HME News

OCT 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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News 6 www.h M enew S . COM / OC t O ber 2018 / h M e new S HOME MODIFICATIONS: TAKE ADVANTAGE OF A RAPIDLY GROWING MARKET JIM GREATOREX, VP, VGM LIVE AT HOME Download today at playbook.vgm.com! Members download for free! Don't forget to check out the other five installments. By Theresa F L aher T y, Managing e ditor SAINT p AUL, Minn. – i ndustry stakeholders here scored a victory in late a ugust when the state tabled its plans to create a preferred incontinence product program, but they said the fight isn't over yet. mame S received a temporary restrain- ing order a ug. 24 to delay the program, which would have awarded a single con- tract to provide incontinence products to m edicaid beneficiaries. "We are celebrating the temporary win, if you will," said r ose Schafhauser, execu- tive director. "But, we still have work to do." a t issue with the program: the reim- bursement was calculated at 20% above acquisition cost—not enough for provid- ers to continue to provide products; and, as proposed, it went against other statutes governing reimbursement for Department of h uman Services programs, says Schaf- hauser. " t he judge concurred and said, 'modify this and prove you are filing within the stat- ute,'" said Schafhauser. o nce the restraining order was grant- ed, the department said it would withdraw the r FP. " o ur main goal is to get this program delayed until the next legislative session and get a bill passed," said Schafhauser. So far, lawmakers have been on their side. mame S succeeded in getting legis- lation passed once already this year, but it was included in an omnibus bill that was ultimately vetoed by the governor. Stakeholders are right to be proactive. Several other states, including i llinois, i ndiana, o hio and Nebraska have limited who can provide incontinence and other products. HME m innesota Judge sides with MAMES on proposal Schafhauser p OST - JAN . 1 c o n t i n u e d f r o m pa g e 4 they can now send business their way, Stark says. " r eferral sources have been told for years now, ' y ou can only send referrals to these 10 contract suppliers,'" she said. t his process will likely be easiest for pur- chased items like walkers and commodes, Stark says. C APP ed-rent A l CO nundru MS For capped-rental items, however, it will be more complicated, Stark says. " i n many cases, these items capped more than a year ago and the supplier is no lon- ger in contact with the beneficiaries," she said. "Suppliers must be careful how they re- engage so they don't violate Supplier Standard 11, which allows suppliers to contact benefi- ciaries but requires them to have provided a covered service in the last 15 months to market new products." a lso, if you're a non-contract supplier that has continued to serve beneficiaries as a grandfathered supplier, you'll want to look at where your customers are in the useful life- time of their equipment, Stark says. " o nce you get to the 36-month marker, you can't bill for a rental, but you get to bill again at the 60th month," she said. " y ou'll want to make sure you've collected all 36 pay- ments before restarting." r el A t IO n S h IP S t A tu S Baird says if there's one thing that providers will likely change right out of the gate, it's common-ownership agreements—where you have one company with a bid contract and one without, and one company buys 5% or more of the other company, allowing both companies to serve beneficiaries. " i anticipate a number of suppliers who are going to undo these," he said. Providers will also rethink subcontracting agreements, Baird says. HME r espiratory Care said it agrees that the impact of the reduced payment rates are not yet reflected in C m S's monitoring activities. "Since the report does not address the impacts of the policy on new patients with C o PD, nor does it cover 2017 and beyond, it is essential for G ao to continue monitoring utilization rates," said Dan Starck, chairman of the CQ r C. GAO RE p ORT c o n t i n u e d f r o m pa g e 4 t he CQ r C also pointed out that the num- ber of suppliers furnishing oxygen, specifi- cally, in non-bid areas in 2016 decreased at a higher rate, 10%. " t his report validates what oxygen provid- ers have been warning for years: that insuf- ficient reimbursement rates make it harder to stay in business and serve m edicare patients who require supplemental oxygen and respi- ratory care to live independently," Starck said. "No business can take on (these cuts) to reim- bursement and expect to survive long." HME ME dtrad E boot H 1627

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