HME News

AUG 2018

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:

Contents of this Issue


Page 16 of 32

Rx and Specialty Providers MedPAC report analyzes orthotics benefit . . . . . . . . . . . . 16 Growing resupply biz starts with marketing . . . . . . . . . . . 16 Medicaid decision expands vent coverage . . . . . . . . . . . . 16 Diabetes digest: CGMs, shoes . . . . . . . . . . . . . . . . . . . . . . 17 ■ The American Sleep Apnea Association brought patients, regulators together in June. See photo this page. 16 hme news / august 2018 / Wide AWAKE The AWAKE Sleep Apnea Initiative was held June 8 in College Park, Md. The event, spearheaded by the American Sleep Apnea Association, brought together more than 100 patients, industry stakeholders and Food and Drug Administration officials to discuss the impact of the disease; another 400 attended online. Ahead of the event, ASAA collected more than 6,000 surveys detailing patient and caregiver experiences, says Adam Amdur, chief patient officer. "I'd say the meeting was a success," he said. By Theresa Flaher T y, Managing e ditor ASHEVILLE, N.C. – North Carolina Medicaid's recent decision to cover non-invasive ventila- tors for patients means Aeroflow Healthcare can now offer the service in its own backyard. The North Carolina Medicaid fee schedule payment amount for EO466 is about $1,211. "This allows us to further our mission of providing the highest level of care to even more patients in need," said Robert Hunter, national sales director for the Ashville-based By Theresa Flaher T y, Managing e ditor WATERLOO, Iowa – For CPAP pro- viders, the keys to marketing your resupply business are leveraging the right data, attract- ing the right referrals and doing right by your patients, says Seth Dixon. "You've got to get the data and you've got to get the right data," said Dixon, director of market- ing and sales for S3 Resupply, during a session at the Heart- land Conference in June. "You need to have transparency." Providers also have to know who they are, says David Bax- ter, owner and president of By Theresa Flaher T y, Managing e ditor WASHINGTON – Although industry stake- holders disagree with a recent MedPAC recommendation to include off-the-shelf orthotics in Medicare's competitive bid- ding program, a recent report by the com- mission is, overall, on point, they say. "It's obvious the bid program is still a threat," Todd Eagen, president of the Orthotic Prosthetic Group of America. "But there is some good news in the report and some continued educational efforts that our community needs to con- tinue to focus on." MedPAC's June 2018 report says expenditures for products not included in the program, like OTS, have grown, making them good candidates for bid- ding. Expenditures for OTS nearly doubled between 2014 and 2016, from $255 million to $547 million. In particular, spending for a certain back brace (L0650) increased from $46 million to $190 million, a 311% increase. H o w e v e r, t h e r e p o r t says the increase is main- ly attributed to a small number of physicians, and stakeholders agree. "There's some fairly com- pelling evidence of impro- priety, which is what causes so much volume of bracing to be generated by a very small number of physicians," said Tom Fise, executive director of the Ameri- can Orthotic & Prosthetic Association. "They are not targeting treatment pro- vided by certified orthotists. The real target is probably telemarketing." S t a k e h o l d e r s w e re p a rt i c u l a r l y pleased that the report got right the definition of what constitutes an OTS device (something the patient can use with minimal self-adjustment) vs. CMS's efforts to expand the definition to include devices that can be adjusted by a caretaker or non-certified supplier. "Obviously, the broader the defini- tion, the broader (range of products) you are going to apply the bid program to," said Eagen. "If that happens, more MedPAC takes CMS to task Medicaid decision expands vent coverage Growing resupply biz starts with sound marketing m E d p A C r E P o r T S E E n E x T PA g E R E S u p p L y b I z S E E n E x T PA g E orthotics Columbia, Tenn.-based Medi- cal Necessities. "Identify what you do and do well," he said. "We identify as a respiratory provider. The easy part is getting business. It's harder trying to develop a team to grow the business, but growing the business starts with marketing." 'Let's not do L unch' Gone are the days of market- ers who bring lunch to physi- cian offices, says Baxter. Today's marketers need to be smart and driven. "You need marketers that are going to set the standards for provider. "We are very proud of North Caro- lina for stepping up and making the same decision." Aeroflow already offers ventilators for its Medicaid patients in South Carolina and Tennessee. Although non-invasive ventilator technol- ogy has been on the market for several years, North Carolina isn't the only state that has been slow to cover them, or to only cover them for certain patients or diagnoses, says Max Hoyt, vice president of government rela- tions for Lafayette, La.-based Viemed Health- care, a large regional provider of ventilators and other respiratory services. "A lot of states will just pay for them with ALS and neuromuscular diseases," he said. "Or, they will only pay for them until age 18." Hoyt is hopeful that as data continues to support the value of non-invasive ventilation that will change. "Non-invasive ventilation drastically drops patient mortality in the first week," he said. "No one asks, 'Does it save lives?' Yes, it does." It also saves money in the long run, says Hunter. "It's the best decision for patient care and for saving money on hospital readmissions," he said. hme 'Non-invasive ventilation drastically drops mortality' Tom Fise Todd Eagen Briefs Proposed rule includes home infusion changes WASHINGTON – Temporary transitional pay- ments for home infusion therapy are moving forward, according to an upcoming proposed rule. The rule, which was published in the July 12 Federal Register, contains information on the implementation of the payments, which will fix a payment gap created by the 21st Century Cures Act. The Cures Act requires Medicare to pay for services associated with providing Part B home infusion drugs, but not until 2021. The temporary payment, which was passed as part of a government spend- ing bill in February, takes effect Jan. 1, 2019. cms overpaid for c P a P supplies, says o I g WASHINGTON – Most Medicare claims for CPAP supplies did not comply with Medi- care requirements, according to a new report from the Office of Inspector General. Out of 110 sample clasims that Medicare paid in 2014 and 2015, 24 complied with Medi- care requirements while 86 with payments totaling $13,414 did not. The OIG estimates CMS made overpayments of almost $631.2 million as a result. CMS's oversight is insuf- ficient to ensure Medicare suppliers meet requirements. Without period claim reviews, contractors were unable to identify suppliers that consistently billed claims that did not meet requirements. The OIG recommends that CMS recover the portion of the over- payments of $13,414 associated with the 86 sample claims that are within the four-year re- opening period, and work more closely with the four Medicare contractors. a ctiv s tyle boosts catheter biz m INNEA p OLIS – ActivStyle has launched Cath- eter Express, a new catheter and urology brand within the ActivStyle portfolio, a move that will grow its catheter division, accord- ing to a press release. ActveStyle is primar- ily known as a direct-to-consumer provider of incontinence supplies. "We are uniquely positioned to provide superior, compassion- ate and reliable service to the catheter cus- tomer," said Gayle Devin, CEO. s hort takes: s oleo, Infu s ystem, P hs McKinney, Texas-based Soleo Health has been selected by Genetech to dispense two limited distribution drugs, Hemlibra for patients with hemophilia A with factor VIII inhibitors; and Ocrevus for patients with a relapsing or primary progressive form of multiple sclerosis…Madison Heights, Mich.-based InfuSystem has been tapped by Smiths Medical, a manufacturer of spe- cialized medical devices and equipment, as an official distributor of CADD prod- ucts…St. Paul, Minn.-based Pediatric Home Service has been recognized for the eighth straight year in the Star Tribune's an- nual ranking of the Top 150 Workplaces in Minnesota.

Articles in this issue

Links on this page

Archives of this issue

view archives of HME News - AUG 2018