HME News

DEC 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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T H E B U S I N E S S N E W S P A P E R F O R H O M E M E D I C A L E Q U I P M E N T P R O V I D E R S HME NEWS POLL ■ Andrea Stark supports CMS's decision to expand a phone demo that tries to resolve denied claims to jurisdictions A, B on Nov. 1. See page 7. ■ Product Spotlight: Check out the latest in products for the incontinence market, including the Hydrophilic Kit from Cure Medical. See page 19. ■ Have you been holding off on equipment purchases in the months leading up to Jan. 1? See results on page 23. Rule disappoints UNFINISHED BIDNESS It's go-time for CRT accessories Year of the woman Georgie Blackburn of Blackburn's in Tarentum, Pa., was named the HME Woman of the Year at Medtrade in October. She joins Regina Gillispie, who was named this year's Van Miller Homecare Champion. See Q&A with Blackburn on page 15. WATCH FOR MOBI POC IN EARLY 2019, RESMED SAYS Stakeholders slam audits R E S M E D ' S M O B I PA G E 2 1 N E W S ■ Medtrade wraps up. PAGE 3 ■ CMS details new documentation lookup tool. PAGE 3 ■ Providers need to do their HIPAA homework. PAGE 6 D E PA RT M E N T S PROVIDERS ■ Providers help out—for a fee. PAGE 13 ■ Q&A: Olivia Patton of Verus Healthcare on staying fi nancially stable. PAGE 13 MOBILITY ■ Will 2019 be the year of the separate benefi t? PAGE 15 ■ NRRTS tweaks requirements. PAGE 15 RX & SPECIALTY PROVIDERS ■ VieMed works to elevate non-invasive ventilation therapy. PAGE 17 ■ Byram hits 50 years. PAGE 17 VENDORS ■ Brightree launches digital hub. PAGE 20 ■ Q&A: Sandra Cannally of The Compliance Team on exemplary providers. PAGE 20 W W W . H M E N E W S . C O M C O M M E N TA RY ■ What's the secret sauce in successful home sleep therapy? Robust, innovative technology, writes Brightree's Steve Rogers. PAGE 11 CMS fails to provide two areas of additional relief VOLUME 24 — NUMBER 12 DECEMBER 2018 $7.00 C PA P A U D I T S PA G E 1 8 BY THERESA FLAHERTY, Managing Editor T HE LACK of substantial changes in the competi- tive bidding-related fi nal rule likely comes down to cost, say HME industry stakeholders. "The challenge has all along been the cost," said Tom Ryan, president and CEO of AAHomecare. "I think the political appointees at the agency wanted to do more but were restricted by cost. Cost is everything." The fi nal rule, released Nov. 1, did not include two areas of additional relief requested by the industry: an extension of the 50/50 blended reimbursement BY LIZ BEAULIEU, Editor WASHINGTON – NCART planned to stage a congressional call-in on Nov. 14 to advance a bill that would stop CMS from applying competitive bidding-related cuts to accessories for complex manual wheelchairs. The clock is ticking: Stakehold- ers would like to see H.R. 3730 passed as part of a larger bill before BY THERESA FLAHERTY, Managing Editor WASHINGTON – A recent request by the DME MAC contractors for certain CPAP providers to audit themselves is setting them up to fail, say industry stakeholders. Noridian and CGS recently sent letters to about 82 pro- viders, asking them to do one of two things: audit 100% of their claims for CPAP supplies going back six years; or pull a statistically valid random sample and extrapolate the results. The fi rst request is unreason- able due to the number of claims BY LIZ BEAULIEU, Editor SAN DIEGO – ResMed is still keep- ing its plans for the Mobi porta- ble oxygen concentrator largely under wraps. During a conference call on Oct. 25 to discuss ResMed's it would involve, and the second is "ludicrous" because it requires a skillset most providers don't have, say stakeholders. "What it's doing is putting a sig- nifi cant burden and a signifi cant responsibility on the supplier to do something that they are prob- ably not used to doing at all," said Wayne van Halem, president of The van Halem Group. "What if it's not done properly? What if the supplier determines something shouldn't be refunded and, a year down the road, the government says it wasn't done properly?" The affected providers are those associated with overpay- ments that were identifi ed in a recent Offi ce of Inspector General report. The report found that, of financial results for the first quarter of fi scal year 2019, CEO Mick Farrell reiterated that the company plans for a "full prod- uct launch" in the third quarter, meaning sometime in January- March. He also doubled down on the company's plans to use a "go- to-market" model that focuses on a "full partnership with our HME customers." "Our competitors are compet- ing with the channel in this space, and I just don't think it's a smart strategy," Farrell said. "I think you want to partner with the channel and really drive value to that end user patient…(Pro- viders) should be the ones to provide portable oxygen." ResMed fi rst made a play to enter the home oxygen therapy market in 2016, when it bought rates to all non-bid areas, and the application of CPI adjust- ments to rates in bid areas ret- roactively from 2008-13. R y a n s a y s it's going to be tough for pro- viders to hold on long enough f o r C M S t o make chang- es to the pro- gram, includ- ing implement- ing maximum winning bids and lead-item pricing, that could help to stabilize reimbursement. "We've got providers in non- bid, non-rural areas sitting on the end of this year. "We feel like we can get this done," said Don Clayback, exec- utive director of NCART. "It's a small bill; it's a specifi c issue." CMS stopped applying the cuts to accessories for complex power wheelchairs on July 1, 2017, fol- lowing pressure from stakeholders and Congress, but not for com- plex manual wheelchairs. van Halem Bachenheimer CPAP IN THE CROSSHAIRS A C C E S S O R I E S PA G E 1 6 F I N A L R U L E PA G E 9

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