In brief: Senators push oxygen template, DME MACs publish supplies guidance

WASHINGTON – Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H., urge CMS to adopt a standardized template instead of a medical record review to ensure access to supplemental oxygen for patients.  

In a letter to CMS Administrator Chiquita Brooks-LaSure, the senators state: 

“We ask that the Centers for Medicare & Medicaid Services (CMS) remove barriers for patient access to supplemental oxygen by establishing clear requirements for determining the medical necessity of prescribed supplemental oxygen therapy. Establishing a requirement for Medicare contractors to use a consistent clinical data element template, aligned with the national coverage determination for supplemental oxygen, would allow CMS to avoid claims being denied based on a physician’s medical record notes.” 

Other senators to endorse the letter include Marsha Blackburn, R-Tenn., James Lankford, R-Okla., and Tim Scott, R-S.C. 

In September 2023, 14 members of the House of Representatives sent a similar letter. 

The Council for Quality Respiratory Care (CQRC), a coalition of the nation’s leading home respiratory therapy providers and manufacturing companies, applauded the lawmakers.  

“CQRC supports and thanks the bipartisan lawmakers for urging CMS to require contractors to adopt a standardized template and the standard written order,” the organization states. “By providing these clear questions for physicians or prescribers to answer, rather than relying on the highly detailed clinical notes, contractors can more efficiently find critical claims-related information. This approach will streamline the documentation process by eliminating potential discrepancies between what the clinical notes contain and what contractors expect to see for the claims process.” 

Industry stakeholders hope an upcoming pilot project by CMS will test the use of a template for oxygen.   

DME MACs publish new guidance for supplies 

WASHINGTON – The DME MACs, in a Dear Physician Letter this week, provided guidelines on completing the standard written order for PAP and RAD supplies, emphasizing key elements like beneficiary information, order date, item description, treating practitioner details and signature. 

The letter also encourages physicians to use general descriptions like “CPAP Mask” or “Mask - Fit to Comfort” to accommodate mask variations without requiring a new SWO for each change. 

“This flexibility not only reduces administrative burdens but also ensures patients receive the most suitable masks and supplies without delays,” AAHomecare stated. “By streamlining paperwork, health care providers and DMEPOS suppliers can focus on patient care. “ 

AAHomecare thanked the DME MAC medical directors for the additional guidance, as well as the volunteer leadership of the DME MAC Jurisdiction councils and the association’s HME/RT and Regulatory councils, which helped advocate for the change.  

Pride names Roll Models 

DURYEA, Pa. – Pride Mobility has named its two newest Roll Models: Chris Carrino and Brooke Slick. 

Each will receive a three-month paid contract and their choice of a Jazzy Carbon power wheelchair or a Go Go Travel Mobility scooter. 

“We are thrilled to welcome Chris and Brooke to the Pride family,” said Stephanie Woodward, brand ambassador coordinator. “This nationwide search has brought us two outstanding individuals who not only embrace the capabilities of our products but also share our commitment to fostering connection and inclusivity.” 

Carrino is originally from Yonkers, N.Y., and is a sports broadcaster with a wide range of professional experience. Most notably, he is the radio play-by-play voice of the NBA's Brooklyn Nets, a position he's held since 2002. 

Slick, a native of New Enterprise, Pa., is a podcast host, blogger, inventor and advocate with multiple sclerosis.  

Sunset Healthcare turns 20 

CHICAGO – Sunset Healthcare Solutions is celebrating its 20th anniversary. The Chicago-based company was founded in 2004 by Greg Wood and CEO Chris Slosar. “Sunset’s dedication to the DME space extends from the smallest providers to the most complex organizations, and starts with industry-renowned, tailored customer support,” says PJ Ruflin, vice president of business development at Sunset. “Sunset brings extensive sourcing expertise, dedicated personnel, a deep catalog of product offerings and highly competitive pricing. We’re excited to take our relationships and momentum into the next 20 years and beyond.” As a startup, it focused on competitively priced, quality respiratory supplies, alongside specialized customer service. Sunset also set out to distinguish itself in the market as a dedicated advocate and partner for DME providers. Sunset’s product offerings started with CPAP filters and tubing, and expanded to CPAP masks, chinstraps, oxygen cannula and other respiratory devices and accessories. In 2020, Sunset launched its Acute Care Division, acquiring GPO contracts with Vizient, Premier, Capstone, and Acurity LLC., and introducing new pediatric products, masks, resuscitation devices, laryngeal mask airways and more.  

VGM’s Lockard moves up 

WATERLOO, Iowa – VGM & Associates has promoted Boone Lockard, CRT, to vice president of clinical services. In his new role, Boone will oversee and collaborate with the VGM Sleep Services team, ensuring effective clinical and operational solutions for medical equipment providers. "For the past 10 years, I've been engaged with outsourced compliance management programs,” said Lockard. “During this time, I've observed the tangible benefits of implementing such programs for DME providers. By outsourcing our compliance efforts, we successfully maintained existing staffing levels while simultaneously increasing the number of PAP setups performed each month. And not to mention, this transition ultimately expanded our patient resupply pool." Boone has more than 16 years of experience in respiratory care and the home medical equipment industry. His background includes sales, account management and clinical education, gained from previous roles at Philips Sleep and Respiratory Care and Lehan Drugs, Inc. He joined VGM as director of VGM Respiratory in April 2022.  

AAH adds board members 

WASHINGTON – Mickae Lee and Steve Wakser have joined AAHomecare’s board of directors, filling at-large seats. Lee, the new senior manager, government affairs, for Permobil, brings expert knowledge of complex rehab technology, proven state and federal advocacy skills, and a record of service on several HME industry work groups and committees to the role. Wakser, senior vice president of sales, North & South America for Drive DeVilbiss Healthcare, has extensive leadership experience across a wide range of critical HME functions, including sales, finance, organizational development and talent management. “I’m gratified that we are able to add proven HME leaders like Mickae and Steve to the board,” said Tom Ryan, AAHomecare president and CEO. “Their skills, experience, and passion for our industry make an exceptional and highly engaged group even stronger.” 

VITAS Healthcare promotes four 

MIAMI – VITAS Healthcare, a provider of hospice services in 14 states, has promoted four leaders to vice president roles, including Mario De La Rosa, who is now vice president of HME operations. De La Rosa, Kathleen Coronado, Anthony Cosma and Angela Hamrick join the executive management team with more than 50 years of combined experience in hospice and palliative care. De La Rosa will be responsible for continuing to evolve the level of internal collaboration among the HME business and operations teams, providing leadership across several key initiatives that drive continuous improvement and increase efficiency through medical supply delivery and management Coronado is now associate vice president of hospice operations, where she will provide expanded leadership for multiple VITAS service areas and special projects. Cosma is now vice president of hospice operations, where he will broaden his reach and continue fostering people development by enhancing their skills, knowledge and potential across clinical and operations teams. Hamrick is now vice president of hospice operations, where she will oversee hospice teams throughout Northern Florida, which includes Citrus County, the Nature Coast, Jacksonville, Pensacola and Panama City. 

NCPA appoints new COO 

ALEXANDRIA, Va. – The National Community Pharmacists Association has named Mark Ey, RPh, its new COO, only the third in the association’s history. His responsibilities will include collaborating with NCPA staff to meet the goals and objectives of the organization’s strategic plan, overseeing growth strategies, and cultivating industry and community relationships. Ey most recently served as vice president of operations for CARE Pharmacies Cooperative, a retail chain of independent pharmacies. “Independent pharmacy is in Mark’s family, as is also the case with so many of NCPA’s members,” says Douglas Hoey, pharmacist NCPA CEO. “He has a wealth of experience, and a deep understanding of the issues community pharmacists are dealing with on the front lines. I am excited to see how his background translates into his role at NCPA as we work together to grow the organization and our industry.” Ey has been involved with a number of pharmacy organizations over the years, including NCPA, the National Association of Chain Drug Stores, the Pharmacy Quality Alliance, the Maryland Pharmacists Association, the Maryland Department of Health and Mental Hygiene Professional Volunteer Corps, the Notre Dame of Maryland University School of Pharmacy Dean’s Advisory Board, the National Pharmacy Technician Stakeholder Advisory Group, and the National Pharmacy Technician Standards Writing Group.  

DME MACs issue 3D guidance 

WASHINGTON – The DME MACs and the Pricing Data Analysis & Coding (PDAC) contractor have released long-awaited guidance on the use of 3D printing and digital scanning for custom fabricated orthoses. They state that 3D printing, or additive manufacturing, can be an acceptable alternative to traditional custom fabrication, if the method used meets the definition of custom fabricated in the DMEPOS Quality Standards, Appendix C. This reminder is consistent with the position of the American Orthotic and Prosthetic Association that 3D printing/additive manufacturing should be considered a valid custom fabrication method.