HME News

DEC 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 22 www.hme N / december 2017 / hme N ews Periodicals postage paid at Yarmouth, ME and additional mailing office. HME News (ISSN 10913823) is published monthly by United Publications, Inc., 106 Lafayette St., PO Box 998, Yarmouth, ME 04096; 207-846-0600. Publisher assumes no responsibility for unsolicited material or prices quoted in the magazine. Contributors are responsible for proprietary classified information. ©2017 by United Publications. All rights reserved. Reproduction, in whole or in part, without written permission of the publisher is expressly prohibited. Reprints may be obtained from The YGS Group at 717-505-9701, ext. 100. Back issues, when available, cost $7 each within the past 12 months, $12 each prior to the past 12 months. Back issue orders must be paid in advance either by check or charged to American Express, Visa, or Master Card. HME News is distributed without charge in North America to qualified home medical equipment providers. Paid print subscriptions to those not qualified cost $65 annually to the U.S. and Canada and $150 to all other countries. All payments must be made in U.S. funds drawn on a U.S. bank. For subscriber services, including subscription information, please call 800-869-6882. POSTMASTER: Send address changes to HME News, PO Box 1888, Cedar Rapids, IA 52406-1888. The legislation would also remedy a "dou- ble-dip" cut to oxygen payments caused by the misapplication of a 2006 budget neu- trality offset balancing increased utilization for oxygen generating portable equipment with lower reimbursement for stationary equipment. It's hard to say whether there will be an appropriate vehicle to attach it to, according to stakeholders. "McMorris Rodgers is Republican leader- ship, so she is really evaluating the options," said Jay Witter, senior vice president of public policy for AAHomecare. "There's been some discussion about the Medicare extenders in the fall or a possibility of moving forward as a standalone." With an interim final rule titled "Durable Medical Equipment Fee Schedule, Adjust- ment to Resume the Transitional 50/50 Blended Rates to Provider Relief in Non- Competitive Bidding Areas," seemingly stalled at the Office of Management and Bud- get and the shocking resignation of industry champion Tom Price from his post as Health and Human Services secretary, stakeholders say they are as ready as HME providers to seem some action this fall. "Short term, we've got to push this bill to say, hey, this is the will of Congress," said John Gallagher, vice president of government relations for VGM. "Get off the dime." hme now that have gotten letters from the Office for Civil Rights (within the Depart- ment of Health and Human Services) requesting information on their HIPAA compliance program, specifically a copy of their security and risk assessment, which is something that HIPAA requires all providers to do at least on an annual basis," said van Halem, president of The van Halem Group. While a large majority of respondents to a recent HME Newspoll (77%) report they have a documented HIPAA compliance pro- gram in place, only a slight majority (56%) report it includes a written security and risk assessment. Providers may be dedicated to protect- ing patient data in practice, but if their efforts aren't in writing, they might as well not exist, says Tom Meadows, owner of HIPAAwise, which offers HIPAA compli- ance software and which has an agreement with The van Halem Group to combine their services. "It's one thing for providers to say they think about the risks and they talk about them in meetings—they need to docu- ment the key elements of the require- ments," he said. "The No. 1 focus of audits is the security and risk assess- a shortened schedule of three vs. four days, though expo hours were extended to 5 p.m. each day, and the overall number of conference sessions remained steady at about 60. r eco NN ectio N s a N d i N troductio N s Judi Taylor, the event planning man- ager for longtime exhibitor DJO Global Brands, feels it's important to have a pres- ence at Medtrade. "The show was pretty good," she said. "We will probably pick up a few new cus- tomers for diabetic shoes and braces, but it's gener- ally our existing custom- ers that we see here." A m b e r Wa t t , t h e o w n e r o f e x h i b i t o r Breathe Technologies, said floor traffic was a bit slow, but overall, she was pleased. "People stopping by our booth are defi- nitely wanting to switch products," she said. "I am more confident with the leads I'm getting this year." a 'refreshi N g' experie N ce Gaffney estimates that a large majority of attendees were focused on learning about the latest and greatest products that exhibitors like DJO and Breathe have to offer. Count provider Meir Tsinman among them. "They definitely have the right, popu- lar brands at the show," said Tsinman, president of online provider medical- "A commode is a commode, but something like a rollator, something that is refreshing, that is what I am looking for." c losi N g time To entice attendees to stick around until 5 p.m. on the show's final day, a recep- tion was held on the show floor, with four open bars and two food buffets. A cash prize drawing for $5,000 was also held at 4:45 p.m. Provider Sandra Chisolm from Heritage Home Medical in Wichita Falls, Texas, was the big winner. "I'm really…good," said the dazed Chi- solm, holding a large check. w ill the cha N ge stick? It's too early to say whether next year's Medtrade, slated for Oct. 15-17 at the GWCC in Atlanta, will have the same schedule, or something entirely differ- ent, show organizers say. "We will continue to look at the sched- ule today—and in the future," Gaffney said. "The final day could be 10 a.m. to 3 p.m., or 4 p.m." hme hme News: Why is there a need for a ses- sion like this? Ross Burris: A lot of providers decide to handle these hearings without counsel or consultant. It's often a financial decision. The problem is, they don't know how the proceedings work. hme : How can providers make the most of their time at these brief hearings? Burris: They definitely need to be pre- pared. They need to understand their doc- umentation and the basis for the denial. They also need to know how they're going to respond because these hearings happen very quickly. The judges don't have a lot of time, so providers need to be ready to get out their important points about why the claims should be paid hme : What are the pitfalls of these hearings? Burris: People aren't preparing at the early stages of the appeal process with a mind toward an ALJ hearing. They've probably handled the first couple stages on their own, so they don't have the necessary documentation. But by the time it gets to the ALJ it's too late. They need to think of it as an audit and get a plan early. hme : Aren't providers often successful during ALJ hearings? Why? Burris: More than half of providers are successful, and the fact is the prepared provider is going to have a much bet- ter track record. Because of the hearing backlog being almost two full years at the ALJ level, people are waiting a long time to get their day in court. They must be prepared to have all their documen- tation, and have everybody lined up if they're going to have physicians or nurs- es testify. hme workers to get regular physicals and to be compliant with any subsequent physician orders should be adequate, as long as the physicians don't rubber stamp the form," wrote Lori Sears of Active Home Medical Supply in Lapeer, Mich. "Advocate that phy- sicians become more proactive at screening all of their patients for risk factors—don't single out a single group and force it." Fortunately, awareness of sleep disorders is on the rise, say 91% of poll respondents. "More primary care physicians are screen- ing their patients," wrote one poll respon- dent. "And, just as important, as more people are diagnosed and treated, they talk about it with friends and family, as well as via social media and the Internet." hme hipaa compliance is lacking c o n t i n u e d f r o m pa g e 1 ment, which is woefully missing in this industry." Documenting compliance may be a mundane process, but it's an important one, say van Halem and Meadows, who readily tick off other things providers should be putting in writing, including when employee training takes place and how their business associate agreements protect patient data. "We know of a company that didn't have a business associate agreement in place for a subcontractor and was fined $30,000," van Halem said. While the HME industry is lucky in that cyber criminals don't see HME records as valuable as, say, EHR records, HME records still often contain Social Security numbers and banking information, which is attrac- tive data. "That's one reason why breaches, and audits, are increasing," Meadows said. The OCR has made a significant invest- ment into an online portal that lists breach- es—some 20,000 in the past five years, Meadows also notes. "The audits started last year and they've only done 150 HME-type companies so far," he said. "But I believe there are more to come." hme medtrade c o n t i n u e d f r o m pa g e 4 bid bill introduced in house c o n t i n u e d f r o m pa g e 1 burris c o n t i n u e d f r o m pa g e 4 newspoll c o n t i n u e d f r o m pa g e 6 United Spinal's Roll on Capitol Hill: h ow pf Q c ca N help PFQC believes in the power of one. Each person has a voice, and when those voices come together to educate legislators about their problems accessing HME, the wheels start rolling, and change can take place. Kelly says the first step in evoking change is, "To put the individuals having prob- stand up c o n t i n u e d f r o m pa g e 8 lems with obtaining the proper medical equipment, supplies and services directly in touch with their legislators in Washington." PFQC encourages people to reach out to their legislators not only through emails, but also through phone calls, Twitter, Facebook and all the vehicles available to them to let those they've elected know the problems they're having receiving the products and services that Medicare is sup- posed to be providing for beneficiaries. "Our key initiative at PFQC is to make sure that beneficiaries who aren't having access to home medical equipment and services get connected to their legisla- tors," Kelly says. "They can explain to those legislators on a personal level what their issues are and ask their legislators to help fight for changes that will pro- tect access to the HME benefit by provid- ing sustainable reimbursement rates and ensuring that there are enough providers to serve the population of Medicare ben- eficiaries." So, if the disability community doesn't make Congress aware of problems, then Washington can't and won't address these issues. Hint, hint: This is why we're encourag- ing you to share your own story online with a personal video! hme Kelly Turner is the executive director of People for Quality Care. She can be reached at kelly.turner@ Lisa Wells is the vice president of marketing for Cure Medical. She can be reached at lwells@cure- Kevin Gaffney

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