In brief: AAH fights brand preferences, CMS releases ASP figures

Thursday, December 15, 2011

BALTIMORE - AAHomecare last week urged CMS to withdraw proposed changes to HME coverage under Medicare Advantage (MA) plans. The proposed rule, issued in October, would allow MA plans to limit coverage to specific products or brands, based on whether the plan negotiated "bulk discounts" with manufacturers. In its comments, AAHomecare stated its concern that the proposal could limit beneficiary access to only products on a preferred list, rather than other products that were better suited to their needs. The association also expressed concerns that beneficiaries prescribed certain products might have to undergo a lengthy approval process before they can obtain the product.

Budesonide up in latest ASP figures

BALTIMORE - Average sales prices for nebulizer medications will remain fairly flat during the first quarter of 2012, according to the latest figures released last week. The one notable change: budesonide (J7626), which increased 23 cents to $4.63. Albuterol (J7613) remained unchanged at just over 15 cents per dose; as did ipratropium (J7644) at 13 cents per dose. Down slightly were DuoNeb (J7620), which decreased just over 3 cents to 28 cents per dose; and Brovana (J7605), which also decreased just over 3 cents to $5.35 cents per dose. 

Sunrise gives notice, offers custom services

LONGMONT, Colo. - Sunrise Medical now provides advance shipping and back-order notifications to providers via email or fax when they sign up and specify their communication preferences at These new features mean providers no longer have to research orders, saving them time. In other news, Sunrise now provides a "custom modification service" for its Jay cushions and backs. "Jay Your Way" offers modifications to foam cushion bases, fluid inserts, backrests and covers. Sunrise provides a catalog to walk providers through the possible modifications with descriptions and clinical applications.

Sanomedics to buy DME provider

MIAMI - Sanomedics International Holdings, which manufactures and distributes baby and pet thermometers, announced last week that it has signed a letter of intent to acquire a DME provider with a platform in sleep apnea treatment services. The West Coast-based provider is a $6 million operation, according to a press release. Sanomedics believes the acquisition will provide it with a foothold in the growing sleep apnea treatment market. "This acquisition is the first step in our strategy as a sleep medicine based business," stated Keith Holihan, co-founder and president. Sanomedics expects the deal to close in early 2012.

Complex rehab advocacy video now available

BUFFALO, N.Y. - Providers that advocate for complex rehab issues now have a new tool: "Complex Rehab Technology--Essential for health. Essential for life," a video released by NCART Dec. 16. The 11-minute video provides an introduction to complex rehab technology (CRT) from the perspectives of: individuals who rely on CRT for their health and independence; physicians who prescribe it; and consumer organizations that work to protect access. See it at

Zip codes added to Round 1 areas

BALTIMORE - The competitive bidding implementation contractor (CBIC) last week added several zip codes to Round 1 re-bid areas to conform with U.S. Postal Service changes. The codes, which apply to mail order and non-mail order are: 75033 in Dallas-Fort Worth-Arlington; and 33106 and 33206 in Miami-Fort Lauderdale-Pompano Beach. View the CBIC message. 

VGM, Dream partner

WATERLOO, Iowa - The VGM Group announced last week that it has joined forces with Dream Software to help providers standardize prescription and documentation of medical necessity, a critical function in today's audit-prone climate. Dream's real-time electronic prescribing and automated documentation software ensures that every patient is processed and documented identically. It also requires all supporting documentation be provided before delivery. The end result, according to a release: "If one provider passes an audit, then all providers pass because the software ensures that all patients were processed identically."

Feature prevents billing mistake

PLAINVIEW, N.Y. - Fastrack Healthcare Systems announced last week that it has launched a new feature that allows providers to find out whether a patient has died. Fastrack DMI uses a master death index database that is updated weekly to determine if patients in a provider's system are deceased. "This could lead to inappropriately billing for rental equipment, as well as the financial loss due to not being able to retrieve the product in a timely manner," stated President Spencer Kay in a release. If the system finds a patient who is deceased, it automatically discharges the patient; places all open orders, including rentals and recurring schedules, on hold; creates a pick-up ticket for equipment on rental; and stops all related billing.