In brief: Philips refutes claims, MA premiums remain stable, NCPA supports CVS lawsuit 

AMSTERDAM – Philips disagrees with “characterizations” in recent articles that the company knew for several years about problems with certain ventilators and sleep apnea devices. 

ProPublica and the Pittsburgh Post-Gazette on Sept. 27 published an article saying that Philips knew about a dangerous breakdown inside its widely used ventilators and sleep apnea machines but waited years before recalling the devices in 2021. 

In a statement, Philips said it had previously responded to ProPublica and the Pittsburgh Post-Gazette in the U.S. and NRC in the Netherlands.  

“The articles do not present new facts and we do not agree with the characterizations made in these articles,” said Philips. 

The company went on to say: “Philips’ priority is patient safety and quality. We understand how important Philips Respironics’ sleep therapy devices and ventilators are to patients that use them. Philips regrets any distress and concern for patients, their families and care providers in this matter, and deeply apologizes for this. Philips acted to protect patient safety by initiating and executing a voluntary recall notification/field safety notice of significant scale. We continue to dedicate all available resources to ensure that patients receive remediated devices. The remediation of the sleep therapy devices is nearing completion, while the remediation of the affected ventilators is ongoing. Everyone at Philips is committed to achieving and maintaining the highest standards, building on a culture of integrity and compliance.” 

Philips earlier this month announced it had reached an agreement to resolve all economic loss claims related to a voluntary recall of certain sleep and respiratory care devices.  

CMS: Medicare Advantage, drug programs to remain stable in 2024 

WASHINGTON – Average premiums, benefits and plan choices for Medicare Advantage and the Medicare Part D prescription drug program will remain stable in 2024, according to CMS. 

The announcement precedes the upcoming Medicare Open Enrollment period, which begins Oct. 15, 2023, to help people with Medicare determine the best Medicare coverage option for their health care needs. 

“A top priority for CMS is to protect and strengthen the Medicare program for people with Medicare, their children, and their grandchildren,” said CMS Administrator Chiquita Brooks-LaSure. “It is important for people with Medicare to review their health care coverage and explore their Medicare options during open enrollment. The Biden-Harris Administration has taken many steps to improve Medicare Advantage and the Medicare Part D prescription drug program, and premiums and benefits in 2024 for Medicare Advantage will remain stable.” 

Improvements adopted in the 2024 Rate Announcement, as well as the 2024 Medicare Advantage and Part D Final Rule, such as increased beneficiary protections around marketing and prior authorization and increased access to behavioral health, are helping to support stability.  

Additionally, thanks to the Inflation Reduction Act, people with Medicare Part D prescription drug coverage will continue to have improved and more affordable benefits, including a $35 cost-sharing limit on a month’s supply of each covered insulin product, recommended adult vaccines at no cost, and additional savings on their Medicare Part D drug coverage costs in 2024. 

The average monthly plan premium for all MA plans, which includes Medicare Advantage-prescription drug plans, is projected to increase from $17.86 in 2023 to $18.50 in 2024. If enrollees choose to stay in their plan, most will experience little or no premium increase for next year, with nearly 73% of beneficiaries not seeing any premium increase at all. Plan choice is also increasing, and people with Medicare continue to have the ability to switch Medicare options. Medicare Advantage supplemental benefit offerings will increase slightly in 2024. 

Enrollment in Medicare Advantage is projected to increase from 31.6 million in 2023 to 33.8 million in 2024. The projected Medicare Advantage enrollment in 2024 will represent approximately 50% of all people enrolled in Medicare, compared to approximately 48% for 2023. 

NCPA supports class action lawsuit filed against CVS 

ALEXANDRIA, Va. – The National Community Pharmacists Association applauded a class action lawsuit filed against CVS Health, Caremark and Aetna that aims to recoup millions of dollars in wrongful back-end penalties for Medicare Part D prescriptions, otherwise known as pharmacy direct and indirect remuneration fees. 

“It’s payback time,” said B. Douglas Hoey, CEO. “Finally, community pharmacies have a chance to recover DIR fees that were unfairly taken. PBMs have been gaming the system for a long time, and it’s time to turn the tables.” 

The lawsuit, announced Sept. 27 by the law firms Berger Montague PC and Cohen & Gresser LLP, claims that Caremark – the largest pharmacy benefit manager in the country and a subsidiary of Fortune 6 corporation CVS Health – has been assessing pharmacy DIR fees in violation of federal antitrust laws and state laws governing contracts. The lawsuit also challenges Caremark’s agreements to arbitrate claims as being unfair and unenforceable. 

Hoey said that DIR fees have risen by more than 107,400% in recent years, a trend that is driving many community pharmacies to the brink of insolvency. 

“It’s very common for individual pharmacies to pay hundreds of thousands of dollars a year in fees that they can’t possibly anticipate, and in many cases long after the point of sale,” he said. “Moreover, those fees do nothing more than line the pockets of PBMs like Caremark. It’s a mafia-style shakedown. We’re thrilled that community pharmacists have a chance to recoup some of their money.” 

NCPA will focus on educating its members about the suit and other ways they can recoup DIR fees that were taken from them wrongfully. 

Trella Health, Integra partner 

ATLANTA – Trella Health, a provider of market intelligence and integrated customer relationship management (CRM) solutions, has joined Integra’s group purchasing organization (GPO). “Our partnership with Integra Partners marks an exciting collaboration dedicated to fueling business growth for HME suppliers,” said Scott Tapp, CEO of Trella Health. “With Trella Health’s market data insights and CRM platform empowering growth opportunities, and Integra’s expertise in streamlining operations within a single payer system, we are spearheading innovation to help suppliers unlock their untapped potential.” Integra’s GPO program makes various products and services available to Integra providers at discounted rates compared to those available if the products and services were purchased independently. “The focus of Integra’s GPO is to encourage business growth for participating DMEPOS providers by increasing access to high-quality referral sources and actionable market data at a special Integra discount,” said Michael Dorrie, vice president of network expansion and partnerships. “This offering, and others to come, are all designed to increase the value we bring to our providers.” 

Medline hosts ribbon cutting at new center 

NORTHFIELD, Ill. – Medline celebrated its now fully operational 710,000-square-foot distribution center in Salt Lake City with a ribbon cutting ceremony and facility tours. The new distribution center is three times the size of its previous facility in the city. “Medline has history in Salt Lake City and a larger facility will help us take care of more health care facilities across the continuum of care,” said Steve Miller, executive vice president of supply chain. “Today we are excited to celebrate our fully operational facility and our employees who work hard every day to ensure the success of our customers.” The Salt Lake City facility is part of Medline’s ongoing Healthcare Resilience Initiative, in which Medline has invested $2 billion since 2018 in domestic manufacturing, distribution and IT to strengthen the country’s health care supply chain. As part of the initiative, Medline added eight constructed distribution centers, totaling 9.7 million square feet, and expanded manufacturing capabilities during the pandemic to help meet ongoing time-to-market demands for PPE. 

Soleo Health makes local list 

FRISCO, Texas – Soleo Health has ranked 16th on Dallas Business Journal’s list of the 50 Fastest-Growing Middle Market Companies throughout the Dallas-Fort Worth area. For the past six years, Soleo Health has been ranked by the local business journal as one of the fastest-growing mid-sized companies in North Texas, which is considered among the nation’s largest metropolitan growth areas and most competitive U.S. marketplaces. “We are honored once again to be recognized on the Dallas Business Journal’s Middle Market 50 list, a milestone we have achieved for the past six years,” said Drew Walk, CEO. “Soleo Health’s growth in the three-year revenue period surveyed for this listing is based on our increasing double-digit patient census, geographic expansion and launch of diverse therapeutic programs. This accolade can also be attributed to all our employees’ efforts as their continued commitment to quality patient care is truly reflected in our impressive growth.” Companies on the list must have annual revenue of $10 million to $1 billion. This year’s list evaluates revenue growth from 2020-22. Winners were revealed at an awards ceremony on Sept. 21, 2023, in Dallas. 

Mobility City St. Louis marks two years 

ST. LOUIS, Mo. – The Mobility City franchise here just celebrated its second anniversary. Mobility City of St. Louis is a family-owned business backed by owners Derrick and Carol Dufresne and Tim and Noelle Humphrey. They have lived in the St. Louis community for more than 30 years. “I’m so proud of our team and what we’ve accomplished in just two short years,” said Dufresne. “We’ve helped so many people in the St. Louis area live better lives, and I can’t wait to see what the future holds.” Derrick and Noelle are specialists with a long history of providing services and support to individuals with intellectual and developmental disabilities and support and training for their caregivers. The owners also own a second franchise location in Ft. Meyers, Fla., which is completing its first year of operation.  

Belluscura taps into Hong Kong market 

LONDON and PLANO, Texas – Belluscura has received approval from the Hong Kong Department of Health – Medical Device Division to distribute its X-PLOR portable oxygen concentrator. The company has already received its first purchase order from a Hong Kong distributor. "We are very excited to receive the approval and begin sales in Hong Kong,” said Bob Rauker, CEO of Belluscura. “I am very pleased with our operations, quality control and sales teams receiving approval ahead of schedule. Hong Kong is phase one of our joint expansion with Innomax into Asia." Hong Kong is part of the licensed territory in its exclusive agreement signed last month with Innomax Medical Device Technologies. Belluscura has also announced it has successfully completed a patient usability study for its DISCOV-R POC, with all participants providing positive feedback on the device. The company will start initial production of the device this week and plans full-scale production, in conjunction with Innomax, in response to significant preliminary demand.   

Aeroflow helps fourth state with tax exemption 

ASHEVILLE, N.C. – Aeroflow Healthcare is celebrating the inclusion of a diaper tax exemption in Ohio state’s operating budget for the 2024-25 fiscal year. HB 33 will make children’s diapers more accessible and remove the tax on Medicaid prescribed adult incontinence supplies starting Oct. 1, 2023. "The diaper tax elimination in HB 33 is just the beginning of our work in Ohio as our government relations team continues to advocate for the residents in the state to have access to medically-necessary products and resources," said Ryan Bullock, COO at Aeroflow Healthcare. "While we're thrilled to see improvements to access to these products starting next month, we're going to be working to eliminate the taxes for all adult incontinence supplies without a Medicaid prescription in Ohio. We're dedicated to continuing our pursuit of improving equitable access to medically-necessary products and resources throughout the country." Ohio is just one of numerous states that Aeroflow Healthcare has been active in, following successes in Texas, Florida and North Dakota. 

Blake Pharmacy sells to PharMerica 

WAYNE, Pa. - Blake Pharmacy has sold to PharMerica, a national provider of pharmaceutical services, according to Paragon Ventures. Blake Pharmacy has established a strong presence in Florida and its sale to PharMerica will allow it to leverage resources, infrastructure and advanced technology platforms. “We are proud to join forces with PharMerica and embark on this exciting new chapter,” said Ashish Patel, founder and CEO of Blake Pharmacy. “By integrating our strengths and capabilities, we will be able to offer an expanded range of services to our valued patients.” The acquisition of Blake Pharmacy contributes to PharMerica’s growth and diversification and expands its footprint in Florida. PharMerica operates more than 180 long-term care, home infusion and specialty pharmacies in all 50 states. Paragon’s advisory team was led by Scott Fife, vice president.