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

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Rx and Specialty Providers hme news / a ugust 2018 / 17 WASHINGTON – CMS will allow Medi- care beneficiaries to use smart phone technology with their con- tinuous glucose monitors. The announcement reverses guidance issued in March 2017 in which the agency said beneficiaries could not use a non-DME device, such as a smart phone or tablet, as the display device—in conflict with how many use their CGMs. "CMS heard from numerous stakeholders who shared their concerns that Medicare's CG cov- erage policy limited their use of CGMs in conjunction with their smartphones, preventing the from sharing data with family members, physicians and caregivers," the agency stated in a bulletin. CMS in January 2017 approved certain CGMs as durable medical equipment if they were approved by the Food and Drug Adminis- CMS changes course on CGMs, smart phones tration for use in place of a blood glucose monitor when making treatment decisions. The DME MAC contractors will issue a revised policy article in the near future, at which tie the change will be effective. b ILL wou L d I ncrease access to thera P eut I c shoes WASHINGTON – Sens. Sherrod Brown, D-Ohio, and Susan Collins, R-Maine, have introduced a bill, the "Promoting Access to Diabet- ic Shoes Act," S. 3067, that would allow nurse practitioners and phy- sician assistants to certify diabe- tes patients' need for therapeutic shoes. "Therapeutic shoes are a proven method for preventing costly and painful complications related to diabetes," said Collins, founder and co-chair of the Senate Diabetes Caucus. hme m E dp AC RE p ORT TA k ES C m S TO TAS k C o n T I n u E D F r o M P r E v I o u S PA g E the referral sources you want," he said. Preferred referra L s It can be hard for providers to turn away potential business, but it's also important to remem- ber not all referrals are good referrals. "We find people who really want to partner with us," he said. "We want to work with referral sources, not for them." g rou P th I nk One of the best things providers can market is group setups. Not only are they more efficient, there's often better buy-in from reluctant patients when they see they are not the only person in the world suffering from sleep apnea, says Stacy Colvett, vice president of S3 Resupply. "The better educated the patient, the more compliant the patient," she said. "Patients that are compli- ant 80% or greater, are 355% more likely to order supplies from you 12 to 18 months down the road." hme RES upp L y b I z C o n T I n u E D F r o M P r E v I o u S PA g E b I d upd ATE C o n T I n u E D F r o M PA g E 1 orthotics are provided without clinical care and that's a problem for the benefi- ciaries." The report also takes CMS to task for its use of 23 split codes that have the same fee schedule amounts whether they are classified as OTS or require customiza- tion. The split codes provide incentives to suppliers to furnish OTS instead of cus- tom-fitted products because they get paid the same amount whether they provide any fitting or not, says the report. It's important for providers to remem- ber, however, that it's unclear whether or not anything will come of the report, say stakeholders. "We would remind everyone that this is an advisory report that policymakers can utilize or not, at their discretion," said Wayne Rosen, BOCP, BOCO, FAAOP, and chairman of the board for the Board of Certification/Accreditation. "BOC will continue to advocate for our credentialees and to move the field forward in a positive manner for beneficiaries, suppliers and the Medicare program." hme Ryan said. "They've been on the sidelines, but they still exist, and now they'll be able to go to refer- ral sources and compete again for that Medicare business. Whether or not they want to at the price, that's their determination." In addition to the temporary "any willing provider" provi- sion, the proposed rule extends the 50/50 blended rates in rural areas through Dec. 31, 2020, something that will cost CMS $1.05 billion. "That is a significant give- back," Ryan said. "That is a cost to them. They're putting dollars back into a benefit that has been decimated due to poor policy." Still, stakeholders will con- tinue to make the case that the blended rates should apply to all non-bid areas, not just rural areas—and CMS may be open to that idea, they say. "They specifically ask that question in the proposed rule: Should we extend the blended rates to all non-bid areas?" said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. "If we can convince the agency, before the final rule is published, that would be another potential upside." The proposed rule also pro- vides a window into how CMS plans to run the next round of the bid program. For one, the agency plans to implement lead- item pricing using maximum bids, a methodology that stake- holders say reflects their input. "It's very similar to a clearing price, which is our language," said Jay Witter, senior vice president of public policy at AAHomecare. "It's a significant win that acknowledges the sig- nificant flaws to median pricing." Will this change, along with o t h e r c h a n g e s t h a t w i l l b e implemented in the next round of program—like tying surety bonds to bids, and implement- ing a higher bid ceiling—result in higher reimbursement rates? That's the $64 million question, say stakeholders. hme Diabetes digest AAHomecare is proud to provide advocacy and lobbying efforts to represent home medical equipment providers, manufacturers, and other stakeholders in our industry in Washington, D.C. Our efforts include engaging Congress, federal agencies, and state Medicaid authorities to support sustainable reimbursement rates and rein in unnecessary regulations. Why Join? • Together We Speak with One Voice on Capitol Hill • Opportunity to guide policy initiatives and have input on legislative priorities • Access to key industry data and experts in the HME fi eld We Help Your Business Succeed 241 18th St. South, Suite 500 | Arlington, VA 22202 202.372.0107 | ANALYSES NEWS SUPPORT Pride Replacement SCOOTER WHEELS (800)429-9600 • 3 & 4 Wheel Scooters • Fits Victory 9, 10, & GoGo Scooters (Front and Rear) Business Summit September 16-18, 2018 • The DeSoto • Savannah, Ga. Event Guide Turn over for special offer! Business Summit Sept. 16-18, 2018 The DeSoto Savannah, Ga. Check out the Event Guide on page 9!

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