HME News

AUG 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 h M e new S / A U g UST 2017 / www.h M enew S .co M 15 'The Climb' n umotion customer g enesis, pictured with C e O Mike s winford, was in for a big surprise in June when, after getting her new complex wheelchair, she received a personal taped rendition of " t he Climb" by Jessi a lexander. g enesis has endured 24 surgeries from complications surrounding her spina bifida. s he considers " t he Climb" to be her theme song, saying it "calmed me down" throughout her surgeries. n umotion says: "With improved indepen- dence, g enesis is now excited to continue her 'Climb' as she pursues her dream." C MS RECONSIDERS ACCESSORIES C O n t i n U e D f r O M pa g e 1 consumers," said Don Clayback, executive director of NCART. "It has been a year and a half of very hard work." CMS said it has "reconsidered" and decid- ed to preserve reimbursement for accessories for Group 3 or higher complex rehab power wheelchairs. It said providers should contin- ue to use the KU modifier when billing for accessories with dates of service beginning July 1. It said no additional action would be required. CMS did not, however, extend the policy change to accessories for complex rehab man- ual wheelchairs. "We will pursue relief from last year's cuts to these accessories as we continue to work with Congress and CMS to protect access," Clayback said in a bulletin to members. Upon hearing from champions in Congress the week of June 19 that a fix was in the works for complex rehab power wheelchairs, Seth Johnson, vice president of government affairs for Pride Mobility Products, said, "It sounds like a positive development. We have a little extra bounce in our step." CMS originally planned to apply bid pric- ing to accessories on Jan. 1, 2016, but Con- gress intervened in December of 2015, pass- ing legislation with a one-year delay, and again in December of 2016, passing legisla- tion with a six-month delay. Pressure has been high to stop the cuts. NCART and NRRTS, as well as the United Spi- nal Association, hosted congressional fly-ins in April and June, and one of their "asks" was getting legislators to again intervene.Then in June, a "Dear Colleague" letter signed by 154 members of the House of Representatives was sent to HHS Secretary Tom Price, asking him to use his authority to stop the cuts. Additionally, in March, bills were intro- duced in the House and Senate to stop the cuts. Stakeholders have argued that accesso- ries for complex rehab wheelchairs, like the wheelchairs themselves, are exempt from competitive bidding per the Medicare Improvements for Patients and Providers Act of 2008, or MIPPA. Yet CMS issued an FAQ in December 2014 that outlined its plans to use pricing from bids for accessories for standard wheelchairs to reduce reimbursement for accessories for complex rehab wheelchairs. hme p RIOR A u THS C O n t i n U e D f r O M p r e V i O U s pa g e ACCESSNSM C O n t i n U e D f r O M p r e V i O U s pa g e days. A CMS official said the contractors are appropriately staffed and ready to handle the increase in volume. This was the fourth forum that CMS has held on the prior authorization process for K0856 and K0861. Previous forums have largely focused on whether or not acces- sories are covered under a PAR affirmation. CMS outlined its plans to require prior authorizations as a condition of payment for certain DME back in February 2016. The agency released a "master list" of 135 products for which it may apply the pro- cess, including CPAP devices, semi-elec- tric hospital beds, manual wheelchairs and oxygen concentrators. Then in a final rule published in the Federal Register on Dec. 21 of that year, CMS announced it had selected K0856 and K0861 as the first codes up for the process. CMS also has a prior authorization pro- cess in place for standard power wheel- chairs in 19 states, as part of a demonstra- tion project. hme synergies in the complex rehab and home accessibility markets," he said. "Strategic investments will enable us to leverage these synergies to continue to expand our reach to those in need of solutions. We are excited about the future for AccessNSM." Unlike complex rehab, the home accessibility market is largely free of regulatory requirements, making it an attractive business, Mixon said. "Home accessibility is a less compli- cated process as most sales involve cash transactions," he said. NSM launched AccessNSM in Octo- ber 2014, when it packaged up the home accessibility businesses of several acqui- sitions, including Hudson Seating & Mobility, as a "single brand." "We are in the accessibility market to stay and will continue to enhance our platform to accommodate continued growth over the next few years," Mixon said. hme b ILL FERTIG C O n t i n U e D f r O M p r e V i O U s pa g e to hear about the event and how it's changed from year to year. hme News: How was this, the 6th Annual Roll, different from previous years? Bill Fertig: It gets slightly bigger and slightly better each year, and this year it was much bigger. We typically do 200 Hill visits; this year, we did around 250. hme : In what ways is lobbying on Capitol Hill important for the disability community? Fertig: It puts us face-to-face with legisla- tors on the issues that are important to us. We also have a visual cue that some other groups don't, because we arrive in our complex power chairs and manual chairs that people don't typically see in the community. hme : Do you feel the Roll visits played a part in CMS's recent decision not to reduce reimbursement for accessories for complex power wheelchairs? Fertig: We certainly like to feel we had influ- ence. There was also progress on a veteran's bill in Congress on the same day. A lot of our community is affected by both. hme : How do you stay motivated when this type of work—lobbying and advocacy—is never done? Fertig: Success breeds motivation, but the biggest point is this is our life. We deal with the challenges every day, and the opportu- nity to advocate fixing things when they're wrong is a big benefit. hme : How is United Spinal working to get more wheelchair users involved in Capitol Hill visits? Fertig: Our general plan for accepting new advocates into the mix is to include younger people, while still maintaining a large proportion of experienced advocates who can partner with newer advocates so they don't feel like they're going it alone in the visits. hme NRRTS C O n t i n U e D f r O M p r e V i O U s pa g e Magazine, Walker said. "This really impacts Congress—not this group and that group, but all groups," she said. The addition of NRRTS to this year's event is "valuable," said Alexandra Bennewith, vice president of government relations for United Spinal, who recently attended the Nation- al CRT Conference hosted by NRRTS and NCART. "All stakeholders who value the consumer voice are welcome to join our efforts," she said. "For this event, consumers are the focus, and they understand that, but we're all work- ing together." hme Local Company - Global Reach Barber Holding LLC Advantages of PROVENT Advantages of PROVENT Small, lightweight, disposable & convenient Does not disrupt bed partner's sleep Is not affected by an electrical outage 30 day supply easily fits in your pocket Can breathe normally using ambient air Can move freely while sleeping This product is the first of it's type in the treatment of OSA GREAT COST CENTER POTENTIAL BE A PART OF THIS BREAKTHROUGH TREATMENT FOR OSA F DA C L E A R E D B e c o m e a S u p p l i e r sleepwellrested.com | info@sleepwellrested.com 888-834-4381 TO GET STARTED CONTACT US TODAY FOR MORE INFO

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