In brief: EnsoData’s investment, pilot’s fraud algorithm, Kennedy’s infusion stance

MADISON, Wis. – EnsoData has received $20 million in Series B financing led by Questa Capital to accelerate adoption of its AI-powered sleep medicine solutions. 

“Traditional approaches in sleep medicine have left nearly 80% of patients undiagnosed and, of the 20% that are positively diagnosed, only one in two will be successfully treated,” said Justin Mortara, Ph.D., president and CEO of EnsoData. “We need to expand patient access with simpler and more economic testing while embracing new approaches for sleep apnea therapies to improve this reality. EnsoData’s AI solutions are uniquely positioned to do both, and this Series B fundraise will allow us to rapidly scale our commercial team to deliver the next wave of AI-driven health care solutions.” 

In addition to Questa Capital, existing investors participated in the Series B, including Zetta Venture Partners, Venture Investors Health Fund, Supermoon Capital and Inspire Medical Systems. 

In May, EnsoData added Bobby Cockrill to its commercial team. 

“The appointment of Bobby is our first step toward establishing a substantial U.S. commercial team,” said Mortara. “His deep experience in diagnostics and managing strategic sales and sales operations are already having an exciting impact.” 

• Related: EnsoData has also formed several partnerships recently, including BodiMetrics and Blackstone Medical. 

Bills would provide more oversight of DME 

WASHINGTON - New legislation introduced in the House of Representatives and Senate would create a pilot program for testing the use of a predictive risk-scoring algorithm to provide oversight of payments for durable medical equipment and clinical diagnostic laboratory tests under the Medicare program,  AAHomecare has reported.  

The algorithm would then assign a risk score to all fee-for-service transactions, with high-risk scores assigned for claims billed at a rate or style that appears to be irregular. That data would allow human inspectors to prioritize reviews of transactions that are most likely to be fraudulent. 

The Medicare Transaction Fraud Prevention Act (S. 2066 & H.R. 3996), introduced June 12, also instructs the Department of Health and Human Services to work with industry representatives, including DME suppliers, on the development and implementation of the pilot program. 

AAHomecare says it supports testing this new approach to identify attempts to defraud the Medicare program, especially where they can help catch emerging fraud schemes before they are widely implemented. 

Read the text of the bill here. 

EqualizeRCM expands DME services 

AUSTIN, Texas – EqualizeRCM, a provider of revenue cycle management (RCM) solutions, has invested in MedNet LLC, a provider of RCM services for durable medical equipment (DME) and physician specialty practices. "This partnership with EqualizeRCM positions us to elevate the level of service and innovation we provide to clients,” said Jeffrey Bierman, CEO, MedNet. “Our 20-plus year relationship, shared values, strategic alignment and complementary capabilities make this an exciting step forward for MedNet and the providers we support. With EqualizeRCM's scale, we are now able to deliver on projects much larger than what we have historically been able to do." MedNet's team of experienced revenue cycle professionals focus on optimizing every aspect of the health care revenue cycle—from registration to final claims resolution, the company says. Their engagements are tailored to the specific needs of each client to maximize financial and operational outcomes, it says. For EqualizeRCM, the partnership will allow the company to enhance its ability to serve DME providers, says Michael Hill, president. “Our goal is to be a leading provider of RCM services in select medical specialties,” he said. “MedNet's exceptional team, deep expertise, and ability to positively impact their clients' bottom lines all align perfectly with our mission. This partnership significantly enhances our ability to serve DME providers – small and large - across the country." 

NHIA welcomes Kennedy’s support for home infusion access 

WASHINGTON – The National Home Infusion Association (NHIA) applauds Health and Human Services Secretary Robert F. Kennedy, Jr.’s recent statement in support of improving access to home infusion services for Medicare beneficiaries. “We agree with his sentiment that commonsense reforms to Medicare – like home infusion – will save taxpayer dollars while improving access to care, especially for rural and elderly patients,” stated the NHIA. “We stand ready to work with the Secretary and HHS to remedy the current lack of coverage for home infusion therapies.” Rep. Diana Harshbarger, R-Tenn., raised the subject during a June 24 hearing of the House Energy & Commerce Committee.  Harshbarger is a co-sponsor of the Preserving Patient Access to Home Infusion Act (H.R. 2172 & S. 1058), which would improve access to home infusion therapy. In response, Kennedy stated: “It makes no sense, it’s much more expensive for our system. It’s literally billions of dollars a year that are unnecessarily spent by forcing these patients—particularly in rural areas, elderly patients—that could easily use infusions at home and are forced to come into a hospital to use them. And it doesn’t make any sense and it’s part of the commonsense reforms we’re doing here at HHS.” 

• Related: Re-introduced legislation seeks to modernize home infusion benefit  

Oh brother: Sibling convicted in Medicare fraud 

NEW YORK - The U.S. Attorney for the Southern District of New York, Jay Clayton, announced today the conviction of Ted Albin for his role in orchestrating a multimillion-dollar Medicare fraud scheme. According to court documents and evidence presented at trial: From approximately 2016 through April 2021, Albin operated Grapevine Professional Services, a medical billing company, which he used to submit fraudulent reimbursement claims for durable medical equipment, including back braces, knee braces, wrist braces and shoulder braces. Albin submitted thousands of fraudulent claims on behalf of DME supply companies, including at least three DME supply companies owned and controlled by Albin and his sister, Erin Foley: Liberty Bell Medical, Skye Medical and Priority Medical. Albin’s fraudulent claims were based on prescriptions for DME which he knew had been illegally bought with kickbacks paid by the DME supply companies. At least some of the prescriptions billed were generated with forged doctor’s signatures and without regard to the medical need of the patients for whom braces had been prescribed. In total, the DME companies that Albin submitted claims for billed Medicare for more than $38 million, on which Medicare paid out more than $12 million. “Ted Albin brazenly defrauded our Medicare system using fake and fraudulent prescriptions,” said U.S. Attorney Jay Clayton. “He cheated Medicare out of millions meant for real patients with every taxpayer footing the bill. Today’s verdict makes clear: if you cheat Medicare, you will be prosecuted.” 

• Related: Siblings charged in Medicare fraud 

Hanger inks purchasing agreement with Premier 

AUSTIN, Texas – Hanger Clinic has been awarded a national group purchasing agreement for O&P care by Premier, a tech-driven health care improvement company. Effective May 1, 2025, Premier members can take advantage of pricing and pre-negotiated terms for O&P care at Hanger clinics across the country. “We are excited to work with Premier’s members to deliver the highest standard of orthotic and prosthetic patient care," said Michael Oros, president of Hanger Clinic. "This agreement will expand access to essential care for individuals who need customized prosthetic and orthotic care solutions to meet their unique needs. By partnering with health care providers and medical centers, we can significantly improve clinical outcomes and empower patients to live life to the fullest." Premier members can access Hanger Clinic’s comprehensive services to support care delivery for patients requiring orthotic and prosthetic interventions, including orthopedic trauma, spinal trauma, stroke rehabilitation and amputee care. Hanger Clinic says it supports health systems driving toward a higher value of care by helping identify solutions that will improve patient outcomes and reduce length of hospital stays and potential readmissions. 

Glucotrack’s implantable CGM shows clinical accuracy 

RUTHERFORD, N.J., and STOCKHOLM — Glucotrack announced the results from its completed first-in-human clinical study of its implantable continuous glucose monitor (CGM) at the American Diabetes Association’s (ADA) 85th Scientific Sessions June 20-23, 2025, in Chicago. Using OneTwo Analytics’ next-generation artificial intelligence and machine learning-based analytics to evaluate the data and assess its clinical value, Glucotrack showed that 92% of the CGM's measurement values were in the green zone and none were recorded in the unsafe zones, demonstrating very high clinical accuracy when compared to the reference blood glucose values. “This study represents an important milestone validating our CBGM technology’s potential,” said Paul V. Goode, PhD, president and CEO of Glucotrack. “With a MARD of 7.7%, which is comparable to leading CGM systems but with direct blood measurement instead of interstitial fluid, we’re advancing our novel technology into further clinical trials, taking us closer to providing patients with a long-term, less burdensome solution for diabetes management. We are excited to be sharing our data at this important industry congress.” Glucotrack expects to initiate a long-term early feasibility study in Q3 2025, which will evaluate safety and performance over an extended period, bringing the technology closer to its goal of providing patients with a less-intrusive alternative to continuous glucose monitoring. The study, which was conducted at the Interventional Cardiology at Instituto do Coração in São Paulo, Brazil, between Dec. 13, 2024, and Jan. 31, 2025, included 10 participants with either Type 1 or Type 2 diabetes who were on intensive insulin therapy. Following device placement, each participant underwent inpatient observation for four days. During this period, frequent blood sampling and glucose tolerance tests were conducted to assess device performance. Detailed analysis showed consistent performance during glucose tolerance testing with minimal lag time compared to venous blood samples. The system successfully remained in place throughout the study period and was successfully removed at study completion, with patients then followed for seven days post-removal. 

Rothman Orthopaedics to implement Dimension Ortho’s platform 

PHILADELPHIA – Rothman Orthopaedics will implement Dimension Ortho's platform for personalized bracing and fracture care across its clinical sites, setting a new standard for patient care, the companies say. "Our goal is to provide more streamlined and patient-centric, comfortable recovery," said Michael Rivlin, MD, president and co-founder of Dimension Ortho. "Dimension Ortho's partnership with Rothman Orthopaedics will allow thousands of patients to experience minimal disruption to daily activity and accelerated recovery from both acute and chronic injuries." Dimension Ortho's modular production system is designed for seamless integration across any treatment setting across outpatient clinics, urgent care centers, hospital systems and O&P sites, ensuring broad compatibility, the company says. With this advancement, Rothman providers can now provide patients with a more advanced and comfortable alternative to traditional casts and braces, the company says. "Our partnership with Dimension Ortho reflects Rothman's ongoing commitment to innovation and elevating patient care," said Alexander R. Vaccaro, MD, PhD, president of Rothman Orthopaedics and the Richard H. Rothman Professor and Chairman of Orthopaedics at Thomas Jefferson University and Hospitals. "This is something patients want and need in an environment of time constraints and rising health care costs."