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In brief: Brooks-LaSure confirmed, SuperCare contract renewed, telehealth monitoring warranted

In brief: Brooks-LaSure confirmed, SuperCare contract renewed, telehealth monitoring warranted

WASHINGTON -- The Senate on Tuesday confirmed Chiquita Brooks-LaSure to head CMS.

Brooks-LaSure served in the Obama Administration, where she helped guide the Affordable Care Act through passage and implementation. She also worked as a Democratic staffer for the Ways and Means Committee in the House of Representatives.

“AAHomecare congratulates Chiquita Brooks-LaSure on her confirmation as CMS Administrator,” said the association. “Her experience in roles at CMS, HHS and on Capitol Hill provide a solid foundation for her work leading federal healthcare programs that support the health and well-being of millions of individuals throughout America.”

Brooks-LaSure's nomination was put on hold in April by Sen. John Cornyn, R-Texas, over a rescinded Medicaid waiver for that state.

The HME industry has been, in many ways, in a holding pattern on various initiatives while awaiting the confirmation of Brooks-LaSure.

“AAHomecare and the home medical equipment (HME) community are especially eager to work with Administrator Brooks-LaSure to provide a meaningful update on Medicare reimbursement rates for HME to reflect increasing product costs and new operational requirements suppliers currently face,” said the association. “We urge the administrator to address this issue through the pending DME Rule and expedite release of this important regulation.”

GAO on telehealth and other waivers: ‘Careful monitoring is warranted’

WASHINGTON – Members of the Government Accountability Office testified before Congress in May saying, while Medicare beneficiaries and providers have benefitted from program waivers and other flexibilities, their continued use beyond the pandemic increases risks and raise considerations.

  • Among those risks and considerations: 
  • Increased spending: Telehealth waivers can increase spending in both Medicare and Medicaid, if telehealth services are furnished in addition to in-person services.
  • Program integrity: The suspension of some program safeguards has increased the risks of fraud, waste and abuse that the GAO previously noted in its high-risk report series.
  • Beneficiary health and safety: Although telehealth has enabled the safe provision of services, the quality of telehealth services has not been fully analyzed.

CMS has issued more than 200 waivers and other flexibilities for Medicare. Telehealth waivers, the GAO points out, have resulted in utilization increasing from a weekly average of about 325,000 services in mid-March to a peak of about 1.9 million in mid-April 2020.

“The long-term effect of these waivers on spending and quality of care is not yet known,” wrote Jessica Farb, director, health care, and Carolyn Yocom, director, health care, in their testimony. “In addition, we reported that careful monitoring and oversight is warranted to prevent potential fraud, waste and abuse that can arise from these new waivers.”

CMS has approved more than 600 waivers or other flexibilities for Medicaid.

F&P reports ‘unprecedented result’

AUCKLAND, New Zealand – Fisher & Paykel Healthcare reported operating revenue of $1.97 billion for the full year ended March 31, 2021, an increase of 56% over the previous year or 61% in constant currency.

The company reported net profit after tax was $524 million, an increase of 82% or 94% in constant currency.

“The unprecedented result was driven by our Hospital product group, which includes Optiflow and Airvo systems used to deliver nasal high flow therapy,” said Lewis Gradon, managing director and CEO. “Sales of our Hospital hardware and consumables have continued to track COVID-19 hospitalization surges in countries around the world.”

F&P reported revenue for the Homecare product group of $466 million, an increase of 2% or 4% in constant currency.

The company declined to provide guidance for the 2022 financial year due to the ongoing uncertainties of vaccinations, lockdowns, COVID-19 variants, localized waves and return to stable hospitalization rates around the world.

“We expect our Hospital and Homecare revenue for FY22 to be impacted by the number of COVID-19 related hospitalizations around the world,” Gradon said.

As part of its financial results, F&P announced a profit-sharing bonus of $29 million for the 2021 financial year for employees who have worked for the company for a qualifying period.

The company also announced a new foundation to support and fund health research and programs that improve access to health care, support environmental protection initiatives and promote awareness of opportunities in science, technology, engineering and mathematics. The value of total donations to the Fisher & Paykel Healthcare Foundation in 2021: $26 million.

Viemed pushes back on OIG’s findings

‘(We) do not expect to receive an overpayment determination from CMS’

LAFAYETTE, La. – Viemed Healthcare says a recent report from the Office of Inspector General shows how disconnected investigators are from CMS’s clinical protocols for non-invasive ventilators and shines a light on the lack of understanding of the critical role HME providers play in providing this life-saving care to patients.

The OIG in May published a report saying most of the Medicare claims submitted for the monthly rental of NIV by Viemed, under its original name Sleep Management, did not comply with Medicare requirements, resulting in overpayments of at least $29.1 million.

“Viemed completely disagrees with the report’s findings and does not expect to receive an overpayment determination from CMS,” said Casey Hoyt, Viemed Healthcare’s CEO. “We expect CMS to disregard the recommendations contained in the report, as they contradict prescribing physicians’ and CMS’s own research-based guidance for the DME industry.”

The OIG found that, of the 100 sampled claim lines with payments totaling $75,694, two complied with Medicare requirements and 98 did not.

The agency recommends that Sleep Management refund the portion of the estimated $29.1 million in Medicare overpayments for claim lines incorrectly billed that are within the four-year reopening period; exercise reasonable diligence to identify, report and return any similar overpayments in accordance with the 60-day rule; and follow existing policies and procedures to help ensure that it complies with Medicare requirements.

Viemed, however, published a response to the report making the following points:

  • The lack of clear guidance on the use of NIV for COPD means that different government entities apply differing, and often conflicting, standards on when NIV is appropriate. This is confusing for physicians, patients and suppliers, and leads to non-medical bodies like the OIG substituting their alleged medical judgment for that of treating physicians.
  • Of the 100 claims audited by OIG, 42 claims were previously audited by CMS during a separate review. As a result of that previous audit, CMS approved and paid 41 of the 42 claims. OIG subsequently failed all 42 of the claims. The report does not address this glaring inconsistency.
  • As part of their treatment plan, 89 independent physicians around the country wrote NIV prescriptions and supplied medical records supporting that decision in a good faith effort to provide NIV for the 100 seriously ill patients with chronic respiratory failure who were the subject of this audit. These treating physicians believed NIV was in the best interest of their patients, but the OIG medical review contractor, Maximus, which had no contact with patients except to briefly review their charts years later, contradicted their physicians’ medical conclusions as to what was best for them.
  • The OIG audit plan instructed Maximus reviewers to “explain why the medical records did not justify treatment with a NHV,” showing that OIG’s intent was to subjectively find ways to deny coverage to these seriously ill patients.
  • Applying OIG’s guidance that NIV is essentially never warranted would deny coverage for life-extending therapy from an estimated 75,000 patients across the country. This would actually increase the cost to CMS by requiring patients to use repeat visits to the emergency room to manage their diagnosed and documented end-of-life conditions.

The OIG says it reviewed Sleep Management’s comments but maintains its findings and recommendations are valid. To avoid potential confusion, it did remove a finding related to a beneficiary’s continued need for NIV, but removing this finding did not change its estimated overpayments or recommendations, it says.

Quipt begins trading on Nasdaq

CINCINNATI – Quipt Home Medical’s shares have begun trading on the Nasdaq under the symbol QIPT. “This Nasdaq listing is an incredible achievement for our company and its shareholders, as we continue our mission of providing superior patient care for at home respiratory patients across the United States,” said Greg Crawford, CEO and chairman. “This listing reflects the substantial organizational growth experienced by our company and our evolution as a publicly traded company over the last several years.” Quipt earlier in May filed a Form 40-F Registration Statement with the U.S. Securities and Exchange Commission. The company’s common shares began trading on the Toronto Stock Exchange TSX Venture Exchange under its new name May 13.

NSM expands presence in Northeast

NASHVILLE, Tenn. – National Seating & Mobility has acquired All-Ways Accessible, a home accessibility provider in New Hampshire, Vermont and Maine. “The All-Ways Accessible team has an established reputation of excellence in the Northeast, and we’re pleased to build upon those services through this acquisition,” said Bill Mixon, NSM CEO. “Mobility often goes beyond the chair, and NSM is committed to helping customers find solutions in their home or on the go. We’re proud to continue expanding holistic mobility and accessibility options throughout New Hampshire, Vermont and Maine.” The Concord, N.H.-based All-Ways Accessible was founded by 30-year industry veteran Jeff Lavoie and offers residential elevators, stairlifts, patient lifts, vertical platform lifts and modular ramps. Including Lavoie, the acquisition will add 16 new employees to the NSM team. NSM has made four acquisitions so far this year.

… deepens relationship with customers

NASHVILLE, Tenn. – National Seating & Mobility has launched a new lifestyle magazine called Let’s Get Moving. The premiere issue will be distributed through NSM’s network of more than 180 locations across the United States and Canada. “Let’s Get Moving is a product of our company’s commitment to our clients,” said Bill Mixon, CEO of NSM. “We want this magazine to be a celebration of our clients’ vibrant lives and a way we can build and deepen our relationship with them. Our customers are at the core of everything we do, and this magazine is no different.” NSM will also provide a digital version of Let’s Get Moving, which will highlight the personal stories of its clients, as well as accessibility issues and product trends. The premiere issue includes a cover story on world champion mountain bike racer Sean Simonson, delving into the topics of technology driven care, alternate funding resources and more. NSM will release two issues of Let’s Get Moving this year.

Quantum Rehab donates chair with ‘wings’

CHESTERFIELD, Mo. – Quantum Rehab recently donated a Stretto power wheelchair to Austyn Martin as part of his wish from the Make-A-Wish Missouri & Kansas chapter. Martin, 17, of Tunas, Mo., was born with spinal muscular atrophy. Because of his love of sports cars, the power wheelchair was presented at Holman Motorcars St. Louis, an Aston Martin dealership, where Martin was able to see the luxury cars up close. An additional surprise for Martin was a set of authentic Aston Martin Wings donated by Aston Martin for the back of his power wheelchair. “At Quantum Rehab, consumer needs and wishes are our driving force,” said Jay Brislin, vice president of Quantum Rehab. “We are pleased to partner with the Make-A-Wish Missouri & Kansas chapter to grant Austyn’s wish of a Quantum Stretto power wheelchair.”

Medtronic, OneDrop earn CE Marks

Medtronic, a global medical technology company based in Dublin, Ireland, has received CE (Conformité Européenne) Marks for the expanded functionality of its InPen smart insulin pen for multiple daily injections and for its Guardian 4 sensor, which requires no fingersticks for calibration or diabetes treatment decisions. The CE Marks allow this next-generation sensor to be integrated with either the MiniMed 780G insulin pump system or InPen, or for stand-alone continuous glucose monitoring use…New York-based One Drop, which offers health solutions for people living with chronic conditions, has received the CE Mark for its Blood Pressure Trend and Analysis Engine-1 to generate blood pressure insights. As part of the One Drop Digital Membership, consumer and employer members worldwide can now receive in-app messages with blood pressure trends, behavioral reinforcements and alerts for hypertensive crises.

SuperCare renews Optum contract

DOWNEY, Calif. – SuperCare Health has renewed its contract with Optum to provide respiratory care services, equipment and supplies for its members in Southern California. “We are honored that Optum has extended our contract,” said John Cassar, CEO. “This continues to strengthen our long-term partnership with Optum, and it will bring even more innovative solutions like our COVID-19 Telemonitoring, iBreathe, and Home Sleep Testing Programs that drive positive patient outcomes for those dealing with chronic conditions.” SuperCare Health quickly developed a COVID-19 Telemonitoring Program for Optum to manage those impacted by COVID-19 who could recover in their own homes, enabling more available beds for those facing more critical infections. Post-program surveys revealed 100% of patients enrolled in the program felt that they were better able to manage their health from being in the program.

Geisinger launches chronic care program

DANVILLE, Pa. – Geisinger has launched ConnectedCare365, a care delivery program for patients with chronic diseases like diabetes, heart failure and hypertension. "This is a fundamentally different approach to chronic disease management," said Karen Murphy, Ph.D., RN, chief innovation officer and founding director of Geisinger's Steele Institute for Health Innovation. "Using predictive analytics, as well as real-time analysis of clinical and patient-generated data, ConnectedCare365 will help our patients achieve their health goals and better manage chronic conditions.” ConnectedCare, which is powered by digital health startup Noteworth, allows patients to take control of their health by monitoring their weight, blood pressure, glucose and other metrics using a smartphone app. By analyzing patient-generated data and relevant information from the electronic health record, the platform communicates directly with the patient's care team, allowing clinicians to triage and prioritize care for high-risk patients to prevent unnecessary emergency room visits and hospitalizations.

Inogen makes board appointment

GOLETA, Calif. - Inogen has appointed Elizabeth (Beth) Mora to its board of directors and its Audit Commitee. She previously served as chief administrative officer, vice president for finance, administration and treasurer at the Charles Stark Draper Laboratory from 2008 to 2020, and in a variety of leadership roles at Harvard University from 1997 to 2008. “I am excited to welcome Beth to Inogen and believe that her financial and business acumen will benefit our board of directors,” said Nabil Shabshab, CEO and president. "We believe her expertise will be a significant asset as we continue to refine and execute on our strategic plan to enhance the freedom and independence of oxygen therapy patients worldwide and further expand our product and service offerings.” Mora will serve as a Class I director, with a term expiring at the annual meeting of stockholders in 2024. She fills the vacancies created by the resignation of R. Scott Greer on May 24. In connection with the transition, Loren McFarland, an existing member of the Audit Committee, was appointed chairperson of that committee.

Connect America expands management team

BALA CYNWYD, Pa. - Connect America has expanded its strategic management team with four new hires, including industry veteran Rosemary Kennedy as chief health informatics officer. Kennedy has spent decades of her professional career in health care technology, specifically mobile communication and medical device monitoring solutions. She has led the development, implementation and value creation of body-worn sensors, mobile apps, mobile communication infrastructure and workflows, algorithms and population analytics. Other new hires are: Dorit Baxter as chief marketing officer, John Fanuko as vice president of finance, and Nicole Kahny as chief human resources officer. “I am thrilled to expand our leadership team in the critical areas of health informatics, human resources, marketing and finance, and enthusiastically welcome Rosemary, Dorit, John and Nicole to the leadership team,” said Janet Dillione, CEO. “Their roles will be instrumental in merging Connect America with Philips Aging and Caregiving business. Each of them has a high level of domain expertise that will continue to reinforce our mission and strength in innovation in the personal emergency response system market and beyond.” Earlier in May, Connect America agreed to acquire the Aging and Caregiving business of Royal Philips.

Ability Member Group partners with Cardinal Health Canada

TORONTO – Ability Member Group has entered into a supplier agreement with Cardinal Health Canada. The relationship will help support HME network members by improving cost-effectiveness and efficiency in care delivery. “Securing this new supplier agreement with Cardinal Health Canada is exciting,” said Jamie Church, CEO of Ability. “With their extensive footprint in Canada, they will be able to support us in further improving how we can help members grow their businesses. Cardinal Health’s products and services offering will provide a significant benefit for our members.” Ability Member Group has members across Canada.

OxyGo adds sales exec

ORLANDO, Fla. – OxyGo has named Ben Kim as Western Regional Sales Manager based in Simi Valley, Calif. Kim brings more than 25 years of sales experience in home oxygen therapy, with a focus on pressure swing adsorption and pulse technology. “I am incredibly pleased with the talent we are attracting as we go through another exciting growth phase,” said V.E. Marquard-Schultz, CEO of OxyGo. “Ben brings a wealth of knowledge and a level of expertise to our team.” Kim will be responsible for developing new business relationships, promoting products and services for the OxyGo brand and ensuring overall client satisfaction for the western territory. He will be supported by OxyGo’s full-service facility in Phoenix.

ATF Medical adds ‘single point of contact’ for catastrophic care

WOODBRIDGE, Va. – ATF Medical, which provides medical equipment and adaptive housing solutions to the workers compensation industry, has added Reneé Espiritu as manager of catastrophic care. In this newly created position, Espiritu coordinates all medical equipment and supplies, along with adaptive housing needs, for seriously injured workers. “Reneé streamlines the process of acquiring all the specialized medical equipment and home modifications that a complex case needs,” said Rick Wyche, director of business development for ATF Medical. “Adjusters and case managers don’t need to coordinate several suppliers. Reneé has the depth of experience and contacts to serve as their single point of contact.” Espiritu most recently served as the catastrophic team lead for MTI America. She previously worked for TechHealth and One Call Company.

Vent bill moves forward in Louisiana

BATON ROUGE, La. – The Louisiana House of Representatives in May passed HB 594, a bill that would prevent insurers, managed care organizations and other payers from setting reimbursement caps for ventilators, according to AAHomecare. The association joined HME stakeholders in the state to support the bill, helping to convince key legislators to remove proposed amendments that would have capped costs for non-invasive ventilators and would have restricted the ability of HME providers to provide important service and maintenance for these specialized products. “This is a very positive development for Louisiana respiratory providers and patients who depend on what are, in most cases, life-support systems,” said Tom Ryan, president and CEO of AAHomecare. “HME leaders in Louisiana have done a terrific job moving this bill forward in a challenging legislative environment.” David Chandler, senior director of payer relations for AAHomecare, testified in person before the House Insurance Committee on May 12 to support the bill. HB 594, which passed 84-14, now moves to the Senate.

Stakeholders meet with staff of Rep. McMorris Rodgers

SPOKANE, Wash. – Members of the Pacific Association for Medical Equipment Services (PAMES), along with John Gallagher of VGM, met with the staff of Rep. Cathy McMorris Rodgers in her office here last week. The group expressed concerns with the increasing costs of home medical equipment. Accompanying Gallagher, vice president of government relations for VGM, were Mike Calcaterra and Paul Sabin of Norco, Don Whitney of Inland Medical and Rehab, and Melissa Roberts of Bellevue Healthcare. McMorris Rodgers, who serves as the ranking member for the Energy and Commerce Committee in the House of Representatives, has been a champion of key legislation to support the HME industry in the past.

Permobil launches resources for cushions

NASHVILLE, Tenn. – Permobil has launched several solutions-based selection tools and resources for clinics and providers to easily find the right cushions based on an individual’s needs. On the company’s new website, clinics and providers can now focus their search for cushions based on product features such as skin protection, positioning, medium and more. Clinicians and ATPs can also reference a combined brochure from Permobil with cushion products from some of the most trusted names in complex rehab, including ROHO and Comfort Company. “By bringing our portfolios together under one brand, we were able to streamline product offerings, as well as the selection process, to truly show the quality solutions available for individuals,” says Audra Watt, vice president of marketing. “We have taken this approach with our wheelchair back supports too and summarized our varying options in a new brochure available now. We have even more seating and positioning resources planned for later this year to provide support to targeted user groups and products such as: pediatric, long-term care, accessories, and ancillary products.” Additionally, Permobil’s sales team is making available printed posters to clinics and providers for a quick reference guide.


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