In brief: Leadership changes at Invacare, layoffs at All-States
ELYRIA, Ohio – Lou Slangen, Invacare’s executive vice president and chief product officer, will retire at the end of February after 27 years with the company, according to a Feb. 27 release. John Remmers, senior vice president of global supply chain and operations since 2010, will take over responsibility for North American commercial operations, according to the release. Since he joined Invacare, Remmers has also overseen global engineering and commercial operations for China and Top End. “He has developed a passion for the home and long-term care markets that we serve, and we believe he is the right person with the right skills and experience to lead Invacare’s North American business,” said Gerald Blouch, president and CEO, in the release. Blouch applauded Slangen’s years at Invacare, saying, “During his years of service, he has been an incredible advocate for the homecare industry and the difference it can make in people’s lives.”
All-States blames audits, cuts for layoffs
FLETCHER, N.C. – All-States Medical Supply has laid off eight employees due to soaring audit rates and recent cuts in Medicare reimbursement, according to a release. When All-States won a contract as part of the national mail-order program for diabetic supplies in 2013, it planned to hire 50 employees to meet an increase in demand. But now, along with the steep cuts associated with the program, the company is also dealing with audits tying up hundreds of thousands of dollars in limbo, said President Jason de Los Santos in the release. “The layoffs were a devastating decision for us, but one we had to make to keep our head above water,” he said. All-States is diversifying into retail stores and therapeutic shoe fittings, as well as adding an on-site pharmacy to take private insurance for diabetic supplies, according to the release.
Fraud program posts record-breaking year
WASHINGTON – The Health Care Fraud and Abuse Control Program recovered $4.3 billion in fiscal year 2013 and $19.2 billion in the last five years. That’s up from $4.2 billion in fiscal year 2012 and $9.4 billion in the previous five years, according to an annual report released Feb. 26. “These impressive recoveries for the American taxpayer are just one aspect of the comprehensive anti-fraud strategy we have implemented since the passage of the Affordable Care Act,” said Department of Health and Human Services (HHS) Secretary Kathleen Sebelius in a release. A highlight from 2013: Strike Force teams coordinated a takedown in eight cities against 89 individuals, including doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $223 million in false billings.In 2013, the Department of Justice (DOJ) also opened 1,013 new criminal and 1,083 new civil healthcare fraud investigations, and helped to convict 718 defendants of healthcare fraud-related crimes.Also as part of fraud prevention efforts, CMS has been revalidating 1.5 million enrolled providers and suppliers under Affordable Care Act screening requirements. As of September 2013, CMS has revoked the ability of 14,663 providers and suppliers to bill Medicare.
Aeroflow signs four new insurance contracts
ASHEVILLE, N.C. – Aeroflow Healthcare has signed new insurance contracts with Cypress Care, Arbor Health, Indiana University and NJ Medicaid, according to a Feb. 28 release. The DME provider is now in-network with 24 state Medicaid plans and hundreds of other insurance providers. As reimbursement cuts, bidding and audits drive providers to close their doors, the contracts allow Aeroflow to step in, said Ryan Bullock, director of sales and marketing. “The additional contracts will position Aeroflow to ensure these patients are still serviced,” he said. The company’s goal is to continue growth nationwide, according to the release.
Insulet grows revenues in Q4
BEDFORD, Mass. – Insulet’s revenues in the fourth quarter of 2013 were $68.5 million, an increase of 19% over the same period in 2012, the company announced Feb. 17. Revenues grew on patient adoption of the OmniPod insulin pump, and despite a reduction in revenues from subsidiary Neighborhood Diabetes, due to competitive bidding. Gross profits for the quarter were $33 million, compared to $25.3 million over the same period in 2012. For the year ended Dec. 31, Insulet’s revenues were $247.1 million, a 17% increase over 2012. Gross profit for the year was $112.4 vs. $92.3 million.
The Compliance Team celebrates 20 years
SPRING HOUSE, Pa. – This year marks the 20th anniversary of The Compliance Team, the only woman-owned Medicare-deeming authority to accredit DMEPOS providers, according to a release. Founder and President Sandy Canally helped to drive a number of improvements to the accreditation process, including the industry’s first plain-language service and product-line specific quality standards, according to the release. “My intent was to make it easier for everyone within an organization to buy into the process by combining a readily-recognizable quality branding message with a third-party validated accreditation tool,” she said. The Compliance Team has accredited thousands of healthcare organization in the U.S., Puerto Rico and the U.S. Virgin Islands.
CMS issues face-to-face reminder
BALTIMORE – CMS has released a “Dear Physician” letter that providers can use to remind doctors they must conduct face-to-face examinations within six months of ordering certain DME items prescribed on or after July 1, 2013. CMS has repeatedly delayed enforcement of the face-to-face rule, but not the written order prior to delivery requirement. In the Feb. 21 letter, CMS said face-to-face examinations are necessary in the following cases: for purchases and initial rentals; when there is a change in the order; when an item is replaced; when the supplier changes; when state law requires it; and on a regular basis only when specified in documentation. It also outlined prescription, and date and timing requirements
Gov’t agrees to re-examine ResMed patents
SAN DIEGO – The U.S. Patent and Trademark Office has agreed to re-examine five ResMed patents in response to challenges filed by Apex Medical, the manufacturer has announced. Apex had filed challenges against ResMed in August 2013 for six patents related to CPAP machines and masks. It’s the latest move in an ongoing patent battle between ResMed and Apex. On Feb. 19, Apex filed challenges to four patents in European and German patent offices. In November, ResMed won preliminary injunctions in Germany against both Apex and BMC Medical, prohibiting them from selling or making certain products without a court order.
Aeroflow expands into South Carolina
ASHEVILLE, N.C. – Aeroflow Healthcare has acquired Easley, S.C.-based Air-Care Home Health, extending its footprint into Greenville, Spartanburg and surrounding areas. As a result of the acquisition, Aeroflow will be the primary provider of oxygen supplies and services to Air-Care patients. Aeroflow will also offer the company’s patients other DME, including vents and negative pressure wound therapy. Aeroflow cites competitive bidding as the driver behind its growth. “This program has presented us with new opportunities,” stated Josh Hill, director of business development, in a press release. “We are actively looking for more strategic locations, acquisitions and expansion opportunities.”
Obama proposes cut to Medicare Advantage
WASHINGTON – The Obama administration has proposed cutting reimbursements rates for Medicare Advantage (MA) plans by 1.9% in 2015, Kaiser Health News reports. Insurers argue, however, that the cut is much bigger when you combine it with new fees on health plans related to healthcare reform, a phase-out of the “star rating” system that helped buffer cuts from previous years and additional cuts due to sequestration, according to the news organization. Last year, CMS proposed a 2.3% rate cut for 2014, but after heavy lobbying, the agency ended up increasing rates by 3.3%. Enrollment in Medicare Advantage plans rose in 2014 by 8.9% to 15.9 million enrollees, according to consulting firm Avalere Health.
CMS to test ICD-10 claims
WASHINGTON – CMS plans to conduct testing of ICD-10 billing submissions across a wide range of fee-for-service providers. In a recent MLN Matters article, the agency said it will offer acknowledgment testing from March 7-10 to allow providers, billers and clearinghouse to determine whether CMS will be able to accept their claims with ICD-10 codes. After analyzing the results, CMS may offer additional weeks of acknowledgement testing. This summer, CMS will offer end-to-end testing to a small sample group of providers. As of Oct. 1, 2014, healthcare claims must contain ICD-10 codes.
Short takes: RESNA, NovaSom
Former Indy 500 driver Sam Schmidt, founder of the Sam Schmidt Paralysis Foundation, will open RESNA’s “Racing Towards Excellence in AT” conference. Held June 13-15 in Indianapolis, the conference will also feature Gregor Wolbring, a University of Calgary scholar of ableism ethics and governance, and Cole Galloway, a University of Delaware pediatric mobility researcher…NovaSom, provider of the AccuSom home sleep test, has joined the American Sleep Apnea Association (ASAA) industry roundtable, according to a release. Corporations on the roundtable support the ASAA mission, activities and programs.
People news: Changing of the guards at ACU-Serve, Jaysec
ACU-Serve Co-founder Jim Knight is now CEO. Co-founders Angie Barone and Tim Barone have left the company to pursue other opportunities. Other changes include Tom Meadows as business partner, Cindy Hoyt as COO, and Samantha Haynam and Yvette Nugent as account managers. Additionally, Stephanie Greene will head up an auditing and consulting division…Gibran Ameer is the new chief operating officer of Jaysec Technologies. He will oversee operations for value and efficiency. Ameer most recently worked with Medical Services of America. “He brings vast knowledge and experience within the home care industry along with a commitment to innovation and client services critical to the success of Jaysec,” said Dan Dillon, CEO.