In brief: Bill seeks to add ‘disposable medical technology’ to DME benefit, CMS holds steady on Medicare Advantage

Friday, February 27, 2015

WASHINGTON – Rep. Renee Ellmers, R-N.C., introduced a bill on Monday that would increase access to disposable medical technologies for Medicare beneficiaries. Co-sponsored by Rep. George Butterfield, D-N.C., the Patient Access to Disposable Technology Act of 2015, H.R. 1018, would establish “disposable medical technology” and incorporate it into existing DME coverage, allowing Medicare beneficiaries to use less expensive equipment at home. “Many of our constituents rely on disposable medical devices that provide healing in the home setting following hospital stays,” stated Ellmers in a press release. “While private health plans cover these innovative devices, Medicare does not—which results in patients returning to the more-expensive hospital setting to receive the care they need.” Under the current DME benefit, descriptions of eligible equipment are limited to items such as crutches, wheelchairs and oxygen tanks.

CMS holds steady on Medicare Advantage

WASHINGTON – CMS has proposed a very small decrease in payments to Medicare Advantage plans for 2016, the agency announced Feb. 20. CMS says it wants to pay private insurers 0.95% less next year. When more intensive services are factored in, however, the agency says it expects overall payments to increase about 1.05%. “The proposed rates will enhance the stability of the Medicare Advantage program and minimize disruption to seniors and care providers,” stated Andy Slavitt, CMS Principal Deputy Administrator, in a press release.

CMS is currently accepting comments on the proposal and plans to publish a final version on April 6. The agency has reported record high enrollment in Medicare Advantage plans each year since 2010, a trend continuing in 2015 with a total increase of more than 40% since the Affordable Care Act was passed. Additionally, CMS reports that premiums for these plans have fallen nearly 6% from 2010 to 2015. In past years, proposed decreases in payments to Medicare Advantage plans have been reversed. In 2014, for example, a 1.9% decline turned into a 0.4% increase.

CMS calls first week of ICD-10 testing a ‘success’

BALTIMORE ­­– Approximately 660 providers and billing companies participated in the first week of end-to-end testing for the new ICD-10 coding, CMS announced last week. Of the nearly 15,000 test claims submitted Jan. 26–Feb. 3, most were submitted successfully and processed through CMS’s billing system, the agency stated in a press release. Of the claims that were rejected, most were due to errors unrelated to ICD-9 or ICD-10. “Testing allows us to identify areas of improvement, and we will work with outside entities and stakeholders to improve those very small deficiencies identified,” stated CMS Administrator Marilyn Tavenner in the release. Full implementation of the news code set begins Oct. 1, 2015.

CMS discriminates against doctors of podiatric medicine, council says

ATLANTA – The AFL-CIO Executive Council issued a statement on Feb. 25 calling on Congress to enact legislation to recognize doctors of podiatric medicine as “physicians” in Title XIX of the Social Security Act governing Medicaid. DPMs are already defined as physicians in Title XVIII of the Social Security Act governing Medicare. The council also called for an amendment of the Social Security Act governing Medicare to recognize the ability of DPMs to independently certify the need for and prescribe appropriate medical equipment. “Failure to recognize DPMs as “physicians” in Title XIX allows a state to eliminate podiatrists from the state Medicaid program as an ‘optional’ service,” the council states. “This optional elimination prevents podiatrists from treating patients under Medicaid, thereby causing unnecessary interruption of ongoing care provided by podiatrists and resulting in potential harm and injury to patients.”

Midwest Medical hosts Sen. Thune

WATERTOWN, S.D. – Midwest Medical, a member of the Midwest Association for Medical Equipment Services, hosted a meeting with Sen. John Thune, R-S.D., on Feb. 19 to discuss concerns over the impact of competitive bidding in rural areas. “Senator Thune was very interested in our facts and stories about the national roll out of competitive bidding rates and the audit nightmares we have encountered,” stated Kay Johnson, owner of Midwest Medical, in a press release. Other MAMES members also participated in the event: Missouri Breaks DME, Northland Rehab Supply, Patient Financial Services, and Avera Home Medical Equipment.

Insulet reports increase in revenues

BILLERICA, Mass. – Insulet reported revenues of $72.6 million for the fourth quarter of 2014, a 6% increase compared to the same period in 2013. It reported a net loss of $5.4 million vs. $2.5 million. Insulet reported revenues of $288.7 million for the year, an increase of 17% compared to 2013. It reported a net loss of $51.5 million vs. $45 million. For 2015, Insulet expects revenue to be in the range of $305 million to $320 million.

Universal Software, CollectPlus continue integration

DAVISON, Mich. – Universal Software Solutions has further integrated the company’s Healthcare Data Management System (HDMS) with CollectPlus, a billing and collection service powered by A/R Allegiance Group. The new integration includes dashboard sign-on, enhanced statement design and auto posting payments at no additional cost to HDMS users. “Based on HDMS users’ needs, we continue to enhance the integration of CollectPlus because we feel it offers the most comprehensive solution for our clients,” stated Christopher Dobiesz, president of Universal Software Solutions, in a press release.

Bill carves out speech generating devices

WASHINGTON – A bill that seeks to protect access to speech generating devices for Medicare beneficiaries has been introduced. The Steve Gleason Act of 2015 would remove SGDs from the DME capped rental payment category and clarify statutory language to ensure coverage of eye-tracking technology for beneficiaries who need it to operate their devices. H.R. 628 was introduced by Reps. Cathy McMorris Rodgers, R-Wash., Erik Paulsen, R-Minn., and Steve Scalise, R-La. CMS classified SGDs as capped rental items in April 2014. The agency then issued a coverage reminder in September stating that the devices can only be used for face-to-face conversations. SGDs enable individuals with disabilities likes ALS and cerebral palsy to communicate and live fuller lives, says Tara Rudnicki, president of Tobii Dynavox, which manufactures the devices. “These devices are literally lifelines to their beneficiaries, allowing them to communicate with loved ones,” said Rudnicki. “The introduction of this bill demonstrates a firm federal commitment to the health and well-being of Americans living with disabilities and a willingness to act expeditiously in their defense.”


California providers get ‘best of both worlds’

LAS VEGAS – The California Association of Medical Product Suppliers has finalized several state-specific sessions for Medtrade Spring as part of its agreement to co-locate its annual conference at the show. “Before the co-location agreement, many CAMPS members were trying to decide, ‘Do I go to the CAMPS show or Medtrade Spring?’” said Tony Myrell, president of CAMPS and owner of Premier Medical Equipment in Colton, Calif. “They will now get the best of both worlds.” The sessions include “California State of the State” and “Managed Care Contracting: Cutting Through the Legalese.” Medtrade Spring takes place at the Mandalay Bay Convention Center in Las Vegas March 30 to April 1.

RESNA seeks board nominees

ARLINGTON, Va. – RESNA seeks nominations to fill three board positions. Candidates must be RESNA members in good standing, preferably with a record of participating in the association’s activities, including in some leadership capacity. Nominations are due April 17. For more information, click here.

Moneyline: Liberator, Oncologix

Liberator Medical Holdingshas approved a quarterly cash dividend of $.0325 per common share payable April 10. This is the ninth cash dividend paid by the Stuart, Fla.-based provider…Oncologix Tech has retired another convertible note. Over the past several months, the Kentwood, Mich.-based company has retired similar notes, eliminating the issuance of more than 55 million shares.

Sunrise Medical unites social media presence

FRESNO, Calif. – Sunrise Medical and its family of brands can now be found on Facebook, Twitter, Pinterest, Instagram, Google+, YouTube and LinkedIn. “Sunrise has expanded its social media presence across the world under a united approach,” the company stated in a press release. Sunrise Medical invites users, therapists and dealers to upload pictures or videos to one of these websites with the hash tag #OneSunrise. The company will highlight one post per week in the coming month.

Short takes: 3B Medical, McLaren Home Infusion

3B Medicalhas promoted Joe Toth to vice president of sales and marketing. In his previous role as national sales director, Toth helped to bring significant product innovations to the market and was instrumental in the growth of the brand, according to a press release…McLaren Home Infusion Pharmacy has been awarded accreditation under the Community Health Accreditation Program (CHAP).