In brief: Potential new NIV coverage, new PHM CEO, new home care alliance

WASHINGTON – CMS is soliciting public comment on a request for reconsideration of NCD 280.1 to establish coverage policies for the use of noninvasive home mechanical ventilators and respiratory assist devices for Medicare beneficiaries with COPD.  

The scope of the agency’s national coverage analysis (NCA) is limited to noninvasive positive pressure ventilation in the home for the treatment of chronic respiratory failure consequent to COPD and will focus on clinical indications for the initial and continued use of bi-level positive airway pressure (BPAP) devices and home mechanical ventilators (HMV), as well as the characteristics of these devices. 

As part of the NCA, CMS will analyze the clinical evidence for outcomes that may include improvement of physiologic signs along with decreased mortality, decreased frequency of exacerbations requiring emergency room or hospital admission, increased time to hospital re-admission for respiratory related disease, and improved function and quality of life. 

The agency is especially interested in comments that include scientific evidence, specifically any peer-reviewed literature, that describes the role of BPAP or HMV devices in the home management of chronic respiratory failure in patients with COPD. It is also interested in aspects of health disparities and health equity that should be considered in the review. 

The request to reconsider NCD 280.1 was made by The Optimal Noninvasive Ventilation Medicare Access Promotion Technical Expert Panel (TEP) consisting of representatives from the American College of Chest Physicians, the American Academy of Sleep Medicine, the American Association for Respiratory Care, and the American Thoracic Society. 

CMS is collecting comments here. 

Related: 

• In July, AAHomecare engaged Dobson Davanzo & Associates to quantify the differences in outcomes and overall treatment costs for patients with significant respiratory challenges who receive non-invasive ventilation (NIV) therapy versus those who don’t. 

• Earlier this month, the association launched a portal to collect end user and family caregiver stories about the impact of policy changes for NIV. 

PHM names Mastrovich CEO 

KENT, Wash. – Performance Home Medical has named Larry Mastrovich, who has served as PHM chairman since January 2024, as CEO.  

Mastrovich brings three decades of leadership, operations, sales and marketing, and strategic transaction experience to the company. For more than 25 years, he worked at Apria Healthcare, most recently as president and COO. Prior to joining PHM, he served as president and CEO of Breathe Technologies, a medical device manufacturer for respiratory products specializing in ventilation and sleep apnea solutions. 

“I am excited to step into the CEO role at this pivotal point in PHM’s evolution,” said Mastrovich. “PHM has served its core sleep apnea patient base meaningfully for over two decades, and I look forward to building upon this foundation to continue improving outcomes while supporting patients to address chronic care disease management. With the support of the talented PHM team and Grant Avenue, we will continue to expand the business across new geographies, products, and services.” 

Mastrovich’s appointment follows an investment from Grant Avenue Capital, a healthcare-focused private equity firm, earlier this year. 

“The home medical equipment market plays a crucial role in shifting the site of care to the home, when clinically appropriate and beneficial to the patient,” said Brian Berkin, partner at Grant Avenue Capital. “Although over 30 million Americans have sleep apnea, only a portion are diagnosed and receiving care. We are confident that under Larry’s leadership, PHM will be well-positioned to grow its access to patients who are out of reach from home-based solutions today.” 

Florida man pleads guilty in fraud case 

TRENTON, N.J. – A Miami Beach, Fla., man has admitted to his role in a DME fraud scheme, pleading guilty to one count of conspiracy to commit health care fraud. According to documents filed in the case and statements made in court: 

• Vehovec and his conspirators solicited and received kickbacks and bribes in exchange for providing DME companies with completed doctor orders for medically unnecessary DME, such as orthotic braces. 

• Vehovec and his conspirators used the service of telemedicine companies to obtain these prescriptions for DME, and the DME orders were subsequently fraudulently billed to Medicare and other health care benefit programs, causing losses to Medicare and other health care benefit programs of at least $4.2 million. 

The charge of conspiracy to commit health care fraud is punishable by a maximum potential penalty of 10 years in prison and a fine of $250,000, or twice the gross profit or loss caused by the offense, whichever is greatest. Vehovec’s sentencing is scheduled for Feb. 27, 2025. 

InfuSystem, Sanara MedTech to distribute chemo-relief device 

ROCHESTER, Mich. – InfuSystem and Sanara MedTech Inc. have executed an exclusive U.S. distribution agreement with ChemoMouthpiece, a device for the treatment of oral mucositis in chemotherapy patients. “Sanara and InfuSystem entered into our partnership to bring together our combined technical, operational and commercial strengths to deliver proprietary efficacious products to patients,” said Rich Dilorio, CEO, InfuSystem. “We believe this exclusive agreement, which builds on our partnership, will allow us to do that by offering the Chemo Mouthpiece, an oral cryotherapy device, bringing potential relief to thousands of cancer patients suffering from oral mucositis.” The Chemo Mouthpiece cools down the entire oral cavity, causing vasoconstriction, which in effect slows and reduces the flow of chemotherapy in the oral cavity, thus greatly reducing the risk of developing oral mucositis. 

Owens & Minor partners with Google Cloud on inventory management system 

RICHMOND, Va. – A new partnership combines Owens & Minor’s expertise in optimizing the health care supply chain with Google Cloud’s Vertex AI platform to help drive meaningful enhancements for QSight, Owens & Minor’s cloud-based clinical inventory management system. By partnering with Google Cloud, Owens & Minor will strengthen QSight’s existing inventory management capabilities while laying the foundation for future platform and service innovations with the potential to dramatically improve the QSight customer experience. “We provide ongoing value to our customers and help drive clinician efficiency in part by staying at the forefront of technology, including via smart investments with one of the most renowned innovators in the marketplace,” said Andy Long, executive vice president and CEO, Products & Healthcare Services, Owens & Minor. “Our partnership with Google Cloud to enhance QSight is just one example of how Owens & Minor is making concrete progress towards the strategic goals we’ve established for the Products & Healthcare Services segment.” The partnership will focus on enhancing QSight’s ability to help hospitals and health systems optimize how they manage the thousands of medical-grade supplies, high-value surgical implants and human tissue products required for patient care.  

VGM Canada names Mogul-Rotman Woman of the Year 

BURLINGTON, Ontario – VGM Canada named Permobil’s Brenlee Mogul-Rotman the 2024 Canadian HME Woman of the Year during a special presentation at the Canadian Seating & Mobility Conference (CSMC). Mogul-Rotman, the national clinical & technical education manager for Permobil, is an occupational therapist and ATP/SMS. “VGM Canada is proud to name Brenlee as the third Canadian HME Woman of the Year,” said Dave Davies, President, VGM Canada. “Her contributions to her community, her company, and the entire HME and mobility industry are so impressive, and we are excited to honor Brenlee with this award” Mogul-Rotman is a member of the Ontario Society of Occupational Therapists Seating and Mobility Team, and a member of the board of directors of the Canadian Spinal Research Organization. She is also a past member of the Professional Standards Board of RESNA. 

NAHC, NHPCO form new national alliance 

WASHINGTON – The National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) have joined forces to from the National Alliance for Care at Home. The Alliance, which has a new logo, as well as an initial website, will carry forward the work of serving home care, home health, hospice and palliative care providers as they deliver patients the highest-quality care in their own homes and communities. “Providers offering various forms of care at home have always looked to our national associations to help create a shared vision for the future,” said Kenneth Albert, chair of the Alliance’s transition board. “It took real imagination, dedication, and guts to take on the tough conversations about combining two organizations, each with more than 40 years of history. This Alliance will be the leading authority on transforming care in the home. We will implement that mission under a new name that welcomes providers across the care continuum to join – the National Alliance for Care at Home.” In August, the Alliance announced that Steve Landers, MD, MPH, would become its first CEO. Through the rest of 2024 and into 2025, the Alliance will continue integrating NAHC and NHPCO operations into a single organization.