In brief: CMS publishes final rule, Rotech taps $50M for acquisitions

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Friday, November 1, 2019

WASHINGTON – CMS on Thursday afternoon released an ESRD final rule that implements a permanent home infusion therapy benefit in 2021 and establishes a methodology for establishing fee schedules for new DMEPOS items.

CMS published the proposed rule in July. The final rule will be published Nov. 8.

Home infusion

Per the rule, CMS will group home infusion drugs into three payment categories, each with a unit of single payment, paid at amounts in accordance with specified infusion codes and units for such codes under the Physician Fee Schedule. CMS also finalized paying higher payment amounts for the first home infusion therapy visit to account for costs to initiate these services. Additionally, in response to public feedback, CMS is soliciting comments on ways to enhance coverage of eligible drugs under the home infusion benefit.

New items

The methodology for establishing fee schedule amounts for new DMEPOS items includes making adjustments to the fee schedule amounts established using supplier or commercial prices if such prices decrease within five years of establishing the initial fee schedule amounts

The final rule also:

·      Revises existing policies related to the competitive bidding program; and

·      Streamlines requirements for ordering DMEPOS items and creates one master list of items that could potentially be subject to the face-to-face requirement and written order prior to delivery and/prior auth requirements.

See a fact sheet here.

Competitive bidding ombudsman reports on complaints

WASHINGTON – The Competitive Acquisition Ombudsman recently published a report to Congress on concerns with the program, including beneficiary access.

Although the CAO publishes the report annually, it has not been publically available since 2011. This most recent report, therefore, combines fiscal years 2012-16.

During this time period, there were 741,065 inquiries made through 1-800-Medicare, 633 of which were escalated to CMS. Complaints made by beneficiaries, discharge planners and DME suppliers centered on timeliness of delivery, locating a contract supplier and quality of the products.

More specifically, complaints included:

·      Difficulty obtaining liquid oxygen. Complaints included notification that a contract supplier would no longer supply liquid oxygen, refusal by another contract oxygen supplier to accept new patients who required liquid oxygen, and changes made by another contract supplier to the oxygen modality being provided.

·      Difficulty locating contract suppliers to provide infusion pumps among those listed in the CMS Medicare Supplier Directory.

·      Difficulty locating contract suppliers that carried the brand of diabetes testing supplies used; and feeling pressured by contract suppliers to switch diabetes testing supply brands when the supplier did not carry the brand used.

Rotech taps $50M for acquisitions

ORLANDO, Fla. – Rotech Healthcare has obtained a $315 million credit agreement to, in part, fuel strategic acquisitions.

The agreement, with lenders SunTrust Bank, SunTrust Robinson Humphrey, Regions Bank and Fifth Third Bank, includes a $250 million five-year term loan, a $15 million revolving credit facility and a $50 million acquisition credit facility.

“I am pleased with the completed refinancing,” said CEO Tim Pigg. “This agreement provides us with sufficient capital over the next five years to continue our growth strategies, as well as to provide a $100 million special dividend to our holding company. 2019 has been a very successful year for Rotech as we have continued to grow all our major product lines and improve profitability by controlling costs and leveraging our fixed cost infrastructure.”

As a result of the transaction, Rotech will also have in excess of $55 million in cash and undrawn revolver.

Rotech, which has rolled up numerous smaller HME companies over the past several years, in 2018 obtained a $185 million credit agreement with SunTrust, Regions, Fifth Third and Citizens.

Hart Medical expands territory with Crittenton acquisition

ROCHESTER HILLS, Mich. – Hart Medical Equipment has acquired Crittenton Medical Equipment, allowing the provider to expand its presence into the Rochester Hills area of lower Michigan. Hart is a regional HME provider with shared ownership by Michigan-based Ascension Genesys, Henry Ford and McLaren health systems. “Hart concentrates on patient outcomes, timely delivery and customer satisfaction, which has helped build trust among our customers across the Michigan market,” said Allen Hunt, president, Hart Medical Equipment. “We look forward to bringing Hart’s focus on continuity of care, reduced readmissions and long-term patient outcomes to the Rochester Hills community.” With the acquisition, Hart will also expand its offerings to include audiology services.

Rehab Medical L.E.A.Ds with new program

INDIANAPOLIS – Rehab Medical launches a leadership program for employees called L.E.A.D. this month. The six-month program, Leadership Exploration and Development, is divided into two tracks, one for emerging leaders and one for “Becoming a Conscious Leader.” “We are continually committed to making Rehab Medical the best company and that comes from having the best people,” said Kevin Gearheart, president. “To have the best people, we need to support them and give them the tools to do their job.” Sessions in the program range from “Developing a Leader’s Mindset” to “Holding Regular One-to-One Meetings” to “Leading Through Change.” They will take place in person and online.

Airway Management, ApriaDirect team up to distribute CPAP alternative

CARROLLTON, Texas – Airway Management has partnered with ApriaDirect to distribute its myTAP oral appliance to treat sleep apnea. The deal will allow Airway Management to leverage ApriaDirect’s large CPAP distribution segment to expand its reach to non-compliant CPAP users, says founder Keith Thorton, DDS. “With CPAP non-compliance rates upward of 80%, we think we can do more,” he said. “By partnering with Apria Direct, we lead an industry shift by following patient demand for alternative therapies to accomplish the following: legitimize oral appliances to all clinicians; empower patients with choices in their therapy options; and open the door to custom therapy and providers.” ApriaDirect is Apria Healthcare’s online marketplace for HME.

NCPA installs president, releases annual digest

SAN DIEGO – Brian Caswell of Baxter Springs, Kan.-based Wolkar Drug has been named the 2019-2020 president of the National Community Pharmacists Association. “Both changing the payment model and pharmacy practice transformation are futuristic goals unimaginable even just a few years ago,” said Caswell. “NCPA strongly feels like this is the future of pharmacy. That future is possible today.” At the association’s annual convention, held Oct. 26-29 in San Diego, the House of Delegates elected Dared Price, owner of Graves Drug in Winfield, Kan., as fifth vice president. Also this week, the NCPA released its 2019 NCPA Digest. The Digest, sponsored by Cardinal Health, provides an annual overview of independent community pharmacy. In 2018, independent community pharmacy made up 35% of all retail pharmacies in the United States and a $75.8 billion marketplace, according to the Digest.

VGM Respiratory guides providers in sleep therapy, home ventilation

WATERLOO, Iowa – VGM Respiratory has released two new resources on sleep therapy and home ventilation to help providers who are interested in expanding into these growing markets.

Existing providers in these markets can also use the Sleep Program Guide and the Home Ventilation Management Program Manual to improve their operational efficiency.

“These comprehensive guides are designed to be not only a starting guide for those entering the market, but also a tool to help experienced professionals save valuable resources so they can spend more time focusing on what really matters—their patients,” said Dave Lyman, vice president of VGM Respiratory.

The sleep guide includes points to consider before starting a sleep program, tips on how to develop and maintain a program, and a variety of resources and vendors that can help with a program. The vent guide features procedure templates, reimbursement information, and tracheostomy and other information.

These two guides are only a starting point, Lyman says.

“We look forward to developing future program guides, used in conjunction with our VGM Respiratory Resource Center, to help our members continue to grow and improve their businesses,” he said.

Both guides are now available to VGM Respiratory members. Email Ashley Monroe at Ashley.Monroe@vgm.com.

Medela participates in mom-and-baby panel

MCHENRY, Ill. – Medela joined U.S. Sen. Tammy Duckworth, D-Ill., and the March of Dimes to host a panel on the racial disparities in the rising maternal and infant mortality rates in Chicago and the rest of the country. Panelists discussed key drivers behind these rising rates and interventions aimed at reducing them, including providing adequate education and resources to support breastfeeding. “Together, we have work to do to keep mothers and their babies healthy and safe,” said Melissa Gonzalez, executive vice president of the Americas for Medela. “We know breast milk feeding support and supplies are a low cost, high value intervention that prevent illness, missed work days and support the overall health of mothers and babies that can help turn this tragic loss around. We are committed to supporting these and other efforts.” Through Medela Cares, Medela has donated more than $200,000 in products to nonprofits this year and more than $1 million in products to more than 135 nonprofits since 2015.

MobilityWorks shuffles location in Ohio

RICHFIELD, Ohio – MobilityWorks will host a grand opening for its newest location in Bedford Heights, Ohio, on Nov. 8 and Nov. 9. On tap for the event: tours of the new facility and a state-of-the-art accessible Winnebago; test drives of accessible vehicles; and food and refreshments. “We are excited to relocate from Mentor to the new, centrally located, state-of-the-art Bedford Heights location,” said Chris Paczak, chief marketing officer. “The new location will expand our reach in the greater Cleveland area and support our mission of accessibility for all.” MobilityWorks has more than 80 showroom locations across the country. Its corporate office is in Richfield, Ohio.

Condo Pharmacy’s Steve Moore receives award

SAN DIEGO – Steve Moore, PharmD, owner of Condo Pharmacy in Plattsburgh, N.Y., has been named the National Community Pharmacists Association’s 2019 Willard B. Simmons Independent Pharmacist of the Year. The annual award, sponsored by Upsher-Smith Laboratories, is given to a pharmacist who exhibits exemplary professional leadership, service to community and commitment to independent pharmacy. Condo Pharmacy, which provides traditional, long-term care, compounding and specialty pharmacy services, is part of the CPESN USA national network of clinically integrated pharmacies. Pharmacies that are part of this network team up with other healthcare providers and insurers to provide clinical care services to patients like wellness visits, chronic care management, and transition care. Moore is board president of the Pharmacists Society of the State of New York; and is a member of NCPA, serving on its State Legislative Committee. The award is named in honor of Willard B. Simmons, a former executive secretary of NCPA and a longtime trustee of the NCPA Foundation.

ResMed unites three software brands

SAN DIEGO – ResMed has launched WellConnected to promote its seamless network of software platforms across multiple care settings.

The company says its network now enables interoperability across seven care settings outside of the hospital: HME, home health, hospice, skilled nursing, life plan communities, senior living and private duty.

“The WellConnected initiative further communicates the ResMed SaaS approach to delivering an out-of-hospital ecosystem that streamlines transitions of care for patients and providers, which improves the experience and outcomes for seniors, their families and healthcare providers,” said Raj Sodhi, SaaS president.

As part of the initiative, ResMed has updated the MatrixCare, Brightree and HEALTHCAREfirst logos to unite the three brands and reflect that they’re part of the ResMed network. The logo now includes a “by ResMed” tagline.

ResMed began to build its network of software platforms in 2016 when it bought Brightree. The company has gone on to buy HEALTHCAREfirst in July of 2018, and MatrixCare in November 2018.

OxygenToGo partners with Virgin Atlantic

JACKSON, Wyo. – OxygenToGo has been tapped by Virgin Atlantic to provide portable oxygen concentrators to passengers requiring medical oxygen onboard flights. The provider also offers pre-board screening services to ensure passengers have the proper equipment, batteries and medical clearance. “Making travel easy, safe and cost effective for medical oxygen dependent passengers has been our goal,” said Dr. Brent Blue, medical director. “Our services provide peace of mind for each passenger, knowing they have the proper equipment under their control during their entire trip plus the 24-7 support licensed respiratory therapists.” To better serve customers in the United Kingdom and Europe, OxygenToGo has also opened an office near Heathrow Airport in London, which joins offices in Jackson, Wyo., Salt Lake City and Atlanta. OxygenToGo has been the exclusive provider of POCs and services to Delta Air Lines for more than 12 years.

NCPA launches CBD resource

SAN DIEGO – The National Community Pharmacists Association has teamed up with PRS to launch the NCPA CBD Source, an online resource for community pharmacies looking for information on cannabidiol products. The goal of the resource: help community pharmacies make educated decisions about the growing CBD marketplace, the association says. “Many pharmacies are deciding to sell CBD products because of the patient demand and because, as the medication expert, they can serve as the source of truth,” said NCPA CEO B. Douglas Hoey. “Pharmacy owners want to be able to answer their patients’ questions and recommend products where they can check their certificate of analysis. The new CBD Source goes a step further and will be sending product samples to an independent lab to verify strength and product integrity.” The CBD Source will function like any other online shopping website, but it will also have education and marketing tools for products that have been researched by NCPA and PRS. While the CBD Source will include experts who pharmacists can call and ask about buying, selling and marketing, NCPA recommends that pharmacists also familiarize themselves with local, state and federal laws governing the sale of CBD products. NCPA notes that the CBD industry grew by nearly 40% in 2017 to $367 million, according to a recent report by New Frontier Data, an analytics company specializing in the cannabis industry. The market is expected to hit $22 billion by 2024.

Healogics campaigns for diabetes awareness

JACKSONVILLE, Fla. – Healogics has launched a campaign to raise awareness of early intervention and specialized care for diabetes-related chronic wounds as part of November’s Diabetes Awareness Month. Throughout Oct. 28-Nov. 1, Healogics Wound Care Centers across the country will visit local physician offices to provide information that can help at-risk patients living with diabetes detect wounds earlier, receive better treatment options when wounds are discovered, and avoid complications, such as infections, amputations and decreased quality of life. “In support of November’s Diabetes Awareness Month, we want to share a message of education, hope and healing in every community we serve,” said David Bassin, CEO. Healogics’ recommendations for preventing diabetic foot ulcers include stopping smoking, getting comprehensive foot exams at each healthcare visit, conducting daily self-inspections and wearing appropriate footwear. The company provided advanced wound care to more than 330,000 patients through its nearly 700 Wound Care Centers last year.

Contest winners: Wheels UP!, MobilityWorks and VMI

Richard Corbett is the winner of the Wheels UP! accessible travel photo contest. Corbett submitted a photo of himself working out at the Original Muscle Beach in Santa Monica, Calif. The contest is sponsored by SPORTS ‘N SPOKES Magazine, the Abilities Expo and Cure Medical. Corbett will receive a $1,000 Southwest Airlines E-Gift Card from Cure Medical and be featured on the November issue of SPORTS ‘N SPOKES Magazine. Other winners: David Nickelson (second place), pictured off-roading along the rim of the Grand Canyon in Yellowstone National Park; Adrienne Terrell (third place) exploring the Mogollon Rim with her family; and Austin Martin (honorable mention), skiing at Holiday Valley in New York…Mike Fritz of Mount Dora, Fla., has won $12,000 toward a Verge II E conversion package for his Dodge Grand Caravan in the national “Driving Forward Together Sweepstake,” sponsored by MobilityWorks in Clermont, Fla., and Vantage Mobility International. Fritz’s wife uses a scooter and their daughter uses a wheelchair, making travel difficult. “Our focus has always been to enable people who use wheelchairs to go where they want to go and do what they want to do,” said Chris Paczak, chief marketing officer at MobilityWorks.

Short takes: Transcend, CAIRE, AllyScripts

Transcend has launched its Transcend 365 miniCPAP, a “smaller, smarter” CPAP with integrated heated humidifier that’s capable of running on a single, travel-size battery. The mini’s Capillary Force Vaporizer Technology is an alternative to pass-over heated humidification, delivering a smaller and more efficient humidification system. Unlike CPAP humidifiers that must heat water in a reservoir to humidify a constant airflow, the mini’s humidifier vaporizes water using an internal element and delivers humidification to the patient during inhalation, “resting” during exhalation…CAIRE has become an AAHomecare member, signaling the company’s dedication to growing its position the HME industry. “This step to support AAHomecare and its initiatives is just another way to show we care about our customers in advocating legislation that can positively impact their businesses,” said CAIRE President and CEO Earl Lawson…Scottsboro, Ala.-based AllyScripts has received URAC accreditation for specialty pharmacy. In addition to achieving URAC accreditation, AllyScripts Specialty Pharmacy is accredited by ACHC.