In brief: VGM tallies costs by region, Option Care debuts in Louisiana

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Thursday, August 9, 2018

WATERLOO, Iowa – The VGM Group has released the results of a “Delivery Cost Survey” that puts into perspective how costly it is for HME providers to provide patients with the necessary equipment.

In New England, for example, providers report that it costs them $22.43 in vehicle costs per delivery and $18 in labor costs per hour, according to the survey. When you take into account the 23.33 miles from business to home and the 31.67 minutes it takes for in-home set up, that’s an average total delivery cost of $67, the report says.

“With the DME industry being a high-touch healthcare service, understanding the costs involved in caring for beneficiaries must be taken into account when determining reimbursement rates,” VGM stated in a bulletin.

VGM has calculated costs for seven other regions: Far West, Great Lakes, Mideast, Southeast, Plains, Rocky Mountain and Southwest.

More than 200 independent providers completed the survey.

CMS issues guidance on national PA program

WASHINGTON – CMS has published guidance for power mobility device providers on the transition to the national prior authorization program. “Inclusion of Power Mobility Device Codes in the Prior Authorization Program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items” lists all the HCPCS codes that will be included in the program starting Sept. 1, according to a bulletin from AAHomecare. For states not currently in the demonstration, the MACs will start accepting prior auth requests Aug. 18. For the 19 states currently in the demonstration, MACs will no longer accept prior auth requests for items that will not be part of the national program.

BioScrip sees improvements

DENVER – BioScrip reported net revenues of $175.8 million for the second quarter of 2018 compared to $168.6 million for the same period last year. Net loss from continuing operations was $15.1 million, a $14 million improvement. Adjusted EBITDA was $11.4 million, a 14% increase, driven in part by a $3 million reduction in operating expenses, reflecting ASC 606 pro forma adjustments. “We remain increasingly confident that BioScrip can achieve at least $75 million in adjusted EBITDA in 2019 and are positioning the company for revitalized longer-term revenue growth and enhanced profitability through key initiatives in sales force productivity, revenue cycle management, procurement and managed care relationships,” said CEO Dan Greenleaf in a press release.

Option Care debuts in Louisiana

NEW ORLEANS – Option Care has opened its first care management center in Louisiana, the home infusion provider announced Aug. 7. The center opened June 11 in Elmwood. Through the center, Option Care’s team of clinicians, nurses, pharmacists, techs and dieticians can now deliver home and alternative site infusion services to patients who rely on infusion therapies for a variety of conditions, including infectious diseases, and nutritional and gastrointestinal disorders. The company says its team of 1,800 are able to provide home infusion services coverage for nearly all patients across the United States.

CMS to pay more for CPAP alternative

MINNETONKA, Minn. – An alternative to CPAP therapy has been approved by CMS for a new technology add-on payment to hospitals. The NTAP program will provide additional reimbursement on top of the standard Medicare Severity Diagnosis Related Group payment to hospitals under the Medicare Hospital Inpatient Prospective System for Respicardia’s remedēSystem, an implantable device that treats the effects of central sleep apnea by restoring a more normal breathing patter during sleep. The add-on payment goes into effect Oct. 1. The NTAP program recognizes innovative medical technologies that substantially improve the diagnosis or treatment of Medicare beneficiaries.

Circadiance secures two more patents

PITTSBURGH – Circadiance has received two additional patents for its SleepWeaver line of soft cloth CPAP masks. The U.S. Patent and Trademark Office has granted a patent titled “Full Face Cloth Respiratory Mask” to Circadiance covering certain features of the SleepWeaver Anew Soft Cloth Full Face CPAP Mask and the United Kingdom Patent Office has granted a patent titled “Improved Respiratory Mask with Disposable Cloth Body” covering certain features of the SleepWeaver Elan Soft Cloth CPAP Mask. “These patents provide further validation of the novelty of our CPAP mask solutions,” said David Groll, founder and CEO of Circadiance. Circadiance now holds nine U.S. and international patents around its cloth mask technology. In addition to its SleepWeaver line, Circadiance offers the Smart Monitor infant apnea monitors and the NeoPAP neonatal CPAP and high flow respiratory support system.

People News: Merits

Cape Coral, Fla.-based Merits Health Products has named Joe McKnight as its western regional sales manager. McKnight has worked for, managed and owned companies in complex rehab technology, DME, and other medical products and services industries since 1977. He currently serves as a board member of NRRTS; is a special interest group co-chair for seating and wheeled mobility for RESNA; and holds other board positions, including positions with the Muscular Dystrophy Association and the ALS Association.