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In brief: Reimbursement relief is in play & ResMed, Inogen shake up exec teams 

In brief: Reimbursement relief is in play & ResMed, Inogen shake up exec teams 

WASHINGTON – Two industry related bills will be considered by the Health Subcommittee today, Nov. 15, according to AAHomecare. 

The subcommittee, part of the Energy & Commerce Committee in the U.S. House of Representatives, will consider: 

H.R. 5555, a bill that would extend the 75/25 blended Medicare reimbursement rates in non-competitive bidding areas and provide a 90/10 blended rate in bid areas; and 

H.R. 5371, a bill that would allow an upgrade within a code for carbon fiber and titanium wheelchairs. 

Stakeholders are asking those who are represented by members of the Energy & Commerce Committee to email their staffers to support both bills. They recommend using the following language: 

Please support legislation sought by the DME community in Wednesday’s Energy & Commerce Health Subcommittee mark-up.   
Congress must address out-of-date DME Medicare payment rates. Please support H.R. 5555, which provides much-needed relief for DME suppliers through 2024 and will send a message to CMS that a longer-term, market-based rate making solution is needed to ensure patient access to cost-effective home-based care.   
Medicare beneficiaries should have the choice to pay for a titanium or carbon fiber upgrade to their manual wheelchair. Please support H.R. 5371, legislation that would enable upgrades within a code, offering benefits to end users at no additional cost to CMS. 

Check out these issue briefs for H.R. 5555 and H.R. 5371 for more information.   

ResMed restructures exec team 

SAN DIEGO – ResMed has implemented a new operating model that adds dedicated leadership in product, revenue and marketing to its global executive team. 

“ResMed is the undisputed leader in digital health for respiratory medicine and residential care, and we aspire to make ourselves even more product-led customer-centric, and brand-enhanced,” said Mick Farrell, ResMed’s CEO. “Today, we are making bold changes to ensure these capabilities are directly represented in our executive leadership team. We will measure the success of our new operating model through increased product velocity, increased vigilance on long-term profitable revenue delivery and increased brand engagement with stakeholders.” 

Leaders appointed into new roles: 

  • Chief Product Officer – Justin Leong (previously president, Asia and Latin America) 

  • Chief Marketing Officer – Katrin Pucknat (previously president, Germany) 

  • Chief Revenue Officer – Mike Fliss (previously vice president, North America sales) 

In addition to the above roles, the executive leadership team also includes: 

  • Chief Commercial Officer, SaaS – Bobby Ghoshal 

  • Chief Financial Officer – Brett Sandercock 

  • Chief Legal Officer – Mike Rider 

  • Chief People Officer – Vered Keisar 

  • Chief Strategy Officer – Hemanth Reddy 

The extended CEO operations team, reporting directly to the CEO, includes: 

  • Chief Compliance Officer – Jim Ellis 

  • Chief Information Security Officer – Todd Friedman 

  • Chief Investor Relations Officer – Amy Wakeham 

  • Chief Medical Officer – Carlos Nunez 

  • Chief Quality & Regulatory Officer – Dawn Haake 

  • Chief Supply Chain Officer – Andrew Price 

Resmed also announced that Rob Douglas, current president and COO, plans to retire on Jan. 1. He will immediately transition to a new role as special adviser to the CEO and will remain in a consulting role through Dec. 31, 2024. 

Additionally, Lucile Blaise, president of sleep and respiratory care, will immediately transition to a new role as senior vice president, strategy & business development, reporting to Reddy. Finally, Leong will oversee the digital health technology product organization, and Urvashi Tyagi, chief technology officer, will transition to a role as special advisor to the chief product officer through Jan. 1, 2024, and will remain in a consulting role through Dec. 31, 2024. 

CMS releases coding plan for power seat elevation 

WASHINGTON – CMS has issued preliminary recommendations for coding and pricing for power seat elevation systems, NCART has reported. 

The recommendations include discontinuing the existing HCPCS Level II code E2300, “wheelchair accessory, power seat elevation system, any type,” and establishing two new HCPCS Level II codes at a set fee schedule amount:  

  • EXXXX, “complex rehabilitative power wheelchair accessory, power seat elevation system, any type” 
  • EXXXX, “power wheelchair accessory, power seat elevation system, any type” 

CMS has also recommended discontinuing HCPCS codes K0830 and K0831. 

NCART says its Coding Workgroup has reconvened following the announcement and is preparing testimony for a hearing on Nov. 30. The organization also encourages manufacturers, providers, clinicians and other stakeholders to submit comments. 

CMS is expected to release final coding, benefit category and pricing decisions on its website in February for an effective date of April 1. 

Inogen replaces CEO 

GOLETA, Calif. - Inogen’s board of directors today, Nov. 13, appointed Kevin Smith as president and CEO effective immediately, succeeding Nabil Shabshab. 

Smith, who will also be a member of the board, brings more than 20 years of commercial leadership experience in the medical device industry, including respiratory care and DME businesses, and has a history of success in executing value-creating transformations across organizations. He most recently served as CEO at Sirtex Medical, a global manufacturer of interventional treatment solutions. 

“We believe we have tremendous opportunities to scale our business, drive operational efficiencies and accelerate our growth trajectory, and the board believes it is the right time for new leadership to improve performance and support Inogen’s next phase of its journey,” said Elizabeth Mora, chairwoman. “With deep global medical device experience and a strong track record of successful business transformations, we believe Kevin is the right leader to capitalize on Inogen’s potential. We look forward to benefitting from his expertise as we seek to advance our commercial strategy, win new customers, and drive sustainable, long-term value for our shareholders.” 

Smith also previously held positions at Sensium Healthcare, Teleflex, Hillrom Holdings and ZOLL Medical Corp. 

Inogen named Shabshab CEO in January 2021, succeeding Scott Wilkinson. 

The company recently posted revenue declines for two of its three business segments. 

Two plead guilty in brace scheme 

ATLANTA – Brett Weiner and Valerie Desalvo have pleaded guilty to federal conspiracy charges for their role in buying and selling fake doctors’ orders used to obtain more than $1.5 million in fraudulent payments from Medicare, according to the U.S. Attorney’s Office for the Northern District of Georgia. Weiner and Desalvo owned and operated Laboratory Marketing Services, a business in Boca Raton, Fla., that, among other things, received kickback payments in exchange for patient “leads” consisting of billable personal identifying information of Medicare beneficiaries, according to court documents. They allegedly received bribes from DME companies such as Medihealth Medical Solutions in Amory, Miss., and Liberty Medical DME in Atlanta in exchange for the leads. They also allegedly bought and sold signed doctors’ orders from Nagaindra Srivastav and his company B2B Apps Solutions in Tampa, Fla., which they sold to DME companies. A substantial portion of the doctors’ orders that Weiner and Desalvo purchased from Srivastav and B2B contained forged signatures or purported approvals of physicians or other health care providers whose names and professional identifying information were used without their authorization or knowledge, according to court documents. In total, Weiner and Desalvo, through LMS, caused the submission of more than $1.5 million in false and fraudulent claims to Medicare, which generated approximately $715,000 in payments, for braces that were procured through the payment of illegal kickbacks and bribes and were ineligible for Medicare reimbursement. Sentencing is scheduled for Feb. 8 before U.S. District Judge Steve Jones. 

NRRTS names new leader 

LUBBOCK, Texas – NRRTS has selected Andrea Madsen, ATP, CRTS, as its new executive director effective today, Nov. 13, replacing Weesie Walker. Madsen, who previously served as the treasurer of the organization, brings more than 20 years of experience in the health care industry to her new role. “I know Andrea will be a tremendous asset in the role of executive director and I plan to help make this transition as smooth as possible,” said Walker, ATP/SMS. Madsen has been a NRRTS registrant since 2011 and has served on the board since 2013. She has also been a member of AAHomecare and NCART. NRRTS expects the transition to be complete by the end of the year. Going forward, Walker, who has worked with NRRTS for 10 years, will focus on completing the organization's CRT Supplier Education Program. Earlier this year, in June, the organization completed nearly 50% of the program, offering courses 1-6 on its website. 

American Lung Association launches COPD campaign 

CHICAGO – The American Lung Association, with support from Sanofi and Regeneron, has launched “COPD for Life,” a campaign to help people who have been living with the disease for 10 or more years live better, more active and enjoyable lives. "Fortunately, we have seen a significant amount of progress in COPD care and treatment over the last decade," said Harold Wimmer, president and CEO of the American Lung Association. "Because their original diagnosis was so long ago, people living with COPD for 10 or more years may have a lack of understanding of recent treatment options, updated treatment guidelines, and the awareness to recognize new or worsening symptoms and report them back to their healthcare provider. The goal of this program is to help people who have this disease reduce their exacerbations and hospitalizations, and to live overall more active lives." Through the campaign, the association will educate people on the latest COPD guidelines, empower them to have conversations with their health care provider about their symptoms, and learn about new treatment and management options available. As part of the campaign, it has also added a new position, COPD patient navigator, to its help line, accessible online or by calling 1-800-LungUSA, to provide education to callers. 


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