In brief: CMS sets two start dates, Numotion names new CEO

Friday, August 1, 2014

WASHINGTON – CMS will expand its PMD demonstration to 12 additional states on Oct. 1, the agency announced in a final rule published last week. CMS plans to require prior authorizations for PMDs in Pennsylvania, Ohio, Louisiana, Missouri, Washington, New Jersey, Maryland, Indiana, Kentucky, Georgia, Tennessee and Arizona—all of which have high expenditures and improper payments based on 2012 billing data, the agency states in the rule. CMS kicked off the PMD demo in California, Florida, Illinois, Michigan, New York, North Carolina and Texas on Sept. 1, 2012. Based on preliminary data, PMD spending in these states has decreased, indicating that physician ordering and supplier billing practices have changed as a result of the demo, the agency states. Together, the 19 states that will eventually be involved in the demo account for 71% of all expenditures for PMDs in 2012, CMS states.

CMS formalizes Oct. 1, 2015, deadline for ICD-10

WASHINGTON – Providers, health plans and healthcare clearinghouses have until Oct. 1, 2015, to transition to ICD-10, according to a final rule published July 31 by the Department of Health and Human Services. Earlier this year, Congress delayed implementation of the new code set for one year as part of its “doc fix” bill. “ICD-10 codes will provide better support for patient care and improve disease management, quality measurement and analytics,” said Marilyn Tavenner, CMS administrator. “For patients under the care of multiple providers, ICD-10 can help promote care coordination.” CMS says the newest code captures more information than its predecessor, so doctors can better understand the details of a patient’s health.

Numotion names GE exec as new leader

ROCKY HILL, Conn. – Numotion’s board of directors announced last week that Mike Swinford has taken over as CEO. Paul Bergantino, the company’s former CEO, will remain onboard as a consultant during the transition process, according to a press release. “Paul has been a leader in our industry for many years and his contributions, especially during the merger of ATG Rehab and United Seating & Mobility, are greatly appreciated,” stated Tim Burfield, one of Numotion’s directors, in the release. “This is a time of significant growth for our company, and we look forward to the addition of Mike to our team, as he has a demonstrated ability to grow and lead multi-location, service-based businesses.” Swinford joins Numotion after a 22-year career at GE, where he worked primarily in healthcare services. He ran businesses that ranged from $200 million in annual revenue to more than $5 billion. His most recent position there was president and CEO of GE Healthcare Global Services.

NCART schedules awareness week

WASHINGTON – NCART has declared the week of Aug. 18-24 National CRT Awareness Week. The group is calling on stakeholders to reach out to members of Congress during the August recess to help secure more support for bills to create a separate benefit for complex rehab. There are currently 146 co-sponsors for H.R. 942 and 19 co-sponsors for S. 948, according to an NCART bulletin. “We are gaining ground, but to continue making progress, we need CRT stakeholders to get their member’s attention and ask for their support,” Executive Director Don Clayback wrote. NCART suggests providers arrange face-to-face meetings with members of Congress in their stores or facilities. The group can assist providers in planning and structuring those meetings.

BMC takes patent fight global

LAKE WALES, Fla. – BMC Medical and 3B Medical announced last week that they have now filed challenges to ResMed patents in China, Germany and the United States. The move represents a “global strategy to go on (the) offense and seek to invalidate portions of ResMed’s patent portfolio” in all three countries, the company stated in a release. “We have to be proactive on the global landscape to assert our right to compete in this product space,” stated James Xu, president of BMC Medical, in the release. Additionally, BMC and 3B recently announced in July the formal filing of an Inter Partes Review (IPR) in the United States Patent and Trademark Office challenging the validity of a ResMed patent on a CPAP humidifier structure. “We are continuing to study ResMed’s patent portfolio to identify future challenges,” Xu stated. BMC and 3B are also awaiting the outcome of a trial before the International Trade Commission that concluded in April. The trial was the result of a complaint filed by ResMed in July 2013 alleging infringement on several patents.

ResMed gets permanent injunction against Apex in Germany

SAN DIEGO – ResMed announced last week that it has won a permanent injunction in Germany against Taiwanese medical device manufacturer Apex Medical, prohibiting sales of infringing headgear used on Apex’s Wizard 210 and 220 masks. The judgment, entered by the Regional District Court in Munich, can be appealed. The permanent injunction continues a preliminary injunction that was entered by the same court in November 2013. The judgment also requires Apex to forfeit its inventory of infringing products, to report on its sales of the infringing products and to pay damages to ResMed. ResMed has also filed separate patent infringement lawsuits in the same court seeking damages and permanent injunctions to stop infringement of other patents. The trials of those cases will occur this fall.

CDC reports rise in doc visits by diabetes patients

ATLANTA – Office-based physician visits made by diabetes patients rose 20% between 2005 and 2010, according to a new data brief from the Centers for Disease Control and Prevention (CDC). The largest increase in visits (34%) was made by adults in their mid-20s to mid-40s, according to the new brief. “Continuing to examine office-based physician visits by patients with diabetes is especially important given changes in standards of care that may influence such visits,” said Jill Ashman, a physician at the CDC’s National Center for Health Statistics, in the brief. The total number of visits was higher among older adults—those 65 and older made 53.7 million visits in 2010, while those younger than 25 made 2.6 million visits, according to the brief. Visits by patients with diabetes made up 11% of all office-based physician visits in 2010.

Trustees report improved outlook for Medicare

BALTIMORE – The Medicare Trust Fund will remain solvent until 2030—four years longer than last year’s projections. The Medicare Trustees released a report last week that credits, in part, cost controls implemented as part of the Affordable Care Act (ACA) for the improved outlook. “Thanks to the ACA, we are taking important steps to improve the quality of care for Medicare beneficiaries, while improving Medicare’s long-term solvency,” said Marilyn Tavenner, administrator for CMS, in a release. “Specifically, we have made major progress in improving patient safety, decreasing hospital readmissions, and establishing new payment models, such as accountable care organizations, aimed at reducing costs and improving quality.” The improved outlook is also attributed to lower-than-expected spending in 2013, and lower projected utilization in the types of health care needed for Medicare beneficiaries. During the past four years, per capita Medicare spending growth has averaged 0.8% annually, much more slowly than the average 3.1% annual increase in per capita gross domestic product and national health expenditures over the same period. In 2013, Medicare covered 52.3 million beneficiaries: 43.5 million age 65 and older and 8.8 million with disabilities. Total expenditures in 2013 were $582.9 billion and total income was $575.8 billion.

Longhorn buys Hallmark

AUSTIN – Longhorn Health Solutions has purchased Hallmark Medical Supply, making it a competitive bidding contract supplier for DME across Texas, according to a press release. With the acquisition of Houston-based Hallmark Medical, Longhorn will add oxygen and CPAP to its existing offerings in wheelchairs, walkers, enterals and hospital beds. As one of the largest providers for Medicaid Managed Care in Texas, the acquisition will also allow Longhorn to service both Medicare and Medicaid patients with one referral from ordering facilities, HMOs and prescribers, according to the release. Frank and Kim Harmon, the previous owners of Hallmark Medical, will remain onboard to help integrate the company’s operations.

Business group weighs in on H.R. 1717

WASHINGTON – The National Federation of Independent Business (NFIB) has thrown its support behind H.R. 1717, a bill that would replace competitive bidding with a market-pricing program (MPP). In a letter to the bill’s sponsor, Rep. Tom Price, R-Ga., the NFIB states: “This flawed program forces small providers to submit unsustainable bids to compete for contracts, and restricts access to and choice of DMEPOS items and services.” The NFIB represents 350,000 members. H.R. 1717 has 180 co-sponsors.

Jaysec, PPM Fulfillment integrate

KNOXVILLE, Tenn. – Providers who use PPM Fulfillment to ship their sleep therapy equipment to patients, and use GoJaysec to contact and follow up with them now have the convenience of an integrated system, the companies have announced. Lincoln, Neb.-based PPM partners with manufacturers to assist providers in drop shipping CPAP supplies. Jaysec develops and provides web-based software applications for providers and their referral sources.

Basic American Medical Products wins award

ATLANTA – Basic American Medical Products earned the “Elite Supplier” distinction at the 2014 LINK Conference. The distinction is give to suppliers that took part in last year’s conference and have ranked as a top supplier based on provider evaluations of their level of preparation, consultation, innovation and overall value. “This seal identifies Basic American Medical Products as a progressive thought leader in long term care and senior living, and as an organization that understands how to build partnerships with clients and support providers’ strategic and operational needs,” stated David Ellis, managing director of LINK Conference, in a press release. The conference is produced by Lincoln Healthcare Group.

National truck company opens sleep apnea clinic

SPRINGFIELD, Mo. – Prime, a nationwide truck carrier, has opened a sleep apnea clinic to test and treat drivers for the disease. “The most important thing is to improve the quality of life for the driver,” said Steve Field, director of safety. “It’s something we’ve been working pretty hard at.” Prime has been testing all student drivers and drivers considered at risk based on weight, body mass index and neck circumference.

Sigvaris launches new educational options

PEACHTREE CITY, Ga. – Sigvaris is offering new educational sessions to expand training for fitters of medical compression stockings, the company announced July 29. The sessions, for those interested in becoming a Sigvaris Certified Fitter, include webinars, two online training courses, a two-hour in-service to increase product knowledge and a one-day in-person course, according to a press release. Sigvaris has also partnered with the International Lymphedema and Wound Care Training Institute to offer a two-day seminar on wound care and edema Sept. 24-25 at the manufacturer’s facility here. “These new opportunities make it easy to work continuing education into a busy schedule and still have the flexibility to also attend a seminar,” said Judith Brannan, educational and medical affairs manager in North America.

HME Home Medical expands offerings

GREEN BAY, Wis. – HME Home Medical has partnered with First Quality Products to distribute its incontinence products, including the Prevail brand, according to a press release. The partnership will enable the provider to expand its distribution division, GOHME. “This strategic alliance will allow us to expand our product base yet again as we reach out to distribute our high-quality products to even more facilities,” said Eric Hagen, director of business development at GOHME. In March, the provider launched GOHME to provideincontinence and skin care products and disposable gloves to skilled nursing homes, hospitals and other HME providers.

The Compliance Team earns dual approvals

SPRING HOUSE, Pa. – Florida’s Agency for Health Care Administration (AHCA) has approved The Compliance Team’s accreditation for HME/DMEPOS, in accordance with a recently enacted law that requires AHCA to ensure accreditors meet state licensing laws for HME providers. Also in July, CMS approved The Compliance Team as a national accrediting organization for rural health clinics. The Compliance Team was founded by Sandra Canally in 1994.