In brief: AAH says to keep using WOPDs; CareCentrix provides additional details on change

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Friday, January 17, 2020

WASHINGTON – AAHomecare recommends that providers continue to obtain written orders prior to delivery for HME until CMS publishes a “required list.”

Earlier this month, the DME MACs said a new standard written order would be the only type of order needed for HME claims starting with dates of service Jan. 1, 2020. But it also said certain HME on a “required list” would still be subject to face-to-face and WOPD requirements.

While AAHomecare has confirmed that as of Jan. 1, 2020, WOPDs are only required for PMDs, “it is recommended that suppliers continue to get a WOPD until the new list is published,” the association stated in a bulletin.

The list of items that will no longer require a WOPD:

Group 1, 2 and 3 pressure reducing support surfaces

TENS units

Negative pressure wound therapy

Wheelchair seating

Wheelchair options and accessories for power wheelchairs

Portable gas oxygen

Liquid stationary and portably oxygen

CPAP

RAD

Nebulizers

CMS plans to publish a “required list” in the Federal Register in the next month or so, according to AAHomecare.

CareCentrix provides additional details on change

HARTFORD – CareCentrix requests that providers temporarily pause PAP equipment/supplies to patients with out-of-pocket balances more than 180 days old, until it sets up payment arrangements with those patients.

CareCentrix says it will provide at least 60 days advance notice to providers and patients of these cases.

“Should providers continue to render PAP services to these patients after their pause effective date, only then will claims payments be at risk,” the company said in a statement to HME News.

CareCentrix says payment arrangements could include an interest free payment plan where the aged balances can be paid over a period of up to 18 months.

AAHomecare reported earlier this month that CareCentrix was withholding payments to providers for PAP equipment/supplies for patients with co-pay balances. The association shared its concerns and CareCentrix responded by developing potential impact reports for individual providers and offering them one-hour online training sessions.

Inogen cites soft demand, manufacturing challenges in preliminary financial results

GOLETA, Calif. – Inogen expects full-year revenue of $361.4 million to $362.4 million, up 0.9% to 1.2% compared to 2018, based on preliminary, unaudited financial data.

The company expects fourth quarter 2019 revenue of $78.4 million to $79.4 million, down 8.2% to 9.4% compared to the same period in 2018.

“We had softer than expected demand, primarily in our direct-to-consumer and international channels, in the fourth quarter of 2019, and we also had some manufacturing challenges that contributed to unshipped orders as of Dec. 31, 2019,” said Scott Wilkinson, president and CEO.

Inogen expects domestic business-to-business sales of about $20.6 million in the fourth quarter of 2019 compared to $25.4 million in the same period in 2018.

Inogen says that, while sales rep productivity increased in the fourth quarter compared to the comparative period, direct-to-consumer sales were affected by an about 31% reduction in its sales rep headcount (329 as of Dec. 1, 2019, compared to 446 as of Dec. 31, 2018) and lower average selling prices.

The company says the primary driver of delayed shipments was certain component part shortages, which are also expected to impact the first quarter of 2020.

Inogen has updated its full year 2020 guidance range for total revenue to $385 million to $400 million, representing 6.4% to 10.5% growth over the 2019 preliminary revenue mid-point of $361.9 million. The company is reviewing its net income and adjusted EBITDA guidance.

Accessories: Updated payments take effect, will be applied retroactively

WASHINGTON – Updated payment rates for complex manual wheelchair accessories went into effect Jan. 1, but they may not be updated until July 1 to allow changes to be made to the claims processing system, according to a bulletin from CMS. As such, suppliers should continue to submit claims for these items with dates of service on or after Jan. 1, 2020, but payment rates will continue to be based on the adjusted fee schedule amounts in the interim. After changes to the system are implemented, payment rates at the full fee schedule amounts for claims with dates of service on or after Jan. 1, 2020, will be available retroactively. In December, both the House of Representatives and the Senate passed H.R. 1865, a year-end spending bill that includes language requiring CMS to stop applying bid pricing to these accessories for 18 months starting Jan. 1, 2020.

CVS adds 15 HealthHUBs in Texas

HOUSTON – CVS has rolled out HealthHUBs in 15 of its pharmacy locations across the greater Houston area, the company announced Jan. 13.

Key features of the HealthHUBs, which CVS began piloting last year, include a greater selection of health and wellness products, including DME and sleep apnea products.

"Customers tell us they want local access to convenient, personalized and integrated health care," said Jeffrey Schmidt, senior vice president, CVS Pharmacy. "Our HealthHUB locations do just that—helping to elevate the store into a community-based health care destination where consumers can engage people they trust, who are accessible and knowledgeable, to help bring everything together in a better health experience at a lower cost."

Currently, CVS has 53 HealthHUBs in Texas, Florida, Georgia, New Jersey and Pennsylvania.

The 15 new HealthHUBs in Houston are part of CVS’s strategy to scale the program nationally, with plans to bring HealthHUBs to 17 states in the first part of 2020.

CVS plans to bring 1,500 HealthHUBs to areas throughout the U.S. by the end of 2021.

Masimo to acquire connected care portfolio

IRVINE and CULVER CITY, Calif. – Masimo will acquire the Connected Care assets of NantHealth for $47.25 million in cash. The deal will further Masimo’s goal to help hospitals improve the continuum of care through automation, connectivity and innovative noninvasive monitoring technologies. "One of the strategic priorities for Masimo is, through our Hospital Automation solutions, to reduce clinician cognitive overload and reduce errors of omission,” said Joe Kiani, founder, chairman and CEO of Masimo. "Not only does Connected Care immediately increase our customer footprint but also provides us with products which complement our current portfolio.” NantHealth’s Connected Care solutions provide medical device interoperability to hospitals and health systems. The transaction is expected to close in the first quarter of 2020. 

On The Mend opens new location

MT. KISCO, N.Y. – On The Mend Medical Supplies & Equipment has opened a 3,000-square-foot retail location here that offers a wide range of HME and supplies, allowing customers to really get a feel for how these products will work in their homes. The company’s portfolio includes portable oxygen concentrators, CPAP devices, beds, scooters, vehicle and stair lifts, compression garments and incontinence supplies. On The Mend also offers home safety assessments. “Our company mission is to provide the medical equipment and supplies necessary to age in place, recover from injuries and surgeries, and to live more independently with life changing illnesses,” said Liam O’Keeffe, who co-owns the store with Bob Rainey. “Our customers’ dignity is of paramount importance to the entire On The Mend team.”

GEMCO re-launches website

HUDSON, Ohio – GEMCO Medical has redesigned its website to feature a streamlined design, improved functionality and an overview of its third-party logistical capabilities. As a fully licensed and VAWD-accredited fulfillment center, GEMCO Medical’s healthcare compliant 3PL services continue to be an area of significant growth for the company, says Vice President and General Manager Richard Keirn. “The new design of our website better reflects not only who we are, but also the sophisticated fulfillment services GEMCO Medical can now offer its B2B healthcare customers,” he said. “When it comes to the complexity of the healthcare supply chain, there’s no one-size-fits-all solution; offering tailored fulfillment programs to our customers has really set us apart.” GEMCO is a distributor of diabetes, wound care, ostomy and other home medical products.

HFMA recognizes Patientco billing solution

CHICAGO – The Healthcare Financial Management Association has awarded Patientco’s billing and payment platform the “Peer Review by HFMA” designation. “Achieving this designation is a testament to the value Patientco delivers for our health system clients and their patients,” said Bird Blitch, Patientco CEO. HFMA is a membership organization for healthcare finance leaders with more than 50,000 members. Its peer review process includes a panel review composed of current Patientco clients, prospects who have not yet made a purchase, and industry experts. Patientco’s platform gives patients easy-to-understand, tailored billing communication through paper, email and SMS text. Once engaged, patients have access to Patientco’s intuitive, self-service payment tools with affordable options, such as payment plans or financing.

Permobil Foundation honors Brandon Edmondson’s legacy

LEBANON, Tenn. – The Permobil Foundation will match donations to a college fund established for the children of Brandon Edmondson, a Permobil employee who recently passed away. Edmondson, OTR, ATP, was the director of clinical sales and outcomes BR Americas. “We lost a hero and a cherished member of the Permobil family, Brandon Edmondson,” the foundation states on its website. “This is a heartbreaking loss for Brandon’s family and friends, for Permobil and the CRT industry. Brandon will be remembered as a dedicated father and husband, and for the positive impact he had on so many. Our thoughts and prayers are with his family and friends during this very difficult time.” Donations are tax-deductible and can be made here.