HME News

JUL 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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VOLUME 23 — NUMBER 7 JULY 2017 $7.00 HME NEWS POLL ■ A new process for serial claims eases the burden on providers, says The van Halem Group's Kelly Grahovac. See page 7. ■ Product Spotlight: This month we feature consumer mobility products, including the Raptor Scooter from Pride Mobility Products. See page 19. ■ Do you think it makes sense for Medtrade to be three vs. four days long? See results on page 23 N E W S ■ Senate committee prioritizes audit reform. PAGE 3 ■ Prior auth legislation could nudge CMS forward. PAGE 3 ■ CareCentrix bends 'cost curve' PAGE 3 C O M M E N TA RY ■ While the urgency of bid relief reform increases every day, we must recognize that change won't happen overnight, says VGM's John Gallagher. PAGE 7 D E PA RT M E N T S PROVIDERS ■ Ransomware attacks have providers assessing web security. PAGE 11 ■ Q&A: George Kucka PAGE 11 MOBILITY ■ Z diagosis codes are in. PAGE 14 ■ Former provider Gerald Sloan is back in business. PAGE 14 RX & SPECIALTY PROVIDERS ■ Soleo Health adds voice to infusion fi ght. PAGE 17 ■ Q&A: Dr. Joseph Krainin PAGE 17 VENDORS ■ Inogen sees growth for POCs. PAGE 20 ■ Changes at Sunrise, VGM, Permobil. PAGE 21 W W W . H M E N E W S . C O M Appeals backlog wears on and on Teijin kills HME bid Strategy session Attendees at AAHomecare's Washington Legislative Conference in May strategize for meetings with lawmakers. They conduct- ed 262 meetings this year vs. 231 last year, a 13% increase. See page 3 for full coverage. Ahead of expansion, process runs smoothly INVACARE READIES FOR LIFE POST CONSENT DECREE PA P R O C E S S S E E PA G E 1 5 PRIOR AUTHORIZATIONS BY LIZ BEAULIEU, Editor YARMOUTH, Maine – A whopping 92% of respondents to a recent HME Newspoll say they have claims stuck at the administra- tive law judge level and are waiting—and w a i t i n g — f o r hearing dates. T h e l a r g - est majority of poll respondents (28%) say their claims are going on three years old. "This is a major cash flow problem," wrote Mary Klavoon of Buffalo Wheelchair in Buffalo, N.Y. "We buy and pay for equip- BY THERESA FLAHERTY, Managing Editor T EIJIN LIMITED'S recent announcement that it was exiting the U.S. homecare market is a textbook example of the cooling off of a once red- hot market, say industry analysts. " We ' v e s e e n these guys com- ing in and going out like a revolv- ing door," said Rick Glass, presi- dent of Steven Richards & Associ- ates. "The U.S. is such a big mar- ket that it looks desirable to these overseas players and then they get in here and fi nd out it's a little more complicated than that." Teijin announced in late April BY LIZ BEAULIEU, Editor WASHINGTON – CMS plans to expand a prior authorization process for two complex rehab codes nation- wide on July 17 and the agency, for the most part, has the blessing of industry stakeholders. CMS fl ipped the switch on a BY LIZ BEAULIEU, Editor ELYRIA, Ohio – Now that Invacare has made signifi cant progress toward lifting a consent decree with the U.S. Food and Drug Administra- tion, it's paving the way to launch a robust pipeline of new products 'Hopefully we're still in business when our cases get to a judge,' says provider Donna Barraclough ment, and dispense to our quali- fi ed Medicare recipients, only to have to wait three to four years to have something reviewed and hopefully paid." At last count, 884,017 appeals were waiting to be adjudicated by the Offi ce of Medicare Hear- ings and Appeals. Using its cur- rent resources (and without any additional appeals), it would take OMHA 11 years to process that backlog. Poll respondents say their busi- nesses could fold, their patients could die—all by the time they're scheduled for hearing dates to review their appeals. that it was selling Braden Part- ners—better known as Pacific Pulmonary Services—and Asso- ciated Healthcare Systems to PPS HME, an affiliate of Quadrant Management, a New York-based private equity and restructuring fi rm. When Teijin acquired Braden Partners, the provider was in growth mode. In 2010, one year after Teijin made the acquisition, it received nearly $46.1 million from Medicare for stationary oxygen concentrators, accord- ing to the HME Databank. But by 2015, the latest fi gures avail- able, that had dwindled to $13.1 million. "Business conditions grew nega- tive due to developments such as the U.S. healthcare reform, placing PA process for K0856 and K0861 in Illinois, West Virginia, Mis- souri and New York in March. "From what I'm hearing from our members, it's going smooth- ly," said Don Clayback, execu- tive director of NCART. "From the start, we've been supportive later this year, company offi cials told analysts during an earnings call May 9. In the fi rst half of 2017, Inva- care expects continued lower net sales—offset by favorable sales mix and increased gross margin as a percent of net sales—but by the end of the year, it expects a "sustainable turn" in both sales and operating income as a result of its transformation investments and activities. "This is really the turn year," said Matthew Monaghan, chair- man, president and CEO. Invacare reported $231.7 mil- lion in net sales for the first quarter of 2017, a 10% decrease compared to the same quarter HME NEWS POLL Another round of layoffs See story page 20 Sells Pacifi c Pulmonary to affi liate of Quadrant Management, which owns Landauer Metropolitan Brad Smith A P P E A L S D R A G O N PA G E 1 8 T E I J I N ' S B I D S E E PA G E 2 2 C O N S E N T D E C R E E S E E PA G E 2 1 T H E B U S I N E S S N E W S P A P E R F O R H O M E M E D I C A L E Q U I P M E N T P R O V I D E R S

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