In brief: Industry keeps CMS on defensive, F&P raises guidance

Friday, February 21, 2014

WASHINGTON – HME industry stakeholders are keeping a close eye on the “doc fix,” a bill that could hold either potential or pitfalls. Stakeholders see the bill as a vehicle for key points of their market-pricing program to replace Medicare’s competitive bidding program, but rumors abound on the Hill that lawmakers are considering applying bid rates to Medicaid to pay for the fix. “It’s difficult to know what’s going to happen,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “We are doing what we can to make sure we stay out of the pay-for package.” As recently as Feb. 5, CMS officials were called up to brief members of the House Ways & Means Committee on the program. “CMS said everything is great, but several members voiced opinions about problems,” said Bachenheimer. The industry’s efforts got a nice boost on Feb. 12, when Rep. Renee Ellmers, R-N.C., published an op-ed in The Hill, calling for reform of the bidding process. “The conversation is alive and CMS is on the defensive,” said Bachenheimer.

F&P raises earnings guidance

IRVINE, Calif. – Fisher & Paykel Healthcare announced Feb. 18 that it expects net profit after tax to be NZ$97 million for the financial year ending March 31, 2014, NZ$7 million more than it expected. F&P had previously projected a net profit of NZ$90 million to $95 million. “Demand during the second half has been very encouraging, particularly for our Simplus, Eson and Pilairo Q masks, which are used for the treatment of OSA,” stated CEO Michael Daniell in a release. F&P also announced plans to expand its manufacturing facility in Tijuana, Mexico. It will spend NZ$4 million to increase the size of the facility by two-thirds to accommodate the installation of additional manufacturing equipment for breathing systems and masks. “We have brought forward the expansion of the Tijuana facility to ensure that we can meet anticipated demand as a result of strong customer acceptance of products, such as our new masks and Optiflow oxygen therapy system,” Daniell stated.

Jaysec partnership marries HME, home health

KNOXVILLE, Tenn. – Jaysec Technologies has teamed up with Intrepid USA, a national home care, hospice and private duty company. The partnership allows doctors to order, manage and complete all required initiating orders and face-to-face documentation for HME and home health using one system, according to a press release. “When our doctors asked us to offer the same beneficial solution for their home health ordering process as we did for DME, it was a no brainer,” stated Dan Dillon, CEO of Jaysec, in the release. Intrepid was impressed by Jaysec’s ability to streamline the referral process for doctors and HME providers. “After learning of the impact that Jaysec was able to have on days to signature for DMEs from an average of 45 days to an astonishing 1.2 days, we couldn’t not pass up the opportunity to try for the same results in home health,” stated Wes Perry, CEO of Intrepid.

DHS secures ‘amazing advantage’ in New Jersey

HARRISBURG, Pa. – Dynamic Healthcare Services (DHS) has made its second buy in as many months. DHS, which is backed by private equity firm GMH Ventures, has acquired Reliable Medical in Hackensack, N.J., it announced today. Reliable, a full-line HME provider covering the northern New Jersey and New York metropolitan areas, was awarded an oxygen contract in Round 2 of competitive bidding. "Reliable's presence in the northern New Jersey market and their Round 2 competitive bid contract in the southern New York Metro CBA, combined with the northern New Jersey Metro CBA contract that DHS was already awarded, gives us an amazing advantage across the New York and New Jersey metro market,” said Michael Holloway, president of GMH Ventures, in the release.The deal is the latest in a string of acquisitions for DHS. In January, the company acquired Clarion, Pa.-based Progressive Home Medical Equipment, a full-line provider serving Pittsburgh and western Pennsylvania. In 2013, DHS acquired APO2; and in 2012, it acquired HomeTown Oxygen and Evanko Respiratory, all in Pennsylvania.Reliable Medical founders Rob O’Connor and Deon DeFreitas will continue to manage operations. Terms of the deal were not disclosed.

Philips Respironics recalls 600 vents

MURRYSVILLE, Pa. – Philips Respironics initiated a worldwide recall of 600 Trilogy Ventilators, models 100, 200 and 202, according to a Feb. 19 release. The voluntary recall is to address a potential defect in part of the power management board, which could cause the ventilator to fail without an alarm indicating a problem, the release says. The recall affects devices shipped between Dec. 30, 2013, and Jan. 30, 2014. Philips Respironics asks customers to stop using the devices and return them to the company for replacement. The company says there have been no reports of death or serious injury related to the problem.

ResMed founder named to CONNECT Hall of Fame

SAN DIEGO – ResMed Founder Peter Farrell has been inducted into the CONNECT Entrepreneur Hall of Fame for his work in sleep and respiratory medicine, the company announced Feb. 19. In 1989, Farrell established San Diego-based ResMed to treat sleep-disordered breathing. The eighth inductee into the CONNECT Entrepreneur Hall of Fame, he has served the San Diego community through a variety of philanthropic efforts. CONNECT supports innovative technology and life sciences work in San Diego County.

CGS launches manual wheelchair review

NASHVILLE, Tenn. – High strength, lightweight manual wheelchairs will be the subject of a service-specific prepayment review because of their high claims payment error rate, CGS, the Jurisdiction C DME MAC, announced Feb. 18. Additional documentation required for K0004 claims may include: detailed written orders; medical records showing the beneficiary meets general manual wheelchair coverage criteria and one of the two K0004 code specific criteria; documentation of an assessment showing the beneficiary’s home can accommodate the wheelchair; delivery documentation; and copy of advance beneficiary notice. Relevant medical records are physician notes, non-physician clinical notes and non-physician clinical evaluations showing the beneficiary’s condition meets coverage criteria. Those records may come from a physician’s office, hospital, nursing home or home health agency, according to the bulletin.

CGS launches review to check on WOPD

NASHVILLE, Tenn. – CGS wants to make sure suppliers are complying with the Affordable Care Act’s requirements for written orders before delivery (WOPD). The Jurisdiction C DME MAC on Feb. 18 announced plans to launch service-specific medical review edits for home blood glucose monitors (E0607), standard manual wheelchairs (K0001), standard hemi manual wheelchairs (K0002), lightweight manual wheelchairs (K0003), octogenesis stimulators (E0748), speech generating devices (E2510), and negative pressure wound therapy electrical pumps (E2402). Suppliers will have to submit additional documentation for edited claims, including detailed written orders, delivery documentation, the advanced beneficiary notice or other records, according to the bulletin.

Patent tug-of-war continues

SAN DIEGO – Apex Medical has initiated challenges to four ResMed patents, it announced today. Apex has initiated challenges in the European Patent Office, the German Federal Patent Court, and the German Patent and Trade Mark Office. In November, ResMed won preliminary injunctions in Germany against Apex and Chinese manufacturer BMC Medical, prohibiting both manufacturers from selling or making certain products in Germany without a court order. In August, Apex asked the U.S. Patent and Trademark Office to reconsider the validity of six ResMed’s patents.

CareCentrix, Cigna stick together

HARTFORD, Conn. – CareCentrix has re-upped its partnership with Cigna, inking a five-year agreement to coordinate home health services, including nursing, home infusion and HME to its members, according to a press release. CareCentrix will also provide sleep therapy management services through its Sleep Management Solutions subsidiary. CareCentrix serves more than 23 million people through a network of 7,400 providers.

INGN opens for trading

GOLETA, Calif. – Inogen (INGN) opened for trading on the NASDAQ on Feb. 14, pricing about 4.4 million shares of its stock at $16 per share, the low end of an expected range of $16 to $18. On Feb. 18, the company’s stock was trading at $15.28 per share. Inogen filed for an initial public offering (IPO) in November. J.P. Morgan was the sole bookrunner on the deal.

Sleep apnea study reaches milestone

ANDOVER, Mass. – The Sleep Apnea cardioVascular Endpoints Study (SAVE) has enrolled 2,500 patients, Royal Philips, a major sponsor, announced Feb. 18. The patients are spread across seven countries, and 84 hospitals and medical institutions. The aim of the study: to determine the effects of CPAP treatment in preventing heart attack, stroke or heart failure in high-risk patients with moderate to severe obstructive sleep apnea (OSA). In addition to sponsoring the study, Philips has played an active role in training personnel at the various SAVE sites in CPAP adherence techniques.