In brief: Vent bill drops in House, hospitals slam bid program

Friday, September 16, 2016

WASHINGTON – The House of Representatives has followed the Senate and introduced a bill last week that would increase Medicare reimbursement for ventilators by 20% on Jan. 1, 2017.

H.R. 6012, known as the BREATH Act, would also establish policies and standards for determining appropriate use for ventilators.

The bills are in response to CMS’s decision late last year to reduce the number of codes for ventilators from five to two, and to reduce reimbursement by about 33%. The agency has been concerned with the drastic increase in the number of Medicare beneficiaries using ventilators—from 60,000 in 2010 to 178,000 in 2014.

The House bill was introduced by Rep. Larry Bucshon, R-Ind., on Sept. 13.

A similar bill in the Senate was introduced by Sens. Bill Cassidy, D-La., and Chuck Grassley, R-Iowa, in July.

Hospitals slam bid program

YARMOUTH, Maine – The VGM Group reported last week that administrators from more than 17 hospitals have sent letters to lawmakers in Washington, D.C., expressing their concerns about the lack of access to HME due to reduced reimbursement. VGM has created a map of the hospitals that have take action. “This is an ongoing campaign,” it stated in a bulletin. “Please continue to encourage your contacts at hospitals to reach out to their legislators.” AAHomecare reported last week that The University of California Health System has urged CMS to carefully evaluate the impacts of its competitive bidding program, saying that hospitals within its system continue to see significant problems obtaining DME. The comments were made in response to CMS’s latest rules proposal covering the bidding program (CMS 1651-P). The health system noted that many winning bidders have actually dropped out of the program, creating delays in patient discharges and forcing some patients to purchase items that should have been covered by Medicare.

Medicaid fraud unit secures millions in recoveries

WASHINGTON – Medicaid Fraud Control Units in 2015 obtained 1,553 criminal convictions and 731 civil settlements and judgments for provider fraud and patient abuse and neglect, according to a new report from the Office of Inspector General. Criminal recoveries were nearly $350 million, while civil recoveries reached nearly $395 million, the report states. Of those numbers, DMEPOS providers accounted for 33 criminal convictions with $12.7 million in recoveries; and 30 civil settlements and judgments with nearly $4.3 million in recoveries. Overall, fraud cases accounted for 71% of convictions, with almost half of those involving unlicensed providers, including personal care attendants and homecare aids. The number of civil settlements and judgments decreased from 908 in fiscal year 2011 to 731 in fiscal year 2015, according to the report.

CMS finalizes emergency preparedness requirements

WASHINGTON – CMS has finalized a rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid. The rule also aims to increase patient safety during emergencies and to establish a more coordinated response to natural and man-made disasters. The rule, which will be published in the Federal Register Sept. 16, requires providers to meet four common and well-known industry best practices: 1.) based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of  provider; 2.) develop and implement policies and procedures based on the plan and risk assessment; 3.) develop and maintain a communication plan that complies with both federal and state law; and 4.) develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual incident that tests the plan. The rule goes into effect Nov. 15, 2016, but providers don’t have to comply with the rule until Nov. 15, 2017.

NHIA responds to OIG report on infusion payments

ALEXANDRIA, Va. – A recent Office of Inspector General report on payment for Part B DME infusion drugs is far too narrow to be the basis for new policy, according to the National Home Infusion Association. The OIG’s report recommends that CMS seek a legislative change that would require payments for DME infusion drugs to be based on average sales prices (ASPs), average wholesales prices from 2003. The NHIA argues, however, that Congress should “fix” the payment issue by passing the Medicare Home Infusion Site of Care Act, a bill that would require CMS to pay for home infusion services and related supplies under Medicare Part B. The NHIA also took issue with the OIG’s claims that home infusion providers are improperly driving over-utilization of one infusion drug, milrinone lactate. The association says providers fill prescriptions for the drug only at the direction of referring physicians.

Hospital readmissions on the decline, says CMS

WASHINGTON – CMS says the Hospital Readmissions Reduction program, which adjusts payments for hospitals with higher than expected 30-day readmission rates for targeted clinical conditions, and the Partnership for Patients program, which aims to decrease preventable complications during a transition from one care setting to another, are working. As a result of the programs, readmission rates have fallen by more than 5% in 43 states and more than 10% in 11 states, according to CMS’s newly released data. “Across states, Medicare beneficiaries avoided almost 104,000 readmissions in 2015 alone, compared to if readmission rates had stayed constant at 2010 levels,” wrote Patrick Conway, principal deputy administrator and chief medical officer, CMS, in a recent blog post. “Since 2010, the HHS Assistant Secretary for Planning and Evaluation estimates that Medicare beneficiaries have avoided 565,000 readmissions.”

Home I.V. Solutions provides $50,000 endowment

JONESBORO, Ark. – Home I.V. Solutions has created an endowed educational fund at Arkansas State University with a gift of $50,000. The Dean’s Excellence Fund will strengthen programs, faculty and facility for students in the College of Nursing and Health, according to a local news report. “The medical communities that have supported Home I.V. Specialists for 25 years greatly benefit from the exceptional education and training that students receive from A-State,” said Brandi Melton, vice president of Home I.V. Specialists. Home I.V. Specialists provides specialty pharmacy, home infusion, enteral and parenteral nutrition, and home medical equipment throughout Arkansas and southern Missouri.

Invacare sees stock movement

ELYRIA, Ohio – Invacare recently lost one investor, but gained two. Linden Advisors sold all of its stake in Invacare during the most recent quarter, according to a disclosure report filed with the Securities and Exchange Commission. It sold 48,554 shares of company stock valued at $604,497. Other hedge funds, including Gotham Asset Management, have sold their stakes in Invacare during the most recent quarter. On the flip side, Alphaone Investment Services bought 54,253 additional shares of Invacare stock in the most recent quarter, according to a report filed with the SEC. It now has a total of 341,253 shares valued at $4.2 million. Pure Vida Investments has also increased its stake in Invacare, buying an additional 67,500 shares, according to a report filed with the SEC. It now has a total of 292,500 shares valued at $3.6 million. Invacare updated investors on the transformation of its business at investor conferences last week.

FODAC seeks donations for relief efforts

ATLANTA – Friends of Disabled Adults and Children (FODAC) will collect DME and supplies at Medtrade to support disaster relief efforts in Louisiana. FODAC will work with its local contacts, particularly those in Baton Rouge and Livingston parishes, two of the worst-hit areas, to contribute the DME and supplies, as well as funding. FODAC asks manufacturers who are attending Medtrade, Oct. 31-Nov. 3 at the Georgia World Congress Center in Atlanta, to make contributions.

Register now for reduced rate
ATLANTA – Early registration for Medtrade ends at midnight on Saturday, Sept. 24. After that date, the $25 expo fee increases to $50, and the $99 conference/education session rate increases to $199. “Even without the early rates, it is a tremendous value,” said Kevin Gaffney, group show director. “However, if you want to get in on this incredible early rate, sign up before Sept. 24 ends.” Medtrade takes place Oct. 31-Nov. 3 at the Georgia World Congress Center in Atlanta.

Short Takes

Health Martwas ranked highest overall in customer satisfaction among chain drug pharmacies across the U.S. in the J.D. Power 2016 Pharmacy Satisfaction Study. The study measures customer satisfaction with pharmacies in four segments: mail order, chain drug stores, supermarkets and mass merchandisers…Shield HealthCare has relocated its Dallas operations and distribution to a larger facility in Carrollton, Texas. The new 52,000-square-foot facility will house 125 home medical supply experts, as well as a customer care center and distribution facility…Universal Power Group, a supplier of absorbent glass mat and gel batteries and chargers, has hired Bret Tracy as director of business development. Tracy recently launched Vita Mobility Werks, a start-up scooter importer, and previously worked at MK Battery and Pride Mobility…Long-time industry expert Louis Feuer has made available his first online series of courses and lectures. Leuer, president of Dynamic Seminars, now offers four courses and 18 lectures on how to build revenues through top-notch customer service…The Accreditation Commission for Health Care (ACHC) has a new partnership with the Florida Alliance of Home Care Services (FAHCS). The partnership allows FAHCS members to receive special pricing on ACHC’s accreditation services, as well as discounts on Accreditation University educational resources.

People: Zacharias, Hizzey

Claudia Zacharias, president and CEO of the Board of Certification/Accreditation, is a 2016 Circle of Excellence Award finalist by Baltimore SmartCEO. Under her watch, BOC has seen its revenue increase nearly 50%. In August, The Daily Record named her one of Maryland’s 2016 Most Admired CEOs … Duncan Hizzey has been named vice president of rehab services at Bellevue Healthcare. Hizzey, an ATP, has extensive industry experience. In his new role, he will help further develop the Bellevue, Wash.-based provider’s complex rehab team.