In brief: Seat elevation systems are a go, Florida providers get rate increase 

WASHINGTON – CMS late on Tuesday posted a final benefit category determination and national coverage decision for seat elevation systems as an accessory to power wheelchairs. 

Effective immediately, seat elevation for Medicare-covered power wheelchairs is now considered a clinically meaningful benefit to people with Medicare who perform transfers from power wheelchairs or use the chair for mobility related activities of daily living, such as dressing, grooming, toiletry, feeding and bathing. 

“For too long, many people who use a power wheelchair could not access everyday items in their homes and may have struggled to get in and out of their device,” said CMS Administrator Chiquita Brooks-LaSure. “This landmark Medicare decision to cover seat elevation is a major milestone that will improve the quality of life for so many who rely on this technology.” 

CMS accepted a formal request from the ITEM Coalition to consider a benefit category and coverage of seat elevation systems earlier this year. Previously, CMS did not consider seat elevation equipment to be a statutorily covered option. 

Based on comments and evidence reviewed as part of an initial proposal to include power seat elevation systems of Medicare-covered power wheelchairs, it was determined that the equipment serves a medical purpose in assisting with transfers in and out of a power wheelchair and with performing reaching activities.   

See the final approval posted here: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&ncaid=309 

Florida providers are in line for rate increase 

WASHINGTON – HME providers in Florida will receive a 7.5% increase to the Medicaid fee schedule, the first in 23 years, AAHomecare reports. 

Additionally, the increase must be passed along from managed care organizations (MCOs), which manage 73% of the Medicaid population in the state, to providers. 

"This rate bump will protect access to critical home care services and begin to relieve the financial stress on businesses in our industry,” said Crispin Teufel, CEO of Clearwater, Fla.-based home care provider Lincare Holdings. “Home medical equipment providers have been on the frontlines throughout the pandemic, offering ongoing support, remote monitoring, product selection, and education of life savings resources – all with reimbursement rates set decades ago.” 

The reimbursement increase was passed as part of Florida's budget, following a four-year advocacy effort led by AAHomecare in partnership with the Florida Alliance of Home Care Services. 

The rate increase goes into effect October 1. 

Rehab Medical adds muscle in Georgia 

INDIANAPOLIS – Rehab Medical has opened its third location in Georgia. 

After serving more than 17,000 mobility users from its Atlanta North and Atlanta South locations, Rehab Medical has opened a location in Augusta to expand its reach to the entire state, as well as break into the neighboring state of South Carolina. 

Lewis Johnson, an ATP who has served users in the state for more than a decade, was recently promoted to lead the location. 

“Augusta allows us to continue our reach in Georgia and provide a steppingstone for future growth in South Carolina,” said Keith Hawkins, vice president of sales for Rehab Medical. “I want to congratulate Lewis Johnson on his promotion and looking forward to improving more lives in Georgia and South Carolina.” 

Augusta is the third territory expansion for Rehab Medical so far in 2023. The company also recently opened a location in Cleveland to round out its coverage in Ohio, and opened a location in Baton Rouge, La. 

Quipt reports significant increases 

CINCINNATI – Quipt Home Medical has reported revenues of $58.1 million for the second quarter of fiscal year 2023, a 73% increase compared to the same period last year. It reported adjusted EBITDA of $13. 1million (22.5% of revenues) vs. $7 million (21% of revenues), representing an 86% increase year over year. “We are thrilled to announce robust financial results that have come in ahead of expectations for the second quarter of fiscal 2023 and are delighted to report that we continue to observe significant and continued momentum throughout the organization,” said CEO and Chairman Greg Crawford. “This past quarter has seen our supply chain return to normal, stronger organic growth, an increase in our Adjusted EBITDA margin, and the seamless integration of our largest acquisition, Great Elm, to date. We are extremely delighted that our team’s focus on operational excellence has produced such outstanding results and believe that our continued focus therein will yield increased margins as we move into the second half of 2023. Additionally, we have a strong acquisition pipeline and will continue to use our tried-and-true approach to integration and our focused acquisition strategy to execute on our long-term vision.” Quipt says its customer base has increased 76% year over year to 137,748 unique patients served in the second quarter of FY23 compared to 78,273 in the same period last year. It says it completed 198,101 unique setups/deliveries in the quarter, a 67% increase year over year. Quipt also announced that it has filed a prospectus supplement establishing a new At-the-Market (ATM) equity program, with Canaccord Genuity and Beacon Securities Limited acting as agents. The ATM will allow the company to offer for sale and issue up to $40 million common shares of the company from time to time, at its direction. 

Independent Living Systems expands into HME 

MIAMI – Independent Living Systems, a provider of health care and social services to complex populations in the Medicare, Medicaid and dual-eligible markets, is now licensed as a home medical equipment provider. The license, which was granted by the Florida Agency for Health Care Administration and which is good for two years, allows the company to provide a wider range of HME, including respiratory therapy equipment, hospital beds and mobility aids. "We are thrilled to be able to offer these additional services to our patients," said Nestor Plana, chairman and CEO of Independent Living Systems. "Our goal has always been to provide the best possible care to those in need, and this license will enable us to do just that." Independent Living Systems has also achieved accreditation from the Accreditation Commission for Health Care (ACHC). The company says it provides “a comprehensive range of turnkey payer services to managed care organizations and health care providers that support high-cost, complex populations.” It owns and operates Florida Community Care, the state’s only statewide Medicaid long-term care provider service network, and Florida Complete Care, a Medicare Advantage special needs plan for people who live in a nursing home, assisted living facility or at home and have complex health issues that require more coordinated and comprehensive care. 

EW partners with Nymbl 

WATERLOO, Iowa – Essentially Women has announced a partnership with Nymbl Systems, a cloud-based billing and business management solution. “Essentially Women is incredibly excited to partner with Nymbl Systems,” said Nikki Jensen, vice president of Essentially Women. “Nymbl’s business management system will allow our members to streamline their processes by helping with complicated billing processes, customizable forms, appointment reminders, point-of-sale (POS) system, and more. As a true partner, Nymbl has a focus on customer driven improvement to their operating system, allowing our members to make suggestions for improvements to their software.” Nymbl provides a comprehensive POS system that is seamlessly integrated into its software. It allows credit card payments to be collected through a terminal, manual entry or an online portal that can be added to a website. It ensures that transactions are tied back to the platform and linked to a patient’s account, allowing for easy management of all payment-related activities in one centralized location. EW, a division of VGM & Associates, is a community of providers catering to the needs of post-mastectomy, compression, mother/baby and women’s health. It represents providers with more than 750 locations. 

Wellcare launches preferred program 

TAMPA, Fla. – Wellcare, the Medicare brand of Centene Corp., has announced the launch of a preferred Medicare sales and distribution partnership program that it says will strengthen sales, enhance customer experience and improve quality. "As Medicare Advantage and Part D marketing regulations continue to evolve, Wellcare is taking a two-pronged approach to our sales and distribution efforts,” said Rich Fisher, Wellcare's Medicare CEO. “In addition to leveraging proprietary channels, we aim to strengthen quality relationships with key strategic partners that deliver excellent customer service, higher retention rates and higher 'lifetime value' (LTV). We are pleased to announce our preferred sales and distribution partnership program to deepen our relationships with select Medicare-focused digital health companies to offer high-quality plans and benefits to best meet the needs of our members and those eligible for Medicare." Wellcare plans to announce the first sales and distribution partnerships in 2023. As of March 31, 2023, Wellcare serves about 1.3 million Medicare Advantage and 4.5 million Medicare Prescription Plan (PDP) members across all 50 states in the U.S. 

ACHC expands footprint 

CARY, N.C. - The Accreditation Commission for Health Care (ACHC) has broken ground on an addition to its headquarters in North Carolina’s Research Triangle that will triple its size. The company expects to complete the addition by late 2024. “ACHC has experienced tremendous growth over the past five years,” said José Domingos, president and CEO of ACHC. “This growth has afforded us the opportunity to expand our workforce to better serve the range of organizations we educate and accredit, and to support the health care professionals who depend on ACHC for guidance on quality improvement.” ACHC says the new building will accommodate 300 employees and will enhance cross-departmental collaboration and promote efficiency for office-based employees by providing technology enhancements, energy efficiency and improved amenities. The company also plans to use the addition to deliver new education programs, featuring space both for dedicated company facilities and a compounding pharmacy cleanroom. 

Medtrade names new associate 

DALLAS – Emerald X officials recently named Kerry Tyler as the new associate show director for Medtrade. Tyler launched her tradeshow career with Emerald X about a decade ago, starting as an account executive on the GlobalShop Show. “This is where I gained a passion for the tradeshow industry,” she said. “It has been so rewarding to create unique experiences for exhibitors and attendees and see it through to fruition on the show floor and within the conference sessions.” Tyler started her post as associate show director at Medtrade earlier this year. Tyler told Medtrade Monday that the HME industry is “special.” “HME is a special industry that brings together purpose and passion for providing reliable equipment and committed in-home care,” she said. “I wanted to be a part of this mission to support those efforts and drive positive change throughout the industry. Medtrade is the perfect opportunity.” 

Mobius Mobility begins processing insurance claims for iBOT 

MANCHESTER, N.H. - Mobius Mobility has announced that its iBOT PMD is now covered under private insurance. The company also says it has relationships with nonprofit organizations and credit unions that offer financing programs to assist with co-pays and deductibles. “As part of an intensive, multi-year program to secure reimbursement support for the iBOT PMD, Mobius Mobility applied and received approval for the relevant insurance billing codes and received the required accreditation from the Accreditation Commission for Healthcare,” the company stated. “Mobius Mobility has begun to process insurance claims for iBOT PMDs.” The iBOT is a multi-model power wheelchair that can climb curbs and stairs, balance on two wheels and traverse a wide variety of outdoor terrain. It has six different operating modes, with each providing a different level of mobility. For example, in four-wheel mode, the iBOT engages all four of its drive wheels to go up and down slopes, while keeping the seat and the user level.