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In brief: Humana MA contracts, Philips CFO, OSA-long COVID connection

In brief: Humana MA contracts, Philips CFO, OSA-long COVID connection

LOUISVILLE, Ky. - Humana has announced agreements with AdaptHealth and Rotech Healthcare to provide home medical equipment services to its Humana Medicare Advantage HMO members. 

The two national companies will begin providing services to these members under a value-based structure beginning July 1, with each serving a specific region of the country. 

“Partnering with national DME partners under a value-based arrangement aligns with our goal to enhance access to the home care services we provide to patients across the country,” said Kirk Allen, senior vice president of Home Solutions at Humana. “We’re excited about the partnerships we’re announcing today because working with these organizations on a national level will help us streamline and simplify our efforts to get Medicare Advantage HMO patients the equipment they require with best-in-class service, while empowering health care providers to more efficiently fulfill their patients’ DME needs. These deeper relationships will also enhance our ability to deploy clinical programs aimed at reducing hospitalizations for our members.” 

Humana says the agreements reflect its commitment to expand value-based care across its continuum of home care services through its onehome subsidiary and its entire Home Solutions business. As part of this commitment, one of the company’s top priorities is to build and rapidly scale a comprehensive value-based home care offering that covers 40% of Humana Medicare Advantage members by 2025. 

Humana says the agreements also exemplify its intent to create a more unified approach to the sourcing of durable medical equipment, resulting in a more coordinated experience for Humana Medicare Advantage HMO members and the physicians and health care professionals who care for them. 

Humana, AdaptHealth and Rotech are in the progress of communicating this transition to Humana Medicare Advantage HME members. AdaptHealth and Rotech will also begin directly contacting members who currently receive DME services to ensure their needs are met once the new contracts take effect. 

The agreements do not apply to Humana Medicare Advantage members enrolled in PPO or private fee-for-service (PFFS) plans, or Humana’s Medicaid, Commercial or TRICARE lines of business. 

Terms of the contracts were not disclosed. 

Signifier, Sunrise partner on sleep diagnostics 

BOSTON and LONDON – Signifier Medical Technologies, a Boston-based med-tech company, has announced a partnership with Sunrise, a health-tech company that offers an easy way to help diagnose sleep apnea from home. Sunrise’s eXciteOSA uses artificial intelligence-powered technology to analyze mandibular jaw movements and other standard apnea signals from a single sensor placed on the chin. “We are excited to partner with Signifier Medical Technologies, starting with the U.K. market, and offer our innovative home sleep test to more patients suffering from OSA,” said Laurent Martinot, CEO of Sunrise. The combination of Sunrise’s technology and Signifier Medical’s patient management portal will enable health care providers to gather comprehensive data on patient day-to-day clinical experiences, while providing tools for them to understand the unique needs of each patient better and optimize outcomes. “We look forward to offering this innovative home sleep test to provide millions of patients suffering from OSA with easier access to diagnostics and personalized treatment,” said Akhil Tripathi, Signifier’s co-founder and CEO. 

APSS to host SLEEP 2023 in Indianapolis 

DARIEN, Ill. – The Associated Professional Sleep Societies will host SLEEP 2023, it’s 37th annual meeting, in Indianapolis June 3-7. More than 4,000 attendees from around the globe are expected to attend the event, which will include an exhibit hall with more than 130 booths displaying the latest products and services from equipment manufacturers and suppliers, pharmaceutical companies, software companies, and medical and scientific publishers. The event will also include invited lectures, symposia, clinical workshops and discussion groups that will explore basic and translational sleep and circadian science, as well as developments in the diagnosis and treatment of sleep disorders, such as obstructive sleep apnea and chronic insomnia. In all, APSS will offer more than 100 sessions and more than 1,000 research abstracts presented in oral and poster formats (including late-breaking abstract presentations), giving attendees the opportunity to enjoy more than 38 hours of continuing education. “The APSS is excited for our program at this year's meeting,” said APSS Program Committee Chair Rebecca Spencer, who has a doctorate in neuroscience. “As the premier clinical and scientific conference in the sleep field, the SLEEP annual meeting enables attendees to immerse themselves in the latest sleep and circadian research, learn about innovations in clinical practice, and network with colleagues from across the country and around the world.” FMI:    

Study: Adults with OSA more likely to have long COVID 

YARMOUTH, Maine - Adults with obstructive sleep apnea were more likely to experience long-term symptoms suggestive of long COVID (75%) than those without the sleep disorder, according to a study supported by the National Institutes of Health (NIH). The findings, part of the NIH’s Researching COVID to Enhance Recovery (RECOVER) Initiative, were published in the journal SLEEP. The EHR data of more than 2.2 million Americans with COVID-19 was studied and suggests close monitoring after a COVID-19 infection for adults with sleep apnea. The findings may also strengthen understanding of why some people are more likely to develop long COVID after acute infection. “We still have a lot to learn about the long-term effects of this virus, but this study could inform clinical care by identifying patients who may benefit from closer monitoring,” said Marishka K. Brown, Ph.D., director of the National Center on Sleep Disorders Research at the National Heart, Lung, and Blood Institute (NHLBI). All participants included in the analysis had tested positive for COVID-19 between March 2020 and February 2022. The researchers also found women had an 89% increased likelihood of having long COVID if they had obstructive sleep apnea, compared to a 59% increased chance for men. The underlying associations aren’t clear; however, women diagnosed with obstructive sleep apnea included in the study may have had more severe conditions than men, according to researchers.  

Foundation Wellness to acquire Currex 

WADSWORTH, Ohio – Foundation Wellness, a manufacturer of insoles and orthotics, has acquired Currex, a leading brand of insoles designed for athletes and active individuals. With the acquisition, Foundation Wellness expands its product offerings and strengthens its position as a top provider of wellness solutions for individuals looking to live active and pain-free lives, it says. "We're thrilled to welcome Currex and its leading brand of performance insoles to the Foundation Wellness family,” said Sean Williams, CEO of Foundation Wellness. “Currex has an impressive following of consumers who rely on their technically advanced insoles, and we believe that they are very complementary with our PowerStep No. 1 podiatrist recommended insole line.” In business for more than 90 years, Foundation Wellness offers wellness solutions and houses popular brands including PowerStep, Foot Petals, Flat Socks and Doctor Hoy's. Bjorn Gustafsson, CEO of Currex, says Foundation Wellness is the “perfect” partner for the company, it shares a commitment to innovation, performance and customer satisfaction. “We are confident that Currex will continue to thrive with this partnership and are proud to have built the brand to where it is today,” he said.  

Philips reappoints Bhattacharya as CFO 

AMSTERDAM – Royal Philips has reappointed Abhijit Bhattacharya for a two-year term as member of the board of management, fulfilling the role of CFO, and reappointed Liz Doherty and David Pyott as members of the supervisory board. With these reappointments, the composition of the supervisory board committees remains unchanged. “Following the recent changes made in the executive committee, I am pleased that Abhijit is adding a two-year term to his tenure as CFO, thereby ensuring continuity and enabling a smooth succession process in parallel,” said Feike Sijbesma, chairman of the supervisory board. “I am also pleased that Liz and David will continue to serve as members of the supervisory board and support Philips with their much-valued expertise and counsel.” Other voting items during Philips’ annual meeting: a proposed dividend of EUR 0.85 per share over 2022, the proposal to reappoint EY as the company’s external auditor for a term of one year starting Jan. 1, 2024, and the proposal to appoint PricewaterhouseCoopers as the company’s new external auditor for a term of four years starting Jan. 1, 2025. 

Gov’t, United Wound Healing settle allegations 
SEATTLE, Wash. – The U.S. Department of Justice, the Washington State Attorney General’s Medicaid Fraud Control Division, and United Wound Healing P.S. have resolved allegations that Puyallup, Wash.-based UWH improperly billed Medicare and Medicaid for services provided in nursing homes and care facilities in Washington, Oregon, Utah and Idaho. UWH will pay $292,132 to resolve the matter, but the company admits no wrongdoing. “Providers have a responsibility to submit accurate claims to Medicare and Medicaid that are driven by patient needs,” said Steven Ryan, special agent in charge at the U.S. Department of Health and Human Services, Office of Inspector General. “As this case demonstrates, HHS-OIG is committed to investigating those who threaten the integrity of federal health care programs and recovering valuable taxpayer dollars so they can be used for their intended purposes.” Between 2015 and 2022 UWH allegedly submitted false claims to the Medicare and Medicaid programs for evaluation and management (E&M) services. Medicare generally prohibits health care providers from separately billing for E&M services provided on the same day as another medical procedure, unless the E&M services are significant, separately identifiable, and above and beyond the usual pre- and post-operative care associated with the medical procedure. The settlement resolves allegations in a lawsuit filed in the Western District of Washington by Dena Walker, a former employee of UWH. The lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act. Walker will receive approximately $58,426 as part of the resolution. 

Ascensia expands payment assistance program 

PARSIPPANY, N.J. – Ascensia Diabetes Care, maker of the Contour Blood Glucose Monitoring (BGM) System portfolio and exclusive distributor of Eversense Continuous Glucose Monitoring (CGM) Systems, announces that it has significantly expanded Eversense PASS, a payment assistance and simple savings program designed to enhance affordability and access to the Eversense E3. Under the new and improved program, there will be more people with diabetes eligible for assistance paying for the system and increased savings for eligible first-time users. “We’ve been working to ensure that as many people as possible can have access to this unique product,” said Rudy Thoms, vice president, CGM Commercial US, of Ascensia Diabetes Care. “Alongside our partner Senseonics, we know the positive impact that Eversense E3 can have on the lives of people with diabetes and that’s one of many reasons why we are pleased to extend the savings and eligibility for Eversense PASS. Although most major insurers now cover Eversense E3 CGM System, we are also proud to offer these savings regardless of coverage, so that no one with commercial insurance is left behind.” Created by Ascensia, the Eversense PASS program has been helping eligible patients in the U.S. access Eversense E3 and its benefits since April 2022. Eligibility for the program has now been extended to all commercially insured people with diabetes across the country, including those who do not have coverage for the Eversense E3 system from their insurance provider. Additionally, new Eversense E3 users will now only pay $99 out of pocket for their first two Eversense E3 systems, extending the $99 introductory offer that was previously available for just the initial sensor and smart transmitter. This results in an out-of-pocket cost of less than $200 for an entire year of continuous glucose monitoring with Eversense E3 for new users. For each sensor thereafter, users will pay a maximum of $100 per month, or $600 for the six-month duration of each sensor.


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