In brief: Bid amounts for braces, changes for CGMs and external pumps, provider reactions

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Friday, October 30, 2020

WASHINGTON – CMS on Oct. 27 announced Round 2021 single payment amounts for off-the-shelf back braces and knee braces.  

The agency has made contract offers for back and knee braces in 127 CBAs, a move that it expects to save $600 million for the Medicare program and beneficiaries over the three-year contract period. 

CMS is not making offers for back and knee braces in certain CBAs where savings would not be achieved. Payment in those areas will be based on adjusted fee schedule amounts. 

In a proposed rule published on Oct. 27, the agency also proposed classifying all continuous glucose monitors, not just therapeutic CGMs, as DME, and establishing payment amounts for them and their related supplies and accessories. 

Moreover, CMS proposed expanding the classification of external infusion pumps under the DME benefit, increasing access to home infusion. 

Providers commend CMS on changes to Round 2021 

WASHINGTON – CMS’s decision not to push forward with the majority of Round 2021 of the competitive bidding program has been met with support from numerous providers. 

CMS on Oct. 27 announced new payment amounts for off-the-shelf back and knee braces but not for 13 other product categories, including CPAP and oxygen therapy, because there were no expected savings.  

In light of the ongoing public health emergency, it’s the right thing to do, says Casey Hoyt, CEO of Viemed Healthcare. 

“While the current pandemic is ongoing, we believe these types of program changes are big signals from CMS that our country must expand access to home care for a growing population of patients desperately needing to be treated out of harm’s way from COVID-19,” he said. 

The agency’s decision means it’s likely CMS has neared the reimbursement floor for these product categories, providing some measure of stability for the industry in the foreseeable future, says Greg Crawford, CEO of Protech. 

“As the COVID-19 pandemic continues, we must continue to build our capacity as an industry to provide the upmost level of care to the growing number of patients that require home-based healthcare solutions,” he said. 

In a proposed rule also published on Oct. 27, CMS also seeks to finalize a previous interim final rule that resumed the transitional 50/50 blended rates for items furnished in rural areas and non-contiguous areas from June 1, 2018, through Dec. 31, 2018. 

“By setting the rural rates permanently at the 50-50 blended, CMS wisely recognized the need to maintain the sustainability of suppliers so that patients in these rural and sparsely populated areas can continue to receive uninterrupted access to care,” said Crispin Teufel, chairman of the Council for Quality Respiratory Care. “We commend CMS for taking this vital step and ensure vulnerable patients’ continued access to home respiratory care in non-competitive bidding areas.” 

Protech sleeps well with latest acquisition 

CINCINNATI – Protech Home Medical has acquired Sleepwell, a company based in Georgia with unaudited trailing 12-month annual revenues of about $13 million. 

Sleepwell has adjusted EBITDA of about $3.25 million, net income of about $2.5 million and no debt. 

The company provides sleep services in the Southeastern corridor, as well as Dayton, Ohio, which is a new market for Protech. It adds five locations and 15,000 active patients to Protech’s roster. 

Dave McLeod, a 12-year veteran of the industry, will join the Protech executive team as director of sleep services. 

Following the close of Sleepwell, Protech has a run-rate revenue of about $120 million to $125 million, and adjusted EBITDA of $26 million to $30 million. 

Protech now has 48 locations across the U.S., 110,000 active patients and 17,000 unique referrals. 

The company has made a number of acquisitions this year, including Buffalo Grove, Ill.-based Health Technology Resources

CQRC promotes bill during Nat’l Respiratory Care Week 

WASHINGTON – The Council for Quality Respiratory Care is celebrating National Respiratory Care Week, Oct. 26-31, by promoting H.R. 8158, a bill that would eliminate the budget neutrality requirement for home oxygen services, supplies and equipment. The annual event, sponsored by the American Association for Respiratory Care, recognizes the critical role that respiratory therapists play in promoting patient health. The CQRC commends RTs for their efforts to ensure continued access to care, even as outdated Medicare policies like the budget neutrality requirement threaten to limit beneficiary access to home oxygen supplies and equipment. “The budget neutrality provision has led to troublingly low rates for oxygen supplies and equipment in both rural and suburban markets,” said Crispin Teufel, CQRC Chair. “We urge Congress to take action this year to pass legislation to correct this outdated Medicare policy to ensure continued patient access to respiratory care for both those living with chronic conditions and individuals recovering from COVID-19.” To participate in the national conversation about National Respiratory Care Week on social media, include #RCWEEK20 in posts. 

LifeScan, Truepill partner on e-commerce channel for OneTouch Reveal users 

MALVERN, Pa. – LifeScan has partnered with Truepill, a digital health platform providing consumer health experiences through its API-connected infrastructure. Through the partnership, LifeScan will leverage Truepill’s platform to provide OneTouch brand diabetes self-management supplies, including test strips, lancing devices and blood glucose monitors, directly to the homes of patients. “LifeScan’s OneTouch Reveal app is already providing meaningful resources, helping users understand patterns and trends to keep them focused on staying healthy,” said Val Asbury, LifeScan president and CEO. “By leveraging Truepill’s powerful API infrastructure, we are able to broaden awareness of our vast array of OneTouch brand tools with an easy to access e-commerce channel for our OneTouch Reveal users.” The partnership will launch in November with an e-commerce platform embedded directly in the OneTouch Reveal mobile app enabling users to buy testing supplies and wellness services from their homes.  

Aeroflow Breastpumps, Medela launch contest 

ARDEN, N.C. – Aeroflow Breastpumps has launched its third annual pumping room makeover contest, in partnership with Medela. Five winners, announced on Nov. 13, will receive $1,000 to create their dream pumping space within their own home, as well as the new Medela Pump In Style with MaxFlow breast pump. “Due to COVID-19, moms have been taking on more roles and responsibilities, both at home and at work, now more than ever,” said Melissa Gonzales, executive vice president of the Americas for Medela. “Medela is committed to helping moms across the country get the support they need on their breastfeeding journey. Through our partnership with Aeroflow, we want to be able to give them a place that they can truly unwind from the day and bond with their baby.” Entries, which Aeroflow Breastpumps will accept through Nov. 6, 2020, must include a link to either: a “PumpingRoom Makeover 2020” Pinterest board with at least five pins from Medela and Aeroflow Breastpumps’ Dream Pump Room board; or a three- to five-image carousel post on Instagram or Facebook that tags Aeroflow Breastpumps and Medela USA and includes #PumpingRoomMakeover. 

United Spinal equips wheelchair users to better weather disasters 

KEW GARDENS, N.Y. - The United Spinal Association has launched a disaster preparedness initiative for individuals with spinal cord injuries and disorders designed to lessen the effects and risks associated with natural or human-caused disasters. “Read to Roll” addresses the significant challenges individuals living with disabilities face when disasters strike, especially those who rely on power wheelchairs, ventilators and other medical equipment and supplies. “Our goal is to help preserve the health and safety of individuals with disabilities in times of uncertainty and upheaval due to disasters through advanced planning, along with the preparation of professionals and local agencies,” said Abby Ross, United Spinal's COO. “Being equipped both intellectually and physically for unexpected events can save lives, lessen the emotional impact and facilitate a quicker adjustment in times of transition.” The initiative addresses planning for emergency evacuation, preparing for power outages, ensuring the safety of pets and service animals, safeguarding critical mobility equipment and supplies, and accessing local resources. In the coming months, United Spinal plans to distribute disaster readiness starter kits with items such as first aid kits, flashlights that easily attach to wheelchairs, wet wipes, garbage bags and emergency blankets. 

Respironics lays off 32 ahead of facility closing next year 

WALLINGFORD, Conn. – Respironics Novametrix is laying off 32 workers, including 25 production workers, by Dec. 18, according to the Hartford Business Journal. Philips, its parent company, announced earlier this year that it will shut down the facility completely by June 2021 due to a reorganization of its hospital respiratory care business, according to the journal. Respironics started laying off workers in March. The other workers in this latest round of layoffs include machine operators and maintenance technicians. The company is offering severance and other benefits, including outplacement services, to all affected employees, according to the journal. 

Linde names new COO 

GUILFORD, U.K. - Linde’s board of directors has appointed Sanjiv Lamba as COO effective Jan. 1. In this role, Lamba will be responsible for the regional operating segments of the Americas, APAC and EMEA, as well as Linde Engineering and Lincare. He will also be responsible for certain global functions, initiatives and businesses. He will report to Linde CEO Steven Angel and will relocate to Danbury, Conn. Prior to being named COO, Lamba served in several roles at Linde, including executive vice president APAC and head of regional business units for South and South East Asia. He has spent 31 years at the company. 

Invacare teams up with Toys for Tots 

ELYRIA, Ohio – Invacare will give a toy to Toys for Tots for every Solara 3G Manual Wheelchair the company sells in November. “We’re honored to continue to find ways to support our community this holiday season,” said Michael Salvi, director of manual mobility and seating. Features of the Solara, which Invacare has nicknamed “the tank” for its durability, include fully adjustable, easy to tilt, low-shear recline, foot-operated wheel lock and 300-pound weight capacity. 

Repair Authority launches CPAP Medic 

CLEVELAND – Repair Authority has launched CPAP Medic, a direct-to-patient CPAP and BiPAP repair service for customer-owned equipment. Repair Authority has 30 years of experience repairing equipment, including CPAPs, oxygen concentrators, ventilators and other respiratory equipment. “By the time patients find us, they are often desperate for help in getting their CPAP device repaired so they can resume therapy,” said Jesse Keirn, CEO. “Once their units become patient-owned and are out of warranty, they often struggle to find a solution to their repair needs, especially when it could be a number of years before their insurance company will approve a new device.” CPAP Medic also offers CPAP Checkup, a direct-to-patient maintenance service. The company is an authorized warranty service center for Philips Respironics, ResMed, Invacare, Drive DeVilbiss and AirSep. 

FODAC receives mayor’s recognition 

TUCKER, Ga. – Friends of Disabled Adults and Children has received the Mayor’s Business Award given to local businesses that actively give back to the community. Since 1986, FODAC has served the community by collecting and distributing durable medical equipment to the benefit of disabled residents and their families. “FODAC really is an example of where our business and philanthropic communities intersect,” said Tucker Mayor Frank Auman. “They embody the notion of Tucker businesses doing well, while also doing good in the community.” FODAC gives away approximately $9 million in worth of medical equipment each year. 

180 Medical named Best Place to Work 

OKLAHOMA CITY, Okla. – 180 Medical has been named one of Oklahoma’s Best Places to Work by the Best Companies Group and the Journal Record. It’s the provider’s 11th time on the list, which is based on anonymous employee surveys on working conditions. This year’s survey included questions about how well companies handled COVID-19 workplace communication and safety. “In light of the unprecedented year that we all have experienced due to COVID, it is a great feeling to know that our employees still feel that this is a great place to work, and that even in crisis, we strongly care for our employees and their families as much as we do our customers,” said Angie Christopher, director of human resources. “Throughout the year and despite most of us working remotely during this time, we have grown closer as an organization, and we have developed new processes and protocols to ensure the safety of our employees.” 180 Medical provides catheters, ostomy, incontinence and other urological supplies. 

United Spinal Association appoints new leader 

KEW GARDENS, N.Y. – United Spinal Association has named Vincenzo Piscopo as president and CEO. Piscopo, a wheelchair user who was paralyzed from a herniated disk in 2010, previously worked at The Coca-Cola Company for 25 years in a variety of strategic roles both in the U.S. and internationally, most recently as community and stakeholder relations director, where he managed and cultivated company relationships with disability, veteran and Hispanic organizations and advocates. “With the help of United Spinal’s talented staff and dedicated chapter leaders, I remain committed to advancing opportunities for people with disabilities, strengthening their voice and empowering them to have a positive impact in their community,” said Piscopo. He officially takes the reins Nov. 16, replacing James Weisman, who is retiring.