HME News

APR 2017

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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Bid relief needs adjustment . . . . . . . . . . . . . . . . . . . . . . . . . 1 Expand phone demo, say stakeholders . . . . . . . . . . . . . . . 3 Two Northeast associations merge . . . . . . . . . . . . . . . . . . . 4 AAHomecare asks Tom Price to freeze rates . . . . . . . . . . . 6 ■ 2017 brings fresh opportunity for the industry, Tom Ryan told Medtrade Spring attendees. See story this page. News Study finds DME saves money WATERLOO, Iowa – Upfront spending on du- rable medical equipment saves Medicare money in the long run, according to an up- dated study conducted by Leitten Consult- ing for The VGM Group. For every dollar spent on DME, CMS could save from $11 to $29 in direct treatment payment, ac- cording to the study, titled "The Case for Medicare Investment in Durable Medical Equipment." Overall, annual savings range from $23 to $41 for every dollar spent on DME. The study updates a previous study conducted in 2014. AAH makes case for preserving Medicaid rates WASHINGTON – AAHomecare has released a briefing paper designed to help HME pro- viders engage state Medicaid programs now that a new law has been passed that limits the federal contribution for HME to these programs to the Medicare rates starting Jan. 1, 2018. The paper, "States Should Not Accept Flawed Medicare Rates," notes the unsustainable rates fac- ing providers operating under competitive bidding-derived Medicare rates and pro- vides perspectives on the problems with applying these rates to state Medicaid programs. AAH boosts corporate partnership WASHINGTON – AAHomecare has added several new companies to its corporate partners program. They are: Acelity, Aero- Care USA, Domtar Personal Care, Med- South, and Rotech Healthcare. The pro- gram, which launched in 2012, now has 23 members. AAHomecare ramped up its efforts to bring on board more corporate partners in 2014. MAMES adopts Wisconsin STILLWATER, Minn. – The Midwest Associa- tion of Medical Equipment Suppliers will extend its geographical coverage to Wis- consin starting March 1. MAMES is a re- gional association that serves Iowa, Kan- sas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota. Ann Barrett, the executive director of WAMES, retired in September. State roundup: Colorado, New York, Kentucky The Colorado Department of Health Care Policy and Financing has issued a proposed rule requiring a face-to-face exam no more than six months prior to the initiation of certain durable medical equipment and services…The New York Department of Health has implemented a reimbursement cut of 20%, on aver- age, for incontinence supplies. The cut goes into effect April 3...Provider David Chesnut has been elected president of the Kentucky Medical Equipment Sup- pliers Association . Chesnut, owner and president of Pennyrile Home Medical in Cadiz, Ky., has been a member of the as- sociation for more than 25 years. WWW . HMENEWS . C o M / A pril 2017 / HME NEWS 3 By Theresa Flaher T y, Managing e ditor LAS VEGAS – The HME industry descended on Medtrade Spring with renewed vigor. "The challenges keep coming but we have an unprecedented opportunity to move the needle this year," said Tom Ryan, presi- dent and CEO of AAHomecare, during the association's Wash- ington Update Feb. 28. "2017 is our year." The key reason for the overall positive outlook: Tom Price, the new secretary of the Department of Health and Human Services, who the industry is looking to for help with everything from competitive bidding to the audit By l iz Beaulieu, e ditor WASHINGTON – Industry stake- holders are throwing their sup- port behind expanding a dem- onstration project that allows providers to speak with recon- sideration professionals by phone to try and resolve their appeals. AAHomecare on Feb. 22 submitted comments to CMS, recommending that the agen- cy also consider applying the By l iz Beaulieu, e ditor C MS' S RECE n T decision to temporarily delay Round 2019 of competitive bid- ding has given HME providers a ray of hope that substantive changes will be made to the program. The agency said it was delay- ing Round 2019 to give the new administration—not only Presi- dent Donald Trump but also recently confirmed HHS Secre- tary Tom Price— time to review the program. "Dr. Price has a history of being a champion for our industry," wrote Bruce Sandler of Wishing U Well Medical in Granada Hills, Calif., in response to a recent HME n ewspoll. "I'm confident he'll come up with a plan to alter or replace competitive bidding. Delaying competitive bidding as it stands, in the meantime, is a good idea. It will save a lot of companies a lot of time and money." An overwhelming majority of respondents to the poll (90%) said they approve CMS's deci- sion to temporarily delay Round 2019. By l iz Beaulieu, e ditor WASHINGTON – The industry's attempts to get other payers to honor a retroactive delay to Medicare reimbursement cuts are starting to pay off. Health n et Federal Services, the contractor for the Tricare n orth region, has indicated to AAHomecare that it believes the delay also applies to its reimbursement, but it needs a directive from the Defense Health Agency to reprocess claims. "It's not a done deal, but we're heading in the right direction," said Laura Williard, Spring renewal: '2017 is our year,' says Tom Ryan round 2019 Industry supports demo expansion phone demo to the first level of appeals. Currently, it applies only to the second level of appeals. "Although the demonstra- tion at the second level of appeals has been a positive experience for suppliers, we believe insti- tuting a dis- cussion at the first level of appeals will enable CMS to sig- nificantly reduce the backlog at the Office of Medicare Hearings Providers cheer program delay mess. The show, held Feb. 27–March 1 at the Mandalay Bay Conven- tion Center, featured dozens of educational sessions that had a major format refresh. More panel discussions, new seating and a tight focus were the result of a "hard look" at attendee feedback from the fall show, says Show Director Kevin Gaffney. "We wanted to create a vibe of having a conversation instead of a classroom setting," he said. "If providers are struggling, we want to address that. We wanted to focus on how we survive and thrive, and go from there." On the show floor, which While providers acknowledge that the delay is likely a stan- dard move in response to a new administration, they also believe that years of access issues created by competitive bidding are final- ly getting through to CMS. "I feel that bidding has been delayed because too many pro- viders have either dropped out of Medicare altogether or stopped taking assignment," said Paul Reses of Lincoln Medical Sup- ply in Pleasantville, n .J. "It is too difficult for discharge plan- ners to coordi- nate care, and I feel that consum- er complaints a n d i n d u s t r y complaints are maybe starting to be heard." Providers do give CMS some credit for making changes to competitive bidding along the way. Planned changes for Round 2019 include moving the bid ceiling to 2015 fee schedule amounts and requiring bidders to obtain a $50,000 surety bond for each competitive bidding area in which they submit bids "CMS has recently made some big changes to the program, but it still has problems, like lack of HME NEWS POLL M E d T R A d E s e e pa g e 6 b I d d e l ay s e e pa g e 4 senior director of payer rela- tions for the association. The 21st Century Cures Act directed Medicare to delay a reimbursement cut in non- competitive bidding areas from July 1, 2016, to Jan. 1, 2017. Because Tricare and other pay- ers often peg their reimburse- ment off of Medicare's, the industry has made the case that they, too, should honor the delay, paving the way for pro- viders to recoup six months of reimbursement. While trying to make inroads at the Defense Health Agency has been slow, Williard believes Industry convinces payers to delay cuts p A y E R S s e e pa g e 6 p H O N E d e m o s e e pa g e 2 2 Andrea Stark 'This is really the first CMS innovation that is really worth a darn,' says Andrea Stark Medtrade Spring, held Feb . 27-March 1 at the Mandalay Bay Convention Center in Las Vegas, featured about 180 exhibitors .

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