HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o
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News 4 WWW.HMEnEWS.COM / AuGuSt 2015 / HME nEWS VGM's Promise - We're committed to the industry's success. 800.642.6065 Go to www.vgm.com/promise to see more and share your promise to patients. Mike Mallaro Chief Financial Officer of VGM Group, Inc. 14 years in the industry to research market dynamics and opportunities and keep our members in the know. I promise Push through The four-day Heartland Conference featured a keynote speech from amy Van Dyken, a six-time Olympic champion and former com- petitive swimmer. Dyken suffered a major spinal cord injury in 2014, severing her T11 vertebrae. Her message to attendees: "You learn to push through the pain and the challenges." The annual event saw a 15% increase in attendance and 13 new vendors. In all, there were 530 attendees and more than 70 vendors. than eight years for DMEpOS, putting it far lower than Medicare rates," said one respondent. "Our new governor wants to do a massive expansion of more enroll- ees, but there is no plan to raise reim- bursement rates to prevent us from losing money on each patient we see." The states that are reducing Medicaid shareholder with greenberg Traurig, the law frm representing Cardiosom and three other providers, believes the judge will make a decision in a few months time. "The plaintiffs believe the cases are essen- tially identical and that the judge should apply the Cardiosom ruling," he said. A U.S. Court of Federal Claims judge ruled in Cardiosom's favor a year ago, say- ing the provider is entitled to damages for being awarded contracts and then having them rescinded as part of an 18-month delay to the program in 2008. There are now nine lawsuits, representing 15 providers. In the Cardiosom case, the judge struck down the government's argument that the contracts were subject to any changes in Medicare regulations. But the government has a new argument: When the contracts were terminated, the providers "were returned to the status quo," meaning they were still able to do business with Medicare and at better reimbursement rates at that. "The government is saying, 'What's the problem? We did you a favor by terminat- ing the contracts,'" Stouck said. "We've responded that the whole purpose of the contracts was to signifcantly reduce the number of suppliers, so that, while the reim- bursement was lower, they'd get higher vol- umes of business." While litigation inches forward, the pro- viders and the government are still pursu- ing mediation, as well. But it's slow going, Stouck says, with the providers still waiting for sales volume data from CMS so they can put together damages claims. "By fall, we hope we'll have a much bet- ter idea of whether the cases can be settled, or whether they need to be litigated," he said. hme shows, similar to diabetic supplies, that competitive bidding is causing problems and CMS is misleading Congress," said gallagher, vice president of government relations. "Because this is (an outside group) and peer-reviewed, CMS can't say it's just our industry numbers." One area where stakeholders are mak- ing progress: In July, language to extend the pMD demo was attached to the 21st Century Cures Act. The House of Rep- resentatives passed the bill July 10, but it's unclear whether the Senate will take it up. Stakeholders had also hoped for language that would expand prior authorizations for other DME and to address payment reductions for CRT accessories. "There's been positive reception to the pA language, and there's sympathy on the accessories issue," said Cara Bachen- heimer, senior vice president of govern- ment relations for Invacare. Rep. Marsha Blackburn, R-Tenn., intro- duced a bill in May that would require prior authorizations for high-dollar DME. hme JuGGlING AcT fOr Hme INduSTry C O n T I n u e D f r O m pa g e 1 bId lAWSuIT C O n T I n u e D f r O m pa g e 3 reimbursement are being shortsighted, respondents say. "Colorado Medicaid has given us an increase in the last two years," said a respondent. "We had major cuts a few years back and they are trying to make up for those cuts with surplus money they have in the budget." hme medIcAId cuTS Are pervASIve C O n T I n u e D f r O m pa g e 3