In brief: CMS makes advance payments, state AG sues Apria, OIG warns of cath scams 

WASHINGTON – CMS on March 9 made available Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions. 

The payments may be granted in amounts representative of up to 30 of claims payments to eligible providers and suppliers. The average 30-day payment is based on the total claims paid to the provider/supplier between Aug. 1, 2023, and Oct. 31, 2023, divided by three. These payments will be repaid through automatic recoupment from Medicare claims for a period of 90 days. A demand will be issued for any remaining balance on day 91, following the issuance of the accelerated or advance payment.   

“CMS recognizes that providers and suppliers may face significant cash flow problems from the unusual circumstances impacting facilities’ operations, preventing facilities from submitting claims and receiving Medicare claims payments when using the Change Healthcare platform,” the agency stated. “CMS has heard these concerns and is taking direct action to support the important needs of the health care sector.”   

CMS stated all MACs will provide public information on how to submit a request for a Medicare accelerated or advance payment on their websites as early as that same day, March 9.    

The agency also stated it continues to work closely with state Medicaid programs and is urging Medicaid managed care plans to make prospective payments to impacted providers, as well. 

Additionally, CMS has encouraged Medicare Advantage organizations to offer advance funding to providers most affected by the cyberattack. The rules governing the agency’s payments to MA organizations and Part D sponsors remain unchanged.   

Change Healthcare expects to begin testing and reestablishing connectivity to its claims network and software on March 18, restoring service through that week. It expects its electronic payment functionality will be available for connection beginning March 15.     

To read CMS’s statement in full, go here. 

State AG sues Apria Healthcare 

INDIANAPOLIS – The Attorney General for the state of Indiana on Feb. 29 filed a lawsuit against Apria Healthcare related to a data breach that the state says persisted for multiple years. Apria, which had its main headquarters in Indianapolis before it was bought by Richmond, Va.-based Owens & Minor in 2022, previously provided notice of the breach in May 2023. The lawsuit requests relief on a number of counts, including award damages of up to $100 per violation for up to $25,000 per violation of an identical requirement per year; and civil penalties of up to $500 for each “incurable deceptive act.” Apria says it took immediate action to mitigate the incident, including working with the Federal Bureau of Investigation and hiring a forensic investigation team to investigate and resolve the incident. Based on its investigation and discussions with law enforcement, it believes that the purpose of the unauthorized access was to fraudulently obtain funds from Apria and not to access personal information of its patients or employees, and that there is no evidence of funds removed. It is also not aware of the misuse of personal information related to this incident. 

FDA announces Ventec vent recall 

WASHINGTON – The U.S. Food and Drug Administration has announced a recall of the Ventec Life Systems VOCSN patient breathing package (pediatric, active, oxygen, blue) for a manufacturing issue with its bonded spiral wrap. The recall, a Class I or most serious type of recall, is a correction, not a product removal. The issue: The spiral wrap detaching before or during ventilation, with the potential of compromising the structural integrity and functionality or of causing blockage, stoppage or leaks in the breathing circuit. The FDA says there have been 15 complaints regarding this issue and no reports of injuries or death. Ventec sent all affected customers an urgent medical device recall notification on Jan. 10, 2024, requesting that they stop using the affected package and replace it with a non-affected product; inspect current stock and quarantine any unused affected products to prevent use; and operate the vent as defined in the Instructions for Use and promptly respond to all alarms activated by the ventilator. 

OIG publishes ‘Consumer Alert’ for cath scams 

WASHINGTON – The Office of Inspector General is alerting the public about a fraud scheme involving urinary catheters. In a “Consumer Alert,” the agency says scammers are targeting Medicare enrollees through phone calls, Internet ads and text messages with offers of free services, medical equipment or gift cards upon confirming their personal information and eligibility for specific Medicare services. Often, the enticement for the individual is that they are “qualified” for items “at no cost” or “free.” The OIG says, once the scammers obtain the enrollee’s personal information, monthly billing to Medicare will begin for medically unnecessary urinary catheters that may or may not actually be sent to the enrollee. The agency is asking the public to stay alert and report any potentially fraudulent activity along these lines to 1-800-HHS-TIPS. Through tips and complaints, the OIG can document instances of fraud and take the necessary steps to protect enrollees and federal health care programs like Medicare. AAHomecare recently issued a statement affirming its support for the government to implement real-time monitoring of claims to detect potential fraud and abuse in response to news reports of potential Medicare fraud by a handful of intermittent catheter companies. 

HME Home Health honors women leaders 

RICHMOND, British Columbia – HME Home Health, in partnership with Motion, hosted an inaugural Women in Leadership Event at its corporate office here on March 4. The event, which was attended by women leaders from across the health care industry, included a panel discussion on the experiences and value women leaders bring to organizations and a networking event. "Under the commitment and direction of HME's founders Robert Boscacci, CEO, and Cameron Fleming, CIO, HME has long led the home medical equipment industry in promoting and advancing female leadership within the company," said Michelle Harvey, COO. "In an industry that has long been male-dominated, HME has routinely promoted female leaders to positions of authority, and that is seen from our leadership team, which is 80% female, down to our general employee base, which is 44% female company-wide." HME Home Health’s workforce comprises more than 120 highly-trained professionals, technicians and support staff. 

Harmar merges two facilities in Missouri 

SARASOTA, Fla. – Harmar Mobility recently celebrated merging two manufacturing facilities in Lake Winnebago and Grandview, Mo., into one facility in Raymore, Mo., with a ribbon-cutting ceremony. The new facility provides almost three times the square footage, including twice the office space. It also features conference room space, an engineering lab and a LiftSquad and employee training area. “It’s important that our employees are comfortable and happy while here at Harmar,” said Harmar CEO Steve Dawson. “Our Lake Winnebago and Grandview facilities served us well in Harmar’s early years, but this new space in Raymore offers our team so much more room to grow and continue producing quality products.” Based in Sarasota, Fla., Harmar Mobility is a manufacturer of mobility solutions, specializing in wheelchair lifts for automobiles, stair lifts for homes, and residential and commercial vertical platform lifts. The company was founded in 1998. 

OPGA, Össur name award recipients 

WATERLOO, Iowa - OPGA and Össur Americas have named Matthew Jones as the 2024 recipient of the Russell Walker CP, LP Emerging Leader Grant, and Kelley Berk as the 2024 recipient of the Todd Eagen Advocacy in Action Memorial Grant. “On behalf of Össur and OPGA, we are privileged to announce Matthew and Kelley as the recipients of these two grants that will provide professional development opportunities for the future leaders of O&P while memorializing the impact that Rusty Walker and Todd Eagen had on the O&P profession,” said Adam Miller, president of OPGA. “Both Matthew and Kelley are proven to be rising leaders in the O&P profession and will be exceptional representatives at the AOPA Policy Forum and the Challenged Athletes Foundation Triathlon Challenge.” Now in its third year, the Russell Walker CP, LP Emerging Leader Grant is designed to pay tribute to Russell (Rusty) Walker, a practitioner who was passionate about mentoring the next generation of O&P leaders. “To me, advocacy is one of the greatest things we can do as clinicians and practitioners,” said Jones, a combined prosthetic/orthotic resident with Alabama Artificial Limb & Orthopedic Service. "I’m really excited to be awarded an opportunity to continue to grow and develop my own skills as an advocate as I continue to make my way through residency.” The second annual Todd Eagen Advocacy in Action Memorial Grant honors Todd Eagen, former president of OPGA, who unexpectedly passed away in 2022 and was an important leader in the O&P profession. “I'm so excited for the opportunity to attend the AOPA Policy Forum in Washington, D.C., as well as cheer on some really amazing athletes at the Challenged Athletes Foundation Triathlon in November,” said Berk, CPO with Shamrock Prosthetics. “Thank you so much for the opportunity to attend these events. I’m so excited to be a part of it.” Both annual grants are designed to provide funding to a current O&P resident and certified orthotist or prosthetist (or both) that will allow them to attend and participate in two non-clinical events that are highly important to the O&P profession and the patients it serves. These events include the AOPA Policy Forum and the Challenged Athletes Foundation Triathlon Challenge. 

Healthy.io, Johns Hopkins partner to advance remote wound care 

BOSTON – Healthy.io is launching a program using smartphone-based technology to improve wound care management for patients suffering from chronic diabetic wounds. The program expands access to Healthy.io’s Minuteful for Wound app to patients in the Vascular Surgery and Endovascular Therapy Department at Johns Hopkins Hospital, enabling patients to scan their wounds with convenience and privacy from their own homes, and enabling care teams to remotely monitor patients in real-time, providing early interventions to prevent severe wound deterioration that can lead to amputations. "We are thrilled to be collaborating with Johns Hopkins to utilize this innovative technology, which empowers patients and their caregivers to take an active role in their wound care management," said Geoff Martin, CEO of Healthy.io. "This new patient-centered technology offers a convenient, precise, and reliable solution for early detection and intervention, ultimately improving the patient outcomes and saving significant costs." The first phase of the ongoing program, documented in a manuscript recently published in Frontiers in Endocrinology, showed for 36% of the patients, the real-time at-home remote-monitoring access through the app led to clinical changes to their wound management, such as changing their wound care procedure or scheduling an earlier clinic appointment. Additionally, 94% of patients reported the system was easy to use and beneficial, with less frequent in-person appointments and better continuity of care. Results to date have led to a follow-up larger study in multiple locations in the U.S. and Canada. 

Researchers use grant to ID risk for cardiovascular disease in OSA patients 

NEW YORK – Mount Sinai researchers have received a $3 million grant from the National Institutes of Health to develop and study AI-powered models to identify the risk of cardiovascular disease events in patients with obstructive sleep apnea. Researchers will use machine-learning techniques on comprehensive multi-modal datasets to identify patients at enhanced risk for buildup of fats and cholesterol in the artery walls, and heightened risk for cardiovascular events such as heart attack and stroke. They said the approach will also predict the cardiovascular treatment effectiveness of CPAP therapy for patients with OSA who scored as “non-sleepy” on a standard clinical test, helping to identify patients who would benefit most from using CPAP and those who should avoid it. The foundation of this work is the team’s recently published study revealing the potential harm of CPAP therapy to non-sleepy patients with OSA and acute coronary syndrome. Those findings underscored the importance of identifying OSA patients who could benefit from CPAP and steering the team toward more personalized treatment strategies. “We are inspired by the transformative potential of machine learning techniques in health care, particularly in analyzing vast amounts of complex data to personalize treatment strategies,” said Dr. Girish Nadkarni, MPH, Irene and Dr. Arthur M. Fishberg professor of medicine, director of The Charles Bronfman Institute of Personalized Medicine, and system chief of Data-Driven and Digital Medicine at Icahn Mount Sinai. “Our study has the potential to revolutionize the management of obstructive sleep apnea by offering decision support tools that optimize treatment plans, improve patient outcomes, and reduce the burden of sleep apnea-related cardiovascular disease events on both individuals and health care systems.” The researchers will use data from two cohorts: the Multi-Ethnic Study of Atherosclerosis (MESA) cohort of more than 6,000 ethnically diverse, generally healthy non-sleepy participants, and the Sleep Apnea Cardiovascular Endpoints (SAVE) randomized clinical trial of more than 2,500 non-sleepy participants with moderate to severe obstructive sleep apnea and established cardiovascular disease. They will use these datasets to identify key variables that predict atherosclerosis progression and cardiovascular events, and to identify subgroups with differential treatment effects with CPAP for events based on demographics or risk characteristics, as well as validation of the models within the Mount Sinai Health System, using clinical data from the electronic health record. 

NikoHealth names account success manager 

MIDDLETOWN TOWNSHIP, N.J. - NikoHealth has named Dana Cline, CDME, a seasoned professional with more than 20 years of experience in the HME industry, as an account success manager. Cline’s career spans a broad range of roles, including 12 years in operations and eight years in health plans, as well as significant contributions to large corporations, local companies and hospital-owned DME providers. Her expertise spans intake, resupply, sales, accreditation, inventory and operations, complemented by her CDME certification. “Dana’s extensive background positions her as a key asset in NikoHealth's mission to disrupt the DME industry,” the company said. “She will play a crucial role in working directly with DME providers to onboard and support the adoption of NikoHealth into their businesses, aiming to enhance and modernize their operations.” 

Product launches: ResMed, Sunrise Medical, HME Home Health 

ResMed has launched the AirFit F40, an ultra-compact, full-face mask, in the United States. The mask is ideal for people who sleep on their side, are claustrophobic, and want the stability and seal of a universal fit mask in a minimalist design. In a ResMed clinical study, 88% of patients rated AirFit F40's mask cushion as soft and comfortable and 100% found AirFit F40 easy to use. "Most users prefer smaller and more streamlined masks, but traditional under-the-nose full-face masks can be challenging to fit properly, maintain a seal, and handle higher pressures,” said Justin Leong, ResMed chief product officer. “Our new AirFit F40 addresses this problem by offering the best of both worlds: an ultra-compact full-face mask with the high seal performance of an over-the-nose mask – bridging the gap between compactness and effectiveness in full-face masks.” A key feature of the AirFit F40 is the AdaptiSeal cushion, a 100% soft silicone cushion designed to maintain a facial seal, even when moving around during sleep. FMI:  ResMed.com/AirFitF40. 

Sunrise Medical has launched the QUICKIE Q50 R Carbon, QUICKIE’s lightest folding power wheelchair with a transport weight of only 32 pounds. Features of the wheelchair include carbon fiber frame, magnesium wheels and motors, breathable upholstery, 15-mile battery and five accent colors. “The Q50 R Carbon is ideal for so many people who want to be more independent and travel further,” says Jeff Rogers, Director of Power Product Management at Sunrise Medical. “This chair is a great alternative to a scooter as it is easier to transport, more maneuverable, and simpler to stow. It is also a great second chair for some manual chair riders that would like the power to go further and some power chair riders that want a chair that is easier for travel.” FMI: https://www.sunrisemedical.com/power-wheelchairs/quickie/folding-power-wheelchairs/q50-r-carbon. 

HME Home Health has launched its new HME Signature Series bariatric surface, the HME Coho Mattress. “The HME Signature Series Coho brings the best value in class pressure distribution for a client needing a mattress with a higher weight capacity by combining the latest in green foam technologies and pressure redistribution properties to ensure users are safe and can receive a restful sleep,” said Michelle Harvey, COO and leader of HME Home Health’s Clinical Development Team. The HME Signatures Series was first launched in 2020 and has steadily expanded to include the HME Signature Series Bumblebee Cushion, HME Signature Series Otter Mattress, HME Signature Series Luna Mattress, HME Signature Series Dove Mattress, HME Signature Series LTC 9000 Mattress, HME Signature Series Positioning Sling, HME Grab and Go Manual Wheelchair, HME Grab and Go Tilt Wheelchair, the HME Signature Series NS2 Cushion, the HME Signature Series GD2 Cushion and the HME Signature Series Coho Mattress.