HME News

JUN 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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By Jeff Rowe, Contributing w riter A s changes in federal and state reimbursement s t r u c - tures continue to squeeze revenue streams, com- plex rehab and mobility provid- ers of all shapes a n d s i z e s a re increasingly try- ing to diversify their product lines and customer profiles. To support those efforts, a a h o m e c a re h a s f o r m e d a new Retail Work g roup within the c omplex Rehab Mobility Briefs Home mods bill returns WASHINGTON – Reps. Charlie Crist, D-Fla., and Bruce Poliquin, R-Maine, have introduced a bill in the House of Representatives that would provide tax credits to seniors who in- stall home modifications. H.R. 1780 or the "Senior Accessible Housing Act" has six orig- inal co-sponsors and has been referred to the Ways and Means Committee. "Giving seniors the option to live more independently in their own home is less costly and can improve their quality of life," Crist said. "Providing tax credits for home modifications is smart policy—it's better for our seniors and better for our communities." Rep. Patrick Murphy, D-Fla., introduced a similar bill last year. The bill would provide incentives to individuals 60 years of age and older to "age in place" by providing a $30,000 tax credit for home modifications like the widening of doorways and the installation of ramps, handrails, grab bars and non-slip flooring. Numotion buys Horn's BRENTWOOD, Tenn. – Numotion has acquired Horn's Medical Supply in Athens, Texas, the company announced April 14. The acquisi- tion allows Numotion to better serve cus- tomers in eastern Texas, it says. Horn's has been in business for more than 20 years and serves thousands of customers, according to a press release. "Expanding our presence in East Texas brings more mobility options to those who need them most," said Mike Swinford, CEO of Numotion. Numotion will continue to serve customers from the Horn's location in Athens. Horn's employees, includ- ing founders Jim and Jerry Horn, will support customer sales and care, and product ser- vice and repair. As part of Numotion, they will have access to a larger product offering and support infrastructure that will help increase efficiency, according to the release. Numo- tion now has locations in nearly every state and serves more 250,000 customers annu- ally, it says. Short takes MobilityWorks has opened a new sales, service and rental location in Bear, Del. Mo- bilityWorks now has 67 stores stretching from Maine to California…The United Spi- nal Association will host Andrea Dalzell, Ms. Wheelchair New York 2015, at its 6th Annual Roll on Capitol Hill in Washington, D.C., June 11-14...Bryan Anderson, Kiel Eigen and Mark Smith of Quantum Rehab made a short film, "Head Over Wheels," and entered it into the 2017 Easterseals Disability Film Challenge. As part of the challenge, filmmakers spend 48 hours writ- ing, filming and producing a five-minute film addressing disability in a unique light. This year's theme was "family comedy"… The U.S. Power Soccer Association and sponsor MK Battery are gearing up for the World Cup in Kissimmee, Fla., July 5-9. It's the first time the event will be hosted in the U.S., with the previous two World Cups held in Tokyo in 2006 and Paris in 2011. The U.S. team kicks off the event with a match against Denmark on July 5. ■ Thanks in part to swift action by stakeholders, Rita Stanley says, DME MACs agree to reprocess claims for seats, backs. See story below. 14 HM e N ew S / ju N e 2017 / www. HM e N ew S .co M Prior auth update: Hoover reviews errors . . . . . . . . . . . . . 14 UPitt launches PneuChair. . . . . . . . . . . . . . . . . . . . . . . . . . 14 AAH debuts Retail Work Group . . . . . . . . . . . . . . . . . . . . . 14 Rehab conference highlights managed care . . . . . . . . . . 15 Custom seats, backs return to individual prices ATP rule trips some New PneuChair The University of Pittsburgh Human Engineering Research Laboratories (HERL) has designed, devel- oped and constructed a patent-pending waterproof power wheelchair that runs on compressed air. The PneuChair pneumatic wheelchair was unveiled in April at Morgan's Wonderland, a theme park in San Antonio built specifically for people with disabilities. complex rehab advocates share suc- cess stories after a day of lobbying on the Hill as part of the National CRT Conference in April. Prior auths AAH MARRIES REHAB WITH RETAIL p R I O R A U T H S S E E n E x T PA g E By Liz Beau L ieu, e ditor WA S H I N G TO N – c M s g a v e insight into how provid- ers are doing with a new prior authorization pro- cess for two complex rehab codes during the third in a series of s pecial Open Door Forums on a pril 25. During the forum, Dr. Robert h oover, the chief medical officer for cgs a dministrators, the DM e M ac for Jurisdictions B and c , cited top non-affir- mation reasons for K0856 and K0861so far. a n issue that has popped up in both jurisdictions: no evidence that an a TP had direct, in-person involvement in the selection of the power mobility device. a n u m b e r o f o t h e r non-affirmation reasons deal with the face-to-face exam: it was not signed by the treating practitio- ner (Jurisdiction B); it was incomplete (B); and it did not paint a clear picture of the beneficiary's func- tional abilities and limita- tions ( c ). O t h e r r e a s o n s a r e : there was no indication of receipt date by supplier for documentation (B); there was no financial attesta- tion stating the licensed/ certified medical profes- sional has no financial relationship with the sup- plier ( c ); and the 7-ele- ment order was not writ- ten by the same physician/ practitioner who complet- ed the face-to-face exam ( c ). Top rejection reasons in Jurisdiction B are dupli- cate request, rep payee on file and wrong jurisdic- tion; and in Jurisdiction c , beneficiary not in program state and faxing error. In two previous forums, c M s officials spent the bulk of their time discuss- ing whether or not acces- sories are covered under the process. That topic came up again during this By Liz Beau L ieu, e ditor WASHINGTON – The DM e M ac s for Jurisdictions B and c have agreed to process all hold- ing claims for custom seats and backs based on indi- vidual pricing, Rita s tanley, vice president of government relations for s unrise Medical, announced at the n ational c RT c onference on a pril 26. s tanley says she was told there are 30 or so such claims for e 2609 and e 2617. " a s of today, they were going to start processing those claims based on individual con- sideration again," s h e s a i d . " I f t h e pricing information they need was submitted, the claims will be processed right away. If the pricing is not attached, they will reach out to suppliers." The DM e M ac s for Juris- dictions B and c had transi- tioned to set pricing for cus- tom seats and backs earlier in a pril, put- ting e 2609 at $450 and e 2617 at $550, according to pre- vious reports by The V g M g roup. Traditionally, seats and backs are priced individ- ually and average about 70% of M s RP/supplier price, V g M says. The DM e M ac s for Juris- dictions B and c will reopen and pay the difference for claims that have already been processed based on set pric- ing, s tanley says. In the long-term, the DM e M ac s for Jurisdictions B and c say they may permanently return to individual pricing for custom seats and backs, 'It's time to get serious' about cash sales, says chairwoman of new work group & Mobility c ouncil with the goal of helping providers tran- sition into new, cash-based markets, even as they work to ensure traditional reim- bursement streams remain steady. "We're very supportive of industry efforts to get regu- latory reform," said a shley Plauche, manager of gov- ernment affairs of aah omec- are. " a t the same time, we want to be sensitive to what members need and offer them opportunities to grow new sources of income." To that end, Plauche said the new work group will be helping providers understand where their revenue current- ly comes from and where it could come from moving forward. "What kind of target market do I currently have?" is among the questions she said provid- ers should be asking. "What do I have to do to reach out? Retail is a different mindset from what many providers are used to." For n ancy Froslie, the work group's chairwoman and rehab manager at s anford h ealthcare a ccessories, the goal is not to move providers away from tra- ditional reimbursements, but to help them supplement in Stakeholders make case for complex rehab See story page 1 R E TA I l W o R k g R o U P S E E n E x T PA g E c u S T O m P R i C i n g S E E n E x T PA g E Ashley Plauche

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