HME News Top Stories

Industry makes midwinter push for Meek bill

Fri, 5 Feb 2010 00:00:00 CST

WASHINGTON - Industry stakeholders plan to turn up the heat on national competitive bidding in the coming weeks to get more co-sponsors for H.R. 3790, which would repeal the program.
On Thursday, the Accredited Medical Equipment Providers of America (AMEPA) will host a public rally in Buena Park, Calif. The state is home to nine competitive bidding areas in Rounds 1 and 2.
"There are many lawmakers who haven't been aware of the significance of NCB," said Sean Schwinghammer, executive director of AMEPA. "We also want to get providers on board because constituents are the best advocates."
The bill, introduced by Rep. Kendrick Meek, D-Fla., currently has 140 co-sponsors. Only four of California's 53 Congressmen--the largest delegation in the country--have signed onto the bill.
"California is just now getting engaged," said John Gallagher, vice president of government affairs for The VGM Group. "People are getting attuned to the fact that NCB might actually come to California."
With California suffering a huge budget crisis, many providers are preoccupied with day-to-day business, said Gloria Peterson, assistant executive director of the California Association of Medical Product Suppliers (CAMPS).
"It's difficult sometimes to engage providers, but once they really get activated, they can be pretty proactive," she said. "Our members have been trying to educate their patients about what NCB is and how it will impact them."
AMEPA also has its eye on Chicago. Only one of the state's 19 representatives is a bill cosponsor.
That's not for lack of trying, says Tom Renk, executive director of the Illinois Association for Medical Equipment Services (IAMES).
"Our members have tried very hard to send messages to Congress," he said. "We sent people to Washington, D.C., to do a day on the Hill and the best they could, do for the most part, was meet with the sub-aides of the minor aides of the legislators," he said. "You never know if you are landing a punch or not."
The National Association of Independent Medical Equipment Suppliers (NAIMES) has declared Feb. 12 to Feb. 22 "SOS Week." Providers are urged to contact their lawmakers during the President's Day recess and ask them to "Save our Jobs--Protect our Patients."
NAIMES is simply following Congress's lead, said Wayne Stanfield, president.
"Jobs are the No. 1 issue in Washington right now," he said. "We are not trying to take the focus off of patient access, but we are projecting that 18,000 HME employees could lose their jobs (under NCB)."
Despite the shift in Congress toward job creation, now is not the time to let up on the reins, say industry stakeholders.
"Something is going to happen in health care in the next couple of months," said Gallagher. "The Democrats and the president can't go without a healthcare bill. We need to keep pushing the message."

Lincare, Gentiva benefit from 'good fit'

Fri, 5 Feb 2010 00:00:00 CST

CLEARWATER, Fla., and ATLANTA - Don't read too much into Lincare's decision to buy the HME, respiratory and home infusion business of Gentiva Health Services, industry watchers say.
"I wouldn't say this means Lincare plans to start knocking down huge deals any time soon," said Bob Leonard, an analyst for The Braff Group, a Pittsburgh-based mergers and acquisition (M&A) firm. "It's an opportunity that was a good fit for Lincare, and it was a good fit for Gentiva."
After months of rumors, Lincare last week announced that it was acquiring about 40 of Gentiva's locations in seven states. In 2009, the locations earned $55 million in revenue.
The acquisition allows Lincare to add to its base of 700,000 customers in 48 states; it allows Gentiva to focus on its core business of home health and hospice services, industry watchers say.
Due to the smaller size of Gentiva's locations (on average, they earn about $1.3 million in revenue each), Lincare will likely roll them up into its existing 1,056 locations, they say.
Although terms of the acquisition were not disclosed, Lincare likely got a good deal due to a downturn in the market and economy, and Gentiva's eagerness to sell, industry watchers say.
"Gentiva is a large, successful home health company that dabbled in HME because they thought there were some synergies, but in the end, it was too different of a business," said Rick Glass, president of Steven Richards & Associates, a Tarpon Springs, Fla.-based M&A firm.
Lincare may not be "knocking down huge deals," but it will continue to make acquisitions, industry stakeholders say.
"I think they've been doing fewer acquisitions, but they've been quietly and opportunistically acquiring companies if something comes up that fits," Leonard said. "They'll continue to do that."

Pile of PECOS news: CMS schedules forum, associations survey providers, industry scrambles to search database

Fri, 5 Feb 2010 00:00:00 CST

BALTIMORE - CMS will host a Special Open Door Forum Feb. 17 to discuss Medicare provider enrollment issues, including the controversial Provider Enrollment, Chain and Ownership System (PECOS) for physicians. Also on the agenda: provider and supplier reporting responsibilities; Medicare ordering and referring issues; and revalidation efforts. To participate in the 2 p.m. EST forum, call 800-837-1935 and use the ID 52537484.

Industry surveys providers
ARLINTON, Va. - AAHomecare and state and regional HME associations completed a survey of providers last week on the number of PECOS-related warnings messages they're receiving. Industry stakeholders plan to use the results of the survey to show CMS and members of Congress that providers are still receiving a high number of warning messages, despite the recent release of a new database of physicians that have national provider identifier (NPI) numbers and PECOS registrations.

Industry scrambles to search database
BALTIMORE - The problem with CMS's new PECOS database, which is 16.63 MB in size, 13,653 pages long and available only in PDF format: It's difficult to search, stakeholders say. To ease the burden, The VGM Group is in the process of converting the database into a more user-friendly "SQL" file, it announced last week. Fastrack announced that its application will compare physicians in CMS's database with physicians in a user's database, as well as keep count of registered and unregistered physicians. PFS, a billing firm, announced that it has added the database to its application, making it easier for users to query physicians and notifying them when NPI numbers and PECOS registrations don't match up. To access CMS's database, go to www.cms.hhs.gov/MedicareProviderSupEnroll

Thousands of HMEs abandon Medicare

Fri, 5 Feb 2010 00:00:00 CST

BALTIMORE - The number of active DMEPOS providers who bill Medicare dropped from 106,707 on Sept. 1, 2009, to 92,629 on Dec. 1, 2009. That's a 13.2% reduction and most likely reflects the number of providers who gave up their supplier numbers rather than become accredited by Medicare's Sept. 30, 2009, deadline.
HME News solicited the data from CMS in early December via a Freedom of Information Act (FOIA) request. Industry watchers surmised that thousands of providers would give up their supplier numbers rather than become accredited. This data appears to confirm that suspicion.
Most likely, the newly inactive supplier numbers belonged to HME companies and not pharmacies. That's because pharmacies had until Jan. 1, 2010, to become accredited.
Here's the change in active DMEPOS supplier numbers by region between Sept. 1, 2009, and Dec. 1, 2009:
- Jurisdiction A: 22,318 to 19,275 (-13.6%)
- Jurisdiction B: 21,791 to 19,077 (-12.5%)
- Jurisdiction C: 39,094 to 34,038 (-12.9%)
- Jurisdiction D: 23,504 to 20,239 (-13.9%)
- Nationally: 106,797 to 92,629 (-13.2%)
Here's the number of providers who voluntarily terminated their numbers before the Sept. 30 deadline (providers in this group can reinstate their supplier numbers once they become accredited):
- Jurisdiction A: 181
- Jurisdiction A: 326
- Jurisdiction A: 708
- Jurisdiction A: 337

New benefit for complex rehab: 'This is an evolutionary process'

Fri, 5 Feb 2010 00:00:00 CST

BUFFALO, N.Y. - Industry stakeholders are drafting a white paper that details a new benefit for complex rehab, and they'll unveil it to the broader industry in a highly anticipated Webinar next month.
"It's at the point where people are getting a little impatient with the process--that's understandable," said Tim Pederson, a member of a steering committee working on the new benefit and chairman of AAHomecare's Complex Rehab and Mobility Council (CRMC). "But it's better to make sure that we have appropriate input from all of our stakeholders so there are no surprises."
The steering committee held a two-day meeting in St. Louis last week to nail down some of the specifics of the new benefit, including coverage criteria and provider standards. It hopes to have four organizations--NCART, NRRTS, CRMC and RESNA--review a draft of the white paper later this month.
During a Webinar on March 4, the steering committee plans to discuss the white paper, answer questions and, most importantly, gather feedback.
"We want to be sensitive to the idea that this is a finished product--it's not," said Don Clayback, who leads the steering committee and is the executive director of NCART. "This is an evolutionary process. We started at 50,000 feet and now we're at 25,000 feet. But we'll continue to drop down as we get into more detailed conversations with broader groups of people."
In addition to hosting the Webinar, the steering committee plans to reach out to the various state and regional HME associations.
"We have to make sure that, along the way, the appropriate people are onboard," said Simon Margolis, a member of the steering committee and executive director of NRRTS. "We keep getting reminded of the debacle to reform the oxygen benefit."
Also this month, the steering committee gave Avalere Health, a Washington, D.C., consulting firm, the go-ahead to start part two of its project: developing a strategy for getting Congress and CMS to buy into the new benefit.

In brief: CMS dumps loan closet provision, sets agenda for PAOC meeting

Fri, 5 Feb 2010 00:00:00 CST

BALTIMORE - CMS has rescinded a provision that would have essentially prohibited an HME provider from maintaining inventory at a location owned by a physician, AAHomecare reported last week. The provision was set to go into effect March 2. "This means the current rules governing consignment closets under Medicare are still in place," the association stated in a bulletin to members. Under the provision, the title to HME would have to be transferred to the enrolled practitioner at the time it was furnished to the beneficiary and the practitioner would have to bill using his or her own billing number. Industry stakeholders warned CMS officials that the provision would be impractical and would likely violate the Stark law, which states that a physician can't refer beneficiaries to entities furnishing "designated health services," including HME, if the physician has ownership or a compensation agreement with the entity.

On the PAOC agenda: Round 2 timeline
BALTIMORE - CMS last week released an agenda for its next Program Advisory and Oversight Committee (PAOC) meeting on national competitive bidding. Topics for the Feb. 23 meeting include "Round 2 tentative timeline" and "Subdivision of MSAs for NYC, Los Angeles and Chicago." CMS expects to open registration for the meeting this week. FMI: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/.

Obama spares HME in budget
WASHINGTON - There appear to be "no major cuts or policy changes" for HME in President Barack Obama's proposed 2011 budget, industry stakeholders reported last week. However, the budget does include an increase in funding to fight healthcare fraud. HHS documents state: "The budget includes $561 million in discretionary resources, an increase of $250 million, to strengthen Medicare and Medicaid program integrity activities, with a particular emphasis on fighting healthcare fraud in the field, increasing Medicaid audits and strengthening program oversight with reducing costs." Also, cuts and policy changes for HME are still in play as part of healthcare reform, stakeholders point out.

CMS projects health expenditures for 2009-2010
WASHINGTON - CMS projects that national health expenditures grew 5.7% to $2.5 trillion in 2009, up from 4.4% in 2008, according to a report prepared by the agency's Office of the Actuary and published online by the journal Health Affairs. In comparison, the gross domestic product (GDP) is projected to have decreased 1.1% in 2009. The growth in health expenditures was due, in part, to faster spending for the Medicaid program (a projected 9.9% in 2009, up from 4.7% in 2008). CMS projects that the growth in health expenditures will decrease to 3.9% in 2010, largely due to a 21.3% reduction in Medicare physician payment rates. Health expenditures are expected to grow 4.7% if that reduction doesn't go into effect.

Invacare pays down debt big time
ELYRIA, Ohio - Net sales for Invacare's North American HME products increased 0.9% to $748.4 million in 2009 compared to $741.5 million in 2008, the company reported Feb. 4 in its year-end financial report. Overall, Invacare's net sales for 2009 decreased 3.6% to $1.69 billion, due mainly to decreases in foreign currency exchanges. Invacare ended the year with $321.6 million in outstanding debt compared to $478.8 million in 2008. The company decreased its debt thanks to improved cash flow from operations ($141.6 million compared to $59.9 million in 2008) and by using cash already on hand. "(Invacare) plans to use its projected strong free cash flow in 2010 of $65 million to $75 million to continue to retire debt or pursue accretive acquisitions as available," stated CEO Mal Mixon.

Brightree travels with Passport
FRANKLIN, Tenn. and LAWRENCEVILLE, Ga. - Passport Health Communications and Brightree have teamed up to provide patient insurance eligibility verification as an integrated service within Brightree's business management software. Verifying coverage and benefits prior to service or product delivery increases the speed and accuracy of billing, reduces rejections and denials, improves staff productivity and increases cash flow, the companies stated in a release. "We anticipate our partnership with Passport will save hundreds of man hours by allowing providers to check patient insurance eligibility within the Brightree system," said Brightree President and CEO Dave Cormack.

Japanese firm to buy HDI
FORT LAUDERDALE, Fla. - Diabetes device maker Home Diagnostics Inc. (HDI) has agreed to a $215 million buyout from Japanese medical device maker Nipro, it announced Wednesday. The deal will allow Nipro to expand its diabetes-related business. The deal is expected to be finalized by the end of the current quarter.

Lincare, Gentiva benefit from 'good fit'

Thu, 4 Feb 2010 00:00:00 CST

CLEARWATER, Fla., and ATLANTA - Don't read too much into Lincare's decision to buy the HME, respiratory and home infusion business of Gentiva Health Services, industry watchers say.
"I wouldn't say this means Lincare plans to start knocking down huge deals any time soon," said Bob Leonard, an analyst for The Braff Group, a Pittsburgh-based mergers and acquisition (M&A) firm. "It's an opportunity that was a good fit for Lincare, and it was a good fit for Gentiva."
After months of rumors, Lincare announced Feb. 4 that it was acquiring about 40 of Gentiva's locations in seven states. In 2009, the locations earned $55 million in revenue.
The acquisition allows Lincare to add to its base of 700,000 customers in 48 states; it allows Gentiva to focus on its core business of home health and hospice services, industry watchers say.
Due to the smaller size of Gentiva's locations (on average, they earn about $1.3 million in revenue each), Lincare will likely roll them up into its existing 1,056 locations, they say.
Although terms of the acquisition were not disclosed, Lincare likely got a good deal due to a downturn in the market and economy, and Gentiva's eagerness to sell, industry watchers say.
"Gentiva is a large, successful home health company that dabbled in HME because they thought there were some synergies, but in the end, it was too different of a business," said Rick Glass, president of Steven Richards & Associates, a Tarpon Springs, Fla.-based M&A firm.
Lincare may not be "knocking down huge deals," but it will continue to make acquisitions, industry stakeholders say.
"I think they've been doing fewer acquisitions, but they've been quietly and opportunistically acquiring companies if something comes up that fits," Leonard said. "They'll continue to do that."

Invacare begins to blog

Wed, 3 Feb 2010 00:00:00 CST

ELYRIA, Ohio - Invacare made its first significant foray into online social media in January when it launched a corporate blog called Invacare Connects (http://www.invacareconnects.com).
"Going forward you will see more," promised Daniel Lee, vice president of marketing for Invacare HomeCare. "In three to five years, you are going to see a whole different digital evolution. It's going to be a different language than today. We are just at the beginning, and we need to make sure that we get the basics down."
Invacare plans to use the blog for multiple purposes: government relations updates, product information, and industry and company news. And don't be surprised if you see CEO Mal Mixon and other top execs make an appearance from time to time.
"We'll have some surprises," Lee said. "It's going to be fun."
Invacare is not alone in exploring social media. Providers can follow The VGM Group on Facebook and Twitter, for example, and Pride Mobility Products has created an Owners Club online community.
"It's completely interactive," said Bernie Allen, Pride's international and Internet marketing manager. "It's a true social network in that you can friend people and create groups, talk in specific forums, upload and post videos and photos. It makes it easier for our consumers to communicate with each other and with us."
At the moment, 50% of U.S. adults use social networking sites, and Lee called the medium "part of the society and business norm."
"The forums that we have and the different platforms that we are using, be it YouTube or our Invacare Connects blog, is another way to communicate and reach the constituents that we want to speak to," he said.

Lobbying: Bill Cheek takes 'that extra step'

Tue, 2 Feb 2010 00:00:00 CST

MONROE, Ga. - Provider Bill Cheek has been working in the HME industry for 16 years, but he'll be visiting Capitol Hill for the first time next month. What's driving him there: H.R. 3790, a bill that would eliminate national competitive bidding. Cheek, COO of Carmichael's Home Medical Equipment, will visit Washington, D.C., as part of AAHomecare's Legislative Conference March 1-3 to try and boost the number of co-sponsors for H.R. 3790. Here's what he had to say about why competitive bidding is a threat and why he does what he does.
HME News: Competitive bidding has been around for a while. Why are you visiting Capitol Hill now?
Bill Cheek: After Congress delayed the program in 2008, I never thought it would come back. Then last year, when it did, I made a lot of phone calls and sent a lot of e-mails—I thought I could do it that way. But now I feel like I need to take that extra step.
HME: What's your strategy for your meetings with legislators?
Cheek: The biggest point I want to make is the need for Medicare patients to have access to the care they expect and deserve. There are so many small providers like us that serve a large number of patients--we probably have 8,000 to 9,000--that won't survive competitive bidding. In Monroe, we're the only option; Athens, the closest city, is 45 minutes away.
HME: You mentioned not being able to survive competitive bidding. Will you also share with legislators the impact you expect the program to have on your company and others like it?
Cheek: Yes. We have 10 employees and our chances of surviving the program are slim to none. We shouldn't be looking to put companies out of business right now, with the unemployment rate the way it is. I've heard upward of 90% of small HME companies could go out of business. This program would kill jobs.
HME: If the industry is unable to derail competitive bidding--what then?
Cheek: We're not in Round 1; we're in Round 2. I can't buy stuff like the larger companies do, so competitively speaking, my bid can't be as low as their bids. My plan is to bid at a reasonable rate so I can stay open and make payroll. That's the best we can do.
HME: How's the morale among HME providers?
Cheek: I have a lot of friends who are considering going back to nursing, because they know they'll always have a job. The thing is, most of us got into this industry to help people. I love what I do. We really do help a lot of people—that's encouraging. I just hope we can continue doing it.

In brief: CMS posts NPI file, AAH disses fraud alert

Fri, 29 Jan 2010 00:00:00 CST

BALTIMORE - CMS has posted a file that contains the national provider identifier (NPI) numbers and names of physician and non-physician practitioners with current enrollment records who are eligible to order and refer Medicare beneficiaries. The file can be viewed online or downloaded at www.cms.hhs.gov/MedicareProviderSupEnroll. Click on "Ordering/Referring Report" on the left-hand side. The file contains about 800,000 records and will be updated periodically. The file can be searched by either name or NPI number.

AAHomecare seeks to rescind fraud alert
ARLINGTON, Va. - A recent fraud alert that prohibits DME providers from contacting beneficiaries to make delivery arrangements upon receipt of a physician's order is impractical and unworkable, and it could compromise the beneficiary's health, stated AAHomecare in a Jan. 21 letter to CMS Acting Administrator Charlene Frizzera. The alert, published Jan. 14 in the Federal Register, is an update to the telemarketing provisions of the 2003 Social Security Act. It would require DMEs to have a beneficiary's written authorization before they can contact him or her. AAHomecare seeks to have that provision rescinded for the following reasons: contacting the beneficiary based on a verbal or written order does not constitute a prohibited telephone solicitation; Congress did not intend to restrict necessary communication between DMEs and beneficiaries; and regulations implementing the telemarketing provisions to the Social Security Act do not restrict a DME provider's ability to contact beneficiaries in order to effectuate a physician's order for DME.

Separate benefit for complex rehab: 'People starting to get engaged'
BUFFALO, N.Y. - Industry stakeholders will convene in St. Louis today and tomorrow to begin finalizing a white paper that will detail the changes they hope to make to the complex rehab benefit. "In our workgroup discussions to date, we've had some pretty freewheeling discussions, understandably and rightfully so," said Don Clayback, executive director of NCART. "Now we need to reign those in and take all the ideas that we've talked about and pare them down." Stakeholders plan to discuss the white paper during a March 4 Webinar (to register for the session at 8:30 a.m. EST, go to https://www2.gotomeeting.com/register/364894402; for 5 p.m. EST, go to https://www2.gotomeeting.com/register/423449202). Efforts to create a separate benefit for complex rehab are attracting more attention: During the last Webinar on Jan. 22, about 120 interested parties participated, Clayback says. "There were about 20 minutes of questions," he said. "I'm happy to see people are starting to get engaged."

ActivStyle boosts offerings
MINNEAPOLIS - ActivStyle, a provider of incontinence products, has acquired Advocate Medical Services, a provider of catheters, the companies announced Jan. 25. Combined, the two companies serve 30,000 patients. The 12-year-old ActivStyle is backed by Riverside Company, a private equity firm. It serves patients in 30 states through three sales channels: a Midwest sales team, TV advertising and direct mail. The Tampa, Fla.-based Advocate Medical Services, which will continue operating under its own name, focuses mainly on Florida and Texas, two states where ActivStyle had only a minor presence. Terms of the deal were not disclosed.

Pride U kicks off 2010 tour
EXETER, Pa. - Pride Mobility Products' 2010 Pride U and Quantum University Seminar Tour begins its 27-city national tour Feb. 9 in Charlotte, N.C., and continues through October with a final stop in Wilkes-Barre, Pa., near the company's headquarters. The 2010 Seminar Tour curriculum will include Medical Diagnosis and Power Wheelchair Electronics, PMD Audit Survival Guide, Reimbursement Fundamentals for Complex Rehab, and The Science of Mat Evaluations & Wheelchair Prescription. In addition, Pride's Silver Star Certification Course will be offered at select locations. Seminar Tour presenters consist of a team of certified specialists. For more information, visit www.prideprovider.com or www.quantum-university.com or call 1-800-800-8586.

NAIMES reaches milestone
SOUTH BOSTON, Va. - The National Association of Independent Medical Equipment Suppliers (NAIMES) now has 200 members, it announced in a bulletin last week. New members include HME providers from Texas, North Carolina, Oklahoma, Wisconsin, Georgia and New Jersey. NAIMES expects to reach 300 members by the end of the year.

Medtrade Spring: It's around the corner
LAS VEGAS - Registration is now open for Medtrade Spring 2010, which will take place May 11-13 at the Sands Expo & Convention Center in Las Vegas. Show organizer Nielsen Expositions is offering an early registration price of $79. It's also offering a $50 discount on the pre-conference. To receive that discount, attendees must contact sponsors directly: AAHomecare (a session on documentation); Pride Mobility Products (two sessions on seating and positioning, and complex rehab reimbursement); Sigvaris (a full-day session on compression therapy); and The VGM Group (a session on sales training and a session on legislative affairs). FMI: http://www.medtrade.com/medtrade_spring/.