In brief: CMS rethinks miscellaneous codes, House votes to repeal medical device tax

Friday, June 26, 2015

WASHINGTON – CMS is proposing new codes for miscellaneous DME to reflect more accurate payment of Medicare claims.

HCPCS codes E1399 and K0108 are currently used to bill for inexpensive items; however, the agency proposes to replace them with new codes effective Jan. 1, 2016.

The public is invited to submit electronic comments on the proposal until July 9, 2015.

The proposed codes are:

KXXX1: Durable medical equipment, miscellaneous, the purchase price does not exceed $150. Based on the average reasonable charges for items that could be included in this code, CMS calculates that the 2015 fee schedule amount would be $97.94; this amount will be updated by the 2016 covered item update.

KXXX2: Durable medical equipment, miscellaneous, the purchase price exceeds $150. Based on the average reasonable charges for all items covered by this code, CMS determines that the 2015 capped rental fee schedule amounts would be $80.60 for rental months 1 thru 3 and $60.45 for months 4 thru 13; these amounts will be updated by the 2016 covered item update.

KXXX3: Wheelchair component or accessory, miscellaneous, the purchase price does not exceed $150. The 2015 fee schedule amount generated based on CMS calculations would be $72.56; this amount will be updated by the 2016 covered item update.

KXXX4: Wheelchair component or accessory, miscellaneous, the purchase price exceeds $150. CMS calculates that the 2015 fee schedule amounts for items in this code would be $53.41 for months 1 thru 3 and $40.06 for months 4 thru 13; these amounts will be updated by the 2016 covered item update.

KXXX5: Repair part for use with beneficiary owned durable medical equipment, other than wheelchair, not covered under supplier or manufacturer warranty, not otherwise specified.  Payment will be made on a lump sum purchase basis, per the contractor's individual consideration of the item.

KXXX6: Repair part for use with beneficiary owned wheelchair, not covered under supplier or manufacturer warranty, not otherwise specified. Payment will be made on a lump sum purchase basis, per the contractor's individual consideration of the item.

Congress looks to repeal medical device tax

WASHINGTON – A bill to repeal the medical device tax has passed in the House of Representatives. H.R. 160, the Protect Medical Innovation Act, passed with a bi-partisan vote of 280-140. The bill now heads to the Senate, where repealing the tax also has bi-partisan support, according to a press release from Rep. Erik Paulsen, R-Minn. “As a country, we take great pride in our ability to create, invent and innovate—especially when it comes to products that improve people’s lives,” stated Paulsen, who authored the bill. “The medical device tax stands in direct contract to this ideal, which is why you’ve seen members of Congress from across the political spectrum support its repeal. It’s time to push this legislation across the finish line and support American jobs and innovation.” The 2.3% medical device tax was included in the Affordable Care Act and went into effect Jan. 1, 2013. Most, but not all, home medical equipment was excluded from the tax.

Contract providers receive termination letters

WASHINGTON – “Secret shopper” calls have lead to dozens of termination letters for contract providers, The VGM Group reports. Providers are receiving the letters after failing to respond to the calls. “Regional liaisons of the Competitive Bidding Implementation Contractor cited numerous complaints about out-of-state suppliers not honoring their contracts and in-state providers not offering all product codes within a category,” VGM says. If they receive a termination letter, providers have an opportunity to submit a “corrective action plan” and/or appeal the termination. “By taking the necessary steps, some providers have enacted plans and their contracts have not been terminated,” VGM says. For more information, read Mark Higley’s blog.

BMC Medical wins case

BEIJING – BMC Medical has announced that it has won an overseas patent infringement case against ResMed. ResMed previously filed a preliminary injunction against the Chinese manufacturer for a CPAP respiratory system machine with a detachable water talk. During an Oct. 23, 2014, hearing, the Court of Munich I lifted the preliminary injunction against BMC Medical “based on the considerably uncertain patentability of ResMed’s patent.” ResMed filed an appeal, but the decision was upheld.

Quantum Rehab turns feedback into solutions

EXETER, Pa. – Quantum Rehab has implemented a cloud-based application that allows its field staff to collect real-time feedback from consumers, clinicians and providers, and provide it to corporate departments via smartphone, tablet or computer. The Quantum Rapid Response System then allows the applicable departments, including R&D, quality, production, sales and customer service, to address any needs. “We wanted a way to convey consumer and market feedback throughout our entire organizations as quickly as possible for prompt solutions and results,” said Megan Kutch, director of marketing for Quantum Rehab, in a release. “With the cutting-edge technology of QRRS, we have the ability to distribute consumer needs from the field among our team almost instantaneously, and deliver solutions remarkably fast.” QSSR was recently used to enhance Quantum Rehab’s iLevel seat elevation technology. After feedback from the field, the company increased iLevel’s driving speed to 3.5 mph and updated existing units in the field in less than four days.

Univita opens second pharmacy

MIRAMAR, Fla. – Univita Health is opening a second state-of-the-art infusion pharmacy in Orlando, Fla. The pharmacy, which will feature a sterile cleanroom specifically designed for compounding intravenous medications, will offer a wide range of infusion therapies, including IV antibiotics, total parenteral nutrition, pain management and enteral nutrition therapy. It will be located in Univita’s distribution center and will serve a 100-mile radius. The company already has such a pharmacy in Miramar, Fla. Together the two pharmacies encompass 11,500 square feet of space and employ 11 full-time pharmacists. “Last year alone, we filled more than 145,000 prescriptions,” stated Michael Muchnicki, CEO, in a press release. “Many patients prefer the convenience of getting their infusions in the comfort of their own homes instead of having to spend hours at an infusion center or other facility.” The pharmacy is slated to open this summer.

Advanced Health Care buys PDG

MONTREAL – Advanced Health Care Products has acquired PDG Product Design Group, a Vancouver, British Columbia-based manufacturer of tilt-in-space, bariatric and high performance wheelchairs. Advanced Health Care is a distributor of home health care, long-term care and rehab products with a portfolio of 15 brands. It will keep PDG’s administration, engineering, manufacturing plant and customer service teams in Vancouver. Advanced Health Care plans to help PDG with an integrated presence across Canada, the U.S. and existing international markets.

PHS, Reliable Medical make grade

MINNEAPOLIS – Pediatric Home Service and Reliable Medical Supply have each been named a Top Workplace by the Minneapolis Star Tribune. The award ranks companies based on confidential employee surveys that measure their leadership, benefits and strategic direction, according to a press release. It’s the fifth year in a row that PHS has made the list, and its first garnering the No. 1 spot for midsized workplaces. “We are incredibly fortunate to employ people who are just as passionate about our business as we are,” said Mark Hamman, president of PHS. Reliable Medical also earned first place in the HME Excellence Awards last year. “We have amazing employees and their dedication to our customers and community makes Reliable a top home medical equipment supplier,” said Jeff Hall, president and CEO of Reliable Medical.

Ottobock makes prosthetics stylish

AUSTIN, Texas – Ottobock will partner with UNYQ to provide stylish prosthetics for lower limb amputees. UNYQ uses 3D printing to customize prosthetic fairings, according to a press release. The deal will allow Ottobock to expand its product portfolio. “Through our partnership with UNYQ, we are excited to offer products that enable our customers to combine their own identity with the technology we provide,’” said Dr. Falk Berster, business unit director for Ottobock.

Wheel:Life publishes travel guide

ATLANTA – Wheel:Life, an online community for wheelchair users worldwide, has published “Discovering: An Accessible US Travel Guide for Wheelchair Users” as an e-book on These accessible travel suggestions were gathered as part of the annual “Get Out & Enjoy Life” program, a joint educational initiative between Wheel:Life and Sports ‘n Spokes Magazine. The book culminates a month-long education program and photo contest launched June 1. “We are thrilled to provide practical advice and encouragement by offering this resource filled with handy travel tips, family-friendly destinations and travel pictures shared by wheelchairs users,” says author Lisa Wells. Wheel:Life was able to publish the book thanks to generous financial support from sponsors like ABC Medical, a provider of urology and incontinence supplies.

Short takes: Medtrade, Convaid, Performance Health

Early registration for Medtrade opened last week. The show will be held at the Georgia World Congress Center in Atlanta from Oct. 26-29… Convaid Products is presenting the First Annual South Bay Kidsfest June 27. The event, in collaboration with Pediatric Therapy Network and United Cerebral Palsy of Los Angeles, features a short-film festival for kids, carnival games, food and other activities, alongside an educational program for caregivers, parents and PT/OTs…Performance Health has relaunched, formerly In addition to focusing on the TheraBand, the academy will now begin to offer resources for the company’s growing portfolio of interconnected products. The site will serve as a resource that connects healthcare professionals and consumers to an ever-growing body of knowledge on exercise and techniques related to Performance Health products.

People news: Mixon, Greatorex, Plauché

Invacare Founder Mal Mixon will retire from the company’s board of directors effective June 30. “After much consideration, I have made the decision to retire from the Invacare board of directors to deal with recent health challenges,” Mixon stated in a press release. “I am very pleased with the transition of leadership to Matt Monaghan. I am confident in the future of the organization.” Monaghan* became Invacare’s chairman, president and CEO earlier this year…Jim Greatorex has joined VGM’s Retail Services Group. Greatorex, who has more than 20 years of HME retail experience, has been tasked with finding new products to help VGM members increase sales and build profitable retail businesses. Greatorex founded Portland, Maine-based Black Bear Medical supply in 1988 and is a former president of NEMED…AAHomecare has named Ashley Plauché to the newly created role of manager of government affairs. She will manage three association councils and provide support on government relations initiatives. Plauché was the director of communications and public relations for her family’s business, Lambert’s Health Care in Knoxville, Tenn. She is also co-founder, vice president and executive director of the Association for Tennessee Home Oxygen & Medical Equipment Services and a former board member of the Tennessee Association for Home Care.