In brief: VA taps online orders, Darby taps Sheehan, BOC taps new members  

WASHINGTON – Veterans Affairs has announced that veterans who use CPAP machines can now order their supplies online. The VA has added a CPAP supply ordering feature to a platform that veterans already use to order hearing aid supplies. “The addition improves how veterans order, manage and efficiently receive health care supplies,” the organization stated in a release. “It’s a notable improvement to the previous CPAP supply ordering process, which was by phone call or traditional mail order forms sent to VA’s Denver Logistics Center (DLC).” Last year, VA’s Logistics Center shipped nearly 5.5 million CPAP supplies like masks, tubing and filters. The VA says the new CPAP supply ordering feature was used for nearly one-quarter of CPAP supply orders on VA.gov within one week of launching and it anticipates that number will grow to be twice as many daily orders as hearing aid supplies. The organization says within one to two days of submission, veterans will receive an email containing an order tracking number, allowing for easy monitoring, and they will receive their supplies typically within seven to 10 business days. In the future, the VA says its Office of Information and Technology will add more ordering supply types to the VA.gov tool. 

Darby looks to Sheehan to help propel growth 

GREENVILLE, S.C. – Darby, which provides AI-enabled order processing technology, has added Gary Sheehan, formerly of AdaptHealth, as a growth advisor. With the recent release of a new version of its Smart Intake product and the current roll out to early adopter HME providers, Sheehan’s industry knowledge and leadership will help propel the company into its next phase of growth. "I'm thrilled to expand my work with Darby and help the team bring this exciting automation technology to market,” Sheehan said. “HME providers continue to buckle under the burden of manual processes and workflows and struggle in a low margin environment to find opportunities to enhance cycle times and automate manual tasks. Darby's technology roadmap provides significant opportunity for innovative providers to enhance their operations, scale more effortlessly and support their key team members who continue to struggle with too many manual processes. I'm happy to work with leaders across HME to better understand how Darby can help.” Sheehan grew his family business, Cape Medical Supply, into a strong regional provider in New England prior to partnering with private equity to combine three separate HME businesses into Spiro Health. Spiro then made two additional acquisitions prior to being acquired by AdaptHealth in the spring of 2021. While with Adapt, Gary continued expanding operations in New England and worked on multiple corporate strategy and partnership initiatives. He has had a long-standing focus on leveraging technology to scale operations and deliver a delightful experience for patients, partners and team members. 

BOC names committee, board members 

OWINGS MILLS, Md. – The board of directors of the Board of Certification/Accreditation (BOC) has announced its 2024 Executive Committee and two new board members. The Executive Committee members are: 

• Chairman: Cameron Stewart, BOCO, BOCP, co-founder of Alcam Medical Orthotics and Prosthetics in Riverside, Calif. 
• Vice-Chairman: Abel Guevara III, DHA, MHIM, FACHDM, RHIA, mMBA, CPhT-Adv, CDME, vice president of DME for MedicusRx in Houston, Texas 
• Secretary: Angela Presley, Ph.D., BOCPD, COF, director of commercialization services for Simbex in Lebanon, NH and accelerator coordinator for Dartmouth College in Hanover, NH  
• Treasurer (incumbent): Daniel Griffis III, PharmD, pharmacist in charge for Rainbow Drugstore in Brunswick, Ga. 
• Member-at-Large: L. Bradley “Brad” Watson, BOCO, BOCP, LPO, past president and regional manager for Clarksville Limb + Brace + Rehab A Bionic Company in Clarksville, Tenn. 
• Immediate Past Chair: Wayne Rosen, BOCP, BOCO, LPO, CDME, FAAOP, clinical consultant 

The new board members are: 

• Farrell Friedenberg, CMF, owner of Jay Ann Intimates 
• Michael Silverman, Esq., CDME, co-founder, attorney and operator of Silverman Bain, LLP 

Renewing board members are Daniel Griffis III, PharmD and Bill Chaudry, CDME; and outgoing members are Diana Klunk, CMF, and William J. “Bill” Powers, MBA, LFACHE. 

HHS-OIG details latest fraud activities 

WASHINGTON – The HHS-OIG’s Fall 2023 Semiannual Report to Congress highlights more than $3.44 billion in expected recoveries resulting from audits and investigations conducted during fiscal year 2023. In FY 2023, HHS-OIG reported 707 criminal enforcement actions against individuals and entities suspected of engaging in crimes targeting HHS programs and the people they serve. They also reported 746 civil actions, which include false claims and unjust-enrichment lawsuits filed in federal district court, civil monetary penalty settlements, and administrative recoveries related to provider self-disclosure matters. Additionally, they excluded 2,112 individuals and entities from participation in federal health care programs. During the fall reporting period, HHS-OIG made 464 new audit and evaluation recommendations, which they say are crucial to encourage positive change in HHS programs. Meanwhile, HHS operating divisions implemented 493 prior recommendations, leading to positive impact for HHS programs and beneficiaries. 

DMEMACs clarify coverage for caths 

WASHINGTON – Both CGS and Noridian have clarified that a high-level spinal cord injury (T3 and above) is an example of immunosuppression, meeting criteria #2 for coverage for closed-system catheters, Coloplast has announced. In October 2021, during a DME MAC council call, it was stated, “The example of high-level spinal cord injury patients (higher than T3) will be considered for coverage when conducting medical reviews of intermittent catheterization using a sterile intermittent catheter kit (A4353),” but this created confusion because it was not one of the examples listed in Urological LCD 33803. The LCD outlines coverage requirements for intermittent catheters (A4351, A4352 and A4353), including five criteria for A4353, of which a beneficiary must meet one to qualify for a closed-system catheter. For criteria #2, immunosuppression, it lists examples of conditions that commonly cause immunosuppression and states the list is not all-inclusive. Because of inconsistencies, stakeholders reached out to CGS and Noridian. 

NC expands Medicaid program 

RALEIGH, N.C. – About 600,000 people living in North Carolina aged 19 to 64 are now eligible for health coverage through the Affordable Care Act’s Medicaid expansion. North Carolina is the fourth state to expand Medicaid coverage during the Biden-Harris administration, joining Missouri, Oklahoma and South Dakota. “Medicaid Expansion is the working families bill of the decade for North Carolina, and its impact on peoples' health, combating the opioid crisis, saving rural hospitals and boosting our economy will be life-changing for families in our state,” said Gov. Roy Cooper. “I am particularly grateful for the federal signing bonus that President Biden signed into law that was a major part of our successful effort to finally expand Medicaid. I encourage anyone who thinks they might qualify to visit medicaid.nc.gov to learn more.” As part of its Medicaid expansion, North Carolina projects it will receive almost $1.8 billion in additional federal funding thanks to President Biden’s American Rescue Plan (ARP). The U.S. Department of Health and Human Services strongly urges the 10 remaining states – Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming – to expand Medicaid. If all remaining states were to expand their Medicaid programs under the ACA, as many as 3.5 million more un- or under-insured individuals could enroll in high-quality, affordable health care coverage through Medicaid. Medicaid, together with the Children’s Health Insurance Program (CHIP), remains the largest source of health care coverage in the U.S., connecting nearly 90 million individuals to a range of critical health services. 

Encore leverages AI/ML 

LIVINGSTON, Tenn. – Encore Healthcare says its Nexus AI/ML Nexus engine, developed in partnership with a global artificial intelligence and machine learning research leader, can save $106 million cumulatively in health care costs over five years per 1,000 ventilator patients, representing a 46.7% reduction. In contrast, the company says traditional management systems save $25 million, a 10.8% reduction. “We leveraged cutting-edge analytics techniques and forecasted potential outcomes with 10,000 simulations,” said Dan Easley, chief strategy officer for Encore Healthcare. “The results are nothing short of astonishing. The Nexus Engine is a game-changer in respiratory management.” 

• CEO Zach Gantt discussed Encore Healthcare’s approach to AI in a recent interview with HME News. 

DME partners with Folds of Honor 

MAUMEE, Ohio – 1 Natural Way, a DME company that provides insurance-covered breastfeeding supplies and educational resources to expectant mothers, has partnered with Folds of Honor Foundation, an organization that provides life-changing scholarships to the spouses and children of fallen or disabled U.S. service members and first responders. "Folds of Honor is proud to team up with 1 Natural Way," said Lt. Colonel Dan Rooney, Folds of Honor CEO and Founder. "We believe the partnership will be a force multiplier to the mission and awareness of Folds of Honor and increase scholarship funding to the families of American military and first responder heroes. Together we will meet sacrifice with hope." Folds of Honor Foundation was founded by Lt. Col. Dan Rooney, a decorated F-16 Viper Fighter Pilot. Since its inception in 2007, the foundation has awarded more than 44,000 scholarships totaling nearly $200 million, with minority recipients representing 41% of all scholarships awarded. In 2022, Folds of Honor expanded its mission to America's first responders, including police, fire, EMTs and paramedics.    

NCART adds members 

WASHINGTON – NCART added four new members in November: manufacturers Homecare Products and Invacare; and suppliers Norco and Laurel Medical Solutions. “We’re grateful to all our members for their support and privileged to work alongside each of them to protect and enhance access to CRT in the community,” the organization stated. “If your company provides or manufactures CRT, help us fight the negative trends in coverage and payment that continue to mount. Your support will enable us to continue to advocate aggressively on your behalf as we work to maintain and establish policies needed to ensure people with disabilities have access to the specialized equipment and services you provide.” Manufacturers and suppliers can apply to become an NCART member here.