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In brief: Prochant’s PE partner, CMS’s supplier suspensions, Samsung’s sleep expansion

In brief: Prochant’s PE partner, CMS’s supplier suspensions, Samsung’s sleep expansion

CHARLOTTE, N.C. – Prochant has formed a strategic growth partnership with Longshore Capital Partners to expand its technology, services and operational capacity for home medical equipment (HME) and other home-based care providers.

"This partnership represents an important milestone for Prochant and a strong validation of the company our team has built," said Joey Graham, CEO of Prochant. "Longshore shares our conviction in the opportunity to combine deep revenue cycle expertise, purpose-built technology and exceptional client service to help home-based care providers improve financial and operational performance. With Longshore's support, we will accelerate investment in the business while remaining focused on the clients and markets we know best."

Longshore will work with Prochant’s management team as the company continues investing in its people, technology and service capabilities. Prochant says the partnership is intended to strengthen client outcomes, while preserving the leadership, culture and market focus that have shaped the company.

The partnership will support Prochant’s growth by:

  • Enhancing the client experience and improving client outcomes
  • Advancing technology, analytics AI, and automation capabilities
  • Expanding service capacity and operational scale
  • Developing additional revenue cycle solutions for home-based care providers
  • Recruiting, developing and retaining industry and technology talent
  • Pursuing complementary growth opportunities within Prochant's core markets

Prochant’s existing management team will remain in place and continue carrying out the company’s strategy, with Longshore providing additional resources, experience and strategic support.

“Our leadership team, culture and commitment to our clients remain unchanged,” Graham said. “This partnership gives us additional resources to build on what is already working.”

HHS, CMS pause $1B in federal matching funds to Medicaid programs in two states

WASHINGTON – The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have deferred more than $1 billion in federal Medicaid payments to California and Minnesota while the states provide additional documentation supporting certain claims. CMS says it is withholding approximately $867.5 million from California and $199 million from Minnesota following focused financial reviews that identified claims requiring further scrutiny. “CMS is done trying to chase down stolen and misused funds after they’ve already left the building,” said CMS Administrator Dr. Mehmet Oz. “That’s why we’re deferring payments with respect to certain high-risk services within the Medicaid programs in California and Minnesota as part of our proactive new approach to program integrity.” HHS emphasized that the actions are payment deferrals, not permanent funding cuts, and that both states will have an opportunity to demonstrate that the claims comply with federal Medicaid requirements. In California, CMS reviewed claims tied to certain in-home care programs after identifying spending growth that exceeded national trends, along with other claims requiring additional documentation. Federal matching funds will remain deferred until the state provides information supporting those expenditures. In Minnesota, CMS reviewed claims across 14 service areas considered high risk. The review identified expenditures connected to providers flagged through program integrity reviews, as well as claims with potential eligibility or billing concerns. HHS Secretary Robert F. Kennedy Jr. says states receiving federal Medicaid funding must demonstrate that claims meet federal requirements before funds are released. The agency says it will continue using financial reviews and exclusion authorities to remove bad actors from Medicare and Medicaid.

CMS suspends more than 100 DME suppliers in fraud crackdown

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has suspended more than 100 DME suppliers and revoked the Medicare billing privileges of 725 suppliers as part of a broader effort to combat fraud in the program. CMS Administrator Mehmet Oz and Deputy Administrator Kimberly Brandt announced the enforcement actions during a July 9 press event, saying the suppliers had billed Medicare more than $1.5 billion. Brandt said the actions have “wiped out the majority of DME fraud in America.” “In South Florida alone, there are twice as many durable medical equipment suppliers as there are McDonald's,” said Brandt. “Think about that just for a minute.” The crackdown is part of CMS’s Anti-Fraud Task Force and follows the agency’s nationwide temporary moratorium on the enrollment of new DME suppliers. CMS has said the pause will give it additional time to strengthen program integrity and combat Medicare fraud. AAHomecare praised the enforcement effort while urging CMS to protect legitimate providers that furnish medically necessary equipment and services. “Fraudulent actors have no place in Medicare, and every dollar lost to fraud and abuse is a dollar taken away from patients who depend on medically necessary care,” the association stated. AAHomecare says it and its members have called for stronger enforcement for years and have repeatedly offered to work with the administration to combat fraud.

Samsung expands sleep apnea detection across wearables

LONDON – Samsung is expanding sleep apnea detection across its wearable lineup, adding the feature to the new Galaxy Watch Ultra2 and Galaxy Watch9, with plans to bring it to the Galaxy Ring later this year. “By continuously tracking health data from the wrist, these new watches act as a vigilant health companion, turning daily vital signs into proactive, actionable insights and providing timely alerts,” said TM Roh, CEO, president and head of Samsung’s Device eXperience Division. The Galaxy Watch Ultra2 and Galaxy Watch9 include a sleep apnea feature cleared by the U.S. Food and Drug Administration (FDA) that uses AI algorithms to provide insight into breathing disruptions during sleep. Both watches also include Vitals, which monitors a user’s personal health baseline during sleep and alerts them to significant deviations. Samsung says the Galaxy Ring will be the first FDA-cleared smart ring available over the counter to offer sleep apnea risk detection. The feature is intended to flag possible signs of the condition, not provide a diagnosis. Samsung has not announced an exact launch date for the Galaxy Ring feature but says it will become available later this year. The Galaxy Watch Ultra2 and Galaxy Watch9 are available for preorder in select markets, with general availability beginning Aug. 7.

MiniMed Flex gains Medicare coverage

NORTHRIDGE, Calif. – Medicare and Medicare Advantage beneficiaries now have access to the MiniMed Flex insulin pump system and its latest sensor portfolio, MiniMed has announced. "Managing diabetes is relentless and no one should have to do it without the best tools available," said Que Dallara, CEO of MiniMed. "Ensuring Medicare access to MiniMed Flex is about making sure more people can benefit from technology that fits into daily life and takes some of the burden off their shoulders. Everyone deserves that regardless of age." MiniMed Flex is the company’s smallest and only app-controlled insulin pump system. It is about half the size of previous MiniMed pumps and roughly the size of two stacked insulin vials, while still holding 300 units of insulin. The system uses the same SmartGuard technology as the MiniMed 780G system to automatically adjust insulin delivery every five minutes, day and night. MiniMed pointed to real-world evidence presented at the 86th American Diabetes Association Scientific Sessions showing that Medicare beneficiaries using the MiniMed 780G system exceeded ADA-recommended glycemic targets. The MiniMed Flex system is currently available in the United States with the Simplera Sync sensor and will be available with the Instinct sensor, made by Abbott, later this summer.

Tansey to retire from Inspire board

MINNEAPOLIS – Casey M. Tansey will retire from the Inspire Medical Systems board of directors after more than 18 years of service, effective July 30. “As one of the first venture investors to recognize the potential impact of Inspire therapy for patients with OSA, Mr. Tansey has provided valuable mentorship, leadership and perspective throughout the company’s founding, initial public offering and subsequent growth,” said Tim Herbert, chairman and CEO of Inspire. Tansey represented U.S. Venture Partners and led Inspire’s Series A financing in November 2007. He has served on the board since that time. Inspire develops and commercializes minimally invasive treatments for obstructive sleep apnea (OSA). The company says its proprietary Inspire therapy is the first neurostimulation technology approved by the U.S. Food and Drug Administration (FDA), EU Medical Device Regulation (EU MDR) and PDMA that provides a safe and effective treatment for moderate to severe OSA. The company expects to announce a new director to replace Tansey in the near future.

netWell DME debuts offering curated products through membership model

RINGWOOD, N.J. – netWell has launched netWell DME, a new resource that provides access to quality health care supplies from home. The platform is designed to make shopping for medical equipment easier and more convenient with curated, quality product selections, secure checkout, and free shipping on every item, according to a press release. “Finding the right healthcare resources should be simple and convenient,” said Bob Malone, president and CEO of netWell. “netWell DME provides a convenient way to access a wide range of approved, high-quality medical equipment and supplies without the hassle of searching for products in multiple places, or the worry of locating true medical-grade supplies. We’re always looking for ways to make health care needs easier to navigate.” netWell is a nonprofit 501©(3) health care sharing ministry that operates on a membership model.

RN Enterprises acquires Helping Hands

JACKSONVILLE, Fla. – RN Enterprises has acquired Helping Hands Home Healthcare, expanding its home-based clinical services and strengthening its presence in Florida. The combined organization will offer skilled nursing, infusion nursing, patient education, care coordination and other in-home support services to patients, providers, hospitals, specialty pharmacies and referral partners. "Helping Hands Home Healthcare has built an outstanding reputation for delivering compassionate, patient-centered care," said Rodney G.B. Clements, founder and owner of RN Enterprises. "Their dedication to clinical excellence and service aligns perfectly with our mission. This acquisition allows us to expand our capabilities, strengthen our presence in the home healthcare market, and continue investing in the resources, technology, and clinical talent needed to meet the growing demand for home-based healthcare services." RN Enterprises operates in more than 40 states, has more than 16 office locations and supports a network of more than 550 registered nurses. Patients currently receiving services through Helping Hands will continue to receive care from their existing clinicians and caregivers. Existing referral relationships and service commitments will also remain in place during the transition. The entire Helping Hands team will join RN Enterprises, preserving continuity of care and existing relationships with patients and referral partners.

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