In brief: Aetna revisits CPAP code change, NHIA pushes bills, Insulet campaigns for diabetes
By HME News Staff
Updated 9:45 AM CST, Wed November 12, 2025
HARTFORD, Conn. - Aetna is once again trying to require adherence codes G8851, G8854 and G8855 for reimbursement for CPAP devices or supplies, the Midwest Association for Medical Equipment Services & Suppliers (MAMES) reports.
The insurer tried the same move earlier this year, but after the HME industry pushed back, saying providers can’t bill these codes, it pulled back the change.
In an October 2025 list of upcoming policy changes and reminders, however, Aetna states:
“Beginning December 1, 2025, we’ll no longer reimburse the CPAP device or the supplies unless you document positive airway pressure therapy using adherence codes G8851, G8854 and G8855.”
Aetna also included the following notes for providers in Washington state, Texas, Maine and Vermont.
Note to Washington State providers: For commercial plans, your effective date for changes described in this article will be communicated to you following regulatory review.
Note to Texas providers: Changes described in this article will be implemented for fully insured plans written in the state of Texas only if such changes are in accordance with applicable regulatory requirements. Changes for all other plans will be as outlined in this article.
Note to Maine and Vermont providers: For commercial plans, your effective date for routine changes described in this article will be the statutory date of January 1, April 1, July 1 or October 1, whichever date follows the effective date(s) referred to in this article. Changes required by state or federal law, or pursuant to revisions of Current Procedural Terminology (CPT®) codes published by the American Medical Association, may be effective outside the statutory dates outlined above.
In a previous letter to Aetna, AAHomecare pointed out that “G” codes identify health care procedures and services that may not have assigned CPT codes and are not listed in the PDAC, which identifies HCPCS codes that are billable by DME suppliers.
NHIA pushes home infusion bills in DC
ALEXANDRIA, Va. - Members of the National Home Infusion Association (NHIA) on Nov. 6 participated in more than 130 meetings with members of Congress and their staff to advocate for a fix to the Medicare home infusion benefit. NHIA members representing provider and supplier companies, along with patients who depend on home infusion services, participated in the event to share their experiences and discuss the critical need to modernize Medicare coverage for home infusion therapy through the Preserving Patient Access to Home Infusion Act (H.R. 2172 / S. 1058). “Home-based infusion is a proven, patient-preferred model that delivers safe, effective care while lowering costs and relieving pressure on hospitals and skilled facilities,” said Connie Sullivan, BSPharm, president & CEO of NHIA. “It’s time for Medicare to evolve and catch up to the private sector, where patients can receive care in their preferred setting – the home – while reducing total health care costs.” NHIA says H.R. 2172 / S. 1058 would modernize Medicare’s home infusion therapy benefit by:
- Closing existing coverage gaps;
- Recognizing pharmacy professional services essential to the safe delivery of care in the home; and
- Expanding care for Medicare beneficiaries who require IV anti-infective treatments.
The NHIA says Medicare's current home infusion benefit is limited to about 36 drugs that use infusion pumps for administration and does not provide adequate coverage for the pharmacy professional services that make home infusion possible. As a result, few home infusion pharmacies participate in the benefit, limiting access for seniors and individuals with disabilities, it says.
Insulet launches workplace-focused campaign for Diabetes Awareness Month
ACTON, Mass. – Insulet has launched a new campaign, “The Day Diabetes Showed Up to Work,” in honor of Diabetes Awareness Month in November.
“Nearly 590 million people worldwide live with diabetes, and approximately 70% are of working age,” said Ashley McEvoy, president and CEO. “Yet too often their experience at work is shaped by misunderstanding, fear of disclosure and a lack of meaningful support. At Insulet, we’re proud to shine a light on this important issue and spark action in the workplace that helps people with diabetes focus on what matters most – doing their best work and living their best lives.”
Insulet is launching a suite of resources to spark awareness and action around diabetes in the workplace, including:
- A dedicated campaign landing page featuring a whitepaper on health care provider support;
- An infographic with key insights, personal stories from Omnipod users and employees with diabetes; and
- Practical checklists for supporting colleagues.
To develop the infographic with key insights, Insulet commissioned an external global survey of 9,656 workers with Type 1, Type 2, and gestational diabetes, as well as caregivers and those without diabetes, across more than 10 sectors in 11 countries. The survey revealed three key issues faced by people with diabetes and their caregivers in their professional life:
- Misunderstanding of diabetes underscores need for education and broader support;
- 42% of people with diabetes and caregivers surveyed reported experiencing workplace-related anxiety tied to diabetes management; and
- While 57% of respondents without diabetes say they feel confident supporting colleagues with the condition, 21% of people with diabetes say poor awareness from colleagues makes their job more difficult.
Related reading:
Pump up the superpower: Insulet, Marvel launch comic hero with Type 1 diabetes
Permobil creates new global role for quality, regulatory leadership
LEBANON, Tenn. - Permobil has appointed Mark Elliott to the new role of executive vice president, quality and regulatory, placing him on the company’s Group Management Team. Elliott, who will report directly to CEO Chuck Witkowski, previously served as vice president, quality, for Permobil’s Americas region. In that role, he demonstrated deep expertise and exceptional leadership in advancing the company’s quality framework. “Quality is at the heart of everything we do because it directly impacts the independence and confidence of the individuals who rely on our solutions,” Witkowski said. “With this new global function, we aim to improve how we develop, manufacture, and respond to market feedback by implementing global standards, breaking down silos, and simplifying processes – without ever compromising regulatory compliance. In a world where speed matters, we need to take our quality culture to the next level, and I am confident Mark is the right leader for that journey.” Elliott joined Permobil in 2022 after roles at Hillrom (now part of Baxter), Mortara Instruments and Cardiac Science. He was drawn to Permobil’s unwavering commitment to the end user and its leadership in an industry that empowers people to live life with independence, he says. “I’m honored to lead Permobil’s global Quality and Regulatory organization,” he said. “Quality and safety are the foundation of trust for our customers and end-users, and that trust drives everything we do. As we accelerate innovation and transform for the future, our global quality framework and quality counts culture will be critical to ensuring we deliver solutions that improve lives – consistently, reliably and at speed.”
VGM names new marketing, events leads
WATERLOO, Iowa – VGM & Associates has named Desiree Trimble vice president of marketing effective Nov. 17. She brings more than two decades of experience in marketing, communications and creative strategy, including more than 20 years with the VGM Group. “Desiree’s creative leadership, strategic mindset, and passion for storytelling have been instrumental in shaping VGM’s voice and brand presence,” said Lindy Tentinger, president of VGM & Associates. “As a long-time employee owner with deep industry experience and strong relationships across our membership and vendor partners, Desiree is uniquely positioned to elevate our marketing and communications strategy at VGM & Associates.” Trimble’s career spans roles such as creative director, marketing strategist and most recently, director of corporate communications & events. She also served as client strategy director at Moxie, where she led strategic initiatives for national brands. Mandi Rodgers, who previously served as vice president of marketing for VGM & Associates, will transition into a new role as vice president of events at VGM Group effective Nov. 17.
McKesson sees flat growth in Medical-Surgical segment
IRVING, Texas – McKesson reported revenues of $2.9 billion for its Medical-Surgical Segment for the second quarter of fiscal year 2026, flat to the same period the prior year. Revenues were driven by higher volumes of specialty pharmaceuticals, offset by lower contributions from illness season products and testing. Operating profit for the segment was $220 million and adjusted operating profit was $249 million, a 2% increase, driven by operational efficiencies from cost optimization initiatives, partially offset by lower contributions from illness season products and testing. Overall, McKesson reported revenues of a record high of $103.2 billion, a 10% increase compared to the same period the prior year. It also reported:
- Earnings per diluted share of $8.92 increased $7.05.
- Adjusted earnings per diluted share of $9.86 increased 39%.
- Generated $2.4 billion of cash flow from operations and $2.2 billion of free cash flow.
For its 2026 full-year outlook, McKesson has raised adjusted earnings per diluted share guidance range to $38.85, from the previous range of $38.05 to $38.55. Among its business highlights for the quarter, the company reiterated its plans to spin off its Medical-Surgical segment.
Tidepool, ŌURA partner to scale diabetes data
PALO ALTO, Calif. - Tidepool, a provider of diabetes software, has announced a strategic collaboration with ŌURA to support a groundbreaking dataset that they intend to make available for diabetes research. With participant consent and authorized disclosure, Tidepool will pair biometric data from Oura Ring – sleep, activity, heart rate, temperature trends and menstrual cycles – with diabetes device data, including continuous glucose monitors (CGMs) and insulin pumps. The companies say this will provide researchers with an unprecedented dataset to accelerate the development of new clinical guidelines, next-generation diabetes technology and personalized care models. "For too long, diabetes research has overlooked critical physiological factors that impact health, especially for women," said Kelly Watson, VP of product and user experience at Tidepool. "This collaboration with ŌURA is a pivotal step toward closing that gap and unlocking new avenues for innovation. By creating a dataset of this scale and detail, we are giving researchers the tools they need to answer long-overdue questions and, ultimately, reduce the daily burden of diabetes.” Recruitment is expected to launch in early 2026 through an International Review Board-approved study. By opting in to this study, participants consent to sharing their data with Tidepool’s Big Data Donation Project, where data is de-identified and, with participant consent, shared with academics, researchers and industry innovators to accelerate diabetes research. "Our mission is to empower individuals to take proactive ownership of their health, and we’re proud to support Tidepool in extending that mission to the diabetes community," said Shyamal Patel, SVP of Science of ŌURA. "The resulting dataset will provide the scientific community with a new foundation for understanding how biometric trends intersect with diabetes management. We believe this collaboration will not only fuel groundbreaking discoveries but also empower individuals with a more complete picture of their health, changing the landscape of diabetes management."
Dynarex honors EMS Captain Jeremy Sonenschein
MONTVALE, N.J. - Dynarex Corp. is honoring EMS Captain Jeremy Sonenschein, who has devoted more than 30 years to fire, EMS, and emergency management, as the recipient of the 2025 Dynarex EMS First Responder Caring Award (FRCA). The award recognizes EMS professionals whose leadership, compassion and service strengthen emergency medical care and their communities. "Jeremy Sonenschein has spent his career helping others – on the job, in the classroom, and through the many EMS professionals he's mentored," said Dynarex VP of Global Sales Bill Roberts. "At Dynarex, we're proud to honor that kind of dedication and the lasting impact it has on the EMS community and beyond." Shauna Winston, RRT, RCP, of Dynarex presented the award to Sonenschein during the National EMS Awards of Excellence at EMS World Expo 2025 in Indianapolis. Sonenschein, MS, BS, AEMT, began his service at 16 as a volunteer with the American Red Cross in Los Angeles, later serving as a Reserve Firefighter/EMT with the Los Angeles City Fire Department and as a paramedic with the Fire Department of New York, where he responded in the aftermath of 9/11 and deployed for disaster relief following Hurricane Katrina. In 2007, he developed a county-accredited fire and EMS training program at Francis Polytechnic High School in Sun Valley, Calif. The initiative gave at-risk students an opportunity to earn certification as emergency medical responders – opening doors to higher education and careers in health care. Sonenschein also serves as the Nevada Family Advisory Representative to the EMS for Children Advisory Committee, where he advocates for pediatric safety and injury prevention programs.
Insulet sees 31% revenue jump
ACTON, Mass. – Insulet reported Omnipod revenue of $699.2 million for the third quarter of 2025, up 31% over the same quarter in 2024. Of that, U.S. Omnipod revenue was $497.1 million and International Omnipod revenue was $202.1 million. “We delivered strong third quarter results, a testament to our team’s exceptional performance and the transformative power of Omnipod 5 for people living with diabetes,” said Ashley McEvoy, president and CEO. “Our continued meaningful engagement with physicians, partners, investors, and our incredible Podder community further reinforces our unique role at the nexus of consumer health, healthcare, and medtech. We’re not just advancing diabetes care—we’re reshaping it.”
Third quarter strategic highlights:
- Integrated Omnipod 5 with Dexcom’s G7 Continuous Glucose Monitor (CGM) sensor in Sweden, Denmark, Finland and Italy
- Secured reimbursement for Omnipod 5 with Dexcom’s G6 and G7 CGM sensors and Abbott's FreeStyle Libre 2 Plus CGM sensor in Norway
- Redeemed remaining $380 million principal of convertible notes
- Partnered with Pantone to launch Omnipod Mango in vibrant new palette
Embla Medical & Iceland launch mobility initiative in Ukraine
REYKJAVIK, Iceland, and COPENHAGEN, Denmark – Embla Medical, a global provider of innovative mobility solutions, has announced the official opening of its new prosthetic clinic in Kyiv. At the clinic’s opening ceremony, Embla Medical also announced a landmark partnership with the Government of Iceland to launch the “Iceland Supports Mobility in Ukraine” initiative, a three-year program designed to deliver high-quality prosthetic care and rehabilitation to up to 1,000 Ukrainian amputees. “Iceland stands firmly with Ukraine, and we are proud to support this initiative in partnership with Embla Medical,” said Thorgerður Katrín Gunnarsdóttir, Iceland’s Minister for Foreign Affairs. “By combining Iceland’s humanitarian commitment with Embla Medical’s expertise in prosthetic care, we can help restore mobility, dignity and independence to those whose lives have been forever changed by the war.” With a total estimated value of USD 11 million over three years, the new initiative will be co-financed by the Government of Iceland and Embla Medical, with charity organization Future for Ukraine (FFU) serving as the implementing partner.
NCPA, APA join legal fight to preserve PBM-related law in Arkansas
ALEXANDRIA, Va. – The National Community Pharmacists Association (NCPA) and the Arkansas Pharmacists Association (APA) have filed a legal brief in the 8th Circuit Court of Appeals defending an Arkansas law blocking companies from operating a pharmacy benefit manager and a pharmacy in the state simultaneously. The case revolves around a state law (Act 624) passed earlier this year blocking PBMs in Arkansas from also operating pharmacies in the state. “The law protects patients by simply saying a business can either be a licensed PBM or a licensed pharmacy - but not both,” said Arkansas Pharmacists Association CEO John Vinson. “PBMs are forcing our most vulnerable Arkansans – including those battling cancer – to use pharmacies owned by or affiliated with the PBMs, and in many cases forcing them to overpay with massive markups for the medications they depend on. This blatant conflict of interest leads to dangerous delays in treatment that threaten patients’ health and safety.” NCPA, which represents nearly 19,000 independent pharmacies across the country, has been active in Arkansas and many other states supporting and defending laws that protect patient access to the pharmacies of their choice. “The Arkansas law is a model for the country,” said NCPA CEO B. Douglas Hoey. “Vertical integration has allowed a handful of giant corporations to control patients and create massive disadvantages for their competition. They deny patients the ability to choose their own health care providers, and they put a lot of small, independent pharmacies out of business, creating pharmacy deserts. The Arkansas law eliminates the obvious conflict of interest at the heart of the problem.”
Tennr adds general manager to focus on health systems
NEW YORK – Tennr is bringing on Maulik Shah as general manager to help health systems streamline referral qualification and routing, improve patient access and ensure they’re reimbursed accurately and on time. In his past work experience, Shah has helped health systems implement electronic health records (EHRs) at Epic, guided hospitals in getting the most out of those systems at Huron and enabled clinicians to work more efficiently with ambient AI at Ambience. "As we started working with some of the largest health care institutions, helping them get patients in the door while defeating care backlogs and leakage, it became clear we needed someone that has been there more than a few times,” said Trey Holterman, CEO and co-founder of Tennr. “And Maulik is that guy. There's simply no one better to accelerate the reach of the Tennr platform within health systems. We could not be more excited to have him on the team.” Tennr has raised $162 million from investors, including IVP, Andreessen Horowitz, Lightspeed, GV and ICONIQ.
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