News

WASHINGTON – CMS and its contractors did not use CERT data to identify providers with higher error rates, according to a new report from the Office of Inspector General.  Using CERT data, the OIG identified 100 “error-prone” providers from 2014 through 2017. Of the $5.8 million reviewed by CERT, $3.5 million was incorrect, an improper payment rate of 60.7%. During the same period, Medicare made $19.1 billion in fee-for-service payments to those same providers.  These...

WASHINGTON – CMS tonight released a “pivotal bid report” for Round 2021, in response to requests to share additional information on its latest round of the competitive bidding program. In the Las Vegas competitive bid area for example, the pivotal bid for CPAP devices, E601, was $110.80, a difference of 157.4% compared to the former CBA adjusted fee schedule amount. “CMS anticipates that this information will be helpful for stakeholders and other interested parties in...

LAFAYETTE, La. – Viemed Healthcare has published a study that shows non-invasive ventilation at home improves survival and decreases health care utilization in Medicare beneficiaries with COPD with chronic respiratory failure.  “This study is the first of its kind published in the U.S. and represents a significant milestone in our mission of educating the medical community on the benefits of NIVH,” said Casey Hoyt, Viemed CEO. “The data supports...

NEW YORK – Providers expect high-single digit growth in sleep patient volumes in the next year, according to Needham’s “1Q21 HME Oxygen and Sleep Survey.”  Respondents saw their sleep patient volume increase by only 0.8% in the last 12 months but expect it to grow by 7.6% over the next 12 months, the survey says. These rates are mixed from the prior survey results of 5.5% and 5%, respectively.  Overall, respondents reported that the COVID-19 pandemic has...

WASHINGTON – The U.S. Department of Health and Human Services has extended the public health emergency for another three months. On Jan. 7, HHS Secretary Alex Azar announced the extension of the PHE, which was set to expire Jan. 21. HHS extended the PHE, originally declared on Jan. 31, 2020, multiple times last year. There are several HME-related provisions tied to the PHE, including Medicare’s 75/25 blended reimbursement rates in non-rural, non-competitive bidding areas; and...

WASHINGTON – In recent comments to CMS’s DMEPOS proposed rule, AAHomecare introduced the idea of a 90/10 blended reimbursement rate in the former competitive bidding areas. Here’s what Kim Brummett, vice president of regulatory affairs for the association, had to say about what stakeholders hope will be a “reasonable” ask – to base rates in those areas 90% on the current rates and 10% on the 2015 unadjusted fee schedule –...

MELVILLE, N.Y. – Henry Schein Inc., a provider of health care solutions to medical and dental offices, has acquired a majority ownership position in Prism Medical Products, a national provider of home medical supplies with a focus in advanced wound care.   Founded in 2006, the Elkin, N.C.-based Prism Medical has more than 200 employees and 10 fulfillment centers. For the 12 months ended Sept. 30, 2020, it reported revenues of approximately $52 million.  “Expanding...

WATERLOO, Iowa ­– VGM has launched the 2021 cost of delivery survey to provide data points for the industry’s efforts to preserve patient access to HME. The data points from a similar survey in 2018 were provided to elected officials, payers and regulatory entities, and helped to secure reimbursement relief. “We were successful in obtaining some reimbursement relief via a 50/50 blend in our rural areas, and CMS and other payers seemed to acknowledge there would be access...

ORLANDO, Fla. – Rotech Healthcare has obtained $425 million in new financing via an amended and reinstated credit agreement with a diverse group of lenders. The provider used part of the proceeds to pay a $100 million dividend to its holding company and will use the remainder to support growth through strategic acquisitions. “This new credit agreement provides Rotech with sufficient capital over the next five years to continue our growth strategies, as well as to provide a $100...

WASHINGTON – Rates in former competitive bidding areas should be based on a 90/10 blended payment formula, AAHomecare argues in its comments to CMS’s recent DMEPOS Proposed Rule.  “The 90% should be based on the current payment rates in former CBAs, and the 10% should be based on the 2015 unadjusted fee schedule,” the association says.  Non-rural, non-CBAs should be based on a 75/25 blended payment formula, with the 75% based on the current rates...