HME News Top Stories

CMS outlines timeframe for competitive bidding

Wed, 10 Mar 2010 00:00:00 CST

BALTIMORE - CMS officials went to Capitol Hill yesterday to sell members of Congress on the "improvements" they have made to the competitive bidding program, according to AAHomecare.
They also sketched out this timeline for Rounds 1 and 2 of the program, according to a participant, AAHomecare reported:
Round 1
- CMS will announce Round One "winners" in June 2010.
- New contracts and prices will be implemented on Jan. 1, 2011.
- CMS will hold a Program Advisory and Oversight Committee (PAOC) meeting on March 17, 2010, "as mandated by law" to focus on the Round 1 transition period and show plans for beneficiary education, including where beneficiaries can go for services and what has changed for beneficiaries.
Round 2
- Round 2 of bidding must begin in 2011, according to the statute.
- CMS is extending review times due to the increase in MSAs--from areas in Round 1 to 79 areas in Round 2.
- Rule making: CMS expects that changes to the bidding program will require the agency to go through the rulemaking process. CMS anticipates that a proposed rule will be published in Summer 2011 with a final rule published in Fall 2010. The rule will include product categories and education requirements for Round 2.
- Winter 2010: CMS will announce the bid schedule and begin registration.
- Spring 2011: CMS will end registration and begin bidding.
- Summer 2011: CMS will end bidding and begin review process.
- Fall 2011: CMS will end review process, notify HME providers and begin evaluating bids.
- Spring 2012: CMS will announce "winning" providers and begin contract bids.
- Summer 2012: CMS will announce contract rates.
- Round 2 pricing will go into effect on Jan. 1, 2013.

ATG Rehab offers 'supercourse'

Tue, 9 Mar 2010 00:00:00 CST

ROCKY HILL, Conn. - Therapists, clinical managers and even other complex rehab providers now have one place to go for education on all things seating and mobility.
ATG Rehab has developed a Web site, http://www.atgrehab.com/?page_id=1396, that lists not only the educational programs that it offers but also those offered by the University of Pittsburgh, and various industry manufacturers and consultants.
"It's what we call at the university a supercourse," said Mark Schmeler, an instructor in UPitt's Department of Rehabilitation Science and Technology, who helped develop the Web site. "Instead of searching multiple sites to get to the courses you want, you go to one portal."
The programs are organized by mode of delivery: online (courses, and live and interactive Webinars) or in-person (regional or on-site). Some programs are free; others, because they're for continuing education units (CEUs), are not.
ATG Rehab has offered educational programs to therapists for years, usually in conjunction with manufacturers, but it developed the Web site after hearing from therapists that they wanted more and they wanted it more conveniently.
"They'd say 'I'm too busy' or 'I can't go because my employer won't let me due to budget constraints,'" said Jerry Knight, ATG Rehab's president of western regional operations. "So we looked in the mirror and asked ourselves, 'We're trying, but what else could we be doing; what else should we be doing?'"
The Web site is another step toward ATG Rehab's goal of becoming the "go-to source" on complex rehab, Knight said.
"We want to continue to build linkages to other Web sites and other sources of information," he said.
In that vein, Schmeler says he envisions consumers also using the Web site.
"This is just another good step in the maturity of rehab technology," he said.

D.C. fly-in: 'Health care is at a crossroads, and we are well positioned'

Fri, 5 Mar 2010 00:00:00 CST

WASHINGTON - The HME providers who pounded the marble halls of Capitol Hill last week must have made quite an impression. H.R. 3790, the bill to repeal national competitive bidding, has picked up 13 new co-sponsors for a total of 163.
"The providers that aren't here owe a debt of gratitude to their colleagues," said Tyler Wilson, president and CEO of AAHomecare, at the association's Washington Legislative Conference last week. "Those who push aside work and money concerns to come to D.C. realize it's a matter of survival. Coming to Capitol Hill to push our cause is part of what they have to do."
Nearly 300 providers spent last Wednesday calling on lawmakers to talk up a range of issues from preserving the first month purchase option for power wheelchairs to repealing the 36-month cap on oxygen.
The biggest priority, however, remains repealing competitive bidding.
"Members are aware there has been a hiccup in the rollout of competitive bidding," Rep. Jason Altmire, D-Pa., told attendees. "One school of thought is that the issues have been resolved. You have to talk about the impact the program will make in the member's district, not just the impact on your business."
During an attendee luncheon last Tuesday, it became alarmingly clear that CMS thinks the issues have been resolved.
"We take the PAOC very seriously and we've learned from the past," Jonathan Blum, director of the Center for Medicare Management, told the crowd. "The online bidding system is smoother, and we are not aware of any significant concerns."
That's all well and good, but you're missing the point, providers told Blum. John Shirvinsky, executive director of the Pennsylvania Association of Medical Suppliers, summed it up this way: "No matter how hard you guys work, it's a fundamentally flawed program. This is going into the market, weaning the players and hoping that the chips fall where they may and everybody is served."
The timing of last week's event was serendipitous. Last Wednesday, healthcare reform, which in recent weeks had been on the backburner, was in the spotlight again as President Obama called on lawmakers to cast a final vote on legislation.
"A period of unprecedented national debate is occurring," said Wilson. "Health care is at a crossroads, and we are well positioned to get our issues out front and center."

Separate benefit for complex rehab: Let the discussions begin

Fri, 5 Mar 2010 00:00:00 CST

BUFFALO, N.Y. - When industry stakeholders gave an overview of a "discussion paper" that details a separate benefit for complex rehab during a Webinar last week, providers and therapists had a lot of questions. That's exactly the response stakeholders were hoping for.
"We've labeled it a discussion paper for a specific reason," said Don Clayback, executive director of NCART and chairman of a steering committee working to create the benefit. "It's meant for discussion. It's not a final plan; it's not a finished product; it's not something that's take-it-or-leave-it. It's meant to be circulated to allow people to respond."
The 24-page paper has been posted to NCART's Web site, www.ncart.us. It proposes changes to products and coding; coverage and documentation; payment; and supplier quality standards.
Highlights from the Webinar:
Products and coding
Current HCPCS codes, where appropriate, would be classified as complex rehab technology (CRT) and would be available only through accredited CRT companies; modifications would be made, as needed, to codes that currently contain both CRT products and non-CRT products to separate CRT from DME; and new codes would be added for CRT products that are routinely provided but currently don't have assigned codes.
"At the end of the day, there should be a fairly bright line," said Rita Hostak, vice president of government relations for Sunrise Medical and a member of the steering committee. "One line says, 'yup, this is clearly DME,' and one says, 'yup, this is complex rehab technology.'"
Coverage and determination
Coverage criteria would be based on a beneficiary's functional abilities and limitations, not specific diagnoses; the burden of clinical documentation would be shifted to the therapist's shoulders instead of the physician's; and the "in-the-home" restriction would be eliminated.
Payment
A payment methodology would be established that covers both the product costs and related service costs that are associated with CRT products. Avalere Health Group will help to determine the potential options and preferred methodology.
Supplier quality standards
Complex rehab technology companies would be required to offer service and repairs to beneficiaries in their sales area, either through their own operations or through another accredited company. For beneficiaries outside their sales area, they would have to make their best effort to locate another accredited company.
Also, the companies would be required to have at least one rehab technology professional (RTP) on staff. An RTP is an individual who has passed RESNA's ATP exam and has fulfilled "additional requirements." Those requirements may include obtaining RESNA's seating and mobility specialist (SMS) certification or an enhanced version of NRRTS's CRTS credential.
Stakeholders pointed out that work on these areas will continue through various working groups.
Questions were largely detail-oriented. For example: In rural areas where there are no seating clinics and few therapists, how would providers comply with the benefit?
"We realize the ideal situation may not be achievable in every instance, but we won't let that dissuade us from getting there, or as close as we can," Clayback said.
Stakeholders plan to collect feedback on the paper all of March. Providers and therapists can do that two ways: e-mail comments to complexrehabtech@gmail.com or post comments to a new blog, http://complexrehabtech.blogspot.com.

The Scooter Store: Coming to a town near you

Fri, 5 Mar 2010 00:00:00 CST

NEW BRAUNFELS, Texas - The Scooter Store's image as just a big call center in New Braunfels, Texas, is no longer accurate, company officials say.
The provider announced last week that it plans to expand the number of storefronts it has from eight to 59 nationwide.
"A lot of it has to do with buyer types," said Mike Pfister, The Scooter Store's executive vice president of government relations and external affairs. "There are buyers that respond to direct mail and TV ads, and there are buyers that like to walk in and kick the tires or meet with a consultant who can talk them through things face to face. We're just trying to cover our bases."
The existing storefronts, mostly in the South, have been in place for several years, allowing The Scooter Store to experiment with what products they should have and how their employees should interact with customers.
The Scooter Store came up with a storefront that displays a variety of products--not just mobility products--and gives its 800 professionals in local markets, including 100 assistive technology practitioners (ATPs) and 175 healthcare relations consultants, a "rallying place" to meet with potential customers, Pfister said.
"Anyone can call to make an appointment to talk to someone," he said.
The driver behind The Scooter Store's latest move: diversification. In addition to different buyers, the emphasis is on different products (insulating itself somewhat from Medicare cuts to particular category) and different payers (meaning cash).
"Seniors are beginning to spend more and more of their discretionary money on health care, and we need to have retail locations that lead that," Pfister said. "That's the direction it has to go in. Medicare will not continue to pay for all of the same products at all of the same ratios forever."
The majority of the storefronts will be carved out of The Scooter Store's more than 50 distribution centers and "dressed up," Pfister said.
"You'd have to go back years, but The Scooter Store was called The Scooter Store because that's what it started out as," he said.

Home Care Medical: Young at heart

Fri, 5 Mar 2010 00:00:00 CST

NEW BERLIN, Wis. - Home Care Medical may be an HME provider, but it's not limiting itself to caring for the sick and elderly.
Over the past year, Home Care Medical has gradually expanded its orthotics and prosthetics (O&P) division, and as part of that, has added related retail items like braces and sports equipment.
"I don't think it has been looked at by HMEs for a long time, but we wanted to give the younger generation a voice in the business," said Kim Slaugenhoup, manager of retail services. "We finally realized O&P was never going to be where we wanted it to be if we ignored that generation--young and younger athletes, those under 60."
As part of expanding its O&P division, Home Care Medical has also added two fitters for a total of three.
Those fitters and other trained personnel are what bring customers to Home Care Medical for braces and other sports equipment, rather than a Sports Authority or Dick's, Slaugenhoup says.
"It took us all of last year and we'll work on it again this year, but at least we know, based on the response that we've had, that we're on the right path," she said.
To get the right braces and other sports equipment on its shelves, Home Care Medical asked referral sources like trainers and physical therapists: What do you recommend for your patients?
"Those are the products that we make sure we have in stock or that we have access to them," Slaugenhoup said.
Home Care Medical's decision to target young and younger athletes reflects its attitude, in general, for retail sales.
"Part of it has to be identifying new clientele," Slaugenhoup said. "That's not because we want to abandon the ones we have, but we know we're not reaching everyone in the community. We want to have the products they want and need."
When it comes to retail sales, braces and other sports equipment may not be as popular as, say, scooter and wheelchair lifts, but it's still a "strong category," says consultant Jack Evans.
"I find that HME providers with a retail presence will have at least 12 feet of orthopedic supports and when you include stockings, it may be 20 feet," said Evans, president of Global Media Marketing. "It's an important revenue generator."

In brief: AHP revenues drop, Walgreens reorganizes

Fri, 5 Mar 2010 00:00:00 CST

BRENTWOOD, Tenn. - American HomePatient last week (AHP) reported revenues of $61.3 million for the fourth quarter of 2009 compared to $67.8 million for the same period in 2008, a 9.6% drop. Revenues were $236.3 million for all of 2009 compared to $266.9 million for 2008, a 11.5% drop. Net losses were $1.2 million for the fourth quarter of 2009 compared to a net income of $1.5 million for the same period in 2008. Net losses were $13.1 million for all of 2009 compared to a net income of $500,000 for 2008. AHP blames Medicare reimbursement cuts that went into effect Jan. 1, 2009, for its lackluster performance: They shaved revenues by about $6.5 million in the fourth quarter and $27.4 million for the year. Also hanging over AHP's head: $226.4 million in debt. Its current forbearance agreement expires March 16, 2010.

Walgreens reorganizes healthcare divisions
DEERFIELD, Ill. - Walgreens Health Services Division's specialty pharmacy, infusion pharmacy, mail service pharmacy, medical campus pharmacies, long-term care pharmacy and home care services will move to Walgreens' core Pharmacy Division as part of a restructuring effort, the company announced March 1. The move will enable the company to offer integrated "Pharmacy, Health and Wellness Solutions" to employers, managed care organizations, pharmacy benefit managers and government clients, the company stated in a release. "Simply put, we are integrating Walgreens 70,000 health care providers, on the front lines of health care across the organization, with a unified sales team offering pharmacy, health and wellness solutions for the benefit of our payer clients and their patients," stated Walgreens President and CEO Greg Wasson.

Sunrise gains 'some bragging rights'
LONGMONT, Co. - Sunrise Medical is keeping some pretty lofty company these days. Quality Magazine in January ranked the company 60th on its 2010 Quality Leadership 100 List. The publication generated the list from more than 800 manufacturer survey submissions. The annual list recognizes companies that put quality programs in place, provide employee quality training and take other steps designed to produce high-quality products. "We don't try to get this kind of public affirmation for the efforts that we make, but it does give us some bragging rights," said Gary Johnson, Sunrise's vice president of quality. "The end game is a satisfied customer.

AgaMatrix reaches millionth sale
SALEM, N.H. - AgaMatrix passed a major milestone recently, selling its millionth blood glucose meter, the company announced Feb. 23. AgaMatrix makes the WaveSense line of blood glucose monitoring products. The company shipped its first meter in April 2006. "We're excited that patients and healthcare professionals have adopted our products so quickly," Dave Conn, chief commercial officer, stated in a release. "We are looking ahead to selling our two millionth meter soon." Currently, there are 285 million people with diabetes in the world; 27 million of those are in the United States."

Pride helps out with relief efforts in Haiti
EXETER, Pa. -- Pride Mobility Products has pitched in to help earthquake victims in Haiti by donating new wheelchairs and seat cushions to Gleaning for the World, a non-profit humanitarian organization. Falling buildings have injured many legs in Haiti, making wheelchairs one of the most requested items by relief organizations, according to Gleaning for the World. "When we saw the devastation in Haiti, and the countless life-changing injuries that would require wheelchairs, we knew that we had to get involved with mobility solutions fast," Mark E. Smith, Pride mobility's consumer research manager, stated in a release.

Medline expands operations
PLAINFIELD, Ind. - Medline Industries has opened an 180,000-square-foot distribution center here, it was announced last week. The Indiana Economic Development Corp. offered Medline up to $210,000 in performance-based tax credits and $6,000 in training grants. The company hired 50 workers for the new center and employs nearly 6,000 people at 10 manufacturing facilities in North America.

Lymphedema bill introduced
WASHINGTON - A bill that seeks to improve Medicare coverage for lymphedema diagnosis and treatment was introduced Feb. 23 by Rep. Larry Kissell, D-N.C. The Lymphedema Diagnosis and Cost Saving Act of 2010 would, among other things, establish therapist qualification requirements and require Medicare to pay for compression garments, compression bandage systems and other devices used in the treatment of lymphedema.

Newsletters 'make a statement' with referral sources

Wed, 3 Mar 2010 00:00:00 CST

SUNRISE, Fla. - HME consultant Louis Feuer "hates" to compare his new marketing/educational newsletters to "pens, pads and mugs." They're just so much more, he said.
"This is information," said Feuer, president of Dynamic Seminars & Consulting. "It's an interesting marketing piece and different than anything else that is out there."
For years, Feuer sporadically created custom newsletters for HMEs and other healthcare clients, but the custom products, while great marketing literature, cost from $500 to $1,500 a month--too expensive for most providers.
Now, by partnering with Prime Education, which offers medical education products and services, Feuer can provide an HME or other healthcare provider with 12-monthly newsletters for $649 a year.
A team of four nurses, two medical researchers and a doctor produce the newsletters, which include easy-to-read healthcare information. The newsletters target healthcare professionals, patients and physicians. Topics cover general healthcare and topics related to HME.
"We try to write about issues and topics that people will actually read about," Feuer said. "And they are not written by average people like me."
Topics for healthcare professionals include: "Helping and Treating Insomnia" and "Keys to Lessen the Likelihood of Infection During Home Infusion Therapy." Topics for patients include: "Skin Care for Patients with Incontinence"; "Recreational Activities for People with Disabilities"; and "2010 Medicare Update: Understanding Your Coverage."
Advance Healthcare in Fort Wayne, Ind., recently began using the newsletters as a marketing tool.
"We feel that if we can be consultants and educators, that brings more value to our referral sources," said Amy Fisher, sales manager. "It makes a statement. It lets them know that Advanced is not only in it for your durable medical equipment, but that we are really patient focused and referral-source focused."
The newsletters are customized with a provider's logo. Nearly 40 newsletters are available and more are being created all the time, Feuer said.
Each month, customers go online and pick the newsletter they want from any of the three categories. They receive a digital version, which they can e-mail to their target audience or print out and deliver in person.
Examples of the newsletters can be seen at www.doestraining.com.

Edward Vishnevetsky: Call him the 'middle man'

Tue, 2 Mar 2010 00:00:00 CST

DALLAS - With so many Medicare regulations to keep track of and the government all-too-ready to brand the HME industry fraudulent, providers need attorneys to have their backs. That's why the Texas Alliance of Home Care Services (TAHCS) named Edward Vishnevetsky and John Browning as its general legal counsel in February. Here's what Vishnevetsky, an associate attorney who specializes in HME at the Dallas-based law firm Thompson Coe, had to say about helping to save the industry from audits and national competitive bidding.
HME News: What role will you play at TAHCS?
Edward Vishnevetsky: Most recently, we had a phone call with members about the ZPIC audits. We were able to tell them that we initiated a dialogue on their behalf with the general counsel at Health Integrity (the contractor conducting the audits), which they hadn't been able to do. We were able to tell them what the audits are about and how they can both deal with them and avoid them in the future.
HME: What else is in the works?
Vishnevetsky: We're holding a seminar with TAHCS in March in Dallas. We're going to have industry leaders and attorneys speaking and perhaps congressional representatives. We're trying to do free or inexpensive events to give members both an industry perspective and legal perspective on what's going on--audits, competitive bidding, HIPAA.
HME: What are the roadblock providers face right now?
Vishnevetsky: On a daily basis, it's the overpayments and potential recoupments from the ZPIC and RAC audits. It's like the contractors feel if they push these companies out of business by putting them on pre-pay audits, they'll be winning the battle, because the companies they push out of business were fraudulent.
HME: That's where you come in?
Vishnevetsky: It's always good to have a legal representative to speak on your behalf, but that's especially true for DME. The government has potentially inappropriately deemed the industry to be fraudulent. Most are not intentionally fraudulent. There are just so many regulations with DME that it's difficult to follow all of them. The government comes out with regulations every day and as soon as it comes out with them, it's going to try and enforce them, whether providers know about them or not, which is why we're there to be a middle man between the provider and the government.
HME: If audits are the day-to-day roadblock, what's the big picture roadblock?
Vishnevetsky: Competitive bidding. Everyone is scared right now, because they don't know if they're going to get contracts or if H.R. 3790 is going to go through. We've had talks with various organizations about, well, if it doesn't go through, will we try for injunctive relief? We're talking about doing that as a last-case scenario because competitive bidding is going to cripple the industry and the people who it's going to hurt are the beneficiaries.
HME: Any predictions on how this is all going to turn out?
Vishnevetsky: There are so many companies now that are getting out of the business. The good thing is the ones that remain are ready fight this thing. The problem that we've had with this industry is fragmentation; we don't have a unified voice. That's what I'm hoping to help provide at TAHCS. Providers in Texas, while they're competing against each other, they need to be united to fight competitive bidding and promulgate regulations that will be beneficial to the entire industry, something they can't do on their own.

In the news: Pacific Pulmonary Services

Sun, 28 Feb 2010 00:00:00 CST

NOVATO, Calif. - Pacific Pulmonary Services plans to add 40 full-time jobs at its customer care center in Lexington, Ky., by June, it announced last week.
"Adding these jobs will allow our Lexington site to expand its focus on patient care," stated Bill Pettus, customer care director, in a release. "We are excited by the growth of this center and the ability to offer more employment opportunities in the community, especially in the current economic climate."
With the new jobs, Pacific Pulmonary will employ a total of 165 in Lexington. It opened the customer care center there in 2008.
Available positions include two levels of customer care representatives in various shifts. The pay range: $11.25 to $12.87 per hour and a competitive benefits package.
Also in February, Pacific Pulmonary launched a Facebook page, its first step into the online social media world. The page will serve as an extension of the provider's career center and feature information about job openings, like those offered in Lexington, and career events.
"We are always seeking to attract the best talent available," stated Terry Killian, talent acquisition manager, in a release. "The Facebook page is one more way to find and interact with potential employees."
Pacific Pulmonary serves more than 75,000 respiratory therapy patients from 109 locations in 20 states.