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In brief: Allina Health partnership, TRICARE appeal, DME scams

October 21, 2022HME News Staff

MINNEAPOLIS – Allina Health has partnered with venture capital firm Flare Capital Partners to launch Inbound Health, a new company that enables health systems and health plans to offer hospital-at-home and skilled nursing-at-home programs.  Allina Health and Flare Capital are leading a $20 million fundraising round for Inbound Health to scale successful acute care-at-home programs nationally through their unique partnership model, they say.  “The home hospital programs...

ACHC, Allina Health, Direct Supply, Home Medical Equipment, Soleo Health, TRICARE

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Doug Hoey

Specialty Providers

NCPA appeals to DOD

October 19, 2022HME News Staff

ALEXANDRIA, Va. – A recent decision by Express Scripts to eliminate the option for TRICARE beneficiaries to obtain their prescriptions at their pharmacy of choice should be rectified to ensure continued access to needed medications, the National Community Pharmacists Association stated in a letter to U.S. Defense Secretary Lloyd Austin.  Express Scripts, the Cigna-owned pharmacy benefit manager that administers the TRICARE benefit on behalf of the DOD, recently announced changes effective...

Express Scripts, National Community Pharmacists Association, TRICARE

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In brief: Medtrade location, Quipt expansion, CGM access

June 24, 2022HME News Staff

ATLANTA – Medtrade will take place March 28-30 in Dallas next year, show organizers have announced.  The event will take place at the Kay Bailey Hutchinson Convention Center in the Convention Center District in downtown Dallas.  “Switching to one show per year was motivated by feedback from attendees and exhibitors,” said York Schwab, show director, in today’s Medtrade Monday. “Moving the show to Dallas is part of the same equation. Dallas is centrally...

CGMs, Hollister, Medtrade, Quipt, TRICARE

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TRICARE expands access to CGMs 

June 20, 2022HME News Staff

FALLS CHURCH, Va. – The TRICARE pharmacy benefit now covers two brands of continuous glucose monitors (CGMs): the Abbott FreeStyle Libre 2 and the Dexcom G6. Previously, CGMs were only available as DME under the TRICARE medical benefit. They will also continue to be covered under the medical benefit. “This change in expanded coverage will improve access for patients to get the CGMs they need,” said Edward VonBerg, PharmD, chief of the Defense Health Agency’s Formulary Management...

Abbott, CGMs, Continuous Glucose Monitors, Dexcom, TRICARE

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Laura Williard


AAH pushes for more timely payments from Tricare 

December 22, 2021Theresa Flaherty, Managing Editor

WASHINGTON – Industry stakeholders met with the Defense Health Agency recently to discuss ongoing issues with timely payment of Tricare East claims and the changes Humana Military is making to improve the process.  The primary issue, says Laura Williard, vice president of payer relations for AAHomecare, stems from the inability to attach supporting documentation to claims submitted to Humana Military, the contractor for Tricare East.  “We felt from a DME claims process,...

Humana Military, TRICARE

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AAHomecare updates: Sequestration, innovative tech, supplier costs, TRICARE

January 22, 2021HME News Staff

Reps. Brad Scheider, D-Ill., and David McKinley, R-West Va., introduced have introduced H.R. 315, new legislation to continue the moratorium on the Medicare sequester cuts through the duration of the public health emergency. In December, Congress extended the pause on the 2% cuts, which were set to expire at the end of 2020, through March 2021…CMS published a final rule on Medicare Coverage of Innovative Technology and the Definition of “Reasonable and Necessary” on Jan. 14. The...

sequestration, supplier costs, TRICARE

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AAH roundup: Proposed rule, Stand Up, TRICARE

November 10, 2020HME News Staff

AAHomecare has published key takeaways from CMS's recent proposed rule outlining changes to the fee schedule methodology starting April 1, 2021, or immediately after the public health emergency, whichever is laterAAHomecare's Stand Up for Homecare, held during last week's Medtrade Virtual Conference, raised $6,500 toward the association's commitment to support ITEM Coalition. The coalition is a policy steering group for more than 80 patient advocacy organizations that have been strong allies on...

aahomecare, Competitive Bidding, Fee Schedule, stand up for homecare, TRICARE

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Tricare to stop recoupments on compounded meds

October 22, 2020HME News Staff

ALEXANDRIA, Va. - TriCare/Express Scripts will no longer seek to recoup prescriptions from compounding pharmacies from 2015 that it says were fraudulent because there was no physician/patient relationship indicated. The amounts to be recouped ranged from less than $100 to more than $200,000. “ESI was basically saying that the only way the pharmacies could exonerate themselves was by producing documentation that the prescribing physician actually had seen the patient,” said Scott Brunner,...

Compounding Pharmacy, National Community Pharmacists Association, TRICARE

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In brief: PHE extension, AdaptHealth's public offering, Tricare update

July 2, 2020HME News Staff

WASHINGTON - It appears the Department of Health and Human Services will extend the current public health emergency.Both AAHomecare and the VGM Group have pointed to a June 29 tweet posted by Michael Caputo, HHS assistant secretary for public affairs, that said: “HHS expects to renew the public health emergency due to COVID-19 before it expires. We have already renewed this PHE once.”HHS first put the PHE in place on Jan. 27. It renewed the PHE on April 26 for another 90 days.Renewing...

AdaptHealth, Aeroflow, F&P, Public Health Emergency, Stander, TRICARE

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AAH provides update on Tricare and COVID-19 relief

June 30, 2020HME News Staff

WASHINGTON - Tricare East contractor Human Military loaded new reimbursement rates authorized by the CARES Act into their system on June 3, according to AAHomecare. Claims from that day forward should reflect the new rates. Humana Military is now working on adjustments retroactive to the start date for the act. AAHomecare has reached out to Tricare West contractor HealthNet for an update on its efforts to implement relief provisions in the CARES Act. Tricare has also confirmed that it's waiving cost...

aahomecare, Coronavirus Outbreak, Relief, TRICARE

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