In brief: Part B drug payments, Kalogon deal, new Vertess managing director

WASHINGTON – CMS should bolster its oversight of manufacturer-submitted average sales price (ASP) data to ensure accurate Part B drug payments, according to a new report from the Office of Inspector General.  

Due to invalid or missing ASP data, CMS could not calculate an ASP-based payment amount for 8% of drug codes at least once between 2016-20, the OIG found. 

“CMS was unable to calculate an ASP-based payment amount for several reasons, including that (1) the manufacturer reported a negative sales or ASP value; or (2) the manufacturer had no sales to report for that quarter,” the agency stated. “The alternative payment methodology that CMS uses when ASP data are either unavailable or deemed invalid often results in higher drug payment amounts for Part B drugs.” 

In total, the OIG found that 24% of drug codes were missing ASP data for one or more specific drugs within that code in at least one quarter between 2016-20. 

The office also found that, when CMS reported late ASP data submissions from manufacturers it substantially hindered the agency’s ability to conduct effective oversight. 

The OIG recommends that CMS build a strategy to strengthen its internal controls for ensuring the accuracy of Part B drug payments. CMS concurred with the recommendation. 

Kalogon snags distribution deal with Merits 

MELBOURNE, Fla. – Kalogon, a leader in smart seating solutions, has announced Merits Health Products, a manufacturer of high-quality mobility devices, will expand the distribution of its Orbiter Smart Cushion. “Merits Health Products offers life enhancing quality solutions that enable independence and accessibility for everyone,” said Bret Tracy, director of sales at Merits. “When we saw Kalogon’s recent technology, we knew it would be a nice enhancement to our range of power chairs. Offering the Orbiter Smart Cushion as a value-add to our line of products will support our customers in helping to prevent pressure injuries and will improve overall comfort so they can live their lives to the fullest.” Using a combination of machine learning and patent-pending air cell technology, the Kalogon Orbiter Smart Cushion analyzes pressure points in real-time, intelligently redistributing weight, increasing comfort and maintaining blood flow in wheelchair users. A connected app enables wheelchair users, caregivers and clinicians to personalize their experience to support healing and pain relief. The cushion will be available for purchase through Merits sales representatives and as an upgrade to any of Merits power and manual wheelchairs. 

Miller named to NCART exec committee 

AKRON, Ohio – Johnny Miller has been appointed to the executive committee of NCART. Miller, owner of Miller’s, has served on the NCART board of directors since 2016. “I am honored to again serve on the Executive Committee alongside an outstanding group of industry leaders,” he said. “NCART is poised for an important 2023 as we focus on seeking Medicare coverage for power wheelchair seat elevation and power standing technology. Additionally, I am eager to help with efforts seeking appropriate wheelchair repair/service coverage and payment policies. Much needed reforms here will ensure wheelchair repairs are readily available for all wheelchair users who need it.” 

NCPA launches third episode of “Show Me” 

ALEXANDRIA, Va. – The National Community Pharmacists Association has released the third episode of “Show Me,” an educational reality series styled after popular TV makeover shows that features real pharmacists who need help getting a certain aspect of their business on track. Unlike the pharmacies in the first two episodes, Halifax Pharmacy in South Boston, Va., already has a strong vaccine program in place. Rather than building a program from the ground up, owner Stephen Anderson, PharmD, and his team are looking to streamline their workflow and become even more proactive. “Make Us More Efficient” coaches Meredy Ayers, CPhT, and Tana N. Kaefer, PharmD, are on site with ways the staff can maximize the use of their technicians and make the most of each patient interaction. The first three episodes of this season are now available on NCPA’s YouTube channel, NCPAvids, and the remaining two will be released in the coming weeks. Follow on YouTube and on social media @commpharmacy for updates and sneak previews.  

Here’s an in-depth look at the first episode. 

Vertess taps former MSC Biomedical exec as new managing director 

FORT WORTH, Texas – Vertess recently hired Jonathan Hadley as their newest managing director. Hadley has experience in the medical device space after leading and growing MSC Biomedical, a large medical device service organization in North America, where he served in various roles, including CEO. At MSC Biomedical, Hadley was able to work directly with medical device manufacturers, HME providers and former competitors as he executed upon a national network acquisition M+A strategy. "I have been in the medical device space for most of my life,” said Hadley. “While it was exciting and rewarding to lead my own company, I believe I can offer much more as an advisor and consultant to other business owners." Vertess also announced that five team members have completed an educational course sponsored by the Alliance of Mergers & Acquisition Advisors called Certified Mergers & Acquisitions Advisor (CM&AA). Currently, Vertess has 13 CM&AA professionals.  

WHILL honored for accessibility at CES 

SAN FRANCISCO – WHILL, Inc., a developer and service provider of electric mobility chairs, announced today that its WHILL Autonomous Model A power chair has been honored with a CES Innovation Award in the accessibility category at the Consumer Electronics Show. The CES Innovation Awards are an annual competition honoring outstanding design and engineering in consumer technology products. "WHILL products and services are uniquely designed to reduce barriers and improve the quality of life for our customers," said Kerry Renaud, CEO of WHILL North America. "WHILL is thrilled to be recognized again at CES, especially as we broaden our reach of innovative products to support customers in their full range of mobility needs, from personal mobility devices to fully autonomous and manual drive power chairs." The WHILL Autonomous Model A enables seniors and persons with disabilities to easily navigate airports, regardless of cognitive, mobile, hearing, or visual abilities. In December 2022, WHILL announced the first permanent installation in North America at Winnipeg Richardson International Airport in Manitoba.  

Enabled Healthcare receives grant 

SEATTLE, Wash. - Enabled Healthcare, a health care solution keeping patients with complex needs on Medicare and Medicaid healthy and at home through telemedicine, vitals monitoring and care coordination, was one of four startups to be awarded a grant of $50,000 from Village Capital’s ADAPT program, supported by the Metlife Foundation. ADAPT: Social Innovation for a More Resilient Future in the United States is a new accelerator program started this year to support the innovation and development of solutions for key issues related to climate change, health care and wellness, and economic mobility. “We had an amazing experience learning and growing from the advice and feedback of the founders in our cohort, each doing amazing work,” said Bethany Doran, MD/MPH, founder and CEO of Enabled Healthcare. “We will use the non-dilutive funding to expand health care into remote areas and continue to build a model for tech enabled high quality healthcare.” Enabled Healthcare provides the equipment necessary for patients to take advantage of telemedicine and home vitals monitoring services. It also pairs patients with a provider to monitor their health and vitals and are there to help manage any health concerns immediately.  

Apnimed secures additional financing 

CAMBRIDGE, Mass. – Apnimed has secured $79.75 million in an oversubscribed financing round that extends its Series C financing to a total of $142.25 million. The company will use proceeds to fund the planned Phase 3 trials for its lead candidate, AD 109 (aroxybutynin + atomoxetine), which has the potential to be the first oral treatment for obstructive sleep apnea. “This substantial additional investment is a significant vote of confidence by our investors,” said Larry Miller, M.D., CEO of Apnimed. “There is a tremendous unmet clinical need for new pharmaceutical treatment options for OSA, and this funding recognizes that need and the unique opportunity for AD109 to change the treatment paradigm for this serious disorder. With this funding, Apnimed can move forward with the late-stage clinical trials that will form the basis for approval of AD109.”  Enrollment for the clinical trials is expected to begin in the second quarter, subject to discussions with the U.S. Food and Drug Administration (FDA). AD109 targets key neurological pathways in OSA that activate upper airway dilator muscles to maintain an open airway during sleep. Apnimed says it has the potential to become a safe, effective and convenient treatment for OSA, addressing some of the key limitations of current standard of care treatments that can be poorly tolerated (e.g., CPAP) and/or invasive (e.g., surgery or implanted devices).