In brief: President signs bill to fix PPP, Anthem eyes steep rate cuts

Friday, June 5, 2020

WASHINGTON – President Trump has signed a bill that makes significant improvements to the Paycheck Protection Program.

The bill, which was passed by the House of Representative last week and the Senate this week, would give recipients nearly six months, instead of eight weeks, to use the funds they receive to qualify for loan forgiveness.

It would also allow recipients to spend just 60% of funds on payroll expenses, instead of 75%, allowing them to spend the remaining 40% on non-payroll expenses like rent, utilities and mortgage interest.

Additionally, the bill would extend the deadline for rehiring employees to Dec. 31, instead of June 30; and lengthen the time to repay any loan not forgiven to five years, instead of two years.

HME providers reported in a recent HME Newspoll that PPP funds were a “must have” for their companies during the current public health emergency.

Earlier this week, the National Community Pharmacists Association applauded the bill, saying “it’s clear the economy will take much longer to recover.”

Anthem eyes steep rate cuts

WASHINGTON – Anthem and its subsidiary, Amerigroup, have proposed rate reductions of between 11% and 60% for home medical equipment, AAHomecare reports.

The proposed reductions would include commercial and government plans across 22 states, according to the association.

In a letter to Anthem President and CEO Gail Boudreaux, AAHomecare asks for a delay to the cuts, citing new cost structures due to the current public health emergency.

“This is a time of crisis for our country and our health care infrastructure,” the association states. “Any rate reductions for DME under these conditions will cause significant hardships for DME suppliers and impact access to care for patients.”

A recent survey by AAHomecare found, among other challenges, increased costs for PPE (85%), oxygen equipment (67%), ventilators (48%), hospital beds (47%) and complex rehab technology (19%).

AAHomecare has also shared its concerns with the National Association of Insurance Commissioners, and will reach out to state Medicaid directors where applicable.

AAH to HHS: Include HME in Medicaid relief

WASHINGTON – AAHomecare has asked the U.S. Department of Health & Human Services to include HME suppliers in any future rounds of relief for providers who bill Medicaid. In a *letter to HHS Deputy Secretary Eric Hargan, the association states: “There are many HME suppliers who do not participate in Medicare but do serve a substantial number of Medicaid beneficiaries; these suppliers did not receive any of the Medicare-based relief from the initial disbursement of CARES Act funds. We believe that any additional allocation that focuses on Medicaid providers should take into account HME suppliers.” AAHomecare will continue to monitor provider relief efforts to ensure that any future disbursements include HME suppliers.

CAIRE acquires respiratory device maker

BALL GROUND, Ga. – CAIRE has acquired Spirosure, a California-based company that recently launched its first product to market, the Fenom Pro, a device that measures FeNO, a key indicator of allergic inflammation in asthmatic patients. “FeNo is quickly becoming recognized by the clinical community as an important diagnostic and management tool for clinicians who treat asthma patients,” said Earl Lawson, CAIRE president and CEO. “The acquisition of Spirosure further diversifies our portfolio and provides access to the $5 billion respiratory diagnostic sector.” Spirosure will operate as a division of CAIRE called CAIRE Diagnostics.

QS/1 launches virtual conference

SPARTANBURG, S.C. – QS/1 is launching the iQ Virtual Series, an online event that replaces its 2020 iQ Conference, cancelled earlier this year due to COVID-19. The iQ Virtual Series will offer product training, industry education and CE credits, and provide an ongoing educational platform for its pharmacy customers. “QS/1 and Integra want to ensure our customers and their staff still receive the valuable information presented at the gatherings each year,” said Kirsten Henry, director of brand experiences for RedSail Technologies, the parent company of QS/1. The program will being June 24 and focus on customer panels discussing lessons learned and response to COVID-19. The virtual event will also feature an exhibit hall, where attendees can connect with vendors and get product demonstrations. For more information:

Short takes: NRRTS, Rotech

NRRTS is inviting members to submit thoughts, photos and memories of life before and after the Americans with Disabilities Act was signed into law on July 26, 1990. Submissions will be featured in DIRECTIONS, Volume 4. Submissions may be sent to Amy Odom at Deadline is June 19…Rotech Healthcare in Lakeland, Fla., donated nearly $900 to the Wooden Spoon diner, which has so far given out more than 1,000 free meals to front line workers during the COVID-19 pandemic.

State short takes: Florida, Arkansas, Georgia, Washington

AAHomecare and the Florida Alliance of Home Care Services have met with the Agency for Health Care Administration to discuss concerns with a recent request for proposal issued by Centene to manage the HME and home health network for all Centene and Wellcare plans in the state. Concerns with the RFP, which is estimated to impact 43% of patients, include a lack of oversight of third-party administrators and subcontractors…AAHomecare seeks a delay in Medicaid rate reductions in Arkansas until the public health emergency ends. CMS has stated that its review process is not complete and it is awaiting information from the Arkansas Department of Health and Human Services…CMS recently approved a state plan amendment to allow bonus pay from state funds to front-line workers during the COVID-19 pandemic. The SPA includes workers in nursing facilities, home health agencies and personal care agencies, but did not include respiratory therapists, ATPs and other direct care workers delivering DME in the home. AAHomecare has sent a letter to Arkansas Gov. Asa Hutchinson asking that they be included…Georgia Medicaid reversed its plan to reduce reimbursement for oxygen concentrators to $70, instead agreeing to increase it to $104, after discussions with GAMES and AAHomecare…Washington state has backed off a proposal to discontinue Medicaid coverage for standing frames for adults age 21 and older. The state had based the policy change on an internal study that was not supported by the clinical community.

NCPA applauds PPP loan extension

ALEXANDRIA, Va. – The National Community Pharmacists Association says allowing small businesses up to two years to qualify for loan forgiveness under the Paycheck Protection Program is a victory for local pharmacies. The Senate passed the measure June 3. The Paycheck Protection Program Flexibility Act extends the term for the forgiveness of emergency loans to 24 weeks (originally 8 weeks), or until the end of the calendar year. It allows for five years to repay any money owed, and it reduces the amount that must be used for payroll from 75% to 60%. “The original law was designed to get small businesses through the initial economic shock,” said B. Douglas Hoey, NCPA CEO. “It’s clear that the economy will take much longer to recover, so extending the PPP is very important. Local pharmacies are being battered by COVID-19’s impact on the economy. They are critical to the country’s health care infrastructure during normal times and during national emergencies.” A recent NCPA survey showed that 96% of independent pharmacies applied for a PPP loan.

NSM prioritizes client safety with new initiative

NASHVILLE, Tenn. – National Seating & Mobility is committed to “Serving Safely” as it kicks off National Safety Month. The company prioritizes the health and safety of its clients and incorporates additional guidance into existing protocols that are part of its Joint Commission accreditation. “In this time of uncertainty, it is more important than ever to reinforce our commitment so those we serve can have full confidence in the industry,” said Bill Mixon, NSM CEO. NSM backs its safety with an operational checklist of best practices, alternate service options and new technologies. The company is introducing a “Serving Safely” seal and launch kits, including internal and external signage, informational posters and vehicle magnets. Additional marketing resources will be distributed to NSM branches nationwide.

Pandemic impacts patient volume, survey says

NEW YORK – Respondents report, on average, a 4.1% decline in their sleep resupply business due to the COVID-19 pandemic in the “2Q20 HME Oxygen, Sleep and Complex Rehab Survey by Needham and HME News.” 

Respondents saw their sleep patient volume increase by 5.5% in the last 12 months before the pandemic and expect their volume to grow by 5% over the next 12 months.

“Both of these growth rates are lower than our prior survey results of 15% and 15.3%, respectively,” writes analyst Mike Matson.

Respondents expect ResMed’s share of flow generator purchases to decrease 2.4% and its share of mask purchases to decrease by 2.9%.

Oxygen & POCs

Respondents report their oxygen patient volume increased 3.4% in the last 12 months before the pandemic and expect their volume to grow 3.9% in the next 12 months.

“Both of these growth rates are slightly higher than our prior survey results of 2.7% and 3.7%, respectively,” writes Matson.

However, respondents expect only 3.5% growth in POC purchases over the next 12 months, down from 11.3% in the prior survey.

Respondents rated Applied Home Healthcare’s OxyGo as the highest rated POC (5.1 out of 7), followed by Applied Healthcare’s OxyGo Fit.

Complex rehab

Respondents rated Quantum Rehab/Pride Mobility the highest rated power wheelchairs (6.7 out of 7), followed by Permobil (6), Sunrise (5.9) and Invacare (4.8).

However, they expect Invacare’s share of power wheelchair purchases to increase by 0.3% over the next 12 months.

Business changes due to COVID-19 will ‘outlast disease,’ survey says

ALEXANDRIA, Va. – Sixty one percent of community pharmacists expect to offer point-of-care testing for various illnesses, including COVID-19 when it becomes available, according to a new survey from the National Community Pharmacists Association. Nearly three-quarters of respondents said they didn’t offer this testing prior to the pandemic. “Pharmacies have adapted to the crisis in ways that may outlast the disease,” said Brian Caswell, president of the NCPA and owner of Wolkar Drug. Many of the operational changes that pharmacies have adopted in response to the pandemic will also last, the NCPA found. Sixty one percent of respondents say consumer demand for online products will remain high even after the pandemic abates, and 82% say they plan to continue home delivery and curbside service. “Our pharmacy, like most local pharmacies, offered same-day delivery before the pandemic,” Caswell said. “We doubled our delivery service and started curbside service to keep our patients and employees safe. Most local pharmacists think those are services that consumers will value after the national emergency fades.” Another finding: Almost 40% of respondents believe telehealth will expand.

BOC offers three certification exams online

OWINGS MILLS, Md. – The Board of Certification/Accreditation has launched a new remote proctored testing option, allowing candidates to complete their exams online and earn certification. Delivered by BOC test partner PSI, the remote proctored testing option allows candidates to take their orthotic fitter (COF), mastectomy fitter (CMF) or DME specialist (CDME) certification exams from a location of their choice. “Live, remote proctored testing gives candidates the opportunity to take exams conveniently from their homes or offices,” said Matthew Gruskin, BOC’s credentialing director. “This is a great option for certification candidates who cannot access an open testing location or who wish to minimize potential exposure to COVID-19.” To take a remote proctored exam, candidates should select “remote online proctored exam” when scheduling their appointment on PSI’s website. Candidates must meet PSI’s requirements, which include having a laptop or desktop computer with a webcam, microphone, speakers and a stable broadband Internet connection.

REHACARE2020 pushed to 2021

CHICAGO – Messe Dusseldorf has pushed REHACARE2020 to Oct. 6-9, 2021, in Dusseldorf, Germany. “We are constantly adapting our pre-existing high-level safety and hygiene standards,” said Werner Dornscheidt, president and CEO of Messe Dusseldorf. “Despite the announcement to make trade fairs and specialist congresses possible again by May 31, 2020, we have decided to postpone REHACARE until 2021 due to its specific demographic.” The event offers exhibitors and private visitors the opportunity to exchange information on all topics relating to life with disabilities and old age. Last year, 36% of visitors were end consumers, the majority of whom were people with disabilities suffering from chronic diseases. therapie DUSSELFORF, a trade fair for therapy and medical rehabilitation scheduled to take place Sept. 25-26 concurrently with REHACARE will take place virtually.

Travis Medical doubles down on Texas

AUSTIN, Texas – Travis Medical has combined operations with Allumed, positioning the regional complex rehab provider to provide additional services from Dallas and Temple, Texas.

“We are focused on the highest level of expertise and exceptional customer experience to individuals with complex rehabilitation needs,” said Chris Yule, CEO of Travis Medical. “Our goal is to positively affect the lives of the community we serve every day. On behalf of the entire Travis team, we welcome the Allumed team and will continue our longstanding commitment of treating our employees as part of the family.”

Travis Medical provides complex rehab services across Texas and seven other states.

Luis Crespo will lead operations for Temple, Texas-based Allumed, as the founders transition into retirement.

“We are very excited to combine the business with that of Travis Medical,” he said. “We look forward to additional opportunities and to continuing to grow Travis Medical.”

Financial Advisory Partners, a Des Moines, Iowa-based investment banking firm, served as exclusive advisor to Travis Medical on the transaction.

Last year, Travis Medical merged with American Seating & Mobility, expanding its reach to the Pacific Northwest.

Invacare completes private exchange to retire $73.9M in convertible senior notes

ELYRIA, Ohio – Invacare has completed its separate, private negotiated exchange transactions with certain shareholders of its 5% convertible senior notes due 2021 and certain holders of its 4.5% convertible senior notes due 2022 to exchange about $35.4 million in aggregate principal amount of 2021 notes and $38.5 million in aggregate principal amount of 2022 notes, for aggregate consideration of about $73.9 million in aggregate principal amount of 5% Series II Convertible Senior Exchange Notes due 2024. Exchanging holders of the 2021 notes received an equal principal amount of new notes, plus an amount of cash equal to the accrued and unpaid interest on the exchanged 2021 notes up to, but excluding the closing date and about $4.2 million in cash. Exchanging holders of the 2022 notes received an equal principal amount of new notes, plus an amount of cash equal to the accrued and unpaid interest on the exchanged 2022 notes up to, but excluding the closing date and about $1.3 million in cash. Following the closing of these transactions, $25.7 million in aggregate principal amount of the 2021 notes and $81.5 million in aggregate principal amount of the 2022 notes will remain outstanding with terms unchanged. The exchange is expected to close June 4, 2020, subject to customary closing conditions.

Jason Morin tapped to lead HOMES

NEW BEDFORD, Mass. – HOMES has named Jason Morin, most recently of Home Care Specialists in Haverhill, Mass., as its new president and CEO. Morin, who replaces the late Karyn Estrella, has 23 years of experience in the HME industry. He is the current chairman of the AAHomecare Payers Relations Council and past chairman of HOMES. He is also a registered respiratory therapist and holds an MBA. In the coming months, Lauryn Estrella, interim director, will work with Morin to align skills and responsibilities. Robbin Eusebio, who rejoined HOMES last summer, will also be available in the short term, as the association determines its needs going forward.

Survey collects trends, patterns

WATERLOO, Iowa – VGM & Associates and HME News have launched the 14th annual HME Financial Benchmarking Survey. The two groups have partnered to bring to the industry a single survey for providers to share their business data for benchmarking purposes. “While yearly survey results provide a ‘snapshot’ of the current state of the industry, more importantly, we are able to observe trends and patterns, which are so valuable to those in the industry considering potential growth opportunities and perhaps a change in direction,” said Mark Higley, vice president, regulatory affairs for VGM Government. “This valuable information provides a baseline to measure and establish benchmarks from which to compare results.” The deadline to complete the survey is July 15. The results will be available for free to participating providers, and will be presented and analyzed during the virtual HME News Business Summit in September.

NCPA issues statement on looting

ALEXANDRIA, Va. – The National Community Pharmacists Association has received reports of pharmacies being damaged and looted in rioting, and is imploring local officials to protect neighborhood businesses. In a statement, the NCPA said: “We understand the protests and agree with the goals. We and our members are appalled by the horrific injustice that took place in Minneapolis and in other communities throughout the country, and we pray for justice and healing. The destruction and robbery of local businesses advances neither. We implore local officials to do more to protect local businesses from the rioting.” Communities left without local pharmacies will lose critical health care access, says the NCPA.

VGM releases three post-PHE business guides

WATERLOO, Iowa – VGM & Associates has released three new resources for its members: “VGM Playbook: Technology and the Patient Care Continuum”; “Technology and the Patient Care Continuum Guide to Remote Work”; and “VGM’s Next Steps: A blueprint guide to preparing your business for the new environment.” “We are so excited to share these latest educational resources with out members,” said Clint Geffert, president of VGM & Associates. “Our experts have worked diligently to provide members with the best information possible in order to help their business adjust to this new environment.” Members can download their copy at or by logging into the VGM members-only portal and downloading them from the Playbook tab.