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
Issue link: https://hme.epubxp.com/i/944166
News 6 www.hmenews.com / march 2018 / hme news Data and Security Compliance and Risk Tax Bill Implications and the Economy Mega Trends and Business Tips Download VGM's latest playbook - Industry Snapshots: Forecasting 2018 – and find out! VGM's thought leaders have composed a comprehensive guide that focuses on health care initiatives you should be prepared for in 2018. This FREE resource is full of relevant and forward- thinking information on hot topics like: What's on the health care horizon? Download your FREE playbook today! playbook.vgm.com Texas lawmakers eye s uperior h ealthPlan contract with m edicaid AUSTIN, Texas – Superior HealthPlan's contract with the state of Texas could face scrutiny by a state ethics committee, according to lo- cal news reports. Texas House Speaker Joe Straus has asked House members to inves- tigate the Texas Health and Human Services Commission after an audit revealed it had mis- handled its contract with the managed care plan. Specifically, it found the state allowed Superior to report $29.6 million in bonus and incentive payments paid to medical providers' employees, even though such payments were not allowed under its contract with the state. Superior Health Plan, part of Centene Corp., has contracted with Medline to serve as the "preferred provider" of DME and supplies to Medicaid recipients. The contract start date was delayed from Sept. 1 to Oct. 1, 2017, after a hearing in August in which lawmakers suggested that Superior HealthPlan amend its notice to patients to say they can "opt out" of using Medline. from Medicare's competitive bidding pro- gram in non-bid areas. President Donald Trump nominated Azar in n ovember after then- s ecretary Tom Price resigned. While Price was an HME cham- pion well versed in issues like competitive bidding, Azar, a pharmaceutical exec who worked most recently as chairman and founder of s eraphim s trategies, a consulting firm, doesn't have much—if any—experience with DME. But that's not necessarily a prob- lem, say stakeholders. "He doesn't have a track record of nega- tive or positive positions (on DME), which in and of itself is not a bad thing," said Cara Bachenheimer, senior vice president of gov- ernment relations for Invacare. "As secretary, CM s is only one of the many agencies he's responsible for and it's unclear how closely he'll be involved." Azar's resume also includes a stint as presi- dent of Lilly us A, an affiliate of Eli Lilly, from January 2012 to January 2017; and a stint at HH s , from 2005-07, as a deputy secretary in the department, and from 2001-05, as gen- eral counsel. As HH s secretary, Azar will be working at 10,000 feet, fighting the Affordable Care Act and other high-profile national healthcare issues, say stakeholders. As long as industry champions look over his shoulder on things like the IFR, they remain optimistic. "We just want to him to remember to come back with his commitment to Thune to look into the IFR," said John Gallagher, vice president of government relations for VGM." hme One likely reason for the lack of responses to the poll: With what seems like unending assaults to reimbursement for Medicare, and now Medicaid, a number of respondents feel they're hamstrung. "We're closing our doors," commented K.C. Martin of s EMO Medical Equipment and s upply in Cape Girardeau, Mo. "It's truly sad for beneficiaries, but I have gone long enough without pay, and far enough dipping into savings and my kid's college account. Good luck to the remaining providers." Other respondents say they're not going that far but it won't be business as usual. "We're preparing for 2019, when the Medicaid hammer comes down, and we start turning people away, because there is no such thing as a non-assigned claim for Medicaid," commented Dave Ander- son of Anderson's Medical in Terre Haute, Ind. Another anonymous respondent says he plans to keep a "credit card on file for all equipment." Other responses to the poll indicate plans to "outsource as much as I can," including delivery and billing; to expand a service area for certain product categories; and to increase participation in advocacy efforts. One respondent kept it short and sweet: "Make money, not lose it." hme CEO of AAHomecare. "But we've also got sideliners who have let others do it and we've got to get them engaged. It's a call to arms." AAHomecare recently launched a Congressional Accountability Project to assign providers to serve as contacts for legislators in their states. These contacts are responsible for asking for support for legislation like H.R. 4229, educating law- makers about industry issues and, basi- cally, stepping up when there's a call to action. While providers in some states are engaged with lawmakers, that's not the case in others, like Alaska, Delaware, Hawaii, Louisiana, n ew Mexico, u tah, Washington and the District of Columbia. "I am reaching out to people I know in other states to say, 'Hey, we need you or somebody you know to get assigned to these legislators,'" said Doug Coleman, chairman of the AAHomecare s tate Lead- ers Council and president of the Colo- rado Association for Medical Equipment s ervices. "This way we know that the vast majority of lawmakers are hearing the stories and the messaging so there's a better chance (of getting H.R. 4229 passed)." hme HHS S ecre TA ry C O N t I N u E d f R O M PA G E 1 S I del IN er S C O N t I N u E d f R O M PA G E 4 m A ke m ON ey C O N t I N u E d f R O M PA G E 4 medtrade booth 513