In brief: Providers sue Philips, Access Infusion buys, Prochant surveys 

PHILADELPHIA – Dynamic Healthcare Services and Hometown Oxygen Pittsburgh on July 15 filed a lawsuit against Philips Respironics, DeLage Landen Financial Services and Philips Medical Capital for cutting off access to financing and leasing programs that the providers say are necessary for them to compete. 

According to the lawsuit, filed in the U.S. District Court for the Eastern District of Pennsylvania: 

• Prior to the Philips recall, DHS purchased thousands of respiratory devices from Respironics, financing those purchases through PMC. After the recall, however, the company was unable to monetize its inventory of recalled devices and, therefore, unable to make payments to PMC. 

• In August of 2022, PMC declared DHS in default. 

• Respironics and PMC then shared this confidential, commercial information with DLL, which informed ResMed and HOP that it would no longer do business with HOP until DHS paid PMC for the recalled devices DHS had purchased from Respironics. 

"Defendants are engaged in an ongoing conspiracy, in violation of Section 1 of the Sherman Act, to cut off access to financing and leasing programs necessary for respiratory device suppliers in the U.S. to compete,” the lawsuit states. “DLL and PMC used their affiliation, market power and exclusivity agreements with respiratory device manufacturers to offer 0% interest financing. Defendants then shared commercially sensitive information about their customers as part of an anticompetitive scheme to foreclose competition from other lenders and respiratory device manufacturers and raise prices for patients in the U.S.” 

DLL is the leading financier of respiratory devices in the U.S., holding about 30% market share, according to the lawsuit, and PMC is a joint venture between DLL and Philips North America and is the exclusive financier of devices manufactured by Respironics. 

DHS and HOP seek to recover all damages and obtain injunctive relief available under federal antitrust law. 

Access Infusion buys Big Sky I.V. Care 

CHICAGO – Access Infusion Care, a portfolio company of Chicago-based New Harbor Capital, has completed its acquisition of Big Sky I.V. Care, a provider of home and specialty infusion services in Kalispell, Mont. 

This marks Access Infusion Care’s first add-on deal as part of New Harbor and is a key part of its broader strategy to partner with high-quality infusion providers in underserved areas with diversified therapy offerings and delivery settings, and outsized growth potential. 

“We are excited to add another high-quality infusion business to the Access family,” said Bo Mlnarik, principal at New Harbor Capital. “The combined resources, culture and experience of the teams, as well as the added scale, diversification and growth avenues make this a great fit for our infusion strategy.” 

Big Sky offers a wide range of infusion therapies, including specialty medications, antibiotics and total parental nutrition for chronically ill patients in their homes and at infusion sites. 

Founded in 2005 in Kalispell, Mont., by Julie Lyon, BSN, and Dave Grady, BA, Big Sky I.V. Care operates a 503A compounding pharmacy and a state-of-the-art ambulatory infusion center facility with a dedicated team of more than 15 professionals, including pharmacists, technicians and nurses. It is accredited by ACHC for home infusion therapy and features USP <797> and USP <800> compliant clean rooms for sterile compounding.  

“We are thrilled to announce our new partnership with the Big Sky I.V. Care team,” said Bruce Kutinsky, CEO of Access Infusion Care. “Julie and Dave have built an impressive and innovative business with a diverse array of service offerings and world-class facilities. This acquisition is a significant step forward in fulfilling our vision of bridging the access gap in healthcare. By improving access to specialized infusion therapies in underserved markets, we are making a tangible difference in the lives of patients who need these services the most.  We are excited about the future and the potential to transform the infusion care landscape through this strategic partnership with Big Sky I.V. Care.” 

Access Infusion Care was formed in January 2024 through the acquisition of AIC North and JLS Infusion Nurse Staffing Services. 

New survey: Denials tops list of challenges 

CHARLOTTE – The No. 1 billing and revenue cycle management challenge for HME providers is preventing or reducing denials and appeals, according to the results of a new survey sponsored by Prochant and conducted by in90. 

The No. 2 challenge: Hiring, training and retaining qualified intake, billing and collections staff. 

“In response to these challenges, 60% of respondents have outsourced at least one RCM function in the past year, with over 70% attributing this decision to resource limitations and cost concerns,” Prochant stated in a press release. “The difficulty in managing RCM effectively, coupled with the high cost and scarcity of local talent, drives many to seek external expertise. For those that have chosen to outsource, about 50% of respondents reported that they were likely to outsource payment posting, claims scrubbing and denials and appeals. For those choosing an outsourcing partner, respondents value revenue capture and real-time performance tracking/visibility.” 

To conduct the survey, in90, an independent third-party consulting firm, interviewed 100 HME executives directly involved in RCM. Forty percent were CEOs or owners. 

The survey also found that more than 80% of respondents reported dissatisfaction with their current RCM approach, citing accounts receivable over 90 days overdue and excessive write-offs due to billing errors and complexities. 

Check out the full report here. 

MediWound raises $25M 

YAVNE, Israel – MediWound has entered into a definitive purchase agreement with several new and existing investors, including Mölnlycke Health Care, a medtech company specializing in solutions for wound care and surgical procedures. MediWound plans to use the $25 million in gross proceeds from the private investment in public equity (PIPE) to advance EscharEx pre-commercial activities and support general corporate purposes. “We are proud to have the strong support of Mölnlycke, and of our new and existing investors in this financing,” said Ofer Gonen, CEO of MediWound. “This significant investment will enable us to further strengthen our strategic plans for EscharEx, creating substantial long-term value for our stakeholders and help improve the standard of care for patients.” Concurrently with the PIPE offering, Mölnlycke will be granted specific rights, including a representative to attend meetings of the company's R&D Committee, and will be able to participate in potential strategic partnership discussions and M&A processes under certain circumstances. Mölnlycke's ownership, however, will be limited to no more than 9.99% of the company's issued and outstanding ordinary shares. MediWound says it has developed a strong R&D pipeline, including the company’s lead drug under development, EscharEx, a Phase III-ready biologic for the debridement of chronic wounds that offers significant potential advantages and an opportunity to expand the market. 

New bill expands coverage for monitors, supplies in Illinois 

SPRINGFIELD, Ill. - A bill sponsored by Democratic State Sen. Julie Morrison to expand insurance coverage for medically necessary glucose monitors and related supplies was signed into law on July 1. “High costs that come with managing diabetes can put an unnecessary economic burden on families,” said Morrison, Majority Caucus Whip. “This law will ensure people with any type of diabetes receive crucial medical care.” Senate Bill 3414 requires insurance companies to cover glucose monitors, related supplies and training for individuals diagnosed with any form of diabetes. Previous law required coverage for individuals with Type 1 and Type 2 diabetes. Additionally, individuals who obtain a prior authorization for a CGM prescription will have cost-sharing waived on a one-month's supply of CGMs and a transmitter, if needed. 

VGM names Dan Bunting as senior advisor 

WATERLOO, Iowa – VGM Group has announced that Dan Bunting, who was most recently COO and strategic advisor to the CEO of AdaptHealth, has joined its team as a senior advisor. In this role, Bunting will help VGM develop long-term strategies to promote and support its customers and the HME industry. “I don’t think there’s anyone in the United States who knows more about our industry than Dan,” said VGM Group CEO Jeremy Stolz. “The health care industry, and HME in particular, is constantly evolving. And I am thrilled to have Dan’s experience and expertise with us as we continue to shape the future of VGM and the industries we serve.” In all, Bunting’s career spans 40 years, with experience in nearly every aspect of HME, including product development and manufacturing. Born and raised in Manchester, Iowa, less than an hour east of VGM’s headquarters, Bunting has been close to VGM throughout his life and career. He first met Van Miller, VGM’s founder, while attending the University of Iowa. At that time, Miller had an HME business where Bunting worked for two years while getting his degree. Later, when Bunting set out to start his own HME business in Iowa City, Miller and a few of his friends helped finance it. Bunting’s HME business, which sold to Rotech in 1996, was one of VGM’s earliest members. “I have dedicated my entire career to helping advance the HME industry, and I’m honored to continue that work with VGM,” Bunting said. “VGM, in many ways, feels like a return home for me. I am excited to do my part to help VGM in its mission to make a difference—both in the industry and in the communities it calls home.” 

DME Service Solutions partners with NAHC 

WASHINGTON – DME Service Solutions, a provider of B2B outsourcing solutions specializing in health care, has partnered with the National Association for Home Care & Hospice to connect with a network of professionals focused on effective home care solutions. "We are honored to collaborate with NAHC, whose dedication to providing affordable care aligns with our mission at DME Service Solutions,” said Ryan Holbrook, president of DME Service Solutions. “We look forward to working alongside NAHC and its members to make a meaningful difference in the lives of those we serve." DME Service Solutions offers HIPAA-compliant workforce solutions, including document management, revenue cycle management, multichannel customer engagement and tech support. The NAHC represents the interests of more than 35,000 home care and hospice organizations, their 2 million nurses, aides and therapists, and the 14 million patients they serve annually. 

CMS announces flexibilities in Texas 

WASHINGTON – CMS on July 12 announced that additional resources and flexibilities are available in response to Hurricane Beryl in Texas. President Biden on July 12 determined an emergency in the state beginning on July 5, and HHS Secretary Xavier Becerra on July 12 determined a public health emergency in the state beginning July 5. The agency says it will permit Medicare beneficiaries who have lost or realized damage to their DMEPOS as a result of the hurricane to receive replacements for such items and services to ensure beneficiaries can continue to access what they need. “CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by consequences of the hurricane,” the agency stated. CMS will also provide waivers, make available special enrollment periods for the Federal Health Insurance Exchange, activate the Kidney Community Emergency Response program and take other measures. FMI, go here.