In brief: Apria settles with MassHealth, Trump stalls sleep reg

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Friday, August 11, 2017

LAKE FOREST, Calif. – Apria Healthcare has agreed to pay more than $750,000 to settle allegations that it billed Massachusetts residents for services already covered by MassHealth, the state’s Medicaid program.

Under the settlement announced Aug. 9, Apria has agreed to pay $99,008 in restitution and $665,934 in penalties to settle allegations that the company improperly billed consumers between December 2011 and April 2017, according to Massachusetts Attorney General Maura Healey.

Despite the settlement, Apria denies it violated any state laws.

“We are pleased to have resolved this matter with the Massachusetts Attorney General,” said Raoul Smyth, Apria’s executive vice president and general counsel, in a statement. “Although Apria denies that it has violated any Massachusetts laws, this resolution reflects Apria’s desire to put this matter behind it so that it can continue to focus on the needs of patients.”

Apria says it addressed the processes that were the focus of the Attorney General’s investigation long before this settlement was reached.

Study: Bid program puts Medicare more in line with commercial insurers

BETHESDA, Md. – A comparison of the prices Medicare paid for certain DME under its competitive bidding program in 2010 and the average prices that commercial insurers paid that same year supports the conclusion that CMS overpaid for DME, according to a new study conducted by the Health Care Cost Institute and published this month in Health Affairs. On average, the Round 1 Rebid prices for the seven items included in the study were 34.7% lower than the prices in the Medicare fee schedule for 2010. On average, commercial payers paid 28.7% less than Medicare for the same items in 2010. “This suggests that in the nine program MSAs, the program resulted in prices that were generally comparable to but lower than the prices obtained by large commercial insurers,” the study’s authors say. Because the bid program has better lined up prices from Medicare with those of commercial insurers, the study’s authors argue it is an “effective mechanism for achieving savings,” with one caveat. “If the concerns about the program’s long-term sustainability can be resolved, competitive bidding for DME and similar items may be an effective mechanism for achieving savings in Medicare, relative to historic fee schedule prices,” they say. The Health Care Cost Institute is a non-partisan, non-profit organization that aims to provide complete, accurate, unbiased information about healthcare utilization and costs to better understand the U.S. healthcare system, according to its website.

Trump stalls sleep reg for drivers, rail workers

WASHINGTON – President Donald Trump, who has pledged to drastically slash federal regulations, has sounded the death knell for a regulation to require sleep apnea screening for commercial drivers and rail workers, according to news reports. The Federal Railroad Administration and the Federal Motor Carrier Safety Administration said late last week that they are scraping the regulation, arguing that it should be up to trucking and railroad companies to decide whether or not to screen their employees. Last year, however, the agencies announced a proposal to require screening for commercial drivers and railroad workers, and sought public input. Deadly rail crashes in New York City and New Jersey, as well as several highway crashes, have brought the issue to the forefront. In the Metro-North train crash in 2013, the engineer fell asleep at the controls because he had a severe, undiagnosed case of sleep apnea. In the New Jersey Transit train crash in September, the engineer also suffered from undiagnosed sleep apnea.

New Apria program helps reduce readmissions

LAKE FOREST, Calif. – Apria Healthcare has launched a new program for patients on non-invasive ventilation that it says significantly reduces hospital admissions.

As part of the Apria Clinical Evidence (ACE) program, respiratory therapists perform regularly scheduled home visits to help patients maintain compliance with therapy and intervene as needed to get patients back on track. During the visits, RTs monitor each patient’s progress and record their responses to a number of quality of life indicators, as well as document emergency department visits and unplanned hospital admissions.

“Apria is uniquely positioned to help these patients reduce hospital admissions by providing them with the tools and support they need for success,” said Dan Starck, CEO of Apria Healthcare. “Through the ACE program, we have seen tremendous success in reducing hospital admissions when comparing the six months prior to initiating therapy with the six months post therapy, particularly for patients diagnosed with COPD.”

Initial results from the ACE program are comparable to a recent study published in the Journal of Clinical Sleep Medicine, which demonstrated that multifaceted COPD intervention—including non-invasive ventilation, RT-led respiratory care and patient education—resulted in an 88% reduction in hospital admissions, according to Apria.

Apria is offering the ACE program nationwide through its locations in Springfield and Wilmington, Mass.

Inspired by Drive launches online community

SANTA FE SPRINGS, Calif. – Inspired by Drive has launched “Live Inspired,” an online community for special needs families. It features a weekly guest blog and other resources, and offers families a place to connect. “Our commitment to special needs families goes beyond our products,” said Matt Lawrence, vice president and general manager. “The Live Inspired community is an extension of our mission to enhance the quality of life of the people we touch and our commitment to families.”

AccessNSM taps new vice president

NASHVILLE, Tenn. – AccessNSM, the accessibility division of National Seating & Mobility, has named Kalen McKenzie vice president. McKenzie previously served as regional account manager at Dornier MedTech and vice president of national accounts at Invacare. “Kalen’s experience and expertise will be extremely valuable to AccessNSM,” said Bill Mixon, NSM CEO, in a press release. “His leadership will play an integral role in the continued strategic growth of the company.” As vice president, McKenzie will focus on integrations and organic growth for AccessNSM.

Pedors launches footwear program

ROSWELL, Ga. – Pedors Shoes has introduced a Geriatric Footwear Program that provides PTs and OTs with a discount code they can share with their patients to help offset the cost of therapeutic footwear. Pedors believes the program can help to address Medicare’s broken audit system and the emergence of e-commerce, which it says have driven orthotics fitters and pedorthists out of the market and made it harder for patients to find footwear. “The objective of the program is to keep the cost of orthopedic footwear on par with what a patient might expect to pay for a pair of sneakers,” said Stephen O’Hare, president.

AAH seeks nominations for homecare champion

WASHINGTON – AAHomecare is accepting nominations for the 2017 Van Miller Homecare Champion Award. The award, which was established in 2016 when the association renamed the AAHomecare Champion Award, recognizes a member who has made exceptional contributions to home care. Nominations can be submitted to Sue Mairena at suem@aahomecare.org until Sept. 8. The award will be presented during the Stand Up for Homecare reception at Medtrade on Tuesday, Oct. 24. Missy Cross, vice president of the homecare division of O.E. Meyer Co., received the inaugural award last year.

Aeroflow donates breast pump kits

ASHEVILLE, N.C. – Aeroflow and Ameda, a breast pump manufacturer, are partnering with Grady Memorial Hospital in Atlanta to provide breast pump kits for new mothers to use at Dekalb Detention Center. The program gives the mothers, most of whom will be in Dekalb for short periods of time, the opportunity to initiate and maintain lactation so they can continue to feed their baby breast milk once they’re reunited at home. "Many women at Dekalb believe they are not allowed to breastfeed, even in the hospital, but I encourage them to consider doing so, even if it's only for a short period of time," said Kelly Webb, the Lactation Program Coordinator at Grady Memorial Hospital. "Access to a breast pump allows a new mother to maintain supply and remain emotionally connected to her infant." Aeroflow Breastpumps, a subsidiary of Aeroflow Healthcare, is a DME provider specializing in helping pregnant and nursing women qualify for their breast pumps through their insurance and the Affordable Care Act.

Last call for HME Woman of the Year nominations

WATERLOO, Iowa – The nomination period for the HME Woman of the Year award closes Monday, Aug. 14. To nominate a woman for the award, all you have to do is complete four questions stating how the woman has made an impact on the industry. Women are also encouraged to nominate themselves. Last year’s recipient, Dr. Kirsten Davis, has used the award as a platform for networking with other women in the industry, and sharing successes and obstacles that impact their businesses. “I would encourage everyone to take a minute to really think about what they do, what they've done, and who they've touched,” said Davin. “By really sitting down and reviewing your career, we often find out that we have a greater impact than we think we do.”  The winner of the award will be announced at Medtrade in October.

QS/1 boasts QIR-certified installers

SPARTANBURG, S.C. – QS/1 has met the stringent guidelines of the Qualified Integrators and Resellers (QIR) Program, giving its pharmacy and provider customers assurance that they meet regulatory requirements to protect consumer credit card data. This Payment Card Industry Data Security Standard (PCI DSS) qualification details the procedures for a secure installation and continued maintenance of payment application systems. QS/1 integrators are PCI-certified under the QIR program to install, configure and maintain payments systems, like the company’s Point-of-Sale. “QS/1 has a history of leading the way in point-of-sale technology,” said Saul Factor, QS/1 president. “With network breaches at an all-time high last year, we want to ensure we stay ahead by taking every step possible to protect our customers and those they serve by reducing the risk of a security breach.”

EZ-Access makes improvements

ALGONA, Wash. – EZ-Access has updated its website, www.ezaccess.com, and strengthened its sales team. The company, which makes accessibility solutions, worked with VGM Forbin to update its website to improve the experience for current and prospective customers who are searching for products. The website, which was built to perform well on all devices, features products segmented by categories, a dealer contact form, a live chat and stronger security. EZ-Access has also added Scott Haisch as West Region Business Manager, reporting directly to David Heinz, director of sales for the company’s Residential Access division. Previously, Haisch was managing director of an international sales and marketing consulting company.