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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Stakeholders are disappointed with final rule . . . . . . . . . . 1 CMS details new documentation lookup tool. . . . . . . . . . . 3 Accept a settlement? It's a divisive issue, poll finds . . . . . 3 Phone demo expands to jurisdictions A, B . . . . . . . . . . . . . 7 ■ Numerous HME champions won re-election. Unfortunately, that wasn't the case for Sen. Heitkamp. See story page 9. News BRIEFS Notes from Medtrade ATLANTA – Medtrade attendees selected Caire's FreeStyle Comfort POC as this year's gold winner in the New Product Pavilion... AAHomecare's Stand Up for Homecare re- ception raised $45,000 to support industry advocacy efforts...David Ranft, of Derby Industries, based in South Bend, Ind., took home a $5,000 check in a drawing during the show's closing reception. To qualify, attend- ees had to have cards stamped by five ex- hibitors (WellSky, AAHomecare, CareCredit, EVENup and PPM Fulfillment) and be present to win...Medtrade Spring is scheduled for April 17-19, 2019, at the Mandalay Bay Con- vention Center in Las Vegas. Medtrade 2019 is scheduled for Oct. 21-23 at the Georgia World Congress Center in Atlanta. Stakeholders debut online bidding resource WASHINGTON – AAHomecare and other in- dustry groups have rolled out a resource to help providers prepare for the next round of Medicare's competitive bidding program. A new website,, brings together information on timelines, require- ments and educational opportunities, as well as information on changes for the next round when it becomes available, so providers can make well-informed decisions. The website is a collaboration between AAHomecare, the CQRC, the MED Group, the VGM Group and ResMed. Group: Final rule didn't go far enough on liquid 02 WASHINGTON – A group of patient and physi- cian groups has expressed its disappoint- ment that CMS did not carve out liquid oxy- gen from its competitive bidding program in a recently released final rule. "Despite CMS's acknowledgement of the problems facing patients, we are disappointed that the ad- ministration chose not to use its full statutory authority to ensure that all patients who re- quire supplemental oxygen receive the treat- ment they need," the group stated. Instead, the rule creates a new class for portable liq- uid oxygen equipment by splitting the exist- ing class of portable gas and portable liquid oxygen. AAH submits comments WASHINGTON – AAHomecare has submitted comments on the anti-kickback statute to the Office of Inspector General. The associa- tion suggested a new OIG Safe Harbor that addresses a supplier disclosing in advance when it will waive or reduce a patient's co- payment obligation. AAHomecare also sug- gested the OIG relax the "60-40 Tests," which state that to form a join venture, not more than 40% of the joint venture can be owned by a party that is in the position to refer to or transact business with the joint venture, and not more than 40% of the business gener- ated by the joint venture can come from one of the parties in the joint venture. When one of the parties of the joint venture is a referral source, it is impossible to comply with the 60-40 tests, the association stated. WWW.HMENEWS.COM / DECEMBER 2018 / HME NEWS 3 BY LIZ BEAULIEU, Editor ATLANTA – The show floor at Medtrade on the first day was bustling, with the number of exhibitors up 4% over last year and the num- ber of attendees set to meet or exceed goals. Of the exhibitors, 60 were companies exhibiting for the first time and 25 were "dark accounts" or companies that haven't exhibited in a few years, says Kevin Gaffney, group show director. "(Bottom line), attendees have more products to choose from than last year," he said. Gaffney says the number of pre-registered attendees for the show's conference sessions was up compared to last year, and the number of pre-registered attendees who showed up for the show floor was expected to hit, or exceed, 85%. AirAvant Medical was one of the 60 first- time exhibitors. It was using Medtrade to build an outside sales team and distributor base for its new product, the Bongo Rx, an alternative to CPAP therapy. The company enjoyed good foot traffic at its booth at the show, thanks to the Bongo Rx being featured in the show's New Product Pavilion. "They're seeing it there and coming over," said Ron Richard, one of the four co-founders of the company. It was also the Medtrade debut for Dynarex's new line of DME products. The company, which recently partnered with FODAC on a new chari- table program, has been in the disposables mar- ket for many years, but not the DME market. "This is our official launch," said Melodi Pomeroy, senior vice president of marketing. "We're getting a lot of inquiries." While the overall footprint of the show floor BY LIZ BEAULIEU, Editor ATLANTA – HME providers need to make a "tough call" on how they plan to handle an upcoming gap period in the competitive bidding pro- gram, healthcare attorney Jeff Baird told Medtrade attend- ees in October. "This is kind of a new area," said Baird, the chair- man of the Healthcare Group at Brown & Fortunato in Amarillo, Texas. "What do we do during the gap period? The short answer is, I don't know. I have specific ideas and suggestions, and have knowledge, but this is new More is more at Medtrade SHOW WRAPS UP Lean on non-assignment to everybody." CMS has implemented an any willing provider provi- sion on Jan. 1, 2019, allow- ing any Medicare-enrolled provider to supply DMEPOS to beneficiaries for 18 to 24 months. Does that mean non-con- tract providers should jump back into Medicare? If they've done a good job diversifying their business away from the government payer, not neces- sarily, Baird says. "If we've gotten to a point where we have pretty much eliminated our financial and emotional dependence on Medicare, I would assert, 'Don't get back into it,'" he said. If non-contract providers Poll: Lack of unified stance on settlements BY LIZ BEAULIEU, Editor I T TURNS out, even with the huge backlog of Medicare appeals stuck at the admin- i s t r a t i v e l a w j u d g e l e v e l , whether or not to accept a settlement is as divisive an issue as it gets in the HME industry. The respondents to a recent HME Newspoll were evenly divided on the issue, with 50% feeling the need to take a stand and 50% feeling the need to take the money and run. "Why should CMS be let off the hook and rewarded for messing things up in the first place?" wrote one respondent. "No settlements." In November, AAHomec- are planned to meet with CMS and the Office of Medi- care Hearings and Appeals to continue discussing settle- ment options. To date, there have been two such options: an offer of 68% of the net allowed amount for acute care and critical access hospitals; and an offer of 62% for pro- viders with fewer than 500 appeals pending at OMHA and the Medicare Appeals Coun- c i l c o m b i n e d , w i t h a t o t a l b i l l e d a m o u n t of $9,000 or less per appeal. A big reason respondents feel the need to take a stand: They know they're in the right, they say. "Ninety percent of the rul- ings we receive are favor- able," wrote one respondent. "We have waited so long that I am no longer willing to accept a settlement that will be less than what w e a n t i c i p a t e to receive from future rulings." For the respon- dents who report they are willing to settle, the most frequently cited percentages of the net allowed amount that they'd be willing to settle at were 90% and 80%. HME NEWS POLL M E D T R A D E S E E PA G E 4 G A P P E R I O D S E E PA G E 4 S E T T L E M E N T S S E E PA G E 4 Lookup tool takes shape BY THERESA FLAHERTY, Managing Editor WASHINGTON – A new initiative underway at CMS would make it easier for healthcare provid- ers to look up documentation requirements, agency officials said during an Oct. 23 Special Open Door Forum. The Medicare Documen- tation Requirement Lookup Service, still in the prototype phase, would pull together existing requirements, which are currently scattered among various manuals, National C o v e r a g e D e t e r m i n a t i o n s and Local Coverage Deter- minations, and present them in a machine-readable format within the electronic health record, according to CMS. For example, a physician ordering home oxygen ther- apy for a patient would log into their EHR system to learn whether there are prior authorization and/or docu- mentation requirements. The DLRS would show there is no PA requirement but that there are documentation require- ments and would provide those requirements, along with any related templates. At some point in the future, CMS officials said, they hope those templates could be D O C U M E N TAT I O N S E E PA G E 6 Jeff Baird schools Medtrade attendees on the upcoming gap period in the bid program. Expo floor included 60 first-time exhibitors, 25 'dark accounts' Kevin Gaffney

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