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In brief: Sequestration cuts, Better Health’s debut, NSM’s latest buy 

In brief: Sequestration cuts, Better Health’s debut, NSM’s latest buy 

WASHINGTON – The House of Representatives has passed a bill that would extend the moratorium on the 2% Medicare sequestration cuts from March 31, 2021, to Dec. 31, 2021. 

H.R. 1868, which passed 246-175, would also exempt the $1.9 trillion American Rescue Plan from the statutory Pay-As-You-Go Act of 2010, eliminating an additional 4% Medicare cut that would amount to about $36 billion in 2022. 

On March 15, Sens. Susan Collins, R-Maine, and Jeanne Shaheen, D-N.H., introduced a bill that would extend the moratorium on the 2% Medicare sequestration cuts through the public health emergency. The “pay for” for the bill, S. 748, would extend the cuts to 2031, instead of 2030. 

Better Health makes debut 

SAN FRANCISCO – Better Health, an online supplier of urological and ostomy supplies, has launched with $3.5 million in seed funding. 

The provider, which offers “white glove service,” also has national contracts with major insurers, including Humana and Oscar Health. 

“Better Health improves the lives of patients who use medical supplies by getting them the best products in a timely, cost-effective and stress-free manner,” said Naama Staubler Breckler, who co-founded Better Health and previously started CompactCath. “More importantly, we provide our members with education and support, so they’re better prepared to manage their chronic condition in the long run.”  

The seed round was led by 8VC, with participation from Caffeinated Capital and Anorak Ventures. 

Also participating in the round: digital health executives Robert Hurly and Scott Flanders of eHealth. 

“I’ve worked with Medicare Advantage and commercial insurers for more than 30 years,” said Hurley. “Patients requiring medical supplies comprise a large and growing share of health care costs, in part because these patients have high hospital readmittance rates related to their medical supplies. Better Health provides expert guidance to help patients select the right supplies and learn to use them.” 

Bill seeks to preserve telehealth reimbursement for PTs, OTs 

WASHINGTON – Reps. Mikie Sherrill, D-N.J., and David McKinley, R-W.Va., have reintroduced bipartisan legislation to increase access to telehealth services, including those provided by physical therapists and occupational therapists.  

The bill, the Expanded Telehealth Access Act, would make permanent reimbursement for telehealth services for PTs, OTs and others, that has been in place during the public health emergency. 

“The use of telehealth services during this crisis has demonstrated the critical role technology can play in improving health equity,” said Sherrill. “Even now, as vaccinations are being distributed and the country begins to hope for a post-pandemic future, the value of telehealth networks has never been clearer. No one should have to go without care when a video or phone conversation with a health care provider could mean quicker, safer medical attention.” 

Right out of the gate, the bill is also supported by 14 other representatives. 

Complex rehab stakeholders have been standing at the ready to support a bill that seeks to make permanent reimbursement for telehealth services for PTs and OTs. 

“Thank you Rep. Sherrill and Rep. McKinley for this important legislation that will protect access to CRT,” Don Clayback, executive director of NCART, tweeted, with a link to the news. “Now let’s get it passed.” 

 NCPA releases two reports 

ALEXANDRIA, Va. – The National Community Pharmacists Association has released a 2020 COVID-19 special report highlighting its work over the past year helping independent pharmacists navigate the pandemic and adapt to changes. “NCPA’s core mission is to defend and support independent neighborhood pharmacies, whether during a pandemic or in calmer times,” said B. Douglas Hoey, NCPA CEO. “2020 was a year of incredible change and with that change came incredible opportunity for our organization and for pharmacy. NCPA has been working with policymakers since the beginning to include independent pharmacies as part of a robust and successful national response to COVID-19, and to keep members informed about the latest news and what to do to administer tests and vaccines.” NCPA also released its 2020 NCPA Advocacy Annual Report, a comprehensive review of its broader advocacy efforts on behalf of independent community pharmacists, including work to change the pharmacy payment model and rein in pharmacy benefit managers through the Rutledge v. PCMA Supreme Court case and other pathways. 

In memoriam: Walt Gorski, David Hartley 

Walt Gorski, former vice president of government relations for AAHomecare, passed away March 10 at his home in Fairfax, Va. Before joining AAHomecare, where we worked from 2006 to 2013, Walt had roles at lobbying firm BKSH and the American Orthotic Association, and held health care policy roles for House Committee chairs Dan Rostenkowski and Pete Starck. Go here to read the complete obituary...David Hartley, who led Home Health Depot before selling it in 2017, passed away March 21. In 2018, he founded Indiana Liquor Group, the state’s second largest retail liquor group. David attended Indiana University. Go here to read the complete obituary. 

 Minnesota: MAMES testifies on recoupments, Gov. rescinds vent cuts 

MINNEAPOLIS – Minnesota’s Department of Human Services should not be able to recoup payments from DME providers for items provided prior to July 1, 2019, as part of the agency’s attempts to become compliant with the 21st Century Cures Act, says MAMES Executive Director Rose Schafhauser. She testified before the state’s Senate Health and Human Services Finance and Policy Committee via Zoom on March 22 on SF 1128, a bill that would require the state to pay back $735,000 using its own funds, not funds from providers. Schafhauser also pointed out that DHS took more than a year to implement legislation that set the Medicaid payment rates at the Medicare rates on the DME items, starting with dates of service on or after July 1, 2019. DHS has temporarily suspended its recoupment process…Minnesota Gov. Tim Walz removed pressure support ventilators from cuts included in his 2022-2023 budget, but other cuts, including for enteral nutrition and CRT accessories, remain.  

NSM buys Albany Lift Company 

NASHVILLE, Tenn. – National Seating & Mobility has acquired The Albany Lift Company in Albany, N.Y., expanding its services throughout upstate New York, western Massachusetts and southern Vermont. “The Albany Lift Company has a strong reputation for customer service that aligns well with NSM’s client-centric focus,” said Bill Mixon, CEO of NSM. “We are proud to welcome this group of experienced professionals on board at NSM and look forward to working with this team to expand the comprehensive mobility and accessibility solutions available throughout the Northeast.” Founded in 2007, the Albany Lift Company provides home accessibility solutions, including stairlifts, vertical platform lifts, modular ramps and residential elevators, in Albany and upstate New York. Terry Farrigan, who leads the company, and 18 staff members will continue to serve area clients. 

Avera HME to open store in health care campus 

SPIRIT LAKE, Iowa – Avera Home Medical Equipment is opening a store at Lakes Regional Healthcare, according to a local radio station, KUOO. Construction on the 2,500-square-foot location, which will be located in a space formerly occupied by Lakes Family Practice, is expected to begin in April and to be completed in the fall, the station says. “Health care has changed and, obviously, due to COVID, we see more and more health care needs being met at home,” Jason Harrington, president and CEO of Lakes Regional Healthcare, told the station. “So, I think having a home medical equipment store on our campus will provide much better access for patients.” Avera HME also has a location in Estherville, Iowa, as well as four locations in South Dakota. 

Kleo King returns to United Spinal 

NEW YORK – United Spinal Association has named Kleo J. King senior director of accessibility operations and counsel. King previously served as deputy commissioner and general counsel for the New York City Mayor’s Office for People with Disabilities from 2014-21. “During her impressive career, Kleo’s steadfast work has helped to achieve unprecedented legal victories providing accessibility in transportation and the built environment for people with disabilities,” said Dominic Marinelli, vice president of United Spinal’s Accessibility Services program. King began her career with United Spinal in 1987, working for 27 years as program counsel and senior vice president of accessibility services. In her new role, King’s responsibilities will include litigating cases before various courts and administrative agencies. “Rejoining United Spinal will continue my work assisting the business community and others in improving accessibility for people with disabilities,” she said. “Working with United Spinal’s 57,000 members will help focus these efforts to areas and concerns that need to be addressed.” 

Great Elm simplifies structure 

WALTHAM, Mass. – Great Elm Group, which has operating companies in DME, has reached an agreement with MAST Capital Management that results in a simplified capital structure and cleaner corporate governance. GEG will issue $2.24 million of 5% Convertible Senior PIK Notes due 2030 to MAST in exchange for all outstanding obligations under the $3.1 million Senior Secured Note issued by GECC GP to MAST, all common stock in GP held by MAST and its affiliates, and termination of MAST’s board appointment rights. MAST was the beneficial owner of about 7.6% of GEG’s outstanding common stock as of Dec. 31, 2020. Following this transaction, MAST’s common stock holdings in GEG and its $2.25 million of convertible notes are its only investments in GEG or its subsidiaries. Separately, GEG has announced that it has repurchased the GP stock held by certain employees of Great Elm for nominal consideration. As a result of both transactions, GEG will own in excess of 90% of the outstanding common stock of GP. “We are pleased to complete these transactions with MAST,” said Peter Reed, CEO. “GEG benefits from the purchase of the GP Corp Senior Secured Note at a discount, and the increase in our ownership of GP results in a greater share of any future profit from GP accruing to the benefit of GEG and, ultimately, our shareholders.” 

CGS launches review of No. 1 product category for CERT errors 

NASHVILLE, Tenn. – CGS will be conducting complex post-pay, service-specific medical review of lower limb prostheses, L5700 and L5701, the contractor announced on March 19. “This review will be conducted because data analysis revealed that Jurisdiction C’s allowed dollars for L5700 and L5701 were significantly above expected amounts,” CGS stated. “Additionally, the orthotics policy group ranked No. 1 in total comprehensive error rate testing (CERT) errors.” The contractor reminds suppliers of the importance of responding to additional documentation request (ADR) letters. 



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