In brief: NCART fights for separate billing, F&P responds to potential Trump tariff on Mexico

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Friday, January 27, 2017

WASHINGTON – NCART has formed a work group and developed an issue paper in response to CMS’s decision not to allow separate billing for titanium wheelchair frames and heavy duty upgrades.

The agency argues these features are included in the initial fee schedules developed for manual wheelchairs.

“This is the most recent example of policy changes and re-interpretations over the past few years implemented by CMS and its contractors that eliminate access,” said Don Clayback, executive director of NCART. “This policy announcement prevents Medicare beneficiaries with disabilities from obtaining complex rehab technology, even in they are willing to pay for the upgrades themselves.”

In its issue paper, NCART argues that CMS must rescind the announcement, and issue a policy clarification stating suppliers can use K0108 to bill for titanium for wheelchairs for K0005, and can use K0108 to bill for heavy duty upgrades for K0004, K0005 and E1161 manual wheelchairs.

NCART says it has reached out to CMS to express its concerns, and is pursuing “other channels in the congressional and advocacy arenas.”

F&P responds to potential Trump tariff on Mexico

WELLINGTON, New Zealand – Fisher & Paykel Healthcare will consider switching manufacturing of U.S. products from Mexico to New Zealand if President Donald Trump’s administration taxes Mexican imports, Yahoo Finance reports. “We’ve got two plants, one in New Zealand and one in Mexico,” CEO Lewis Gradon told Yahoo. “We have the capacity to supply the United States from New Zealand if that makes more economic sense.” Shifting manufacturing to New Zealand would raise production costs, Gradon said. The White House has said one of the ways it is considering paying for a wall along the border with Mexico is a new 20% tax on goods coming from the country.

Rep. Price says audits should focus on actual fraud

WASHINGTON – Rep. Tom Price, R-Ga., nominee for secretary of Department of Health and Human Services, told members of the Senate Finance Committee that he thinks the agency should focus audits on weeding out blatant fraud instead of verifying medical necessity. The comments came in response to a question from Sen. Orrin Hatch, R-Utah, about what HHS can do to protect Medicaid from scammers, according to an article on Law360. The Senate Finance committee will vote soon on whether to accept Price’s nomination.

AmeriCare Medical takes its message on air

TROY, Mich. – AmeriCare Medical, which provides medical staffing, private duty nursing, DME and specialized pharmacy services, has launched a TV show to address a variety of health-related topics specific to baby boomers. “As baby boomers continue to age, they are finding themselves in a unique situation where they are not only caretakers for their parents, but also dealing with health concerns of their own,” said Greg Jamiam, president and CEO of AmeriCare Medical. “This new show provides this generation with the answers they need to make informed decisions about their health and future.” AmeriCare Medical is presenting “Boomer Health at Home” in partnership with local health professionals and Bloomfield Community Television. Topics will include everything from financial planning to memory care to general first aid to illness prevention. “Boomer Health at Home” is available online and on local public access channels serving the Bloomfield area. New episodes air monthly.

CMS evaluating PMD demo

WASHINGTON – CMS has contracted with Provider Resources to conduct an evaluation of its power mobility device demonstration project. CMS has sent letters to physicians, asking them to schedule interviews with Provider Resources to share their opinions and thoughts on the process. “Your feedback could have a direct impact on how PMDs and other services or supplies could be requested and/or processed in the future,” the agency states in its letter to physicians. As part of the demo, which kicked off in 2012, providers must submit prior authorization requests for certain PMDs.

Permobil consolidates websites

NASHVILLE, Tenn. – Permobil has a new website that features its entire product portfolio—not only power wheelchairs, but also seating and positioning products, and manual wheelchairs—in one place. The manufacturer has beefed up its product portfolio with the acquisitions of The Roho Group in 2015 and TiLite in 2014. “We will better serve our clients by showing our full line of rehabilitation products on the new website, all in one place,” said Larry Jackson, president of Business Region Americas. The websites for Roho and TiLite will now redirect to the new Permobil website, www.permobilus.com.

Routine OSA screenings not necessarily necessary

YARMOUTH, Maine – There isn’t enough evidence to support routine screenings for obstructive sleep apnea says the U.S. Preventive Services Task Force. No studies have examined whether using questionnaires to screen people without symptoms led to changes in their health, according to a statement published in the Journal of the American Medical Association. Task force member Dr. Alexander Krist said, however, that the findings shouldn't stop people with symptoms from being tested.

Moneyline: PharMerica, FOSRx make buys

LOUISVILLE, Ky. – Amerita, the Specialty Infusion Division of PharMerica, has acquired Fairlawn, N.J.-based Nextron, a provider of certain specialty medications in the home. The move allows Amerita to further its expansion in the eastern United States.

“This expansion is consistent with our strategy to become a national home infusion provider,” said Greg Weishar, PharMerica's CEO, in a press release.

Paragon Ventures served as adviser to Nextron. Terms of the deal were not disclosed.

FOSRx closes deal

CUMBERLAND, Md. – Factor One Source Pharmacy has acquired Metairie, La.-based Fast Access Specialty Therapeutics. Together the two companies generated approximately $136 million dollars in revenue in 2016 and are projected to generate $156 million in revenue for 2017.

Sajal Roy, CEO of FOSRx, will become CEO of the combined companies.

FAST, which has 42 employees and annual revenue of nearly $100 million, will retain its brand but operate under the FOSRx umbrella.

Paragon Ventures served as adviser to Nextron. Terms of the deal were not disclosed.

Wellness bill introduced in House

WASHINGTON – A companion bill has been introduced in the House of Representatives that seeks Medicare payment for services such as wellness screenings, immunizations and diabetes management. H.R. 592, the Pharmacy and Medically Underserved Areas Enhancement Act, was introduced by Reps. Brett Guthrie, R-Ky., G.K. Butterfield, D-N.C., Tom Reed, R-N.Y., Ron Kind, D-Wis., and 104 co-sponsors. A Senate version of the bill was introduced Jan. 12 with 27 co-sponsors. Both bills have been endorsed by the pharmacy community, including the National Community Pharmacists Association.

MTA pushes sleep screening

NEW YORK – The Mass Transit Authority has said it will seek to expand sleep apnea screening to Long Island Rail Road engineers and conductors; New York City Transit subway train operators, conductors and bus operators; and MTA bus operators, according to local news reports. The proposal comes in response to a 2013 Metro-North train crash that killed four people. The Federal Motor Carrier Safety Administration has long sought to implement recommendations for sleep screening, amid push back from the transportation industry. But in the wake of the Metro-North crash, as well as other recent, high-profile crashes, the tide may finally be turning, say sleep stakeholders.

SCA grants high-flying senior wish

PHILADELPHIA – SCA will grant another senior wish when Jim Willis, 87, embarks on a tandem hang-glide flight Jan. 26. The resident of Bradenton Brookdale Senior Living wants to show older people that “you are never too old to try something new.” SCA, a manufacturer of personal hygiene and forest products, partners with Wish of a Lifetime and Brookdale Senior Living to fulfill dreams of seniors to shift society’s perception of aging.