In brief: Payment increase, CAIRE expansion, Philips update

WASHINGTON – CMS on Dec. 2 announced a 9.1% increase for competitively bid DMEPOS items in non-competitive bidding areas and a 6.4% increase for bid items in former CBAs for calendar year 2023, AAHomecare reports. 

Non-bid items will receive an 8.7% increase. 

Typically, the CPI-U increases for DME have been 1%-3%. Last year, the inflation adjustment was 5% in former CBAs and 5.4% non-CBAs. 

“These increases will help DME suppliers who have been dealing with rising product and operational costs over that last two years, but more comprehensive adjustments are needed,” said Tom Ryan, AAHomecare president and CEO. “Thanks to the cancellation of one bidding round and the decision not to implement results of the most recent round, DME rates remain disconnected to the market realities suppliers face. That has to change, and it has to change now.” 

CMS will be publishing the official CY 2023 fee schedule soon. 

See the Calendar Year 2023 Update for DMEPOS Fee Schedule (CMS Claims Processing Update Change Request 13006) for more information. 

CAIRE expands into cardiorespiratory market 

BALL GROUND, Ga. – CAIRE, a subsidiary of NGK Spark Plug, has announced its plans to acquire St. Paul, Minn.-based MGC Diagnostics Holdings. 

MGC designs, develops, manufactures and markets non-invasive cardiorespiratory diagnostic systems, accessories and consumables for the detection, classification and management of cardiorespiratory disease. 

“CAIRE is firmly committed to driving future growth by expanding our offerings in the clinical setting to better serve those individuals affected by cardiorespiratory diseases,” said Earl Lawson, CAIRE president and CEO. “MGC has a state-of-the-art portfolio that is widely adopted to diagnose respiratory disease and to ensure that the information obtained benefits disease management. These tools are an excellent complement to CAIRE’s complete range of oxygen therapy solutions. Furthermore, we are very excited to work with the talented MGC senior management team and global team of professionals who were responsible for the strategic planning and execution driving MGC’s strong growth. This will be key to a seamless integration of the business and the ongoing expansion in the marketplace.” 

The deal is expected to close by the end of the year. 

MGC, the No. 2 player globally in the cardiorespiratory diagnostics market, has facilities in Belgium, Germany, France and Australia, in addition to St. Paul, and employs 200. Its product portfolio includes pulmonary function testing systems, cardiopulmonary exercise systems, spirometers, flow sensors, gas analyzers, and associated consumables. 

“The MGC team is excited to become a part of the CAIRE organization,” said Todd Austin, MGC CEO. “After outperforming the market consistently, we look forward to leveraging the resources of CAIRE and NGK Spark Plug to drive continued growth in our existing markets and to launch new products and technologies through our best-in-class distribution channels.” 

Philips updates complaint count 

AMSTERDAM – Philips Respironics filed an additional 70,000 medical device reports (MDRs) with the U.S. Food and Drug Administration between April 2022 and October 2022, the company stated in a Nov. 22 update on its recall of certain CPAP, BiPAP and mechanical ventilator devices. 

The vast majority of the 90,000 MDRs filed since April 2021 are alleged technical malfunctions that do not involve serious injury, the company stated.  

“It is important to note that the submission of an MDR itself is not evidence that the device caused or contributed to the adverse outcome or event, and that the cause of an event cannot typically be determined from this reporting system alone,” the company stated. “Philips Respironics investigates all allegations of technical malfunction, serious injury or death.” 

Philips noted that, following public statements on the potential health risks related to the polyester-based polyurethane (PE-UR) sound abatement foam in certain devices in April 2021 and the announcement of the recall in June 2021, the company received a steep increase in complaints. 

In its announcement, the FDA noted that 260 deaths were included in the 90,000 MDRs. 

• Read about how Philips recently paused its remediation program for recalled vents to investigate a limited number of complaints. 
• As of November 2022, the company was still in talks with the U.S. Department of Justice on a consent decree to resolve identified issues related to its recall. 

Debt ceiling legislation offers opportunity to pass H.R. 6641 

WASHINGTON – With Congress required to pass legislation to extend the federal debt ceiling by Dec. 16 to avoid a government shutdown, industry stakeholders are urging providers to use the next few weeks to push for including competitive bidding relief. 

AAHomecare says providers who haven’t done so should contact lawmakers and ask them to support H.R. 6441, which would extend a 90/10 blended reimbursement rate that’s currently in place for competitive bidding items in competitive bidding areas. The bill currently has 25 co-sponsors.  

Stakeholders are also pushing for extending the 75/25 blended reimbursement rate that’s currently in place in rural areas for a set time beyond the public health emergency. 

Direct email and personalized outreach to health care staffers, especially staff that providers met with as part of AAHomecare’s Virtual Washington Legislative Conference in September, is the most effective way to make a strong impression, the association says. 

• Read about the push for competitive bidding relief during the Legislative Conference. 

CQRC fears lack of template could increase denials 

WASHINGTON –– The Council for Quality Respiratory Care has expressed disappointment that the recently published local coverage determination for oxygen does not call for the use of a data-driven oxygen template when documenting medical need.  

Instead, the LCD, released on Nov. 18, continues to rely on the use of patient medical records, which the CQRC says can be subjective and inconsistent and which can lead to a high rate of oxygen claim denials. 

“It is concerning that CMS missed another opportunity to streamline the claims review process by failing to adopt the use of oxygen templates with standardized clinical data elements instead of paper records,” said Crispin Teufel, chair of CQRC and CEO of Lincare. “By requiring the use of oxygen templates, CMS could protect access to a medically necessary therapy that allows individuals to remain independent in the home, reduces burdens on providers and suppliers, and cuts costs.” 

The new LCD also raises concerns, the CQRC says, that Medicare contractors could now deny patient access to supplemental home oxygen if health care providers cannot prove that “[t]he provision of oxygen and oxygen equipment in the home setting will improve the beneficiary’s condition.” 

While health care providers may seek to improve the lives of patients with certain treatments, the long history of supplemental oxygen, especially when used for patients battling chronic respiratory diseases, has shown that oxygen is needed to maintain the patient’s current status so that it does not worsen, the CQRC says. 

“This added language, unfortunately, does not recognize that each patient is unique and the important role that supplemental oxygen plays in preventing these individuals from experiencing worsening symptoms,” said Teufel.  “We hope that CMS will work with patients, providers, and suppliers to make sure that the new coverage rules do not result in patients losing access to medically necessary oxygen.”   

• Read why Crispin Teufel believes a template for oxygen is needed. 

Viemed secures new funding of up to $90M 

LAFAYETTE, La. – Viemed Healthcare has entered into new syndicated credit facilities consisting of a five-year senior secured revolving credit facility of up to $30 million and a five-year delayed draw term loan facility of up to $30 million, which may be borrowed in multiple drawdowns. The new credit facilities contain an accordion feature that allow the company to increase the size of the facilities by up to $30 million, subject to certain conditions, for a total borrowing capacity of up to $90 million. Concurrently, Viemed has retired its previous senior credit facility, which included a $10 million unfunded line of credit commitment and a building term note in the principal amount of $4.7 million, scheduled to expire and mature in 2023 and 2026, respectively. “The significantly increased commitments enhance the company's financial flexibility and liquidity, providing capacity to complement our impressive organic growth through strategic acquisitions,” said Todd Zehnder, Viemed’s COO. “By working closely with our lending group, we were able to tailor the structure of the credit facilities according to our specific strategies and objectives. The scalable features provide immediate access to capital when investment opportunities are identified, while also limiting interest expense exposure. We appreciate the resounding confidence and strong support of the lending group.” 

• Read about Viemed’s plans to grow through acquisition. 

InfuCare Rx acquires Health First Infusion 

FAIRFIELD, N.J. – InfuCare Rx has completed its acquisition of the business assets of Health First Infusion (HFI), a licensed home infusion pharmacy located in West Palm Beach, Fla. “The HFI asset acquisition is part of a multi-faceted plan to expand into new regions and pursue our mission of providing high-quality, cost-effective care to patients with acute and chronic health conditions,” said Deven Patel, founder and CEO of InfuCare Rx. InfuCare Rx currently has locations in New Jersey, Pennsylvania, Maryland, Louisiana, Texas, and California. It is licensed to serve patients in all 50 states, Washington, D.C., and Guam. Financial terms of the deal were not disclosed. 

Vizient partners with SafeSource Direct on PPE 

IRVING, Texas, and BROUSSARD, La. – Vizient, a health care performance improvement company, has entered into an agreement with SafeSource Direct, LLC, for chemo-rated nitrile gloves. The agreement is the latest move by Vizient to increase supply assurance of critical medical supplies. “The health care supply chain is global, extremely complex and remains an open invitation for unexpected disruptions,” said Simrit Sandhu, executive vice president, Vizient. “Vizient is committed to supporting efforts that help ensure our members are insulated against supply chain disruptions like those that occurred with the COVID-19 pandemic.” SafeSource Direct is a joint venture between the Gulf South’s largest health system, Ochsner Health, and Trax Development that was launched in 2021 amid the COVID-19 pandemic as a solution to national shortages of PPE. “The pandemic shined a light on significant flaws in sourcing PPE from outside the U.S., and through this new agreement, we’re helping insulate Vizient members from future price increases, stockouts and international supply chain disruptions,” said Justin Hollingsworth, CEO of SafeSource Direct. “Our health care partners have had to resort to stockpiling, which is costly and inefficient. We’re ensuring they can always count on a readily available, high-quality supply of PPE.” 

RRI to continue supporting HomeFill 

ST. LOUIS, Mo. – Responsive Respiratory says it is committed to providing cylinders and valves compatible with the HomeFill system, despite Invacare’s decision to exit the respiratory market by the end of the year. “We stand committed to servicing the needs of oxygen providers,” said Steve Bannon, RRI president. “The departure of Invacare in the respiratory market leaves a tremendous gap for providers utilizing the HomeFill compressor. Rather than decommissioning units for the lack of compatible cylinders and valves, providers can be confident there will continue to be a steady supply available from Responsive Respiratory to meet their needs.” Responsive Respiratory fully stocks valves and cylinders compatible with the HomeFill system in its central U.S. warehouse for quick shipment. Accessory items are also available for use with the system, including cylinder carry cases, carts, racks and respiratory disposables 

• Read what Geoffrey Purtill had to say about Invacare’s decision to exit the respiratory market. 
• Read what HME providers had to say about the impact. 

Wright & Filippis hit with ransomware attack 

ROCHESTER HILLS, Mich. – Wright & Filippis has reported a data breach with the U.S. Department of Health and Human Services Office for Civil Rights, as well as the California Attorney General, after the company learned it had been the target of a ransomware attack, according to news reports. The breach resulted in names, dates of birth, patient numbers, Social Security numbers, financial account numbers and health insurance information being compromised. Recently, Wright & Filippis sent out data breach letters to all affected parties, informing them of the incident and what they can do to protect themselves from identity theft and other frauds. The company discovered the attack shortly after it was conducted and enlisted the help of third-party experts to assist with its investigation. Wright & Filippis also has a Notice of Security Incident section on its website to answer frequently asked questions, outline the company’s response and recommend steps to protect your personal data. 

NCPA releases second episode of reality show 

ALEXANDRIA, Va. – The National Community Pharmacists Association has released the second episode of “Show Me,”” a reality series styled after popular TV makeover shows, only the stars are real pharmacists who need help getting a certain aspect of their business on track. This episode takes place in Wagoner, Okla., where pharmacist Steve Nicholas is looking for help start a vaccine program from the ground up at the 50-year-old Rogers Drug Company. “Show Me” coach Jonathan Marquess, an owner of multiple stores in Georgia, flew across the country to see if he could help. Can he convince Steve that a vaccination program is an essential revenue stream and build his confidence enough to take the leap? Does life get in the way and keep the Rogers Drug Company team from offering this service to area patients? Episodes one and two are now available on NCPA’s YouTube channel, NCPAvids.  The remaining three episodes of this season will be released in the coming weeks. Follow on YouTube and on social media @commpharmacy for updates and sneak previews. 

pVerify launches DME solution 

TUSTIN, Calif. – pVerify, Inc., a patient insurance eligibility solution, has released pVerify Connect with its signature same or similar claim history solution and real-time eligibility verifications for DME suppliers. Through the Salesforce app, pVerify incorporates real-time advanced eligibility, completely automating the two-step process required to fulfill orders. The same or similar solution, a flexible five-year range of Medicare claims history, allows users to submit thousands of requests at a time through a SOC2 compliant, single sign-on platform, resulting in reduced labor and increased shipments. The solution includes interpretation flags, further replacing manual interpretation with automated conclusions that solidify accurate billing. 

Woman of the Year finalists named  
WATERLOO, Iowa – VGM Group has announced the finalists for the HME Woman of the Year: Sherry Krug, vice president of Binson’s Medical Equipment & Supplies; Dalia Morales, ATP, director of compliance, HR, and complex rehab technology at Respiratory and Medical Homecare Unlimited.; Sheila Roberson, chief compliance officer of Great Elm Healthcare; and Erin Weiman, CEO and owner/operator of Nunn’s Home Medical Equipment. VGM received nearly 50 nominations for the award this year. “These finalists for the HME Woman of the Year exemplify innovation and forward-thinking in the industry,” said Jeremy Stolz, president of VGM & Associates and VGM Fulfillment. “Every day, these women are making a big impact on not only the patients and communities they serve, but for the entire HME industry. Each of these finalists is well-deserving of this award.” A panel of judges selected the finalists using criteria that included implementing new business processes, advocating on behalf of the industry, improving the lives of patients, and impacting their community through volunteerism. VGM will announce the winner at a special virtual ceremony on Dec. 15, 2022. Register for the event here.  

• Read about the finalists for the 2021 HME Woman of the Year Award, including winner Katie Stevens. 

VGM Gov’t Relations: Help us determine priorities 

WATERLOO, Iowa – VGM Government Relations has launched a survey to help it determine where to focus its efforts in 2023. During a recent State Leaders Summit hosted by VGM, a group of state and regional association leaders came up with the following top issues: improved reimbursement, audit relief, MCO/Medicaid accountability, among others. VGM is asking providers to prioritize these issues and add others. “We want to hear from you,” it stated in an update. “VGM Government Relations wants to ensure that we focus on the issues that mean the most to our VGM members. Our team will review the survey responses and frame our planning for 2023 around the feedback received.” Go here to take the survey. 

Quality Biomedical launches new technology  

BOULDER, Colo. – Quality Biomedical has launched QTags, a QR code label that’s integrated with the company’s management platform QConnect, to help its provider customers better track equipment. “Customers often commented about the time required to generate RMAs, and their ability to accurately track the equipment they sent for service and received back after service” said Jim Worrell, chief commercial officer of Quality Biomedical. “We listened to those concerns and developed a comprehensive solution called QTag to solve this industry-wide problem.” Here’s how it works: Customers download the app “QConnect Mobile” from the Apple App Store to turn their smartphone into a scanner for QConnect and they apply a QTag to the equipment needing service and scan it, generating a request for pick up, assigning a unique ID and providing the next pick-up date. The Quality Biomedical driver who picks up the equipment then scans the same QTag and produces an electronic receipt for the equipment picked up.  

OxyGo launches sleep line 

ORLANDO, Fla. – OxyGo, a supplier of portable oxygen concentrators, has launched a new sleep line. OxyGo SLEEP offers a full line of products, including CPAP and BPAP devices, travel batteries, sanitizers and accessories, as well as a web-based compliance portal for managing patient devices. “Launching a portal that will allow providers to communicate stats and share data with other health care professionals is key to making the user experience better for both sleep providers and patients,” said Duane King, director of sales. “We are very excited to be adding this sleep line to our award-winning products and services.” The CLOUD provider portal gives providers secure web access to manage and monitor patient data. Providers also have the ability to share data and statistics with physicians and other health care professionals. 

ResMed’s acquisition of MEDIFOX DAN is official 

SAN DIEGO and HILDESHEIM, Germany – ResMed has completed its acquisition of MEDIFOX DAN for 958.6 million Euros. MEDIFOX DAN, which is headquartered in Hildesheim, Germany, and employs 700, now operates under its current brand within the ResMed SaaS business segment, which also includes Brightree and MatrixCare. “We’re excited to have closed this important expansion of our SaaS business and to officially welcome MEDIFOX DAN to our ResMed SaaS team and global ResMed family,” said ResMed CEO Mick Farrell. “MEDIFOX DAN is a German leader in software innovation, united with the rest of ResMed in its mission to improve tens of millions of people’s lives through technology. Today, its strong offerings and dedicated staff expand ResMed’s out-of-hospital SaaS business into new health sectors, and to build on our strong ResMed healthcare business in Germany, the world’s second largest health care market in per capita spending.” ResMed intends to retain MEDIFOX DAN’s employees, locations and business processes. The company will report into ResMed SaaS President Bobby Ghoshal. 

• Read why ResMed calls MEDIFOX DAN the company’s ‘beachhead’ for global expansion in Europe. 
• Read Bobby Ghoshal’s take on how technology can up the HME provider’s game. 

Wesper raises $9.6M 

NEW YORK – Wesper, the first clinical-grade wireless home sleep lab cleared by the U.S. Food and Drug Administration, has announced a $9.6 million Series A round to accelerate growth and revenue, as well as continue to develop diagnostic sensing technology. Wesper's wireless biometric sensors and algorithms enable at-home medical diagnosis with professional services and ongoing measurement before, during, and after treatment. "Wesper is at the forefront of revolutionizing the sleep industry through superior access to biometric data and an increased focus on patient experience, working to ensure that every patient who suffers from sleep problems gets the care they deserve," said Amir Reuveny, founder and CEO. The round included participation from Valor Equity Partners, Breyer Capital, Spark Capital, as well as angel investors from leading health-tech firms. With this new funding round, Wesper will build partnerships with sleep centers, dental clinics and coaches to bring Wesper to patients across the US. Through FDA clearance for assistance with HSAT (home sleep apnea testing), clinics can use Wesper's superior algorithms, biometric data, and patient experience to help more patients. The company has on-boarded key medical institutions and is set to expand its presence in the sleep clinic space. This includes expanding its medical adviser network and forging strategic partnerships with key players such as hospitals, sleep labs, and insurance providers. "Improving your sleep used to be a very lonely and complicated process, and we are here to change that," says Dr. Chelsie Rohrscheib, the head sleep expert at Wesper. "We are committed to our users every step of the way to getting high-quality sleep." 

• HME News interviewed Amir Reuveny in 2021 about Tatch, the predecessor to Wesper.