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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Mobility Briefs NSM makes debut in Washington state NASHVILLE, Tenn. – National Seating & Mobil- ity announced two acquisitions on May 12, including its first in Washington state. NSM has acquired Dependable Medical Equip- ment in Seattle, adding four assistive tech- nology professionals (ATPs) and one rehab technology supplier (RTS) to its roster. NSM has also acquired Columbus Medical Equipment in Columbus, Ohio, adding three ATPs and one RTS to its roster, and increas- ing its existing service capabilities in the central Ohio area. Additionally, in conjunc- tion with its acquisition of Columbus Medi- cal Equipment, NSM will launch its first Ac- cessNSM home solutions location in Ohio. NSM launched its home solutions company in 2015. Including Ohio, it now offers stair lifts, wheelchair lifts, ramps, door openers and barrier-free showers in nine states. RAC to perform rare underpayment review ATLANTA – Performant Recovery, the new national RAC for DME, will perform an underpayment review for Group 3 power wheelchair options. The Patient Access and Medicare Protection Act mandates that adjustments to the 2016 Medicare fee schedule amounts for certain DME that are based on the competitive bidding program cannot be applied to wheelchair acces- sories furnished in connection with codes K0848-K0864. The change was effective Jan. 1, 2016, but CMS was unable to im- plement changes to its processing systems until July 1, 2016. Payments during that time were based on adjusted fee schedule amounts. "DME suppliers rarely experience RAC underpayments, so this is a welcome change," said Wayne van Halem, president of The van Halem Group. "In this environ- ment, every little bit helps." OIG pushes monthly rentals for all PMDs WASHINGTON – Medicare could save millions if it sought legislation to shift from a lump- sum purchase option to a monthly rental payment for all power mobility devices, according to a report from the Office of Inspector General (OIG) published in May. In January 2011, Medicare eliminated the lump-sum purchase option for standard power wheelchairs, a move that saved $86 million from 2011 to 2014, according to the OIG. If legislation were in place to also elim- inate this option for scooters and complex power wheelchairs—what the OIG calls "nonstandard PMDs"—Medicare would have saved an additional $10.2 million from 2011 to 2014, according to the report. The OIG conducted an audit that covered Medicare payments totaling $264,376,368 for PMDs obtained by 85,761 beneficiaries choosing the lump-sum purchase option during 2011through 2014. The PMDs were new and used nonstandard devices pro- vided to Medicare beneficiaries during the four-year period. ■ The DME MACs have agreed to add Z codes to the seating LCD thanks to a change request filed by consultant Martin Szmal. See story below. 14 h M e N e WS / july 2017 / WWW .h M e N e WS . COM Prior auth process runs smoothly . . . . . . . . . . . . . . . . . . . . 1 Seat elevation study off the ground . . . . . . . . . . . . . . . . . . 14 Gerald Sloan is back in the business . . . . . . . . . . . . . . . . 14 Q&A: RespectAbility's Jennifer Laszlo Mizrahi . . . . . . . . . 15 Wheelchair users rally around improved seat elevation tech STUDY RAMPS UP update on cushions S E AT e l e vat i o n s e e n e x t pa g e By Liz Beau L ieu, e ditor WASHINGTON – There was important work to do to protect accessories during the recent National CRT Conference, but the talk of the town may have been seat eleva- tion technology. As part of an industry update at the c o n f e r e n c e , company offi- c i a l s f r o m Pride Mobil- ity Products and Permo- bil discussed their recent advancements in seat elevation technology, to the applause of wheelchair users in the room. "One of the reasons this tech- nology resonates so much with By Liz Beau L ieu, e ditor EXETER, Pa. – A study to examine how seat elevation technolo- gy can improve the everyday lives of wheelchair users is off the ground. Researchers at Georgia Tech, which is conducting the study, have taken data loggers off the first wave of participants, says Julie Piriano, vice president of clinical education and rehab industry affairs, and the com- pliance officer for Pride Mobil- ity Products/Quantum Rehab, which is sponsoring the study. "But we still have a lot more participants to add to the By Liz Beau L ieu, e ditor T he DM e MACs have agreed to add several ICD-10 Z diagnosis codes to applicable sections of the Wheelchair Seating LCD. That means complex rehab provid- ers can submit claims with either S or Z diagnosis codes for positioning cushions for lower extremity amputations. "This has been an oversight in policy since the policy was written," said Martin Szmal, owner/president of The Mobility Consultants, who submitted a change request to the DM e MACs in May. "This opens the door for providers and patients to get the cushions they need." Before now, only S diagnosis codes were included in the Group 3 and Group 4 diagnosis codes lists in the LCD. S and Z diagnosis code differentiate between an acquired amputation (due to complica- tions from diabetes, for example) and a traumatic amputation, respectively. Szmal made the case that, although two sets of different codes are used to properly describe the manner of the amputation, the end result for the patient Stakeholders say they're committed to working with Medicare to secure coverage users is they can see the direct impact of it," said John Goetz, director of government affairs for Permobil. "They see it and they think, 'If I had that, think of all the things I could do on my own.'" While industry stakeholders have done yeoman's work to get third-party payers and Medicaid programs to cover seat elevation technology on a case-by-case basis, there's still no Medicare coverage. And therein lies the rub for a large population of users who are on Medicare, or whose insurer mirrors the federal pro- gram's coverage. Stakeholders are having an "ongoing conversation" with CMS about seat elevation tech- nology, but to date, the agency study," she said in May. "It's ongoing." Georgia Tech's Rehabilita- tion e ngineering and Applied Research Lab has already conducted a pilot study on seat eleva- tion. It found 90% of par- t i c i p a n t s u s e d t h e t e c h n o l o g y for increased safety and inde- pendence during activities of daily living. They also used it for transferring, reaching and John Goetz Julie Piriano Z diagnosis codes are in Back in business By Jeff Rowe, Contributing w riter T h R ee ye ARS ago, Gerald Sloan sold his mobility device company, Pro- gressive Medical e quipment, and retired to his 40-acre horse farm outside Kansas City, where he committed to help- ing his wife build a pumpkin business. " h ard labor never hurt anyone," he said recently. But Sloan admitted that between weathering the early days of com- petitive bidding and his efforts in Washington, D.C., on behalf of the h M e industry, he was "emotionally exhausted." But then he was approached by Max and Liliana y ounger, Mobility Designed's co-founders, and he basically couldn't resist. Their re-designed crutch was "unlike anything I'd ever seen," Sloan said. "It removes the pressure points from the arm and wrists," he said. "I thought, 'This is a product that could really help a lot of people, and it will also help my dealer friends.'" What made the opportunity even more compelling, Sloan explained, was the role he could play in the aspiring company. Max and Liliana came with a back- ground in industrial design, and they'd already enlisted the help of professionals with serious regulatory compliance and marketing experience. What they didn't have was someone who knew the h M e industry. It was enough to pull Sloan off the pumpkin patch and onto the road intro- ducing the new product to his former colleagues. One of the attributes that most attract- ed him to the product, he says, is the opportunity providers have to rent the crutch, in addition to selling it. "As a cash product that can also be rented, it's a good way for companies to generate revenue," he said. "Which kind of makes it the h oly Grail." hme Profile: former provider Gerald Sloan How do you go from working in a pumpkin patch to selling a "re-invented" crutch? If you're Gerald Sloan, vice president of business development for Kansas City, Mo.-based Mobility Designed, you do it by coming out of a somewhat reluctant retirement and getting back into a business you loved for many years. c u S H I O N c o d e s s e e n e x t pa g e S E AT s t u d y s e e n e x t pa g e

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