In brief: Benefit manager acquisition, prior auth deadline, provider revalidation
By HME News Staff
Updated 9:53 AM CDT, Fri May 22, 2026
MIRAMAR, Fla. – Integrated Home Care Services has acquired Dina Care, combining an in-home benefit manager with an artificial intelligence (AI)-enabled care coordination and referral management platform.
Together, the companies say they form the first comprehensive in-home benefit management and technology platform for health plans and risk-bearing organizations.
“Given the mounting pressures on health plans and risk-bearing organizations—to improve outcomes, member experience, and administrative efficiency while lowering costs—alongside the industry’s shift toward home-centered care, the case for reimagining in-home benefit management has never been clearer,” said Christopher Bradbury, CEO of Integrated Home Care Services. “Dina’s platform and AI capabilities align perfectly with Integrated’s mission: to meet health plans and risk-bearing organizations wherever they are on their in-home care transformation journey, helping them achieve better outcomes, simpler administration, and greater affordability. Whether they’re looking to supercharge their internal care and network teams, pursue fully delegated benefit management, or find a hybrid approach in between, we have the platform and expertise to deliver.”
As part of the transaction, Ashish V. Shah, founder and CEO of Dina, will join Integrated as chief product & technology officer, where he will lead product strategy, technology innovation, and AI-driven platform initiatives.
The combined platform, the companies say, immediately supports the full array of in-home service categories: home health, personal care, long-term services and supports (LTSS), durable medical equipment and supplies (DME), home infusion, private duty nursing and other home-based services. It also supports all major lines of business and populations: Managed Medicaid, Medicare Advantage, commercial, ACA Marketplace, special needs plans, self-insured plan sponsors and others.
The companies say they serve millions of members nationwide from 20-plus states.
- Related: IHCS plays ‘critical role’
CMS extends prior authorization exemption deadline
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has extended the deadline to opt out of prior authorization and continue submitting requests to May 26, AAHomecare reports.
This extension only applies to suppliers that received a letter from the DME MACs in early March regarding their prior authorization exemption status.
The updated MAC notice specifies:
If you reached exemption and want to continue submitting prior authorization requests, you must submit the opt-out form though myCGS or at Jurisdiction B or Jurisdiction C (PDF forms) between May 19, 2026, and May 26, 2026! Opt-out requests received after this period will be rejected.
The exemption process, introduced in last fall's DMEPOS/Home Heath Final Rule, allows suppliers that meet specified claim approval thresholds to be exempt from prior authorization requirements under specific conditions.
More details on the exemption process and how to opt out can be found here.
Ohio Gov. DeWine signs executive order aimed at Medicaid fraud
COLUMBUS, Ohio – Ohio Gov. Mike DeWine has signed Executive Order 2026-01D to allow the Ohio Department of Medicaid (ODM) to implement emergency rules to require more frequent revalidation of providers identified as higher-risk for committing fraud.
Additionally, DeWine sent a letter to the Centers for Medicare & Medicaid Services (CMS) on May 1 committing Ohio to partnering with the Trump Administration and using a more stringent revalidation process to better prevent fraud.
Under the authority of Ohio Revised Code Sections 5164.02. 5164.32, 5164.33, ODM will immediately amend Ohio Administrative Code rules to:
- Permit Ohio Medicaid to terminate the provider agreements of Medicaid providers that have not provided Medicaid services or billed the Medicaid program in more than one year
- Require Medicaid providers that are at a higher risk for committing fraud to revalidate enrollment more frequently to confirm compliance with Medicaid program rules
- Allow Ohio Medicaid to require certain Medicaid providers to recredential as determined necessary by the Medicaid Director
- Permit the denial of a provider enrollment application when a federally approved moratorium is in effect, even if the enrollment application was received but not approved before the moratorium began.
Related: Florida also issues moratorium on new DME providers.
CMS proposes changes to state-directed provider payment rates
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has published a proposed rule that would cap state-directed provider payment rates at 100% of Medicare payment rates for expansion states and 110% of Medicare payment rates for non-expansion states (or 100% of the Medicaid state plan rate if a comparable Medicare rate is not available).
The rule would also:
- Apply similar limits to certain targeted Medicaid fee-for-service payments, and
- Establish consistent national standards to improve transparency and accountability.
“Medicaid was never meant to be a blank check – it was meant to be a lifeline – and lifelines only work when they're strong, reliable, and built to last,” said CMS Administrator Dr. Mehmet Oz. “Right now, misaligned payment incentives and opaque financing arrangements are driving up costs without delivering better care. This rule restores balance by aligning Medicaid payments with Medicare standards, strengthening accountability, and ensuring taxpayer dollars support patients, not payment schemes. When we hold the line on spending and put patients first, we protect Medicaid for the people who depend on it today and for generations to come.”
If finalized, the “Medicaid Managed Care State Directed Payments (SDP) and Medicaid Fee-For-Service (FFS) Targeted Practitioner Payments Proposed Rule” would generate an estimated $775 billion in total sayings over 10 years, including $510 billion in federal savings.
Here’s how CMS describes SDPs
With the rule, CMS is targeting SDPs, an arrangement where the state directs health plans on how to pay provider reimbursement rather than allowing the plan to negotiate provider payment, the agency says.
“States have often used these arrangements to increase provider payments toward a limited set of providers, typically those capable of providing the non-federal share through provider taxes and intergovernmental transfers,” it says. “Provider taxes are fees charged to entities such as hospitals based on health care services, and an intergovernmental transfer is when a local government entity (like a public hospital) transfers funds to the state to be used as the non-federal share, both of which are used as the state’s portion of Medicaid payments made back to those same providers. Essentially, shifting money from federal coffers to state coffers. By combining these financing tools with excessive payments, states can shift the state’s share of Medicaid financing to federal taxpayers by drawing more federal dollars without equivalent state fund spending; as a result, the federal government’s effective match rate has shifted far higher than specified in federal law.”
To view a fact sheet, visit: https://www.cms.gov/newsroom/fact-sheets/medicaid-managed-care-state-directed-payments-medicaid-fee-service-targeted-medicaid-practitioner.
Aeroflow Urology reinforces commitment to wellness with donations
ASHEVILLE, N.C. – Aeroflow Urology has made donations to the National Diaper Bank Network (NDBN) and United Way, reinforcing its commitment to community wellness and health equity, the company says. Aeroflow Urology says its contribution to the NDBN directly combats the growing issue of diaper insecurity by providing essential hygiene products to vulnerable populations through a network of more than 200 community diaper banks. "At Aeroflow, our mission is to improve the quality of life for the communities we serve," said Mica Phillips, executive vice president of Aeroflow Urology. "These donations are an investment in the health and dignity of individuals and families nationwide, ensuring basic necessities and support systems are accessible to those who need them most." Aeroflow Urology’s donation to United Way Worldwide also supports global initiatives aimed at improving education, financial stability and health outcomes for families in need. By supporting both the NDBN and United Way, Aeroflow Urology continues to provide vital resources that foster healthier outcomes for children and adults alike, the company says.
Soleo Health taps new VP of sales
FRISCO, Texas – Soleo Health has named Joy Rowan as senior vice president, sales. Reporting to the chief commercial officer, she will lead the company’s field sales organization to accelerate commercial performance and deliver on its strategic growth initiatives. "I am thrilled to be joining the Soleo Health team,” she said. “The company’s commitment to improving patient outcomes and expanding to specialty therapies is something I am deeply passionate about. I look forward to leveraging my experience to grow the sales organization and help ensure that more patients receive the life-changing treatments they need." Rowan joins Soleo Health with an extensive background as a health care executive and a deep expertise in navigating complex specialty markets, the company says. Prior to joining Soleo Health, she held key leadership roles at Cencora and Merck, where she built and scaled dynamic sales teams, drove market expansion through innovative go-to-market strategies and supported the successful launch of numerous specialty infusion therapies.
CCS to present latest research on impact of coaching for CGM users
ST. PETERSBURG, Fla. – CCS will offer a poster presentation entitled, “Effect of Structured Coaching and Education on Glycemic and Patient-Reported Outcomes Among Adults Initiating CGM: A Randomized Study” at ISPOR 2026 May 17–20 at the Pennsylvania Convention Center in Philadelphia. The poster showcases soon-to-be-published research highlighting the impact of LivingConnected, a DEAP-accredited program delivering coaching and education for adults starting continuous glucose monitoring. “Continuous glucose monitoring provides powerful insights, but access to data alone is not enough to sustain behavior change,” said Coni Dennis, DNP, RN, NE-BC, SVP and chief clinical officer at CCS. “We often see early improvements following CGM initiation, but without ongoing support, that improvement doesn’t always last. Coaching and education help people build confidence in how patients manage day to day and turn personal health data into habits they can sustain over time.” The randomized trial enrolled 424 adults new to CGM, comparing standard CGM initiation alone with CGM paired with a nine-month, remote, CDCES-led education and coaching program. As health care providers and health plans grapple with growing continuous glucose monitoring (CGM) adoption and persistent gaps in diabetes outcomes, alongside growing chronic care costs, CCS says it is challenging the assumption that simply being prescribed a CGM device is enough. While CGM initiation is often associated with early improvements in glycemic control, its new research suggests those improvements are not consistently sustained without ongoing support.
DME Service Solutions expands in Philippines
TAGUIG CITY, Philippines – DME Service Solutions, a U.S.-led health care outsourcing company, has opened a new operational hub located at Twenty-Four Seven McKinley, Bonifacio Global City (BGC), Taguig City. The expansion marks a significant milestone in the company’s global growth strategy, strengthening its ability to deliver specialized support across clinical services, revenue cycle management, customer engagement and back-office operations, it says. “This office at McKinley Park reflects the continued strength and maturity of our organization as we expand our global operations,” said Richard Lee, CEO. “As we grow, we remain focused on building the infrastructure, investing in the right talent, and creating an environment that supports long-term operational excellence for our teams and partners.” The new BGC facility is designed to support the company’s growing global workforce, which now exceeds 1,000 team members across the U.S., Mexico and the Philippines. Strategically located in one of the region’s premier business districts, the company says the office reinforces its long-term commitment to operational stability, workforce development and scalable health care support services. The space was built to provide a secure, technology-enabled environment where teams can collaborate efficiently while supporting the increasingly complex demands of modern healthcare organizations.
Sunrise Group receives FDA clearance for home sleep test
NEW YORK – Sunrise Group has received clearance from the U.S. Food and Drug Administration (FDA) for its Sunrise Air home sleep test. This clearance marks a major step forward in Sunrise’s mission to expand access to high-quality sleep care by providing a best-in-class, convenient, and clinically robust sleep apnea diagnostic solution that can be completed entirely at home, the company says. “Sunrise has already set a new benchmark for home sleep testing through its high level of diagnostic accuracy even across complex sleep apnea phenotypes, including central sleep apnea, supported by its unique ability to measure respiratory effort," said Laurent Martinot, CEO and co-founder of Sunrise. "With a fully rechargeable model, we're unlocking what sleep medicine has always lacked: multi-night insight with clinical-grade accuracy, from the patient's bedside. Nobody sleeps the same way twice, yet we've been diagnosing based on a single night.” The Sunrise device records mandibular jaw movements (MJM), a clinically validated biosignal for sleep assessment, then analyzes the data through proprietary AI-supported algorithms to generate a comprehensive sleep report for clinician review, the company says. The announcement comes on the heels of a $29 million raise to support the expansion of the company's clinical services and accelerate its investment in next-generation sleep technology.
Medi-Rents reports data breach
BALTIMORE, Md. – Medi-Rents & Sales is providing notice of an event that may affect the privacy of certain information. On or about Feb. 4, 2026, Medi-Rents became aware of unusual activity in its email environment. The information potentially impacted by this event varies by individual and not all data elements were impacted for every individual, but may include name, date of birth, insurance information, and/or limited health information. “We take this event and the security of personal information in its care very seriously,” the company stated. “Upon learning of this event, we moved quickly to investigate and respond to the event and notify potentially affected individuals. As part of our ongoing commitment to the security of information, we are reviewing and enhancing existing policies and procedures to reduce the likelihood of a similar future event.” A notice letter is being mailed to individuals whose information was determined to be in the affected files, for whom a valid mailing address is available. If an individual does not receive a letter but would like to know if they are affected, they may call our dedicated assistance line at 833-877-2603.
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