HME News

SEP 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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News Briefs Tricare will make payment adjustments WASHINGTON – Tricare, the healthcare pro- gram for uniformed services members and their families, will also adjust payments from June through December 2016 per a provision in the 21st Century Cures Act, according to AAHomecare. The provision in the Cures Act requires Medicare to ret- roactively delay a second round of reim- bursement cuts in non-bid areas from July 1, 2016, to Jan. 1, 2017, allowing providers to recoup a portion of six months worth of payments. In a letter responding to HME providers who inquired about whether Tri- care, which bases its payments on Medi- care's payments, would also make adjust- ments, Tricare stated: "You are correct TRICARE uses Medicare's DMEPOS fee schedule, Medicare reduced their rates in the second half of 2016, and a subsequent resolution (the 21st Century Cures Act) delayed that reduction, and retained the original, higher rates for claims with dates of service between July 1 and December 31, 2016. Study: Bid program puts Medicare more in line with commercial insurers BETHESDA, Md. – A comparison of the prices Medicare paid for certain DME under its competitive bidding program in 2010 and the average prices that commercial insur- ers paid that same year supports the con- clusion that CMS overpaid for DME, ac- cording to a new study conducted by the Health Care Cost Institute and published this month in Health Affairs. On average, the Round 1 Rebid prices for the seven items included in the study were 34.7% lower than the prices in the Medicare fee schedule for 2010. On average, commercial payers paid 28.7% less than Medicare for the same items in 2010. "This suggests that in the nine program MSAs, the program re- sulted in prices that were generally compa- rable to but lower than the prices obtained by large commercial insurers," the study's authors say. Because the bid program has better lined up prices from Medicare with those of commercial insurers, the study's authors argue it is an "effective mechanism for achieving savings," with one caveat. "If the concerns about the program's long- term sustainability can be resolved, com- petitive bidding for DME and similar items may be an effective mechanism for achiev- ing savings in Medicare, relative to historic fee schedule prices," they say. AAH seeks nominations for homecare champion WASHINGTON – AAHomecare is accepting nominations for the 2017 Van Miller Homec- are Champion Award. The award, which was established in 2016 when the association re- named the AAHomecare Champion Award, recognizes a member who has made excep- tional contributions to home care. Nomina- tions can be submitted to Sue Mairena at- until Sept. 8. ■ Lawmakers are ready to move on from healthcare reform, says VGM's John Gallagher. See story page 1. States look to single-source more DME . . . . . . . . . . . . . . . 4 AAH survey to dig into access issues . . . . . . . . . . . . . . . . . 4 Newspoll: HME industry divided on younger workers . . . . 4 Q&A: VGM's Buhrmester, Fedor . . . . . . . . . . . . . . . . . . . . . . 6 4 HM e new S / S ep T e MB er 2017 / www. HM enew S .co M By Liz Beau L ieu, e ditor D istributors have been picking up Medicaid contracts for incon- tinence supplies in a number of states for years. Now the stakes have been raised. i n i ndiana, for example, Medline has won a single-source contract to provide all DM e and supplies to Medicaid patients under Managed h ealth s ystems, a man- aged care company that's administering part of the state's program. Medline plans to drop ship aides, soft goods and supplies, and has set up a network that includes By Liz Beau L ieu, e ditor AMARILLO, Texas – h M e providers in t exas have solid ground to stand on when it comes to their criticism of a new Medicaid con- tract that makes Medline a single-source provider of 244 DM e supplies, says an industry attorney. Pam Colbert, a mem- ber of the h ealth Care Group at the law firm b rown & Fortunato, out- lined a number of ways the contract vio- lates t exas law in her complaint on behalf of a lliance Medical s upply, a provider in s an a ntonio. I T ' S A ny THI ng B u T co M pe TITI ve Per the t exas Government Code and the By Liz Beau L ieu, e ditor YARMOUTH, Maine – t he v GM Group gave a nod to young professionals when it host- ed a meet-up for the h M e Young Professionals Group at the h eartland Conference in June, but it turns out the h M e industry is still very much gray. t he majority of the respon- dents to a recent h M e News- poll (54%) say they're n o t e x p e - riencing a shift to a younger workforce. "We have more over 65 than under 40," wrote one respon- dent. "What shift?" t he majority of respondents (46%) to the poll say they only have one to five employees under 40. Five percent say they have none. Young professionals, who States single-source more and more DME a pria h ealthcare to pro- vide "hard DM e ," says George Kucka, president and C eo of Fairmead- ows h ome h ealth Cen- ter in s chererville, i nd., " t his is completely changing the paradigm," said Kucka, who is also the h M e / r espiratory t herapy Council Chair for aah omecare. " i t's starting to spread, and it's not good. t his points to the fact that no one respects that there's a service aspect to this." Kucka got word of the contract via a letter in February. h is contract with M hs will be terminated—he serves about 150 patients under the plan—and the new con- tract with Medline will start on s ept. 1. Down in t exas, Medline has won a Contract 'promotes favoritism' By T. F L aher T y, Managing e ditor WASHINGTON – i ndustry stake- holders are reaching past the ranks of h M e providers to gauge the impact of competi- tive bidding, as they contin- ue to push for reforms to the program. aah omecare, working with Dobson Da v anzo & a ssoci- ates, a well-respected healthcare research group, has launched a new survey to seek input from not only h M e providers but also Medicare beneficiaries, caregivers and other healthcare professionals like hospital dis- charge planners. "We've made headway at CM s , certainly, with t om Price, but there continues to be (push- back) from some career folks that do not believe there's an access issue," said t om r yan, president and C eo of the a s s o c i a t i o n . " We b e l i e v e it would be beneficial to get a third- p a rt y g ro u p like Dobson D a v a n z o t o d o a n o n - biased survey, reaching out to discharge planners and o t h e r s w h o have patients a f f e c t e d b y bidding." aah omec- are created a survey steer- ing committee to create a matrix of providers to participate in the survey and develop ques- tion sets. Discharge planners are uniquely situated to see firsthand AAH survey to dig deeper into access issues What shift? HME industry divided over role of young professionals a re m o re likely not t o h a v e experience in the h M e i n d u s - try, can detract or add to a business, depending on the respondent, according to the poll. " u nfortunately, we can't afford to spend time training inexperienced staff," wrote on respondent. " t h e re i s w a y t o o m u c h t o learn. i myself started at a young age with no experience, but that was a different time." o n the other hand, "While experience is valuable, there are so many changes to the way we do things from five years ago that we are find- ing it easier to train someone 'They're commoditizing this portion of health care, and it's scary to think about how far they'll take it' M E D I c A I D c o n t r a c t s s e e pa g e 8 f A v O R I T I S M s e e pa g e 2 9 N E W S p O L L s e e pa g e 6 S U R v E Y s e e pa g e 8 HM e NEWS POLL shut out Pam Colbert George Kucka Tom Ryan Gary Sheehan Discharge planners are uniquely situated to see firsthand the problems created by bidding program VGM creates network for young professionals See Q&A with Ryan Ball page 8

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