In brief: Bid relief, first audits, new Numotion location

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Friday, August 14, 2020

WASHINGTON – The HME industry’s champions in the House of Representatives have indicated that they’re still invested in securing permanent relief for rural and other non-bid suppliers, AAHomecare says.

The champions are also invested in eliminating the oxygen budget neutrality requirement that’s impacting reimbursement in rural areas, according to the association.

“The lead sponsors for (H.R. 2771) have suggested that building additional co-sponsor support for (the bill) will increase prospects that provisions from this bill can be included in other omnibus legislative packages before the end of the year,” AAHomecare stated in a bulletin.

Currently, H.R. 2771 has 75 co-sponsors.

AAHomecare recommends targeting the 66 representatives who supported a previous rural relief bill but who haven’t yet co-sponsored H.R. 2771.

H.R. 2771 would make permanent the 50/50 blended reimbursement rates in rural areas and would introduce a 75/25 rate for non-rural, non-bid areas, as well as eliminate the oxygen budget neutrality requirement.

CGS announces reviews for back braces, glucose monitors

ATLANTA – CGS has announced that the Jurisdiction B medical review department will begin complex post-pay service-specific reviews on back braces and lithium batteries for glucose monitors, according to the van Halem Group.

Both reviews are the result of data analysis that indicates the allowed dollars for the two codes in Jurisdiction B are significantly above expected amounts. Each code also ranks high in the CERT Errors Top 15, with L0650 ranking No. 6 and A4235 No. 11, according to the van Halem Group.

Based on earlier information from CMS, which restarts audit activity this month, post-payment reviews will be on items/services provided before March 1, 2020.

van Halem Group highlighted the following from CGS’s announcement: “CGS would like to remind suppliers of the importance of responding to additional documentation request letters. Suppliers are in violation of Supplier Standard #28 when, upon request, they fail to provide requested documentation to a Medicare contractor. Therefore, the consequences of failure to provide records may not only be a claim denial but also referral to the National Supplier Clearinghouse.”

A referral to the NSC, the van Halem Group points out, will likely result in unannounced site inspection visits or even investigations by a provider’s Supplier Audit and Compliance Unit. Violations of DMEPOS supplier standards can result in revocation of a supplier number for a minimum of a year.

Protech works to build NIV business

CINCINNATI – Protech Home Medical has executed a non-binding letter of intent to acquire a private respiratory company in the Midwest reporting unaudited trailing annual revenues of about $5 million, positive adjusted EBITDA and positive net income.

The acquisition would expand Protech’s presence in the Midwest, including adding a large new market, and increase the company’s active patient count by more than 3,000.

“The acquisition would be immediately accretive to Protech’s EBITDA and overall profitability and would continue to build scale on the top-line, which has not reached a run-rate of $100 million,” said Greg Crawford, chairman and CEO. “We are excited about the target’s diverse payer mix with minimal Medicare exposure, and strong recurring revenue base and product mix.”

The acquisition target has a high acuity respiratory program that provides non-invasive ventilation in a 90-mile radius and that makes up one-third of its overall revenues.

Protech “feels strongly about bolstering its non-invasive ventilator volume as a percentage of its product mix, given the strong market fundamentals,” including CMS’s decision earlier this year to remove the product category from Round 2021 of its competitive bidding program.

Protech expects to close the acquisition within the next 30 days.

BraunAbility report card reveals low satisfaction with ADA

INDIANAPOLIS – People with mobility disabilities say the Americans with Disabilities Act isn’t very effective most of the time, according to the new BraunAbility Drive for Inclusion Report Card. 

To create the report card, BraunAbility surveyed both the general population and The Driving Force, the company's online community of people with mobility impairments and their caregivers.

  • While 68% of the general public believe people with mobility challenges are fairly accommodated and included in most aspects of society, only 23% of The Driving Force agree with that statement.
  • The No. 1 barrier to achieving inclusion, according to The Driving Force, is the lack of involvement of people with mobility issues while mobility accommodations are designed and developed.
  • Forty percent of The Driving Force believe mobility challenges are rarely considered when organizations and governments develop programs or accessibility accommodations under the category of "diversity and inclusion."
  • The general public cited people who use wheelchairs as second only to immigrant populations in terms of marginalized groups that have the least input on decisions that impact them – less than women, aging populations or any race or religion.
  • After having experienced restricted mobility and isolation under shelter-in-place orders, nearly 70% of the general population expressed having a greater willingness to understand and accommodate others who experience isolation or challenges because of a mobility impairment.

BraunAbility launched Drive for Inclusion to amplify the voices of people with mobility challenges and their caregivers. The Driving Force community provides invaluable insight and feedback through online surveys. In turn, BraunAbility amplifies their voices, helping bring mobility disability related issues to the forefront.

"At a time when the pandemic is challenging us all to create new accommodations, and society at large is seeking heightened awareness around social justice, it's imperative this new level of empathy extends to those with mobility challenges," said Staci Kroon, president of BraunAbility.

Parks Associates to hold virtual Connected Health Summit

ADDISON, Texas – Parks Associates will host its 7th annual Connected Health Summit: Consumer Engagement and Innovation conference online Sept. 1-3. The event will feature research presentations and interactive sessions focused on key topics in the connected health space. Special networking events will allow industry leaders to connect, share insights, and discuss the immediate, near-term, and long-term impact of COVID-19 on the consumer health care market. Speakers include Richard Culberson, executive director, Cox Homelife Strategy & Operations, Cox Communications; Angie Kalousek Ebrahimi, executive director, Mind-Body Medicine, Blue Shield of California; and Gene Wang, CEO, People Power. “Deep analysis of these topics is critically important as service providers, insurers, health facilities, and consumers seek new strategies to deploy connected solutions in service of care delivery and wellness services,” said Elizabeth Parks, president, Parks Associates.  “We are excited to offer a virtual networking experience, with the best audience to examine recent shifts in the care delivery model and measure the long-term impact of these trends.”

NCPA moves conference online

ALEXANDRIA, Va. – The 2020 National Community Pharmacists Association Annual Convention is shifting to a virtual meeting, Oct. 18-19, 2020, because of the ongoing COVID-19 pandemic. The business-focused programs that attendees have come to expect from NCPA will be available exclusively online in a live and virtual format. NCPA will employ a state-of-the-art virtual exhibitor platform to help conference attendees find new business tools and opportunities for their pharmacy. Registration for the online event opens Aug. 28. The cost is $250. For those who had already registered for the live meeting, there are options for refunding the registration fee. NCPA will be sending information via email.

OMHA expands eligibility for settlements

WASHINGTON – The Office of Medicare Hearings and Appeals has extended the eligibility requirements to participate in a Settlement Conference Facilitation to appeals filed on or prior to March 31, 2020, that are pending at the administrative law judge hearing or Medicare Appeals Council review level, AAHomecare and the van Halem Group report. CMS launched the Settlement Conference Facilitation pilot program in July 2014 as an alternate dispute resolution process designed to bring the appellant and CMS together to discuss the potential of a mutually agreeable resolution for claims appealed and awaiting a hearing. “Based on the success with this program, and to make a dent in the existing ALJ backlog, the SCF program has been expanded yet again,” the van Halem Group wrote in a bulletin.

DarioHealth improves revenue, looks to shift business model

NEW YORK – DarioHealth reported revenues of $1.79 million for the second quarter ended June 30, a 7.2% sequential increase from the first quarter this year and an 8.2% increase from the same period last year. Net loss attributable to holders of common stock was $4.8 million for the second quarter this year vs. $5.4 million for the same period last year. The company reported revenues of $3.45 million for the first six months of 2020, an 11.3% decrease from the same period in 2019. Net loss was $13.9 million vs. $10.7 million. DarioHealth cited as highlights for the second quarter: securing two remote patient monitoring agreements in the U.S., allowing health care providers to monitor patients between visits, while using new CMS reimbursement codes, an added source of revenue; and entering the RPM market in the U.K. through an agreement with Williams Medical. Going forward, the company aims to transform to a business-to-business-to-consumer company. “We advanced late-stage discussions with health plans and self-insured employers,” said Erez Raphael, CEO. “Our pipeline continues to grow and mature, and although the normal sales cycle can be lengthy, we believe that we are poised to announce new and potentially transformational agreements in the next few weeks.”

More on Inc. 5000 list: Sunset Healthcare Solutions,

Chicago-based Sunset Healthcare Solutions, a manufacturer and distributor of HME supplies, has ranked among the Inc. 5000 fastest-growing private companies in America for the ninth time. This year the company ranks 2,576, with a three-year revenue growth of 159.78%.

People news: Ashley Plauche, Melissa Puccio

AAHomecare has promoted Ashley Plauche to assistant director, membership and public relations. Plauche has been with the association since 2015. She manages five of the association’s councils: the HME/Respiratory Therapy Council, Complex Rehab & Mobility Council, Medical Supplies Council, State Leader’s Council and Corporate Partners Providers Council. Plauche also plays a leading role in the AAHomecare/VGM Grassroots Advocacy Program…Boulder, Colo.-based Quality Biomedical has named Melissa Puccio as its corporate materials manager. Puccio is a Six-Sigma Black Belt certified Quality Expert, the second Six-Sigma Black Belt to join the company’s operations team. Previously, Puccio worked in the aviation division of General Electric, where she managed several high-profile projects with upward of $80 million in materials requirements.

Numotion opens fourth location in Wisconsin

BRENTWOOD, Tenn. – Numotion has expanded its footprint in Wisconsin with a new location in Madison. The new location is home to two assistive technology professionals, bringing the company’s total number of ATPs in the state to 14. “Expanding our presence with this new location strengthens our ability to provide mobility solutions to not only Madison but also surrounding communities throughout south central Wisconsin,” said Mike Swinford, Numotion CEO. “Madison is a great community with strong health care systems and we look forward to continuing to partner with area physicians and therapists to provide the best possible solutions for individuals with mobility needs in Wisconsin.” Numotion has existing locations in Wisconsin in Milwaukee, Eau Claire and Appleton. The company has more than 150 locations across the country and serves more than 260,000 people.

Medtronic makes ‘strategic’ acquisition in diabetes market

DUBLIN and SAN DIEGO – Medtronic plans to acquire Companion Medical, the manufacturer of InPen, a smart insulin pen system paired with an integrated diabetes management app. The InPen, which has been cleared by the U.S. Food and Drug Administration, expands Medtronic’s ability to serve people where they are in their diabetes journey and offer them a unique and expansive ecosystem of support, the company says. “This acquisition is an ideal strategic fit for Medtronic, as we further simplify diabetes management and improve outcomes by optimizing dosing decisions for the large number of people using multiple daily injection,” said Sean Salmon, executive vice president and president of the Diabetes Group at Medtronic. “We look forward to building upon the success of the InPen by combining it with our intelligent algorithms to deliver proactive dosing advice personalized to each individual.” Medtronic will also look to expand the availability of the InPen globally. The acquisition of Companion Medical, which is expected to close in one to two months, builds on previous strategic acquisitions, including Nutrino and Klue.

Inc. 5000 list: 3B Medical, HomeCare Connect

Winter Haven, Fla.-based 3B Medical has earned a spot on the Inc. 5000 list of America’s fastest growing companies for the second year in a row. 3B Medical ranked 1,685 on the list with a growth rate of 255%. “Our robust year over year growth has continued reflecting our delivery of our strategy to design innovative medical devices to service respiratory and sleep patients,” said Alex Lucio, CEO. The company’s COO, Dave MacDougall added, “2020 is shaping up to be another blockbuster growth year for 3B Medical, as we are seeing annual revenue growth targeted to exceed 75% over 2019 levels”…Winter Park, Fla.-based Home Care Connect has earned a spot on the Inc. 5000 list for the third consecutive year with a growth rate of 120.5%. Home Care Connect has also been named one of the Orlando Business Journal’s 2020 Fast 50 Companies and a candidate for its Elite 50 list, which recognizes central Florida’s 25 fastest growing and largest, privately held businesses.

Ascensia partners with Senseonics on implantable CGMs

BASEL, Switzerland – PHC Holdings Corporation and Ascensia Diabetes Care have announced a strategic partnership with Senseonics Holdings, Inc., a medical technology company focused on the development and commercialization of long-term, implantable continuous glucose monitoring (CGM) systems for people with diabetes. As part of the agreement, Ascensia will serve as the exclusive global distribution partner for Senseonics’ CGM systems, including Eversense, Eversense XL and future generation products in development, such as the 365-day implantable sensor. In the U.S., Ascensia will initiate marketing and sales activities of the Eversense product in the coming months, in collaboration with Senseonics, and will take over full responsibility in the first quarter of 2021.  “We are thrilled to be entering into this partnership with Senseonics and strongly believe in the value of the Eversense technology,” said Robert Schumm, president of Ascensia Diabetes Care and Diabetes Management Domain Head. “This partnership is the next step in building a world-class diabetes care franchise for Ascensia, as we look to expand our business beyond blood glucose monitoring.” PHC is the parent company of Acensia.

CU moves users conference online

BILLINGS, Mont. – Computers Unlimited will transition is annual Users Group Conference to a virtual event due to the ongoing COVID-10 pandemic. The event, which takes place in September, highlights enhancements to the mobile delivery application, advancements to existing TIMS applications, as well as new software modules. It also creates the opportunity for TIMS users to receive additional training, and for potential customers to view a variety of TIMS modules. Registration is open to users and prospects alike free of charge this year. Visit https://www.cu.net/medical/ug2020for agenda and registration information.