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In brief: Interim president, Cardinal Health expansion, improper PMD payments

In brief: Interim president, Cardinal Health expansion, improper PMD payments

WATERLOO, Iowa – VGM Group has named Jeremy Stolz, a member of the company’s senior leadership team, as interim president of VGM & Associates. 

Stolz, who joined VGM in 2003, has served as president of VGM Fulfillment since 2017. 

“Jeremy is a recognized leader in the HME industry,” said VGM CEO Mike Mallaro. “Over his nearly 20-year tenure at VGM, he has been dedicated to developing solutions for our partners, customers, and the patients they serve. And under his leadership, VGM Fulfillment has grown from a single location to a network of four facilities, sending over five million packages each year. Jeremy’s passion and expertise make him the ideal steward for our membership communities.”   

VGM expects to name a permanent president of VGM & Associates by the end of July. 

Stolz will attend the upcoming Heartland Conference, June 13-15 in Waterloo, to meet members and attendees in-person. 

“We are here to serve our members and vendor partners, as well as the HME community as a whole,” said Stolz. “If you’re going to be in Waterloo for the Heartland Conference, I’d love to network with you to learn how we can better support your business.”  

During the transition, members and vendor partners can also reach out to their regional account managers with questions. 

Cardinal Health expands warehouse footprint 

DUBLIN, Ohio – Cardinal Health will open a new distribution center in the Columbus, Ohio, area as part of a multi-year warehouse modernization and growth plan.  

The 208,144-square-foot distribution center will support Cardinal Health at-Home Solutions, a market-leading medical supplies provider and specialized business focused on providing comfortable care in the home for people with chronic and serious health conditions. It will be the 10th distribution center in the U.S. for Cardinal Health at-Home Solutions. 

"We have been committed to helping patients take care of their health at home for decades,” said Rob Schlissberg, president, Cardinal Health at-Home Solutions. “As a result of the pandemic, the health care industry is experiencing accelerated consumer demand for personalized experiences when it comes to health care at home. Expanding our warehouse footprint optimizes our distribution network and enhances our customer service levels, while positioning us for sustained growth in an area of patient care that continues to evolve.” 

The distribution center, which is expected to be fully operational in November, will integrate state-of-the art logistics technology, including robotic storage capabilities, conveyance and the Kinaxis RapidResponse platform, to optimize digital supply chain planning. All technology and automation will work alongside Cardinal Health employees to deliver operational efficiencies, as well as enhanced employee and customer experiences, while supporting fluctuations in volume and labor. 

The distribution center joins another recently announced 574,670-square-foot center also expected to open later this year in Columbus. 

AHA supports scrutiny of Medicare Advantage 

WASHINGTON – The American Hospital Association has urged the U.S. Department of Justice to establish a task force to conduct False Claims Act investigations into commercial health insurance companies that are found to routinely deny patients access to services and deny payments to health care providers. 

The AHA’s letter follows a recent report from the Office of Inspector General that found Medicare Advantage organizations are violating their obligation to cover the same services as original Medicare and not to impose additional clinical criteria that are “more restrictive than original Medicare’s national and local coverage policies.” 

“The HHS-OIG report offers several forward-looking recommendations to remedy this serious problem of improper denials,” the letter states. “Those recommendations are sensible, and the AHA applauds them. But they are not enough. It is time for the Department of Justice to exercise its False Claims Act authority to both punish those MAOs that have denied Medicare beneficiaries and their providers their rightful coverage and to deter future misdeeds.” 

The OIG found that 13% of prior authorization denials and 18% of payment denials actually met Medicare coverage rules and should have been granted. 

In a program the size of Medicare Advantage — with 26.4 million beneficiaries, or 42% of the total Medicare population in 2021 — improper denials at this rate are unacceptable, according to the AHA. 

“Yet, as the report explained, because the government pays MAOs a roughly $1,000 per-beneficiary capitation rate, they have every incentive to deny services to patients or payments to providers in order to boost their own profits,” the letter states. “As HHS-OIG’s report shows, this is exactly what certain MAOs have been doing – again and again. And in a $300-plus billion federal program, the losses to the public are immense.”    

OIG: Medicare improperly paid for PMD repairs 

WASHINGTON – Medicare improperly paid $7.9 million for power mobility device repairs between Oct. 1, 2018, and Sept. 30, 2019, according to a new report from the Office of Inspector General. 

The OIG looked at Medicare Part B paid claims for 37,013 beneficiaries for whom suppliers submitted charges for 244,667 claim lines totaling $40.1 million for PMD repairs provided during the audit period.  (A claim line represented one PMD repair for a beneficiary on a single date of service.) A random sample of 100 beneficiaries was selected, for whom 52 suppliers submitted charges for 922 PMD repairs totaling $170,776. The OIG found that 637 of the 922 PMD repairs complied with requirements, and 261 did not. 

Specifically, the OIG found documentation did not adequately support the charges for PMD repairs, the labor time associated with PMD repairs was not documented, or PMD repair charges were not reasonable and necessary, resulting in $41,137 in improper Medicare payments and $10,494 in associated beneficiary coinsurance payments.  

The OIG also identified questionable charges for 183 PMD repairs associated with 19 sampled beneficiaries. Although the billing of these PMD repairs did not reflect noncompliance with Medicare requirements, suppliers did not meet documentation standards established by guidance or submitted charges that may not have been reasonable and necessary, resulting in $20,692 in questionable Medicare payments and $5,278 in associated beneficiary coinsurance payments. 

Based on these sample results, the OIG estimated that $7.9 million of the $40.1 million paid for PMD repairs was improperly paid. It also estimated that Medicare could have saved as much as an additional $3.7 million for questionably paid PMD repairs.  

The OIG conducted the audit to see if errors identified in a prior audit were still occurring. In that audit, for 2006 through 2008, the OIG found Medicare paid DME suppliers approximately $26.8 million for DME repair claims that did not meet Medicare requirements. 

Harmar Mobility: A ‘Great Place to Work’ 

SARASOTA, Fla. – Harmar Mobility has been certified as a great place to work for the second year in a row by the Great Place to Work organization. The certification is based on feedback from current employees on company culture, work environment and leadership. This year, 84% of team members agreed that Harmar is a great place to work – 27 points higher than the average U.S. company and nine points higher than its score last year. “We’re thrilled to be recertified as a Great Place to Work,” said Steve Dawson, CEO. “2021 and 2022 were eventful years for us – not only because we structured a hybrid schedule for our corporate offices to enjoy the benefits of both working from home and in the offices, but also because we successfully completed a major one-mile move for our Sarasota facility. At Harmar, we pride ourselves on our teamwork and exceptional service to our customers and dealers and without that determination and support from each employee, we wouldn’t be able to continue growing and expanding our mission to lift lives.” Harmar highlighted that, as part of leading a positive, inclusive and productive work environment, it has established six core values: team player, get stuff done, can-do attitude, genuinely cares, does the right thing and embraces inclusion. 

Medline to offer workshops throughout 2022 

NORTHFIELD, Ill. – Medline is offering in-person and virtual sessions for outpatient wound centers and virtual boot camps for post-acute care providers on complex skin health topics, ranging from prevention of skin breakdown to wound etiologies, and appropriate treatments. "It will take time to fully assess the impact of the COVID-19 pandemic on skin health management, but we have learned that successful organizations continue to empower their staff," said Amin Setoodeh, senior vice president of skin health and clinical services for Medline. "Medline strives to be more than just a medical supplier, and we are fortunate to have a robust clinical team at Medline to arm healthcare providers with essential skin and wound care knowledge to help their organizations run better." The acute and post-acute care education is an extension of Medline's efforts to build knowledge and confidence in clinicians, and the sessions are led by Medline clinicians who have extensive experience in the health care industry. 

Online registration for Heartland closes soon 

WATERLOO, Iowa – Online registration for VGM’s 21st anniversary Heartland Conference will close June 6. Guests will still be able to register on-site, however, for the in-person educational event. “Heartland has something for every home medical equipment professional,” said Jill Blaser, conference chair and design and development manager of VGM Education. “There’s going to be so much to learn, see and experience. We can’t wait to welcome our members and show off our community’s recently renovated hotel and convention center.” Registration is all-inclusive and provides access to every educational opportunity Heartland has to offer, including four pre-conference sessions. This year’s passes also cover meals, entertainment and access to the hottest products and business solutions offered by VGM's vast network of vendors inside the newly renovated exhibit hall. Heartland takes place June 13-15 in Waterloo, Iowa. 

OM elects two to board 

RICHMOND, Va. – Owens & Minor announced Rita Johnson-Mills and Terri Kline have been elected to its board of directors effective June 1, 2022. “Rita and Terri each have deep health care expertise, and we look forward to the new perspectives they will be able to offer,” said Mark A. Beck, chair of the board. “Rita’s leadership across different health care sectors and Terri’s experience in home health care will enhance the board’s diversity of thought and help sustain Owens & Minor’s success over the long-term.” Johnson-Mills has more than 25 years of experience in health care, most recently as CEO of Qualified Opportunity Zone Fund Nightingale Partners, leading its mission to address the social determinants of health. Prior to that, she held senior leadership roles at CMS, UnitedHealthcare and Centene Corp. Kline has more than 25 years of leadership experience in a wide range of health care industry verticals. Her most recent leadership role was as the president and CEO of Health Alliance Pan, a subsidiary of Henry Ford Health System in Michigan.  

RESNA elects new board members 

ARLINGTON, Va. – RESNA members have elected new board members. Officers are President-Elect Jim Lenker, PHD, OTR/L, (8/2022-7/2024); and Secretary Dan Cochrane, MA, MS, ATP (8/2022-7/2024). Board members elected to three-year terms beginning in August are Ana Allegretti, PhD, OTR, ATP; Ed Giesbrecht, PhD, OT REG. (MB); and Seong-Hee Yoon, ATP. The board thanks Secretary Rita Stanley and board members Jen Boger, Alisa Brownlee and David McNaughton for their service to RESNA. 

Abbott receives FDA clearance for FreeStyle Libre 3 

ABBOTT PARK, Ill. – Abbott has received clearance from the U.S. Food and Drug Administration for its FreeStyle Libre 3 system for people with diabetes age four and up. "The FreeStyle Libre 3 system is a direct result of listening to our customers – and giving them the innovation and sensing technology they've been looking for," said Jared Watkin, senior vice president of Abbott's diabetes care business. "It's a game changer for the millions of people living with diabetes. They'll be able to manage their health minute-by-minute with the world's smallest and thinnest sensor and most accurate 14-day continuous glucose monitoring system." The FreeStyle Libre 3 offers: high accuracy with a 7.9% overall mean absolute relative difference; a small size comparable to two stacked pennies; and Bluetooth integration. It will be available later this year. 

AAH to payers: Temporarily relax CPAP requirements 

WASHINGTON – AAHomecare has developed a letter that providers can send to payers explaining the CPAP device shortage and asking them to temporarily relax compliance requirements. In the wake of supply chain challenges related to semiconductor chips, manufacturers have released products that don’t have wireless cell modem data tracking technology for recording patient compliance data. The letter asks payers to remove, for a limited period of time, any policy requiring patient compliance data for continued use or authorization to help maintain access to CPAP devices. Current Medicare guidelines call for patients to use their CPAP machines for at least four hours per night at least 70% of the time. 

CMS commits to comment period 

WASHINGTON – CMS has committed to seeking public comments on the request to reconsider the national coverage determination for mobility assistive equipment to include power seat elevation and power standing systems no later than August, according to NCART. This 30-day public comment period is the next step in the process. “NCART continues to collaborate with the ITEM Coalition on preparing advocates for this,” it stated in a bulletin. “A website dedicated to this issue will be available to act as a hub of resource materials, talking points, templates and comment submissions.” The commitment follows the news that Sens. Tammy Duckworth, D-Ill., Bob Casey, D-Pa., and Marsha Blackburn, R-Tenn., and Rep. Jim Langevin, R-R.I., met directly with CMS Administrator Chiquita Brooks-LaSure on moving the request forward. 

Lifeway Mobility grows in NC 

RALEIGH, N.C. – Lifeway Mobility has expanded its coverage area in North Carolina with a new distribution facility here. The company now offers stair lifts, wheelchair ramps and a variety of basic transfer aid solutions to customers in Greensboro, Raleigh, Durham, Fayetteville, Wilmington and the surrounding areas in eastern North Carolina. “Lifeway Mobility’s expansion in the Carolinas makes it one of the top providers of accessibility solutions in the local area,” said Richard Constantino, general manager of the Carolina locations. “We are looking forward to providing extended coverage in the state of North Carolina and can’t wait to assist more residents with their aging-in-place needs.” Lifeway will accept deliveries at the new facility, but it can’t accept mail there until July. The company provides equipment and services in 17 states. 

NSM gains Momentum 

NASHVILLE, Tenn. – National Seating & Mobility has launched NSM Momentum Academy, a series of events designed to educate clinical partners, including physical therapists, occupational therapists and other health care providers, about best practices in mobility solutions and complex rehab technology. “At NSM, our goal is to ensure that more people have access to the most advanced mobility and accessibility solutions available,” said Bill Mixon, CEO of NSM. “Through NSM Momentum, we look to strengthen relationships with our clinical partners to provide the mobility solutions our clients need for the best clinical outcomes.” NSM will host seven Momentum Academy events throughout 2022. In addition to detailing best practices in mobility solutions and CRT, the events will provide access to continuing education credits, networking opportunities and a tradeshow featuring gold sponsors, including Invacare, Ki Mobility, Permobil, Quantum Rehab and Sunrise Medical, and silver sponsors, including Altimate medical, Inspired by Drive, Merits, Rifton and SleepSafe Beds. The inaugural event took place April 12-13 in Austin, Texas. 

F&P selects Future Director 

AUCKLAND, New Zealand – Fisher & Paykel Healthcare has selected Tracey Barron to participate in the Future Directors program starting June 1. Barron has more than 25 years of experience across a broad range of health-related roles, including chief of strategy for Southern Cross Healthcare. “We welcome the perspective and experience Tracey will bring,” said Scott St. John, chairman of the board. “She is a proven executive with a deep understanding of public and private health systems. I’m looking forward to her contribution.” Future Directors is an initiative of the Institute of Directors aimed at giving talented executives exposure to a company board for a 12- to 18-month period to develop governance experience. Future Directors attend board meetings to observe and participate in discussions, but they do not have voting rights. F&P’s previous Future Director, Toni Moyes, has now completed her term with the company.  

F&P adds professor to board 

AUCKLAND, New Zealand – Cather Simpson, a PhD with expertise in lasers and photonics, has been appointed as a non-executive director of Fisher & Paykel Healthcare starting June 1. Simpson is a professor of physics and chemical sciences at the University of Auckland and a partner at Pacific Channel, an early-stage investment company. She is also a director of the International Society for Optics & Photonics (SPIE) and founder/director for Orbis Diagnostics. “We are pleased to announce Cather’s appointment to the Board,” said Scott St John, chairman of the board. “With her extensive experience commercializing scientific research and involvement in a range of high-tech companies, Cather’s perspective will be a valuable addition.” Simpson will be an independent director. She will also serve as a member of the Quality, Safety and Regulatory Committee.

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