In brief: CMS sets ICD-10 start date, AAH adds videos to campaign toolbox

Friday, May 2, 2014

WASHINGTON – In an April 30 proposed rule that sets hospital and long-term care inpatient payment rates and rules for 2015, CMS acknowledged it plans to implement ICD-10 on Oct. 1, 2015. Congress forced the agency’s hand when both the House of Representatives and the Senate passed “doc fix” bills that included a one-year delay in the transition to the new coding system. CMS “expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning Oct. 1, 2015,” according to a statement from the agency published in Modern Healthcare. “The rule will also require HIPAA-covered entities to continue to use ICD-9-CM through Sept. 30, 2015.” In the proposed rule, CMS also seeks comments on how “if at all, we should adjust performance scoring under the Hospital VBP Program to accommodate quality data coded under ICD-10-CM/PCS, or otherwise ensure fair and accurate comparisons under the Hospital VBP Program once the transition date has passed.” Industry stakeholders have urged HME providers to prepare for the transition to ICD-10 for some time.

AAHomecare adds videos to campaign toolbox

WASHINGTON – AAHomecare has made available for sharing three videos through its Save My Medical Supplies campaign. The short videos, available at, help to educate Medicare beneficiaries, families and caregivers about how Medicare problems can impact them, according to a release. The first video is an overview of major issues related to Medicare reform. The second: an interview with Thomas Morris, a beneficiary with diabetes and an amputee, that highlights issues related to the national mail-order program for diabetes supplies. The third: an interview with Bert Burns, a Paralympian, that highlights issues with wheelchair repairs. “These issues aren’t partisan, they’re personal,” said Tom Ryan, president and CEO of AAHomecare, in the release. “Please take a moment to share these videos with your personal network.” Save My Medical Supplies uses email, social media and online resources to reach consumers and make it easier for them to contact Congress to support H.R. 1717, a bill to replace the competitive bidding program with a market-pricing program. Since its April 1 kickoff, the campaign has generated more than 3,000 letters.

VGM doubles up on retail

WATERLOO, Iowa – The VGM Group has boosted its retail offerings by acquiring Minneapolis-based Simply Shops. VGM will merge Simply Shops, a healthcare retail consultant primarily to hospitals, with VGM Retail Services. Simply Shops is known for its “Retail Science” concept—offering a blend of gift/floral, convenience, health and wellness, and logo wear to support patients, families, staff, visitors and the overall community in the hospital environment, according to a press release. “Blending these business practices with what has been considered traditional HME retail will open up new opportunities for VGM member business,” the release states. Together, VGM Retail and Simply Shops will offer a wider range of business consultation and implementation offerings, including merchandising plans for various health needs/space requirements, business plans and operational service options.

Price raises bidding issues at hearing

WASHINGTON – During an April 30 Ways and Means Health Subcommittee hearing on waste, fraud and abuse, Rep. Tom Price, R-Ga., pressed Kathleen King, director of the Government Accountability Office (GAO), to explain CMS’s conclusion that the competitive bidding program has had no negative impact on beneficiaries. The GAO released a report on the program April 18 that drew its conclusions largely on information provided by CMS. During his questioning, Price learned that CMS had not conducted clinical data reviews and that the agency only tracked patient progress for 120 days, according to a bulletin from The VGM Group. “He also talked about the COPD foundation release, and wanted more information about patient care,” said Jay Witter, vice president of government affairs for AAHomecare, which had a representative at the meeting. To view Price at the hearing, click here.

Study highlights clinical, economic benefits of CPAP therapy

SAN DIEGO – CPAP therapy lowers blood pressure in obstructive sleep apnea patients with Type 2 diabetes and helps to control their diabetes, according to a new study sponsored by ResMed. What’s more: it’s cost effective. The study used a case-control design, during which 300 patients with OSA and Type 2 diabetes were randomly selected from a nationally representative database of patients in the U.K. Researchers then analyzed the total National Health Service (NHS) cost and outcomes of patient management over a five-year span in the 150 patients who underwent CPAP therapy, compared to the remaining 150 patients who did not. Researchers found that using CPAP therapy was associated with significantly lower blood pressure at five years, and increasingly lower HbA1c levels over five consecutive years, compared with untreated OSA patients. At five years, the HbA1c level in the CPAP-treated group was 8.2% versus 12.1% in the control group. The study also demonstrated that use of CPAP led to an increase in health status by 0.27 quality-adjusted life years (QALYs) per patient over five years, and only increased NHS management costs by £4,141 per patient over that same five-year period. The NHS uses QALYs to measure how much a patient’s life is improved by a therapy. If a treatment costs more than £20,000 per QALY gained, it is not considered cost-effective by NHS standards. Researchers found that the cost per QALY gained with CPAP was £15,337, suggesting that initiating treatment with CPAP in OSA patients with Type 2 diabetes is a cost-effective use of resources.

GAO supports delay in RAC fees

WASHINGTON – The Government Accountability Office (GAO) last week signed off on Medicare’s plan to pay RACs for audits of hospitals only if a second-level appeals judge upholds their findings, according to news reports. The change is one of several that CMS plans to put in place as part of signing on a new group of RACs in 2014. “At this point, I do not think that the change will impact how much the RACs get paid, since appeals to the first and second levels are almost always decided in favor of the RAC/CMS,” Emily Evans, a partner and analyst at Obsidian Research Group, told Modern Healthcare. RACs receive between 9% and 13% of payment amounts flagged as inappropriate.

PHS expands infusion pharmacy

ST. PAUL, Minn. – Pediatric Home Service (PHS) has expanded its infusion pharmacy to meet the demands of its growing population of medically complex pediatric patients, according to a release. The expansion will also enable PHS to increase efficiencies in workflow, better use space and enhance staff communication. “Thanks to our additional capabilities and a rise in infusion therapies that can be delivered in the home, we’re able to continue providing this unique service to a growing patient population at the highest level of care,” said Jill Liebers, pharmacy manager, in the release. PHS, which was founded in 1990, also provides respiratory, specialty pharmacy and private duty nursing services to pediatric patients.

Golden expands operations with new distribution center

OLD FORGE, Pa. – Golden Technologies has doubled the capacity of its Pennsylvania Lift Chair Distribution Center by opening a new warehouse in Laflin, Pa. The warehouse has 100,000 square feet of storage and distribution space, and features energy efficient lighting, railroad ramp access and truck loading docks. In addition to the larger distribution center, Golden’s long-term plan includes increasing its manufacturing capabilities by adding new production lines. That’s exactly what the company will do at its former distribution center in Old Forge. “Now that we’ve emptied out that building, we can begin the process of installing manufacturing lines, creating an additional 50,000 square feet of manufacturing space,” stated Richard Golden, CEO, in a release. “This will allow us to maintain and improve our entire quality systems for lift chair manufacturing.”

Home Care Medical gets in with health network

NEW BERLIN, Wis. – Home Care Medical has reached an agreement with Sheboygan Employer’s Health Network (SEHN) to be an in-network provider for area health insurance members. SEHN offers health insurance to the employees and their families of six major self-funded employers located in Sheboygan County. The agreement allows SEHN members to access products and services from all five of Home Care Medical’s lines of business: infusion and enteral therapy; high-tech rehab equipment; respiratory care; HME and supplies; and bracing and compression garments. Home Care Medical also has a retail showroom conveniently located in Sheboygan.

Short takes

Reps. Tim Walberg, R-Mich., and Mark Amodei, R-Nev., have thrown their support behind H.R. 1717, the “Medicare DMEPOS Market Pricing Program Act of 2013.” The bill, which would replace the current competitive bidding program with an industry supported market-pricing program, now has 173 co-sponsors. The bill was sponsored by Rep. Tom Price, R-Ga., on April 24, 2013….Ewing, N.J.-based Goodwill Home Medical Equipment now offers refurbished power wheelchairs from Hoveround, Pride Mobility Products, Invacare and Golden Technologies. “All chairs are refurbished to like-new condition upon donation,” states a press release...Online medical supplies provider Disposable Medical Express (DME) has revamped its website to make it easier for customers to navigate. The new site divides products into categories and brands for easier shopping, and includes a pricing schedule of shipping and tax rates for all items that cost more than $25.

People in the news

Mervyn Watkins, the founder of Convaid, has been named one of the 15 Most Influential Business Leaders in Torrance, Calif., by the Torrance Chamber of Commerce. He was recognized for his commitment and leadership in support of growing the local economy. Watkins served as Convaid’s CEO until 2008 and maintains an active role on the company’s board of directors…Ottobock has promoted Kathy Schuerman to vice president of finance for North America. She joined the company in 2006 as controller and has been serving as executive director of finance since 2012.

In memoriam

Provider Lynn Giglione, a leader in home medical equipment and home infusion, died April 30, according to an announcement from the National Home Infusion Association (NHIA). Giglione joined the NHIA’s board of directors in 2005 and became the association’s first female board chairwoman in 2009. During her tenure at the association, Giglione helped establish the NHIA Standards for Ethical Practice and the NHIA Industry-Wide Data Initiative. During her career, Giglione held positions at Keystone Medical Equipment, Critical Care America and Apria, before joining Chartwell Pennsylvania in 1998. In 2011, she was named president.