HME News

JAN 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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New Products 22 www.hmenews.com / january 2019 / hme news Periodicals postage paid at Yarmouth, ME and additional mailing office. HME News (ISSN 10913823) is published monthly by United Publications, Inc., 106 Lafayette St., PO Box 998, Yarmouth, ME 04096; 207-846-0600. Publisher assumes no responsibility for unsolicited material or prices quoted in the magazine. Contributors are responsible for proprietary classified information. ©2019 by United Publications. All rights reserved. Reproduction, in whole or in part, without written permission of the publisher is expressly prohibited. Reprints may be obtained from The YGS Group at 717-505-9701, ext. 100. Back issues, when available, cost $7 each within the past 12 months, $12 each prior to the past 12 months. Back issue orders must be paid in advance either by check or charged to American Express, Visa, or Master Card. HME News is distributed without charge in North America to qualified home medical equipment providers. Paid print subscriptions to those not qualified cost $65 annually to the U.S. and Canada and $150 to all other countries. All payments must be made in U.S. funds drawn on a U.S. bank. For subscriber services, including subscription information, please call 800-869-6882. POSTMASTER: Send address changes to HME News, PO Box 1888, Cedar Rapids, IA 52406-1888. which includes everything from hospital beds to support surfaces to commode chairs; and mobility, which includes everything from manual and power wheelchairs to accessories to walkers. "We're finalizing recommendations to CMS on how to organize the product catego- ries into more discrete product categories," said Cara Bachenheimer, chair of the govern- ment affairs practice at Brown & Fortunato. "We're hoping to request a meeting for late December or early January to discuss it." In the first round of competitive bidding, back in 2011, CMS had more specific prod- uct categories but then bun- dled products into broader cat- egories in sub- sequent rounds of the program. Stakeholders sus- pect the agency made the change based on feedback, but it "may have taken it too far," they say. In a recent final rule, CMS suggested it was open to re-arranging the product cat- egories, they point out. Having more product categories may create difficulties for providers and referral sources—conceivably, a contract for walkers may go to one provider, beds to another and support surfaces to another—but "with lead- item pricing, there's no other way to do it," said Kim Brummett, vice president of regula- tory affairs for AAHomecare. Stakeholders are under the gun to influ- ence the product categories: When the agen- cy announces the timeline for its next round of bidding—some time in early 2019, they expect— it will likely also announce the impacted product categories and bid areas. "It needs to happen quickly," Bachen- heimer said. hme wants us to cover these warning lights with duct tape, but it's not going to work! Even with all this research that showed the CBP was harmful to beneficiaries with diabe- tes, CMS implemented the program nation- ally for mail-order supplies and supplies obtained from retail channels. This move eliminated more than 98% of suppliers that provide mail-order diabetes supplies. Information obtained through the Free- dom of Information Act retrieved by DME industry advocates from data.medicare.gov shows the estimated number of DME sup- pliers and locations has dropped by nearly 38% nationwide. CMS clearly admits there are problems with the current CBAs and current reim- bursement rates, when they issued a final rule that updates payment policies and rates under the ESRD Prospective Payment System (PPS). The rule also included changes in the current CBP. These changes do not address the immediate need for a rate increase. AAHomecare President and CEO Tom Ryan deemed the final rule a net positive that reforms future rounds of the bid program and offers relief to rural providers. He also noted that it reflects recognition on CMS's part that the bid program has problems and a willing- ness to work with the HME industry to fix it. However, the work isn't done, he said. The final rule does not contain two provi- sions that both HME stakeholders and many members of Congress supported and urged CMS to add to the final rule: The broader application of the 50-50 blended rate relief to all non-bid areas and retroactively applying Consumer Price Index (CPI) adjustments in CBAs based on the increase in the CPI from 2013 through 2018. How does CMS ignore Congress? The current CBP contracts will end on Dec. 31, after which any Medicare creden- concern for the patient. We are all in this business because we care about the patient, so convincing us of that is not necessary." Other issues discussed during the confer- ence included strategies states are employ- ing to fight the growing number of "deaths of despair" and other related impacts of increased opioid abuse. One of the more emotional sessions was led by caregivers discussing the obstacles they face in deal- ing with the Medicaid program and recom- mendations they have for states to increase the quality of life of both beneficiaries and caregivers. Looking ahead to 2019, state programs will be focusing on improving how they measure quality of care, imple- mentation of the MCO final rule changes, and evaluating of their systems to ensure data accuracy. This event was a great opportunity to net- work with state Medicaid directors and get fresh perspectives on their challenges. I highly recommend it next year to anyone dealing directly with these professionals. hme Laura Williard is vice president of payer relations at AAHomecare. tialed DME provider may provide DME for Medicare beneficiaries. The idea of contracts means that contracted providers would have potentially more patients to provide for, thus improving their margins. On Jan. 1, 2019, the potential pool of Medicare beneficiaries will have to be spread among many providers at razor thin or even negative margins. On one hand, CMS admits there are prob- lems with the CBP; on the other hand, CMS failed to address the immediate problems with the current rates that are unsustainable per many industry experts and Congress. The final rule leaves me scratching my head wondering why CMS is allowing pricing gen- erated under this clearly flawed program to stay in effect. Congress clearly sees the issue with the current system and has requested rates for DME to be increased. I fear many more DME companies will close their doors if relief is not provided now. The question on the minds of many DME providers is this: Industry experts, outside experts, DME providers and even Congress agree the current rates are unsustainable; why is CMS taking so long to address obvi- ous problems? Currently, CMS's plan is to take the next two years to fix the CBP issues that may or may not address the current rates? Our industry clearly needs to get the attention of Congress to pass legislation that forces changes. Asking and suggesting is not enough. The DME industry, Congress and indus- try experts agree this vehicle (competitive bidding) is broken down and needs major repairs. CMS continues to say nothing is wrong; after all, the tires are only flat on one side. hme Jonathan Temple is the owner of OxyMed in Birmingham, Ala. subregulation c o n t i n u e d f r o m pa g e 1 Provider P ers P ective on cb P c o n t i n u e d f r o m pa g e 1 0 slee P thera P y c o n t i n u e d f r o m pa g e 2 2 "We're finalizing recommendations to cm S." c ara Bachenheimer CompactCath CompactCath Coude CompactCath Coude's compact design is easy to use and provides a discreet catheterization experience. It is a pock- et-sized, 16-inch long catheter with a coude tip that fits in the palm of the hand. Features a 100% non-touch system, fire-polished eyelets, silicone oil lubrication and drainage control. DEHP, BPA and rubber latex free. www.compactcath.com Therafirm Ease Lymphedema Arm Sleeves Ease Lymphedema Arm Sleeves deliver a controlled amount of pres- sure that is greatest at the wrist and gradually decreases around the upper arm. Ultra stretchy yams are easier to put on and moisture- wicking fibers offer a dry and comfortable coolness. Engineered elbow pocket gives the arm sleeve a more precise fit. A specialized knit pattern at the inside of the elbow bend keeps the sleeve in place. www.therafirm.com Royal Philips InnoSpire Go Small, lightweight, handheld nebulizer delivers medication in just four minutes, reduc- ing treatment time by up to 25%. Aerosol performance is maintained over the life of the product and is delivered with audible and visible indicators that signal therapy completion. Easily detachable mouthpiece makes device clean and easy to maintain. Each InnoSpire Go includes our Lite Touch mask for optimal comfort. www.philips.com encourages users to engage more with their therapy, plus enables their clinicians to remotely assist them without the need for time- and cost-consuming in-person visits." r etail opportunities The sleep market is also becoming a force in new retail-oriented products, including CPAP cleaners and alternatives to CPAP. "These products have huge growth potential," said PJ Ruflin, director of national accounts for Chicago-based Sun- set Healthcare Solutions. "More providers are searching for ways to increase compli- ance and drive better patient outcomes. If a product can accomplish those things, along with increasing the bottom line for the provider it can create a great opportu- nity for everyone." Fort Belvoir, Va.-based Barber DME is banking on retail as a key component of the sleep therapy business, said CEO Tim Barber. "People are really taking their CPAP ther- apy quite seriously," Barber said. "We feel that as more quality products are introduced to the marketplace, consumers will feel that they truly do have options and will embrace these products as an additional element to their overall treatment." w here f it B its fit Wearable technologies such as Fitbits have also made inroads as electronic monitors for public health and wellness have gained in popularity with consumers. Even though these products are typically sold at national retail chains, market specialists believe they can also be applicable to the independent HME segment. "Any viable new introductions to the market that have a direct benefit to the HME provider should be embraced," Barber said. "Technology is a great thing when properly utilized and understood. The introduction of Fitbit and other wearable technologies may be viewed as competition by the traditional CPAP equipment providers, but from a purely HME retail perspective, it's long overdue and should fit nicely into existing business." hme laura williard c o n t i n u e d f r o m pa g e 9 We repour and refurbish worn out factory oxygen columns. Service includes new molecular sieve, filters and full cleaning. Highest safety and quality standards, each pair is tested before shipping. TX License# 1000276 www.apexoxygen.com Call 469-858-2926

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