In brief: HHS reports reduction in backlog, McKesson hosts roundtable

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Friday, October 18, 2019

WASHINGTON – The Department of Health and Human Services has reduced the backlog of Medicare appeals at the administrative law judge level by 25% through June 30, according to a status report provided to a federal court and obtained by the American Hospital Association.

The status report is part of a federal court ruling last year that established annual deadline-based targets for reducing the backlog of Medicare appeals at the ALJ level.

From Nov. 1, 2018, through the end of the third quarter of fiscal year 2019, there has been a net reduction of 108,340 appeals pending at the Office of Medicare Hearings and Appeals, leaving a total of 318,254 appeals pending, a 25.4% reduction from the 426,494 appeals pending on Nov. 1, 2018, HHS reports.

Last year’s ruling in favor of the AHA required HHS to achieve the following reductions: a 19% reduction by the end of FY2019; 49% by the end of FY 2020; 75% by the end of FY 2021; and no backlog by the end of FY 2022.

OIG to review PAP supplies, PMD repairs

WASHINGTON – The Office of Inspector General has updated its Work Plan to include new reviews for PAP replacement supplies and power mobility device repairs. Medicare paid approximately $945.8 million for replacement supplies in 2017 and 2018, but OIG has previously found that most claims did not comply with Medicare requirements.

For supplies and accessories used periodically, orders must specify the type of supplies needed, the frequency of use, if applicable, and the quantity to be dispensed, and suppliers must not automatically ship refills on a predetermined basis.

PMD repairs

Medicare paid approximately $46.7 million for PMD repairs in 2018, including replacement parts. Suppliers must maintain documentation from the physician or treating practitioner indicating that the PMD being repaired continued to be medically necessary and that the repairs were reasonable and necessary.

DME suppliers must also maintain detailed records describing the need for and nature of all repairs, which includes a justification for the replaced parts and the labor time. In addition, if the expense for repairs exceeds the estimated expense of purchasing or renting another PMD for the remaining period of medical need, no payment can be made for the amount of the excess.

McKesson hosts industry roundtable

CHINO, Calif. – McKesson hosted a roundtable last week with HME providers and other industry stakeholders to discuss the future of HME at its facility here. “I was excited to connect with this passionate and forward-thinking group of providers to hear about their policy concerns and share how AAHomecare and other stakeholder groups are working to address these issues on the state and federal level,” said Laura Williard, vice president of payer relations for AAHomecare, who attended the day-long event.

Bonafide, PlayMaker form partnership

THOUSAND OAKS, Calif. – Bonafide Medical Group, a provider of ERP software, and PlayMaker Health, a post-acute data solutions provider, are collaborating on integrated business solutions for HME providers. “The integration of Bonafide's ERP system for HME and PlayMaker Health’s data capabilities provides 100% visibility into service areas by leveraging the most current and comprehensive claims and sales data available,” said John Griscavage, CEO of PlayMaker Health. “This gives HME providers the real-time business intelligence they need to increase sales and expand competitive market share.” Bonafide recently announced it was consolidating Next Level 11 and Next Project 11 under the Bonafide umbrella as part of the newly formed Bonafide Medical Group, LLC.

Workers’ compensation: ATF Medical, HomeCare Connect

Woodbridge, Va.-based ATF Medical, a provider of medical equipment and adaptive housing solutions to the workers’ compensation market, has hired Melissa Freeman, ATP, CEAS, as senior rehabilitation consultant. She has more than 30 years of experience in assistive technology, vocational rehab, and seating and mobility. Most recently, she worked for Georgia Vocational Rehabilitation in Rome, Ga., where she served as the assistive work technology team lead…Winter Park, Fla.-based HomeCare Connect, which manages home health, DME, home modification, O&P and supplies for workers’ compensation patients and payers, has named Lisa Maciolek national account manager. She will be responsible for managing national client relationships, and implementing new concepts and services. Most recently, she served as assistant vice president, account management, for Optum.

Invacare overhauls IT system

ELYRIA, Ohio – Invacare has signed a $240 million, multi-year contract with Birlasoft to transform its IT system, the two companies have announced.

Birlasoft will modernize the company’s system, taking responsibility for service desk, applications, server, network and telephone support. The digital and IT consulting company will also implement a new Product Lifecycle Management system, including a new e-commerce portal for customers to access products, spares and supplies.

"A business transformation of this magnitude requires significant capital investment,” said Matthew Monaghan, chairman, president CEO of Invacare. “We want to improve customer experience and IT operating costs through automation and digitalization. By having Birlasoft deliver IT-as-a-Service through an achievement-based agreement, we have a partner in this transformation that is invested in our success.”

Invacare has a long-term target of $85 million to $105 million adjusted EBITDA run-rate by the fourth quarter of 2020.

Birlasoft, part of the $2.4-billion The CK Birla Group based in New Delhi, employs 10,000 engineers.

Quantum Rehab partners with Reeve Foundation on content…

DURYEA, Pa. – Quantum Rehab is joining forces with the Christopher & Dana Reeve Foundation on co-branded educational content that sheds light on the importance of finding the right wheelchair to increasing independence and overall quality of life. Content will include blogs and social media posts, as well as articles for the foundation. “It’s our privilege to begin working with the Christopher & Dana Reeve Foundation,” said Megan Kutch, director of Quantum marketing. “Our products address both the mobility and lifestyle needs of those living with paralysis. Quantum shares the foundation’s dedication to improving the quality of life for individuals living with paralysis providing mobility products, information and advocacy specific to the needs of those with mobility challenges.”

…names Q Roll Models

DURYEA, Pa. – Quantum Rehab has announced the winners of its Q Roll Models Contest: Amy Bleile of Wisconsin, Isabella Bullock of Minnesota, Merlisha Henderson of Arizona, Emily Ladau of New York, Sakina Shamsi of New Jersey and Tim Shin of New Jersey. Each winner will receive a four-month paid Q Roll Models contract and a Quantum Power Chair with iLevel technology with complementary future service and parts. “Each Q Roll Model comes from a different background and a different part of the country, and each one of them is fun, authentic and relatable,” said Stephanie Woodward, brand ambassador advisor. “I cannot wait for each of them to share their experiences of how iLevel helps them live their best lives in different ways.” Judging consisted of picture content and an explanation of how iLevel would help the contest participant live their best life.

WellSky gives away data analytics tool

OVERLAND PARK, Kan. – WellSky has made available its recently launched WellSky Home Health CareInsights for free to current home health clients. The company’s 3,000 home health clients can now sign up to receive complementary access to CareInsights through March 31, 2020. CareInsights equips caregivers and care managers with the information they need to make informed, individualized clinical care decisions to improve patient experience and enhance outcomes, leveraging historical data from more than 7 million home health episodes. “With this unprecedented rollout of CareInsights across our 3,000 home health clients and more than 300,000 clinical end users, WellSky will enable the largest utilization of machine learning technologies in post-acute healthcare,” said Ben Chapman, senior vice president and general manager of WellSky Home Health and Hospice.

Product news: Invacare, Fisher & Paykel, Precision Medical, GCE Healthcare

Elyria, Ohio-based Invacare will highlight a number of newer products at Medtrade, Oct. 21-23, including the Etude HC Bed, Aquatec Bath Lifts and a series of Aquatec Ocean Ergo Shower and Commode Chairs. The company will also highlight the Motion Concepts MPS Maxx Modular Power Standing System, exclusively available on the ROVI A3 Power Wheelchair through Motion Concepts; and the Platinum Mobile Oxygen Concentrator. “The products exhibited at Medtrade are not only examples of Invacare’s commitment to innovation but also opportunities for providers to provide clinical benefits to their customers, excel at e-commerce and optimize their portable oxygen business,” said Joost Beltman, vice president, North America sales and marketing…Auckland, New Zealand-based Fisher & Paykel Healthcare has released a new mask for OSA, the F&P Vitera, for sale in the United States. The full-face mask features a RollFit XT Seal designed to minimize leaks and pressure on the bridge of the nose, and a stability bar that keeps the mask in place throughout the night. “Vitera is designed to remain stable on the face and maintain a comfortable and effective seal, so patients can sleep in their preferred position and wake up refreshed and energized,” said Justin Callahan, president of Fisher & Paykel Healthcare’s U.S. business. The mask’s headgear also incorporates VentiCool breathable technology to help dissipate heat and moisture, increasing comfort. The mask is already available in Australia, Canada, New Zealand and Europe…Northampton, Pa.-based Precision Medical has officially launched its latest portable oxygen concentrator, the Live Active Five. The POC features a bright LCD screen and large numbers that display the remaining battery duration in a percentage, as well as hours and minutes. It also features a top-loading lithium-ion battery, AC wall charger and DC car charger, carry bag and three-year warranty. “(Additionally), we’ve engineered the Live Active Five with a sieve bed assembly that is field replaceable using a standard screwdriver, avoiding the need to return the device to a service center or back to the manufacturer,” said Mike Krupa, CEO. Precision Medical has been manufacturing respiratory care devices since 1982…ST. HELENS, U.K.-based GCE Healthcare is making Clarity, its online monitoring platform, available on its Zen-O Lite portable oxygen concentrators for U.S. customers. Clarity, launched in 2018, uses cellular technology to transmit data like oxygen purity, usage history, location and battery life. Providers can monitor the POC 24/7 from any online device to ensure customers are using it properly and adhering to their prescriptions.