HME News

OCT 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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Page 18 of 32

Rx and Specialty Providers HME Excellence winner: PediStat . . . . . . . . . . . . . . . . . . . 18 Lofty goals at Lofta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 PHS publishes recreation guide . . . . . . . . . . . . . . . . . . . . . 18 Lawmakers question CPAP bundling plan . . . . . . . . . . . . 18 ■ It's likely cooler heads will prevail on issue of sleep screening regs for truckers, says Steven Garrish. See story page 1. 18 hme news / october 2017 / By John Andrews, Contributing e ditor MIAMI – PediStat President Grizzy Miller, RN, says she knew that when she founded the company in 1990 that pro- viding healthcare services to children would become more than a job—it would become her life. Miller understood that being available all the time is just the nature of taking care of young patients, and 27 years later she still embraces that role. WASHINGTON – A bipartisan group in the House of Representatives in September was circu- lating a congressional sign-on letter that asks CMS to delay a CPAP bundling pilot program from the next round of competi- tive bidding. The letter states a number reasons for delaying the program, including the lack of evidence that it will save money or enhance care, and CMS's lack of authorization to test alternative payment models as part of its competitive bidding program. "Instead, we encourage the agency to work with Congress and stakeholders to prioritize efforts that bring stability to the program," the letter states. "If the agency is interested in reforms to ensure better compliance with CPAP therapy and other home respiratory care, we stand ready to work with you on initiatives that have a greater potential to save money and improve health outcomes." The association has argued that bundling a CPAP device, consumable items, mainte- nance and service into a single monthly pay- ment could cause disruption for providers, could provide an incentive to furnish inferior products, and could result in lower quality of care. CMS announced earlier this year that it had added 10 new competitive bidding areas for the CPAP product category. In five of those CBAs, payment for CPAP devices, relat- ed accessories and services will be made on a bundled, non-capped monthly rental basis, while payment in the other five CBAs will be made on a capped monthly rental basis like other existing CBAs. The sign-on letter is spearheaded by Reps. Tim Walberg, R-Minn., Debbie Dingell, D-Mich., Cathy McMorris Rodgers, R-Wash., Scott Peters, D-Calif., and Michael Bishop, R-Mich. hme By Kelly Bothum, Contributing w riter M e DICA l PR o B le MS are only one hurdle for families raising children with special needs. It can be just as challenging to find places to play, shop and eat that not only accommodate wheelchairs and other medical devices but welcome them as part of an inclusive atmosphere. Pediatric Home Services, a children's home healthcare com- pany in Minnesota, is trying to make the search easier with its inaugural PHS Top Spots, an online guide featuring the most accessible recreation areas, welcoming downtowns and helpful By t heres A Fl A herty, m anaging e ditor SAN DIEGO – New provider Jay l evitt wants to revolutionize the sleep therapy space with a streamlined path to treatment and "shockingly" good cus- tomer service. "We've created a holistic experience that people can navigate in under a week for screening, testing, diagnosis and treatment," said l evitt, founder of l ofta. "I just got off the phone with a man who has been put- ting off getting tested for 10 years because the thought of going to sleep labs and doctors and all of these other fragmented inef- ficient steps taking 60 days are a nonstarter." At press time, l ofta's full launch was about 90 to 120 days out, but l evitt says he's already fielding calls from consumers attracted to the company's "Com- plete Path" program, which takes patients from screening to diag- nosis to therapy in a week or less. Seventy percent of people don't make it through the traditional path, which can include a visit to a sleep lab and can take much longer, says l evitt. "We pull them through the (typically) arduous stage of get- ting diagnosed and quickly move from the problem to the solu- tion," he said. "We pull 100% through the path and our com- pliance rate is in the high 90s." The cost: $399. "We are completely off the Lofta carves out 'Complete Path' " We a re e m o t i o n a l l y involved—we're not a busi- ness, we are here to serve our patients with whatever they need," said Miller, whose Miami-based company earned second runner-up honors in the HM e e xcellence Awards. "We've been around since 1990 and some of our patients have been with us all that time. Some of our employees have been here for 20 years. We're still here, doing the same thing More than a biz Lawmakers question CPAP bundling plan grid with insurance," he said. "Most people find, with copays and deductibles, and the incon- venience on top of it, that they'll end up paying more to go to sleep labs." l ofta will only offer ResMed sleep products, which l evitt believes will e n h a n c e t h e shopping expe- rience for cus- t o m e r s , w h o won't have to wade through thousands of SKUs. He is par- ticularly gung- ho about ResMed's new AirMini, and in August launched www., dedicated exclusively to the new CPAP. "We feel like this is the per- fect product to bring our name to the market," he said. "It's sexy, it's primarily cash pay and it's got the Apple-like feeling to it." l ofta offers a 30-day no-risk trial, free shipping and even a 12-month 0% interest payment program for the AirMini—poli- cies that will carry over to its main e-commerce site, says l evitt. "It's an expensive proposition to spend $1,000 on a CPAP," he said. "We wanted to take the risk out of it." l evitt hopes his entry into the sleep space will also help change the larger conversation about sleep apnea, which he says still has a stigma associated with it. "We are trying to come at it more from a wellness stand- point," he said. "This is good stuff to talk about: If you have sleep apnea and you treat it, it's such a life changer." hme PHS lists top spots P H S g u i d e s e e n e x t pa g e P E D I S TAT s e e n e x t pa g e Grizzy m iller, right, front row, and the team at PediStat . Jay Levitt "We've created a holistic experience that people can navigate in under a week for screening, testing, diagnosis and treatment' pediatrics Briefs Dexcom ships G5 to m edicare beneficiaries SAN DIEGO – Dexcom has begun shipping the Dexcom G5 to Medicare beneficiaries who meet coverage requirements for continu- ous glucose monitoring, according to news reports. CMS in January classified "thera- peutic" CGMs as DME, paving the way for coverage if certain criteria are met. In July, Dexcom reached an agreement with As- censia Diabetes Care to bundle Ascensia's ContourNext One glucose monitoring sys- tem with the G5. CMS has set a one-time fee of $236 to $277 for the CGM receiver, and a monthly allowable of $248.38 for re- lated accessories. Demand for the G5 is so high that 20,000 beneficiaries are "in the pipeline" for a device. The G5 is currently the only CGM approved for insulin dosing. Aeroflow forms advocacy group ASHEVILLE, N.C. – Aeroflow Healthcare today announced that it has formed a breast- feeding advocacy department to promote access to breastfeeding support, supplies and services for families nationwide. With the introduction of this team, the company expands its advocacy efforts for healthy families, aiming to increase breastfeeding rates on both a local and national scale. In February, Aeroflow, which has a Mom & Baby division, launched a petition to keep breastfeeding support as a preven- tive health benefit. Greater n ebraska h ome Infusion fills need GRAND ISLAND, Neb. – When a local phar- macy that provided home infusion services closed, Rick and Cindy Lobeda, who have owned Midwest LTC Pharmacy for 10 years, saw a need and opened Greater Ne- braska Home Infusion. They opened their doors earlier this year, but they only recently completed the paperwork to get their ser- vices approved by Medicare, according to the Grand Island Independent. "We wanted to provide a better service and take care of those customers the other pharmacy has had over the years, so they didn't have to lose a good service," Cindy Lobeda, a licensed pharmacist, told the newspaper. In addition to providing home infusion ser- vices, Greater Nebraska Home Infusion has three infusion suites. The company also of- fers total protein nutrition. Accredo passes muster with o IG WASHINGTON – Accredo Health Group has properly billed Medicare for inhalation drugs, according to a report from the Office of Inspector General. The review follows the inclusion of inhalation drugs in the top 20 DME products with the highest improper payment rates for calendar years 2014-15. Accredo is the first of three providers that will undergo reviews by the OIG. Medicare paid about $1.3 billion for inhalation drugs during 2014-15, with Accredo receiving 26% of payments.

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