In brief: Bid relief, COVID-19 data, vent coverage, telehealth

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Friday, July 31, 2020

WASHINGTON – A last minute push by HME providers boosted to 101 the number of signatures on a “Dear Colleague” letter that seeks to pause Medicare’s competitive bidding program. 

The letter, spearheaded by Reps. Cathy McMorris Rodgers, R-Wash., and Dave Loebsack, D-Iowa, asks CMS to pause the next round of the program for a year or through the duration of the public health emergency, whichever is longer.  

The PHE was extended another three months on July 24. 

The letter closed for signatures July 29, after only a week, with stakeholders hoping to get between 80 and 100 signatures. 

CMS updates COVID-19 data 

WASHINGTON – CMS paid $2.8 billion in Medicare fee-for-service claims for COVID-related hospitalizations, or an average of $25,255 per beneficiary, according to new data released by the agency. 

“The updated data confirm that the COVID-19 public health emergency is disproportionately affecting vulnerable populations, particularly racial and ethnic minorities,” CMS stated. 

Other key data points: 

Beneficiaries eligible for both Medicare and Medicaid – who often suffer from multiple chronic conditions and have low incomes – were hospitalized at a rate more than 5 times higher than beneficiaries with only Medicare. 

Beneficiaries with end-stage renal disease continue to be hospitalized at higher rates than other segments of the Medicare population, with 1,911 hospitalizations per 100,000 beneficiaries, compared with 241 per 100,000 for aged and 226 per 100,000 for disabled. 

Black beneficiaries continue to be hospitalized at higher rates than other racial and ethnic groups, with 670 hospitalizations per 100,000 beneficiaries. 

The data cover the period from Jan. 1 to June 20, 2020, based on Medicare claims and encounters that CMS received by July 17, 2020. 

For the first time, the data also include American Indian/Alaskan Native Medicare beneficiaries. The new data indicate that these beneficiaries have the second highest rate of hospitalization for COVID-19 among racial/ethnic groups after Blacks.  

State news: Hazard pay in Pennsylvania 

HARRISBURG, Pa. – The Pennsylvania Association of Medical Suppliers (PAMS) has helped to secure COVID-19 hazard pay for HME providers as part of the state’s grant program for frontline workers, AAHomecare reports. 

The Department of Commerce and Economic Development added HME providers to the definition of qualified recipients after a letter to Gov. Tom Wolf, and numerous emails between Mindy Eberhart, executive director of PAMS, and the department. 

“We are pleased that the Pennsylvania DCED has agreed that home medical equipment providers are eligible to apply for the hazard pay grants, as they should be,” said Eberhart in an AAHomecare bulletin. “Our providers have faithfully worked throughout the public health emergency to continue to service their customers. We are thankful that their efforts are being recognized, and that our perseverance has paid off on behalf of our members and the industry.” 

AAHomecare says this win in Pennsylvania will help other states seek similar protections. 

OJ Medtech/Charm Medical buys into respiratory market 

ISLIP, N.Y. – OJ Medtech/Charm Medical Supply has acquired PRO2 LLC, an oxygen and CPAP supply company that operates two locations in Buffalo, N.Y., and serves more than 10,000 patients annually. 

PRO2 will help OJ Medtech/Charm Medical expand its product offerings. OJ Medtech in Islip, N.Y., provides compression garments; and Charm Medical in Pembroke, Mass., also provides compress garments, as well as incontinence and urological and wound care supplies, nutritional products and lift chairs. 

“We admire PRO2’s clinical focus and market presence in the respiratory services and sleep therapy sectors in western New York,” said says Peter Tallas, president and CEO of OJ Medtech/Charm Medical. “We found strong synergies with our existing service model of connecting patients, physicians and payers. We see the product line expansion into the respiratory and sleep services sector as a key growth initiative in the years ahead.” 

Upstream Capital, OJ Medtech’s equity sponsor, partnered with Midwest Mezzanine Funds and Eagle Private Capital to assist with the acquisition. 

Paragon Ventures initiated the transaction and acted as the exclusive advisor to PRO2. 

“The acquisition of PRO2 by OJ Medtech/Charm Medical emphasizes the increasing voracity and strength of strategic acquisitions for HME companies,” said Tony Marsallo, managing director for Paragon Ventures. “PRO2 has grown consistently through its local market sales efforts and created operating efficiencies to drive revenues and profits over the past few years.” 

MEDCAC agrees patients need access to appropriate respiratory devices 

WASHINGTON – The Medicare Evidence Development and Coverage Advisory Committee agreed that there is a need for COPD patients to access the respiratory device that is best suited for their condition, during a recent virtual meeting, according to AAHomecare. The committee met to discuss the use of noninvasive positive pressure ventilation for COPD patients and to advise CMS on coverage criteria for devices such as CPAP, BiPAP and ventilators. The committee also agreed there is no evidence to support a requirement for four hours of use for CPAP and there is no evidence to support setting a time requirement. CMS will be reviewing MEDCAC’s discussions. 

NCART, NRRTS set CRT Awareness Week agenda 

WASHINGTON – NCART, NRRTS and others are calling on stakeholders to educate lawmakers and policymakers about why access to complex rehab technology matters as part of the upcoming CRT Awareness Week. They have dedicated each day of CRT Awareness Week to a specific group: consumers on Aug. 10, suppliers on Aug. 11, manufacturers on Aug. 12, and clinicians on Aug. 13, followed by an all-out “CRT Advocacy Day” on Aug. 14. Their suggestions on how to support CRT Awareness Week: make a short video about the CRT services you provide, share NCART posts on social media using the hasthtag #crtawareness, post a CRT product video, write a post sharing a success story, write a post about how your CRT is customized for you, post a photo of your CRT and tag NCART, post a photo of your staff members working with CRT, and write a post about why you participate in advocacy for CRT access. “Helping spread CRT awareness is simple: pick a day to participate, decide which way you want to share details about CRT with others, and use #crtawareness so we can see your posts and help spread the word,” NCART stated in a bulletin. “We can’t wait to see how everyone broadcasts the CRT message.” 

AAHomecare regulatory round up 

WASHINGTON – The DME MACS has been instructed to reprocess claims from March 6-April 22 that should have received the CARES Act relief rates (75/25 blended rate). Only competitively bid items in non-rural, non-bid areas are impacted. Suppliers will be notified via the listserv…CMS will resume some accreditation and enrollment activities. Depending on a state’s reopening plan, surveys will be conducted onsite, virtually or a combination. New DME suppliers who enrolled during the pandemic that have not been accredited will receive notification from the national Suppliers Clearinghouse and will have 30 days to complete an application to an accrediting organization. CMS has posted an FAQ…Tricare West will adjust its fee schedule to reflect rates granted by the CARES Act in response to a request from the AAH payer relations team. Tricare East adjusted their rates in June…AAHomecare has stated its support for the Eliminating the Provider Relief Fund Tax Penalties Act 2020, introduced this week by Reps. Cynthia Axne, D-Iowa, and Neal Dunn, R-Fla. The legislation would ensure providers don’t lose 20% or more of the relief Congress has provided to offset increased costs and lost revenues stemming from the pandemic. 

NSM to boost telehealth services 

NASHVILLE, Tenn. – National Seating & Mobility will partner with regional telehealth providers Blue Sky Therapy, Lightning Mobility Evaluations and Spero Rehab to boost its complex rehab offerings nationwide. “NSM is working to set industry standards for CRT provision via remote evaluation with telehealth partners,” said Bill Mixon, NSM CEO. “Partnering with regional telehealth experts helps us ensure our clients across the country have coverage and access to this essential service. These partners also allow us to support our existing referral sources in facilities currently challenged by the impact of COVID-19.” CMS has allowed PTs and OTs to conduct telehealth services during the public health emergency and added a code for “wheelchair management” to the list of approved codes for those services. 

AdaptHealth names tech exec to board 

PLYMOUTH MEETING, Pa. – AdaptHealth has named David S. Williams, co-founder and CEO of Care3, to its board of directors. Care3 is a technology and data platform for patients, families and medical and social care providers to optimize care in the home and community. Prior to that, Williams founded two digital health care companies. “David is a tested, proven national healthcare executive and thought leader who has repeatedly helped bridge the communication and care divide between patients, physicians and their families through the use of technology,” said AdaptHealth CEO, Luke McGee. “We expect to benefit greatly from David’s experience and insights as we continue to apply innovation, technology, and best-in-class processes to further expand AdaptHealth’s role as an integral part of the healthcare delivery ecosystem.” 

‘Unstoppable’ Jenny Siegle given award 

LUBBOCK, Texas – Jenny Siegle was awarded the Consumer Advocate of the Year during the Unite4CRT Town Hall Meeting on July 28. Siegle helped to form Unite4CRT and has been a driving force in planning the monthly town hall meeting topics and discussions, NRRTS says. “As the host for these meetings, Jenny’s warm and welcoming personality ensures that everyone feels welcome,” NRRTS stated in a bulletin. “She is able to initiate and encourage discussion for a diverse audience, and embodies the group’s mission to bridge the gap between the perception and the reality of living with a disability.” Siegle has also, among other things, supported Ride Designs’ wheelchair seating courses for ATPs and worked as a sports producer for Altitude Sports. Tom Hetzel, PT/ATP, co-founder and CEO of Ride Design, calls her “unstoppable.” “In 2009, I invited Jennifer to join the CRT industry event in Washington, D.C., as a consumer advocate in support of a separate benefit category,” he said. “Her powerful and personal messaging regarding the importance of access to CRT has helped move the needle significantly toward a much broader understanding and support of these bills. Since then, she has become a critical consumer advocate, returning to Capitol Hill annually to join our industry in support of consumer access to CRT.” The next Unite4CRT town hall meeting takes place Aug. 25 at 7 p.m. EST. The topic: “Stay Calm and Drive On – Tips for Driving with a Disability.” 

NEMEP news: New board, virtual event 

CARY, N.C. – NEMEP has elected its new board of directors and officers. They are: John Quinlan, Quinlan’s Pharmacy & Medical Equipment, president; Patty Reni, McKesson Homecare, president-elect; Michael Grabko, Dynamic Healthcare Services, treasurer; and Kathy Sircovitch, At Home Medical (Atlantic Health), secretary…This year’s NEMEP Annual Meeting will take virtually Sept. 28-Oct. 2. The original, in-person event was slated for April. Attendees can expect the same high-level content, including sessions lead by Ronda Buhrmester, director of reimbursement, VGM, on “Billing During the Gap Period”; and Jeff Baird, Brown & Fortunato, on “Managed Care Contracting Made Simple.” Click here for a full agenda. 

NSM gets exclusive access to measurement tool 

NASHVILLE, Tenn. – National Seating & Mobility has secured exclusive access to Complex Rehab Systems, a platform developed by Ki Mobility in collaboration with the company’s ATPs. The CRS platform enhances measurement precision, accommodates collaborative chair customization, and supports order facilitation and approvals. “We are leveraging our partnerships with industry experts to bring advanced technology to the market and improve outcomes for those we serve,” said Bill Mixon, CEO of NSM. “We are proud to partner with Ki Mobility on the introduction of the CRS platform, which we believe will impact the evaluation process and the total clinical experience.” NSM has been collaborating with Ki Mobility on the CRS platform for the past four years. The evaluation and scanning platform allows ATPs to collect detailed electronic records to assist in the design, documentation, review and justification of custom mobility solutions. This includes the ability to capture a 3D scan of the client to “take them with you,” providing measure points or planes for reference by the ATP and clinical team when designing a client’s custom mobility solution. Where appropriate, the platform can also support social distancing during seat evaluations by replacing traditional tools with digital mapping software.   

Pride Mobility, 11-year-old work together on donation 

PLYMOUTH, Pa. – Pride Mobility has donated a Jazzy Air 2 Power Wheelchair to Ann-Marie Kelly. Pride Mobility learned of Kelly’s need after being contacted by the mother of 11-year-old Brian Lyons, her neighbor. Lyons had noticed that Kelly’s power wheelchair was old and no longer reliable, and he decided to start a GoFundMe fundraiser and hold lemonade stands to raise money for a new wheelchair. Lyons helped Pride Mobility present the new power wheelchair to Kelly on July 20. “It makes me feel good to help people,” Lyons said. “I saw my neighbor was having trouble with her wheelchair and I knew I wanted to raise money for her so she could get a new one.” The Jazzy Air 2 will help increase Kelly’s independence. “It means a lot,” she said. “I’ve had my other wheelchair for many years, and I’ve had issues with it on and off, but I’m very happy to have this chair now.” 

Oventus Medical grows presence in Canada 

BRISBANE, Australia – Oventus Medical has signed agreements with two new sleep groups, Tri Hospital Sleep and Ontario Sleep Care, both in Canada. Under these agreements Oventus O2Vent devices will be offered to patients at nine sites. “These businesses have been delivering high quality respiratory care for many years, even decades,” said Dr. Chris Hart, founder and CEO. “Oventus is proud that such well-respected sleep groups in North America have chosen to strengthen their existing sleep offering by adopting our treatment platform.” Oventus also has an agreement with Aeroflow Healthcare in the U.S. whereby Aeroflow is introducing O2 Vent devices throughout its locations and direct-to-consumer platform, as well as through agreements with referring sleep clinics across the southeastern U.S. Tri Hospital in Ontario, which provides diagnostics and treatment for OSA, plans to implement lab-in-lab facilities in its largest location with 14 beds of sleep diagnostics. Ontario Sleep Care, which provides treatment for OSA, will offer O2Vent Optima and ExVent therapy across its network for CPAP-intolerant individuals. 

NSM now in-network with Prime Health Services 

NASHVILLE, Tenn. – National Seating & Mobility has been designated as a preferred complex rehab and home accessibility provider for Prime Health Services, a managed care company specializing in preferred provider networks. Prime Health’s network provides workers’ compensation, and auto and group health solutions for insurance carriers, third-party administrators, self-insureds and government entities. The new relationship authorizes NSM branches nationwide as approved and in-network. “Prime Health Services is pleased to announce NSM is now a preferred provider in our national PPO network,” said Todd Hurt, executive vice president of network development for Prime Health. “Adding a nationwide provider offering products and services to meet mobility and accessibility needs, no matter the complexity, allows our clients the ability to access care to move through life with confidence.” 

Brightree launches blog 

ATLANTA – Brightree has launched a blog called “Insight” to provide insights into the HME, pharmacy and home infusion industries. The blog will feature posts from company subject matter experts and industry experts on topics like leading during the changing environment, preparing for regulatory changes, and leveraging best practices for building and running a provider business. The first two posts are: “Business continuity best practices from providers” and “5 ways interoperability can benefit you.” 

People news: Michael Hanna 

ATHOMES has welcomed a new board member: Michael Hanna, director of compliance and education for Home Medical Products in Jackson, Tenn. Prior to Home Medical Products, Hanna was a provider outreach and education senior analyst for CGS, the DME MAC for Jurisdiction C. “While I have not been on the DME supplier side very long, I feel that I can bring knowledge to the group with my Medicare DME MAC experience,” Hanna said. “I have worked with all types and sizes of suppliers for a number of years and realizing the frustrations of this aspect of the health care business. Now that I am on ‘your’ side, I will continue to learn and grow as I hope to share my knowledge and experience with peers at ATHOMES.” Hanna will also serve as an ATHOMES appointee to the Jurisdiction C Council.