARC), American College of Chest Physicians (CHEST), American Lung Association, American Thoracic Society, COPD Foundation, Council for Quality Respiratory Care (CQRC) and Pulmonary Fibrosis Foundation. “World Oxygen Day is an important time to shine a light on the challenges that many people who depend on supplemental oxygen face every day, and underscore the urgent need for oxygen reform in the U.S. Our organizations are urging Congress to get this done this year because oxygen is a lifeline, and patients cannot wait,” the groups said in a joint statement. “Many of our constituents—particularly those on Medicare—are homebound due to not having access to the appropriate supplemental oxygen equipment and services. When passed, the SOAR Act would result in people being able to get out of the house to run errands, attend social events, go to work and spend time with family.” 

• Here is a link to a recent letter that the groups sent to the Senate in support of the SOAR Act and here is a link to a recent letter sent to the House of Representatives. 

• Related: The Council for Quality Respiratory Care recently called on members of Congress to support and act on the SOAR Act before the end of the year.  

JTEK Solutions rebrands, opens second location 

COLUMBUS Ohio – JTEK Solutions Group, a provider of home access solutions, has opened its second location in Columbus, Ohio, and will rebrand as JTEK Home Access Design. “We’re thrilled to expand our presence in Ohio,” said Jared Chevraux, executive vice president of JTEK Home Access Design. “The new Columbus location allows us to serve more customers with improved access to personalized home modifications and mobility solutions. We are confident that franchise partners Joel Cooper and Chris Hartsel, with their extensive experience in residential construction, remodeling, and business operations, are the perfect team to lead this new chapter. The rebrand to JTEK Home Access Design reflects our dedication to making homes safe, functional and beautiful for all of our customers.” The new Columbus location will include JTEK’s Home Access Design Studio, building on the success of their award-winning North Canton showroom. Customers can expect the same industry-leading services that have made JTEK a trusted name, including home access installations like ceiling tracks, stairlifts, grab bars and ramps, as well as JTEK’s signature custom bathroom remodeling, focused on enhancing safety and mobility. Additionally, JTEK is expanding into the smart home and technology sector, offering cutting-edge accessibility solutions.  

AARC recognizes Medline for respiratory commitment 

NORTHFIELD, Ill. – Medline is the recipient of the American Association for Respiratory Care (AARC)'s annual Zenith Award for its commitment to the respiratory care profession. The award, which is presented to only eight out of more than 300 manufacturers and service organizations, is based on several factors, including quality of equipment and supplies, accessibility and helpfulness of sales personnel, responsiveness, service record, transparency in advertising and support of the respiratory care profession. "AARC shares our congratulations and is proud to recognize Medline with the Zenith Award, an honor extended by our 42,000-strong membership to respiratory companies for the quality of their service and commitment to the respiratory care profession," said Dan Garrett, CAE, executive director for AARC. Medline launched its Respiratory Care division in 2021, offering high-quality products within oxygen delivery, medication delivery, bronchial hygiene, ventilation products and airway management. "Medline is thrilled to be recognized by the members of the American Association for Respiratory Care,” said Carrie Miller, national director of field sales, Medline Respiratory Care. “The Zenith Award speaks volumes to the strides we've made in such a short amount of time as a respiratory care division. From day one, we've been committed to working side by side with respiratory therapists to create solutions that fulfill their biggest challenges.” 

• Related: Medline added the Flight 60 ventilator to its respiratory portfolio last year. 

Ascensia launches Eversense 365 

PARSIPPANY, N.J. – Ascensia Diabetes Care has launched its Eversense 365 continuous glucose monitoring system, which received clearance from the U.S. Food and Drug Administration in September. “Eversense offers a completely differentiated CGM experience, overcoming many of the frustrations experienced with traditional, short-term CGMs, such as early failure, disruptive false alerts and skin irritation,” said Brian Hansen, president of CGM at Ascensia. “With only one CGM replacement a year, fewer failed or wasted sensors, and alerts you can trust, Eversense 365 allows patients to live life uninterrupted by their diabetes technology.” The Eversense 365 CGM has been approved by the FDA for Type 1 and Type 2 diabetes for people aged 18 years and older. It has been approved as an integrated CGM system, meaning it can integrate with compatible medical devices, including insulin pumps, as part of an automated insulin delivery system. 

Vertess taps new managing director 

FORT WORTH, Texas – Vertess has added senior health care executive Christine M. Bartel to the team as managing director. Bartel has nearly 30 years of health care experience in administration and executive leadership positions responsible for clinical compliance, care coordination and operational efficiencies, including financial integrity and growth strategies. She started Hope at Home, Inc. and Aspire Home Care, a private duty agency and skilled home care agency, respectively, in Colorado. "After years of directly providing health care supports, I believe my skills and experience offer a critical advantage to other health care leaders considering their next steps,” said Bartel. “I am keenly aware of the daily struggles owners have to maintain high-quality care while also managing the daily operational demands.” Vertess was also recently named No. 1 lower middle market sell-side M&A advisor on Axial’s 2024 Healthcare Top 50 list. Axial is a private deal network serving professionals who own, advise and invest in North American companies. The list features the top 50 most active and sought-after members who worked on transactions across various health care sectors over the past 12 months. VERTESS was recognized for the number of deals brought to market and the level of interest those deals received in the network.