In brief: React acquisition, Numotion settlement, complex rehab carve out

SARASOTA, Fla. - React Health subsidiary Ventec Systems has acquired Invacare’s respiratory assets. 

Invacare announced late last year that it would be exiting the respiratory market. 

“With this acquisition, React Health is well positioned to continue to support the end-to-end care of patients with cardiology, sleep and respiratory illnesses, in partnership with physicians and providers of diagnostic and needed therapies,” said Tom Pontzius, president of operations for React Health. “Invacare’s respiratory line provides a perfect complement to React’s current product offering and shows React Health’s commitment to providing quality products to support the needs of the sleep and respiratory space.” 

The assets include: 

• Platinum 5L Stationary Concentrator 
• Platinum 10L Concentrator 
• Platinum POC (Portable Oxygen Concentrator) 
• HomeFill Equipment/Cylinders 
• Pediatric Oxygen Flow Meter 
• Oxygen Analyzer 
• Service Parts & Accessories 

React says it has begun the process of integrating Invacare’s products and will let customers know when they’re available for purchase. 

The company also noted that for customers with products in repair prior to Jan. 28, they are the responsibility of Invacare, and that for customers with requests for parts, there will be a lag of about 30 to 60 days, depending on availability.  

For additional information, go to www.reacthealth.com/invacare.  

Numotion to settle Medicaid lawsuit 

BRENTWOOD, Tenn. – Numotion has agreed to pay $7 million to settle a lawsuit related to Medicaid claims for mobility equipment as part of an agreement with the U.S. Attorney’s Office in the Eastern District of Kentucky. 

The company says the allegations focused mainly on a complicated set of Medicaid billing regulations that it believed, in good faith, that it was interpreting correctly.  

“Numotion is committed to cooperating with external investigations, as well as fulfilling our responsibility to submit self-disclosures where appropriate,” said Mike Swinford, CEO. “We are proud of the work we do helping our customers lead active and independent lives, and we are dedicated to supporting them with medically necessary products and services. Putting this matter behind us ensures we can direct all our attention to our mission.” 

Numotion says the settlement, which was also signed by the Office of Inspector General and the Department of Health and Human Services, was reached without any admission of liability and there was no indication that any equipment provided was not reasonable and medically necessary. 

Also as part of the settlement, the company has entered into a Corporate Integrity Agreement with the OIG to implement specific corporate compliance obligations that complement its existing program. 

Waud Capital pursues home care platform 

CHICAGO – Waud Capital, whose investments in DME include PromptCare, has formed an executive partnership with Steve Jakubcanin to pursue a platform investment in the broader home care and post-acute services market. 

Waud expects to invest more than $100 million of equity capital to support the initiative. 

"We are thrilled to announce our partnership with Steve," said Kyle Lattner, principal of Waud Capital. "He has created value throughout his career and brings deep experience operating and scaling organizations across a variety of post-acute care settings and service offerings. Both the volume and scope of healthcare services being provided in a patient's place of residence are growing rapidly. In partnership with Steve, we believe there is an opportunity to build a market leading organization focused on delivering high quality care, in the most convenient setting for patients, while also lowering the total cost of care for payors."   

Most recently, Jakubcanin served as CEO of Cornerstone Healthcare Group, guiding the company through its recent sale to ScionHealth. Cornerstone is one of the leading operators of long-term acute care, senior living and behavioral healthcare facilities. Under his leadership, the company experienced transformative growth, expanding their service offerings from long-term acute care into skilled nursing, assisted living, behavioral healthcare, and rehabilitation services. Prior to Cornerstone, he held senior leadership roles at AccentCare and Kindred Healthcare, two nationally recognized providers of home care and post-acute care services. 

Waud’s prior investments include not only PromptCare (home infusion and durable medical equipment) but also Concierge Home Care (home health and primary care), Ivy Rehab Network (outpatient physical therapy), CarePoint Partners (home infusion), Acadia Healthcare (behavioral health), Regency Hospital Company (long-term acute care) and DS Medical (home medical supplies). 

Patsy Taylor named EW’s Ruth Addison Award winner 

CLEARWATER BEACH, Fla. – Patsy Taylor was named the winner of the EW Ruth Addison Award of Excellence 2023 during a special ceremony at the Focus Conference.  

Taylor, a former respiratory therapist, entered the women’s health industry after two of her four sisters were diagnosed with breast cancer and had difficulty finding a place for a breast prosthesis fitting.  

“Patsy exemplifies what the EW Ruth Addison Award of Excellence has set out to recognize, which are the trailblazers in the women’s health industry who have impacted their companies, the industry and their community,” said Nikki Jensen, vice president of Essentially Women. “Congratulations, Patsy, and thank you for your foundational work in our industry.” 

Taylor opened her first boutique to serve the Greensboro, S.C., area in 1985, which became Designed By Nature, and subsequently opened a second Designed By Nature in Aiken, S.C. After having the boutique for 15 years, Self Regional Hospital purchased the business.  

Taylor has also been active with the breast cancer community in her area, even raising $30,000 in one year for Relay for Life in Laurens County, S.C. 

Essentially Women presents the EW Ruth Addison Award each year to an individual who has made a significant impact within her company, her community and the women’s health industry. 

CVS pushes further into health care delivery, acquiring primary care company for $10.6B  

WOONSOCKET, R.I. – CVS Health will acquire Oak Street Health, a leading multi-payer, value-based primary care company focused on older adults, in an all-cash transaction at $39 per share, representing an enterprise value of approximately $10.6 billion. 

“Combining Oak Street Health’s platform with CVS Health’s unmatched reach will create the premier value-based primary care solution,” said CVS Health President and CEO Karen S. Lynch. “Enhancing our value-based offerings is core to our strategy as we continue to redefine how people access and experience care that is more affordable, convenient and connected.” 

Oak Street Health employs approximately 600 primary care providers and has 169 medical centers across 21 states. The company differentiates itself with its technology solution, Canopy, which is fully integrated with its operations and is used when determining the appropriate type and level of care for each patient. 

That care will be enhanced by CVS Health’s community, home and digital offerings, the companies say. 

“This agreement with CVS Health will accelerate our ability to deliver on our mission and continue improving health outcomes, lowering medical costs, and providing a better patient experience while offering significant value to our shareholders,” said Oak Street Health CEO Mike Pykosz. “Together with CVS Health, we will have access to greater resources and capabilities to expand the reach of our platform, provide more opportunities for our teammates and, most importantly, make a meaningful difference in the lives of the patients we serve.” 

Following the close of the transaction, Pykosz will continue to lead Oak Street Health, which will become part of CVS Health’s recently formed Health Care Delivery organization. Oak Street Health will continue to serve its extensive network of health plan partners and patients – consistent with CVS Health’s payer-agnostic approach to delivering leading solutions. 

DOJ recoups $2.2B under False Claims Act 

 WASHINGTON – Settlements and judgments under the False Claims Act exceeded $2.2 billion in the fiscal year ending Sept. 30, 2022, according to the Department of Justice. 

The government and whistleblowers were party to 351 settlements and judgments, the second-highest number of settlements and judgments in a single year. Recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, now total more than $72 billion. 

“Protecting taxpayer dollars by preventing fraud and abuse is a critical priority for the Department of Justice,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The large number of settlements and judgments this past year demonstrates that the False Claims Act remains one of the most important tools for ensuring that public funds are spent properly and advance the public interest.” 

Of the more than $2.2 billion in False Claims Act settlements and judgments reported by the Department of Justice this past fiscal year, more than $1.7 billion involved the health care industry, including drug and medical device manufacturers, durable medical equipment, home health and managed care providers, hospitals, pharmacies, hospice organizations, and physicians. The amounts included in the $1.7 billion reflect recoveries arising only from federal losses, and, in many of these cases, the department was instrumental in recovering additional amounts for state Medicaid programs. 

The recoveries in fiscal year 2022 also reflected the department’s focus on new enforcement priorities, including fraud in pandemic relief programs and alleged violations of cybersecurity requirements in government contracts and grants. 

CCS launches Scientific Advisory Council 

DALLAS – CCS has launched a Scientific Advisory Council comprised of four industry leaders who, it says, will support the company in its commitment to redefining patient care at home through a more holistic approach. They are: Alexander Ding, MD; Karmeen Kulkarni, MS, RD, CD, CDCES, BC-ADM; Steven Wittlin, MD; and Francine Kaufman, MD. The announcement of the new council follows CCS’s news that it has hired its first chief medical officer, Arti Masturzo, MD. “Dr. Masturzo has assembled a multi-stakeholder group of experts to comprise our newly formed Scientific Advisory Council,” said Tony Vahedian, CEO at CCS. “Dr. Ding, Ms. Kulkarni, Dr. Wittlin and Dr. Kaufman each bring unique industry expertise to the council. Arti will lead the council in helping to inform new approaches to simplifying chronic care management for the patients we serve.” More info about the council members: 

Ding is a practicing diagnostic and interventional radiologist, associate vice president of physician strategy and medical affairs at Humana, and a board member of the American Medical Association.  

Kulkarni is a global clinical leader in diabetes management with more than 30 years of experience. Prior to spearheading her own consulting group, she spent 15 years with Abbott as the director of global scientific affairs. 

Wittlin is an endocrinologist, frequently published author and director of diabetes services at the University of Rochester. 

Kaufman is a practicing pediatric endocrinologist, Distinguished Professor Emerita of Pediatrics at the Keck School of Medicine of the University of Southern California and Children's Hospital Los Angeles, and the former president of the American Diabetes Association. She is the chief medical officer at Senseonics and previously held the same position at Medtronic Diabetes. 

Industry pushes through carve out for complex rehab 

SACRAMENTO, Calif. – NCART and the California Association of Medical Product Suppliers have scored several wins in California around a 10% rate reduction for Medi-Cal for CRT that was eliminated in the 2021-22 Budget Act and was effective Jan. 1, 2022. Though the California Department of Healthcare Services submitted the State Plan Amendment to make the change, it had still not been implemented or had any retroactive adjustments on claims paid since Jan. 1, 2022. DHCS has said a 10% cut for CRT will be eliminated April 1, 2023, and has agreed to expand the list of covered CRT codes. It will also initiate an electronic payment correction 60 to 90 days later to adjust prior claims retroactive to Jan. 1, 2022. 

Soleo Health names new chief strategy officer 

FRISCO, Texas – Soleo Health has named Susan Faust to the newly created role of chief strategy officer. In this role, Faust will guide Soleo Health’s strategic initiatives, expanding the company’s position with pharmaceutical manufacturers, payers, health systems and providers. “We created the chief strategy officer position because we believe our recent growth warranted the development and implementation of cohesive, dedicated strategic initiatives to take our Company to the next level,” said Drew Walk, CEO. “Susan’s deep industry expertise and knowledge with payors, providers and industry relations complement Soleo Health’s goals and objectives, and we look forward to the contributions she will make in her new leadership role.” Faust worked most recently as executive vice president, commercial strategy, for Soleo Health. Prior to joining Soleo Health, Faust held senior leadership positions at PANTHERx Rare Pharmacy, Diplomat Pharmacy and Accredo Health/Medco Health Solutions.   

Health care exec joins ATF Medical 

NEWNAN, Ga. – Brendan Swift will join ATF Medical as vice president, payer partnership and marketing, to lead the company’s sales and marketing strategies and oversee national payer relationships. “I’ve always admired the heart and passion that the ATF Medical team has for their seriously injured workers,” said Swift. “Its focus on workers’ comp has produced a business model that delivers fully integrated mobility and accessibility solutions with an enhanced level of service and partnership with payers and injured workers.” Swift has held a variety of roles, including vice president of payer relations and strategic accounts for National Seating & Mobility. Most recently, he was staff vice president, provider operations/enterprise provider data management, for Elevance Health, formerly Anthem, Inc.   

NHIA: Pandemic shortages sent drug prices soaring 

WASHINGTON – Prices for parenteral nutrition (PN) components and disposable supplies rose dramatically during the pandemic due to supply chain challenges and shortages, according to a new white paper from the National Home Infusion Association. “It’s important that payers have a full understanding of the context in which home infusion providers are delivering high-quality, cost-effective care and work to reflect those factors in their reimbursement models,” said Connie Sullivan, BSPharm, president and CEO of the NHIA. “Most of us are familiar with pandemic supply chain issues and associated price increases, but for many home infusion providers those challenges have combined with prolonged product shortages and other market dynamics to stress their ability to provide services to patients who need them.” An analysis of 402,940 bags of PN from 12 home infusion providers found a cumulative five-year price increase per bag of PN of 50.12% over 2016 costs. In addition, the mean overall cost increase for 223 disposable supplies in 2021 was 9.88%. Prior to 2021, the typical cost increase was reported by the distributor to be, on average, 5% annually. The white paper offers recommendations for payers regarding ways to ensure complex home infusion services such as PN remain widely available. Integrated Medical Systems and WellSky contributed to the report. 

Great Plains Homecare receives CHAP accreditation 

NORTH PLATTE, Neb. – Great Plains Homecare Equipment has been awarded CHAP accreditation under the organization’s home medical equipment services standards of excellence. The rigorous evaluation by CHAP focuses on structure and function, quality of services and products, human and financial resources and long- term viability. “Great Plains Health Homecare Equipment places an emphasis on quality, outcomes, patient safety and remarkable care,” said Clint Brady, general manager, Great Plains Health Homecare Equipment. “We are pleased to earn CHAP accreditation and continue to be an outstanding community resource for medical products and equipment.” Great Plains Health Homecare Equipment offers a full range of specialty medical products for purchase, as well as provides rental medical equipment for those with short term needs for home medical equipment. Created in 1965, CHAP was the first to recognize the need and value for accreditation in community-based care. “By achieving CHAP accreditation, Great Plains Health Homecare Equipment has shown a commitment to excellence,” said Nathan DeGodt, CHAP president and CEO. “We are excited to begin our partnership with Great Plains Health Homecare Equipment by offering support in its commitment to providing quality care and continuous improvement.” 

Mednow offers integrated CGM program 

TORONTO – Mednow has launched its enhanced Virtual Diabetes Management program to enable convenient on-demand access to Dexcom G6 real-time continuous glucose monitoring supplies and personalized diabetes care services. The new integrated program combines Mednow virtual pharmacy services with Dexcom rtCGM technology to provide individuals with a comprehensive services like access to a team of certified diabetes educators (CDEs) and clinical pharmacists for ongoing health coaching; personalized treatment; and convenient home delivery. “Mednow is thrilled to partner with Dexcom Canada and bring cutting edge health solutions to patients across Canada living with diabetes,” said Ali Reyhany, CEO of Mednow. “Our virtual pharmacy services, combined with Dexcom's rtCGM technology, will provide patients with a more convenient and accessible solution for managing their condition. This program and partnership strongly align with our vision of utilizing innovative technologies to support patients in managing their care at home. Further, this leverages our investments in diabetes, including access to multilingual Certified Diabetes Educators, virtual pharmacist access, nutritional support and preferred pricing for other non-prescription diabetic supplies.” The Mednow clinical team will use the Dexcom Clarity data platform to integrate individual glucose patterns and trends into personalized coaching and care. For individuals without access to a physician, Mednow’s Virtual Care service can also connect them with a licensed Canadian clinician who can offer medical advice, diagnose and prescribe, online or on the phone. The Virtual Diabetes Management program will initially be available in Ontario and British Columbia starting in early February. 

Trace Medical expands through acquisition  

WHITEMORE LAKE, Mich. - Trace Medical has announced the acquisition of Medequip Service Solutions in Greenbrier, Ark. Medequip, a factory authorized equipment repair services company, will allow Trace to further expand its scope of services to an even greater number of HME providers nationally. “We are very pleased to have the Medequip team join Trace Medical,” said Greg Apostolou, CEO of Trace Medical. “They are a well-respected operator in biomedical services and represent a critical first step for Trace in building a national service platform.” Effective immediately, any Trace customer requiring biomedical services for ventilators, portable oxygen concentrators and CPAP devices can email Info@TraceMedical.com for support. Medequip provides repair services in the following verticals: HME, mobility, physician and animal health. “We’re very excited to be joining the team at Trace Medical,” said Steve Eaton, CEO of Medequip. “This acquisition positions us to further expand service offerings, as well as provide a national platform for HME fleet equipment service management.” 

• Read about Trace Medical’s acquisition plans in this interview with Elliot Campbell. 

AASM launches ‘More than a Snore’ 

DARIEN, Ill. - The American Academy of Sleep Medicine has launched a new national campaign called “More than a Snore” to raise awareness of obstructive sleep apnea. “This campaign will raise national awareness of obstructive sleep apnea and encourage undiagnosed patients to advocate for themselves and seek treatment,” said Jennifer Martin, a licensed clinical psychologist and president of the AASM. “It is important that patients and health care professionals feel confident to discuss sleep apnea and identify the optimal, personalized treatment plan.” The multi-year campaign is a collaborative project funded through a grant awarded to the AASM by the Centers for Disease Control and Prevention’s National Center for Chronic Disease prevention and Health Promotion. Obstructive sleep apnea affects nearly 30 million adults in the U.S., with approximately 80% undiagnosed, costing more than $149 billion annually in health care costs, lost work productivity, and workplace and motor vehicle accidents, according to the AASM. The campaign will inform the public that untreated sleep apnea is “More than a Snore,” affecting a person’s long-term health and quality of life. Left untreated, it increases the risk of other health problems, such as cardiovascular disease, Type 2 diabetes and depression. The campaign was created through the Count on Sleep partnership, a collaboration between several professional and patient-focused organizations led by the AASM and the Sleep Research Society. Other partnering organizations are the Alliance of Sleep Apnea Partners, American Academy of Dental Sleep Medicine, American Academy of Otolaryngology – Head and Neck Surgery, American College of Chest Physicians, American Society for Metabolic and Bariatric Surgery, American Thoracic Society and National Sleep Foundation. Resources to assist the public and health care professionals in recognizing sleep apnea are available on the Count on Sleep website at www.countonsleep.org. 

Tomorrow Health adds former Cleveland Clinic exec to board 

NEW YORK – Tomorrow Health has added Dr. Toby Cosgrove, a former CEO of Cleveland Clinic, to its advisory board. During his tenure at Cleveland Clinic, Cosgrove grew the health system into an $8 billion organization and expanded it to multiple locations nationwide and internationally, including in Canada, London and Abu Dhabi. “We’re thrilled for Dr. Cosgrove to join our advisory board as we work together to restore the home as the primary place of care,” said Vijay Kedar, CEO of Tomorrow Health. “Home-based care coordination can be confusing and fragmented. At Tomorrow Health, we seamlessly connect patients, providers, health plans and suppliers to deliver quality home-based care and drive down costs.” Other members of Tomorrow Health’s advisory board include Eric Hagen, former deputy secretary of the Department of Health and Human Services; Bob Badal, chief revenue officer at Strive Health; Dr. Trent Haywood, former chief medical officer at Blue Cross Blue Shield Association; and Phyllis Yale, an advisory partner at Bain & Company. Currently, Cosgrove, who is a member of the National Academy of Medicine and is a fellow of the National Academy of Inventors, serves as the executive advisor at Cleveland Clinic. He is also the recipient of numerous accolades celebrating his work in health care, including the Woodrow Wilson Center Award for Public Service and Cleveland Clinic’s Master Clinician Award, Innovator of the Year Award and Lerner Humanitarian Award. 

Community pharmacies still experiencing shortages, NCPA finds 

ALEXANDRIA, Va. – Many independent community pharmacies are experiencing ongoing drug and labor shortages, according to a new survey released by the National Community Pharmacists Association. “These ongoing pressures with the supply chain, PBMs and our economy continue to make it a challenging time for the very pharmacies who, for so many patients, are the most accessible health care option,” said NCPA CEO B. Douglas Hoey. “Policymakers must not only keep this in mind but also work to advance pharmacy payment reforms that will better support pharmacy teams and the patients they serve.” Ninety-three percent of independent community pharmacy owners/managers responding to the survey say they are dealing with a shortage in children’s pain and fever relief medicine; 85% report a shortage of diabetes medicine; and 80% report a shortage of amoxicillin. Additionally, 97% say they are experiencing a shortage of Adderall. When it comes to labor issues, the survey finds that pharmacy technicians continue to be in highest demand (80%), followed by clerks/front end staff (43%), pharmacists (19%) and delivery drivers (17%). Sixty-seven percent, overall, report having a difficult time filling open staff positions, a slight decrease from previous surveys. 

MedPAC provides data on dual-eligibles 

WASHINGTON – The Medicare Payment Advisory Commission (MedPAC) and CHIP Payment and Access Commission (MACPAC) have released an updated data book, “Beneficiaries Dually Eligible for Medicare and Medicaid,” that presents information on the demographic and other personal characteristics, expenditures and health care utilization of individuals who were dually eligible for Medicare and Medicaid coverage in 2020. “We hope these data will provide a comprehensive picture of program spending, enrollment and the experiences of dually eligible beneficiaries,” MedPAC states. The 7th edition of the book compares subgroups of dual-eligibles, including those with full vs. partial benefits and those under 65 vs. those over 65. Additionally, it compares dual-eligible beneficiaries with non-dual eligible Medicare and Medicaid beneficiaries. The book is the result of an ongoing effort by MedPAC and MACPAC to create a common understanding of the characteristics of dually eligible beneficiaries and their use of services. 

JAS agrees to settle false claims violation 

RALEIGH, N.C. - Joint Active Systems, a manufacturer of range-of-motion devices based in Effingham, Ill., has agreed to pay $500,000 to settle civil claims under the federal and North Carolina False Claims Acts concerning allegations the company caused submission of false claims to the North Carolina Medicaid program for certain DME. Specifically, the United States and the state of North Carolina alleged that from Jan. 6, 2012, through January 29, 2021, JAS was unable to directly bill North Carolina Medicaid for its “EZ” range-of-motion devices because the company did not meet North Carolina Medicaid requirements and/or lacked the necessary credentials necessary. The company allegedly bypassed those requirements by entering into arrangements with local North Carolina orthotics and prosthetics providers to bill the company’s “EZ” devices on its behalf. JAS allegedly directed the local North Carolina O&P providers to improperly submit claims for its “EZ” devices as orthotics using L-codes, thereby bypassing the medical necessity reviews and/or authorization processes that may have otherwise taken place. The governments alleged that the “EZ” devices did not qualify for reimbursement as L-code orthotics under North Carolina Medicaid, and that they were not listed as reimbursable devices on the North Carolina Medicaid fee schedule. JAS had actually received an official coding verification from CMS that designated its “EZ” devices as an E-code (DME). The government noted that the civil claims resolved by the settlement are allegations only and that there has been no judicial determination or admission of liability, and that JAS denies the allegations.