In brief: Report raises concerns, court pressures HHS
WASHINGTON – Lawmakers should heed the findings of a new report that raises concerns about the roll out of competitive bidding rates nationwide, says The Council for Quality Respiratory Care.
The report, published by The Moran Company, highlights several “deficiencies” with the program, including: use of non-binding bids; use of the median bid to calculate payment amounts; and use of composite bids, which it says incentivizes bidders to “game the system” by bidding low for some products and high for others.
“Given the problems with the competitive biding program outlined in this report, doubt has been cast on the validity of the pricing information the program has produced,” said The Moran Company. “Applying this information nationwide, to non-competitively bid areas, could lead to unsustainable reimbursement levels.”
“State of Expert Judgment Regarding Medicare’s Competitive Bidding Program for Durable Medical Equipment” looks at the history and intent of the program, its implementation, and the problems that result when bid pricing is used to develop reimbursement amounts for home respiratory care supplies and services, and other DME.
The report underscores the need for legislation to roll back a second round of cuts that took effect July 1, says CQRC Chairman Dan Starck.
“It’s time for Congress to pass this legislation before patient care coordination and care management services are jeopardized,” he said.
AAHomecare releases latest Audit Key results
WASHINGTON – The average percent of DME MAC prepayment audits denied nationwide increased 6% between Q4 2015 and Q2 2016, according to the latest results from AAHomecare’s HME Audit Key survey.
Other results from the survey, all for the second quarter of 2016:
· 36% of hospital beds, support surfaces and manual wheelchair new patients were subject to MAC prepayment audit.
· 72% of completed MAC prepayment audits nationwide were paid upon review.
· The supplier appeal rate for MAC prepayment denials decreased 10% nationwide between Q1 and Q2 of 2016.
· 51% of completed appeal determinations for respiratory products favored providers.
AAH last reported results for the survey in July.
The association asks that more and more providers participate in the survey, regardless of the number of audits they’re receiving.
“With wider participation, we will be able to make a better case to policymakers for much needed audit reform measures, as well as increasing the value of the data for industry benchmarking purposes,” the associate said.
The next round of data submission for the HME Audit Key survey opens Oct. 15.
Court pressures HHS over audit backlog
WASHINGTON – A federal court has ordered the U.S. Department of Health and Human Services to solve the backlog at the Administrative Law Judge level, according to an update from The VGM Group. In a decision handed down Sept. 19, the court denied HHS’s request to put litigation with the American Hospital Association on hold until Sept. 30, 2017. “Between fiscal years 2010 and 2014, the number of appeals filed at step three grew 936%, from 41,733 to 423,534,” noted the D.C. court. “Because of the consequent financial burden, some providers are ‘forced…to reduce costs, eliminate jobs, forgo services, and substantially scale back,’ all of which affects the quality and quantity of patient care.” While ordering HHS to resolve each pending appeal by the prescribed deadlines was described as “wishful thinking” by the court, VGM called the ruling “a great win for the health care industry.”
DASCO named Best HME Provider
CHARLESTON, S.C. – DASCO Home Medical Equipment of Westerville, Ohio, took home the 2016 HME Excellence Award for Best HME Provider at the HME News Business Summit on Sept. 19.
Carolina’s Home Medical Equipment of Matthews, N.C., took home second place; and Professional Respiratory & Rehab Medical Equipment & Supplies of Chattanooga, Tenn., took home third place.
Profiles of all of the award winners will appear in the Show Dailies distributed at Medtrade, Oct. 31 to Nov. 3, at the Georgia World Congress Center in Atlanta. They will also appear in future issues of HME News.
This year’s judges were Miriam Lieber and Anna McDevitt, both independent consultants; and Jonathan Sadock, managing partner and CEO of Paragon Ventures.
The judges evaluated provider performance in the following categories: financial, community involvement, staffing and quality control.
For more information on the HME Excellence Awards, go to http://hmeexcellenceawards.com/index.php.
Drive DeVilbiss expands e-commerce retail program
PORT WASHINGTON, N.Y. – Drive DeVilbiss Healthcare is expanding its Authorized E-commerce Retailer Program to online retailers in Canada. The program directs consumer traffic to a provider’s website through a web link and offers the opportunity to be featured on the Drive DeVilbiss Healthcare website. “Drive DeVilbiss introduced the program in the United States more than 5 years ago, and customers have thrived on the simplicity of the program, helping to grow their business online,” said Seth Diamond, vice president of the company’s commerce division.
Brightree gets connected at Medtrade
ATLANTA – Brightree will hold its Brightree Summit, which will have the theme “Get Connected!,” on Oct. 31 at the Georgia World Congress Center in Atlanta, in conjunction with Medtrade. The Summit will focus on interoperability—the key, Brightree says, to sharing data across the care continuum for greater coordination. The Summit will overlap with the first day of Medtrade’s education conference sessions, allowing attendees to best use their time and travel budgets to attend both events. “The Summit is the perfect place for our customers to engage with industry leaders and their peers, and learn how to enhance operations and efficiency,” said Brightree CEO Matt Mellott, who will deliver the keynote, in a release.
Allegiance ignites possibilities
OVERLAND PARK, Kan. – The Allegiance Group, also known as A/R Allegiance Group, has a fresh look and purpose. As part of a rebranding effort, the company, which offers private-pay patient billing and collections, completed interviews, surveys and focus groups to determine its focus. What it found? A re-commitment to focus on purpose, it says. As a result, the company has a new logo, and an enhanced brand anthem and brand purpose that emphasize Allegiance’s role as a “spark that ignites possibilities.”
Collins Medical Equipment celebrates 85 years
FAIRFIELD, Conn. – Collins Medical Equipment celebrated 85 years in business with a grand re-opening ceremony Sept. 23. The family owned and operated business started as Collins Pharmacy in 1931. It added home medical equipment in the mid-70s. Collins sold its prescription department to CVS in 2002, and focused on HME and supplies. It launched a new division, “Collins Accessibility Solutions,” in 2010. Four generations of Collins managing the business today: Jack Collins, president; Chris Collins, general manager, who is celebrating 30 years; Tom Collins IV, finance; and Bryan Collins, sales and marketing.
AvaCare helps seniors fundraise
LAKEWOOD, N.J. – AvaCare Medical has partnered with GoFundMe to help seniors, disabled individual and their caregivers raise money for medical equipment and supplies. Anyone who needs assistance purchasing products from AvaCare’s website can start a GoFundMe campaign; the provider will kick in the last 10% toward a purchase. AvaCare recently launched a veterans initiative to offer 10% discounts to all active, reserve or retired U.S. veterans and their families.
VGM runs up to Woman of the Year award
WATERLOO, Iowa – The VGM Group has announced the members of its HME Woman of the Year Honorary Selection Committee. They are Andrea Walsh, executive vice president and chief marketing officer with HealthPartners; John Frank, CEO of Philips Respironics’ Sleep and Respiratory Care Business; Liz Beaulieu, editor for HME News; and Tanya Warren, head coach of the University of Northern Iowa women’s basketball team. The committee received 37 nominations for the award. Committee members will narrow the number of nominees down and VGM will select the winner. The HME Woman of the Year will be announced Nov. 1 at Medtrade.
ITC to investigate Fisher & Paykel
AUCKLAND, New Zealand – The International Trade Commission plans to investigate certain sleep apnea devices manufactured by Fisher & Paykel, it announced Sept. 19. The investigation is in response to a complaint filed by ResMed in August that seeks to ban imports of the Simplus full face mask, Eson nasal mask and Eson 2 nasal mask, which it says infringe on various ResMed patents. That complaint came after Fisher & Paykel filed patent infringement proceedings against ResMed, saying that ResMed’s AirSense 10 and AirCurve10 range of flow generator products, its ClimateLineAir heated air tubing and its Swift LT and FX masks infringe patents that it holds.
Study: OSA common in Type 1 diabetics
YARMOUTH, Maine – Obstructive sleep apnea is common in people with Type 1 diabetes, especially those who have had the disease for a long time, says a study reported on Medscape.com. The incidence of sleep apnea is linked to abnormal glycemia and microvascular complications, but not obesity. Sleep apnea was also associated with higher rates of complications, including retinopathy. The link between Type 1 diabetes and OSA has been reported in several previous studies, but this study is the first to use both continuous glucose monitoring and sleep studies.
Short takes: Wilpage, Option Care
Wilpage, a provider of home medical equipment in the New York metro area, has purchased Mediware’s CareTend software to boost its growing business. Wilpage says the cloud-based system will allow it to spend less time managing technology and more time taking care of patients…Option Care, a national provider of home infusion services, is now a contract provider of Exondys 51 (eteplirsen), the first drug therapy specifically for the treatment of Duchenne Muscular Dystrophy.