HME News

NOV 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 BRIEFS House passes LCD Act WASHINGTON – The House of Representatives has passed a bill that outlines a set of stan- dards that MACs must adhere to before they hold meetings related to local coverage de- terminations. The Local Coverage Determi- nation Act, H.R. 3635, passed by a voice vote on Sept. 12. The standards are: publishing online a proposed version of the determina- tion and other specified, related information; convening one or more public meetings to review the draft determination, receive com- ments and ensure that meetings of the MAC's advisory panel are on record; posting online a recording of the minutes from each such meeting; providing a period for submission of written public comments; and posting online specified information related to the rationale for the final determination. AAH issues white paper on sole-source contracting WASHINGTON – AAHomecare's Medical Sup- plies Council has published a white paper on the impact of sole-source contracting. The paper, "How Sole Source & Narrow Network Contract Arrangements Lessen Patient Choice and Reduce Access," de- tails problems that arise when managed care organizations use sole-source con- tracting, including limiting product choice, reducing personalized patient services and potentially disrupting continuity of care. Gov't makes concessions for Hurricane Florence WASHINGTON – Health and Human Services Secretary Alex Azar declared public health emergencies in North and South Carolina and Virginia, giving Medicare beneficiaries and their healthcare providers there great- er flexibility in meeting emergency health needs. CMS has temporarily suspended cer- tain requirements necessary for beneficiaries who have lost or realized damage to their DME, prosthetics, orthotics and supplies as a result of Hurricane Florence. Ways and Means weighs in on proposed bid changes WASHINGTON – The Ways and Means Com- mittee in the House of Representatives has sent a letter to CMS asking the agency to provide broader relief from competitive bidding during an upcoming transition period. "It is crucial to any fresh start that the playing field be set in a fair manner to avoid the over-correcting and re-correct- ing required through both regulatory and congressional action over the last seven years," the letter states. In a recent pro- posed rule, CMS outlined plans to extend 50/50 blended reimbursement rates in ru- ral and non-contiguous areas from Jan. 1, 2019, through Dec. 31, 2020, but not in all non-competitive bidding areas. The com- mittee also commends CMS for its plans to move to lead-item pricing but cautions the agency not to be "overly restrictive" in the amount of lead items and not to tie the pricing rations of these items to older fee schedules into perpetuity. ■ Patients Over Paperwork could use improvements when it comes to DME, says Kelly Grahovac. See story page 6. Pressure is on with sign-on letters . . . . . . . . . . . . . . . . . . . 1 Newspoll: Providers draw line in sand . . . . . . . . . . . . . . . . 4 Q&A: Regina Gillispie, Van Miller Homecare Champion . . 4 MedPAC comments on bid proposal . . . . . . . . . . . . . . . . . . 7 4 HME NEWS / NOVEMBER 2018 / WWW.HMENEWS.COM BY LIZ BEAULIEU, Editor YARMOUTH, Maine – A large majority of respon- dents to a recent HME Newspoll (69%) say they won't buy products from manufactur- ers that are selling direct to consumers. "If the manufacturers choose to chase this business, we should, as an industry, stand together and refuse to carry their products," wrote one respondent. "These manufactur- ers may deny it, but they have decided they can grow their business without us." Invacare and Philips recently joined Ino- gen in selling portable oxygen concentra- tors direct to consumer for cash. Inogen also provides POCs through insurance. A slimmer majority of respondents (56%) say it doesn't matter if manufacturers are Poll: Providers draw line in sand just selling POCs direct to consumers for cash, not through insurance. "Cash sales are the future of our industry, and I find it difficult to support these manu- facturers," wrote one respondent. "They need to do better at supporting us." As an example, a number of respondents say they've already stopped buying prod- ucts from Medline, a distribu- tor that has been tapped by a number of managed care com- panies as a preferred provider for incontinence supplies for Medicaid recipients in numerous states. "Medline won the bid for all inconti- nence products to Medicaid patients in our state," wrote one respondent. "This cut us out completely. After that, we only bought things (from them) that were a complete necessity. This is not exact, but if we used to spend $1 million, we now only spend $50,000." Respondents who will continue to buy products from these manufacturers cite the Holy Grail—service—as the reason con- sumers will continue walking through their doors, regardless of what manufacturers are doing. "I think we have to expect this as an industry," wrote one respondent. "Sony sells TVs off of their website, but that doesn't mean Tar- get doesn't sell them in their store. It's about positioning the service behind the product, or at least positioning yourself as the main choice for the consumer." A few respondents even say manufactur- ers selling direct to consumer will boost their businesses. "I believe we will benefit, indirectly, from 'After 40 years in this field, I never thought I would see this happen,' wrote one poll respondent HME NEWS POLL BY T. FLAHERTY, Managing Editor R EGINA GILLISPIE was a l re a d y a 2 0 - y e a r veteran of the HME industry when parts of her rural service area were com- bined with the Ashland, Ky., MSA in Round 2 of competi- tive bidding. That forced her off the sidelines and to Wash- ington, D.C., in 2009. "I didn't have a choice," 'We've got to do something,' says Regina Gillispie said Gillispie, owner of Best Home Medical in Barbours- ville, W.Va., who was recent- ly named the 2018 Van Miller H o m e c a r e C h a m p i - on. "I said, 'We've got to do some- thing,' and s o I j u s t kept going." G i l l i s p i e doesn't get to Washington, D.C., as often as she used to, but she still works hard to build and maintain those all-important BY THERESA FLAHERTY, Managing Editor WASHINGTON – The havoc wrought by Hurricane Florence in Sep- tember highlighted, once again, the need for policy changes in disaster situations, say HME stakeholders. "What gets lost (is the need) to get better reimbursement to take care of people in devastated areas," said Bill Guidetti, execu- tive vice president, East Zone, Apria Healthcare. "There are a lot of hidden costs." G u i d e t t i s e r v e s o n a n AAHomecare work group that was formed in the aftermath of Hurricane Harvey, which soaked the Houston area with nearly 50 inches of rain and caused massive flooding in August 2017. The work group has priori- CMS, industry need to have 'conversation' on disaster relief tized a list of issues—and the history and rationale behind those issues—to present to CMS. It hopes the agency will consider the list and deter- mine whether or not it can fix the issues using regula- tion, says Kim Brummett. "We need to have the con- versation within different areas of CMS to see if we can move forward," said Brummett, vice president of regulatory affairs for AAHomecare. At the top of the list of issues: the increased costs of delivering equipment and services during a Pingree in the Pine Tree State HOMES members met with Rep. Chellie Pingree, D-Maine, at her Portland offices in August. Among the topics of discus- sion were access issues in the state, and how the adoption of Medicare rates by other payers has impacted the ability of providers to provide quality care, said Karyn Estrella, HOMES executive director. From left: Mike LeBlanc, Bedard Pharmacy & Medical Supplies; Anita Doucette, Kennebec Pharmacy and Homecare; Mark Hassett, MedCOR Professionals; Rep. Pingree; Kelly Hassett, MedCOR Professionals; Cathy Hamilton, Coastal Med Tech; Kathy Fallon, Kennebec Pharmacy and Homecare; and Estrella. N E W S P O L L S E E PA G E 7 G I L L I S P I E S E E PA G E 7 D I S A S T E R S E E PA G E 7 This year's Van Miller Homecare Champion speaks on behalf of her tiny state and resonates in a larger industry Kim Brummett R. Gillispie

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