In brief: President touts bidding, Brightree seeks buyer
WASHINGTON – The president’s proposed federal budget for fiscal year 2017 includes a provision to expand Medicare’s competitive bidding to new product categories.
The budget proposes that inhalation drugs; all prosthetics and orthotics; and ostomy, tracheostomy and urological supplies, all be included in the program.
“Since implementation, the competitive bidding program for durable medical equipment, prosthetics, and supplies has saved the Medicare program and beneficiaries billions of dollars by aligning payment amounts with market-based prices,” the budget states.
Expanding competitive bidding to these additional product categories would save $3.8 billion over 10 years, the budget states.
The budget also proposes eliminating the 36-month cap for oxygen equipment and, instead, reducing the monthly payment amount for oxygen and oxygen equipment by the necessary percentage to be budget neutral, according to AAHomecare’s analysis.
Another provision in the budget: Extend the authority to require prior authorization to all Medicare fee-for-service items and services, particularly those that are at the highest risk for improper payment. This would save $75 million in 10 years, the budget states.
A number of provisions in the budget are related to the Medicare appeals process, according to AAHomecare. They include:
· Provide Office of Medicare Hearings and Appeals and Departmental Appeals Board Authority to use Recovery Audit Contractor collections.
· Establish a refundable filing fee.
· Establish magistrate adjudication for claims with amount in controversy below new administrative law judge amount in controversy threshold.
· Expedite procedures for claims with no material face in dispute.
· Increase minimum amount in controversy for administrative law judge adjudication of claims to equal amount required for judicial review.
· Remand appeals to the redetermination level with the introduction of new evidence.
· Sample and consolidate similar claims for administrative efficiency.
Brightree seeks buyer?
ATLANTA – Brightree has retained William Blair & Co. to explore a sale of the company, according to VentureWire.
Brightree, which in 2008 secured a significant investment from Battery Ventures, a Boston-based private equity firm, is attracting interest from a variety of buyers, including financial sponsors, according to the news agency, which is part of the Dow Jones family.
Brightree gave management presentations to prospective buyers before Thanksgiving, VentureWire reports.
Since Battery Ventures came onto the scene, Brightree has significantly expanded its foothold not only in the HME industry but the post-acute care market at large, mostly by acquisition. Brightree acquired CareAnywhere in 2013, Pacware in 2011, CAU in 2010 and C&S Billing in 2008.
Brightree also acquired Strategic AR in 2014, a provider of private-pay billing and collections solutions.
A sale of Brightree could pull in at least $450 million to $600 million, based on the company’s $45 million to $50 million of EBITDA, with multiples in the healthcare IT space running at least 10 to 12 times EBITDA, according to VentureWire.
NSM picks up complex rehab biz
NASHVILLE – National Seating & Mobility has expanded in eastern Pennsylvania with the acquisition of the complex rehab division of Webb Medical Systems. Short-term, NSM will continue operating out of the existing Webb Medical Systems locations in Reading and Allentown, Pa., according to a press release. Christopher Kritzer, ATP, will lead the Reading office, and Sarah Adams, ATP, will lead the Allentown office. Webb Medical Systems, which has provided complex rehab products and services for 30 years, will continue to expand its offerings in respiratory, HME and home accessibility, according to the release. “Sharon and I have long known and admired the reputation of NSM,” stated Richard Webb, owner of Webb Medical Systems. “Their mission and ours are so closely aligned that they were our only choice to continue the tradition.”
Providers lobby House Speaker
JANESVILLE, Wis. – The VGM Group and Mercy Health System hosted House Speaker Paul Ryan to discuss the challenges faced by the HME industry. Multiple health providers across the state, including Mercy Assisted Care DME, Agnesian Health, Home Health United, Home Care Medical, Home Care Pharmacy, Oxygen One and Knueppel Healthcare Services, asked for Ryan’s support of a payment freeze of the current rates in regional and rural areas. “Mr. Ryan agreed that the bidding program is a real problem and wants to be helpful where he can so DME suppliers can continue to serve those who need these services,” said Tom Powers, director of government relations for VGM & Associates.
Juzo opens office in Canada
CUYAHOGA FALLS, Ohio – Juzo has opened Juzo Canada in Burlington, Ontario, the manufacturer of compression garments has announced. Juzo has hired Byron MacPhee as sales director to lead the Juzo Canada sales force. He has nearly 15 years of experience in compression therapy and sales management. Prior to joining Juzo, MacPhee was vice president of sales for Sigvaris. Since opening, Juzo Canada has launched a website that includes a dealer locator; added two territory managers; launched Shop Juzo, an online product offering platform for authorized dealers; implemented credit card processing; and formed a dedicated support channel to field questions about product orders.
BMC wins action against ResMed
BEJING – BMC Medical has won a global patent infringement litigation action against ResMed, it has announced. The U.S. Patent and Trademark Office issued a series of judgments in connection with inter partes review of U.S. Patent No. RE44453 on Jan. 21, 2016, and found 32 claims invalid, the company says. “We have now built a powerful patent team to support our strong resources in research and development,” stated Denny Wu, BMC’s head of intellectual property department. “In less than three years, we have applied for hundreds of patents and now we are able to proactively protect our rights and interests.”
Short takes: QS/1, BraunAbility, RESNA
QS/1has received certification under the latest Payment Application Data Security Standard version 3.1, used to ensure safety through payment applications. To be certified, point-of-sale vendors must develop a secure payment application that does not allow storage of prohibited information, such as magnetic stripe, CVV or PIN data, and adhere to all the industry mandates for the secure handling of credit card data…BraunAbility has joined forces with Ford to create BraunAbility MXV, a wheelchair-accessible SUV. The SUV features patented sliding-door technology, removable driver and passenger seats, and a powered, lighted in-floor ramp…RESNA is now accepting innovative assistive technology designs for the 2016 RESNA Student Design Competition. Up to six semi-finalist teams will win a trip for two team members to attend the RESNA Annual Conference, July 10-14 in Arlington, Va, for final judging. The final deadline for submission is April 11.
People news: Vantage Home Medical Equipment, GF
Meadville, Pa.-based Vantage has appointed Melody Sidor vice president of Vantage Home Medical Equipment and Oxygen. She brings 25 years of experience in health care to the role. She will lead and manage all aspects of Vantage’s HME operations, and will be responsible for all five of the company’s locations in northwest Pennsylvania and Ohio. Most recently, Sidor was director of branch operations…GF Health Products has announced that 23 homecare and medical-surgical sales representatives have earned the “Accredited in Medical Sales” designation administered by the Health Industry Distributors Association. The AMS program consists of 13 scored courses covering topics such as Medicare/Medicaid reimbursement, healthcare trends, and medical products and procedures.