HME News

FEB 2019

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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By Liz Beau L ieu, e ditor LOS ANGELES – Cure Medical par- ticipated in a special Abilities Expo in November. The com- pany, which manufactures intermittent catheters, was among more than a dozen selected to help recreate the expo for an episode of the TV show Speechless, which features JJ, a teenager with cerebral palsy, that will air on Feb. 1. Here's what Lisa Wells, vice president of marketing for Cure Medical, had to say about the show's quest for authenticity and being one of its extras. HME N E ws: Give me a 1-min- ute rundown of the show. Lisa Wells: Min- nie Driver plays a mom of three k i d s a n d J J , played by Micah Fowler, is the oldest. Minnie is sort of the stereo- typical mama bear, taking care of the family and advocating for the needs of JJ. It's a lot about their journey of trying to give JJ the most inclusive experience possible. HME: Does Micah have cerebral palsy in "real life"? Wells: He does, and he uses power and manual wheelchairs. The only difference between him and JJ is that he can speak, whereas JJ has a speech impair- ment, hence the name of the show. It's very unusual in TV today to have an actual person with a disability portray a per- son with a disability. The show stands out in Hollywood for setting that as their standard. It's one of the reasons why it has such a rabid fan following in the disability community. HME: Why did they want to re- create an Abilities Expo? Wells: All I can say is that Min- nie's character has created her own adaptive clothing line. The producers at Speechless recognized the expo as a fam- ily conference for people with disabilities, and they contact- ed the organizers to ask if they Newspoll: Providers set priorities for 2019 . . . . . . . . . . . . . 3 CMS updates TPE program . . . . . . . . . . . . . . . . . . . . . . . . . 3 State news: Washington, Kansas. . . . . . . . . . . . . . . . . . . . . 4 Budget neutrality dampens 0 2 reimbursement . . . . . . . . . 6 ■ The industry has its work cut out for it over the next several months, says VGM's John Gallagher. See story page 1. News CMS releases 2019 fee schedule adjustments WASHINGTON – CMS's 2019 fee schedule provides a "modest" 2.5% CPI-U in- crease to single payment amounts for DME in former competitive bidding ar- eas, according to AAHomecare. The fee schedule also provides a 2.5% increase to SPAs for diabetes supplies as part of the mail-order program. It provides a 2.3% increase to current rates for DME not included in the bid program. As previously determined, by a final rule, DME in rural/non-contiguous areas will be paid a 50/50 blended reimbursement rate. "While adjustments to keep pace with inflation are certainly welcomed by home medical equipment suppliers, they do nothing to offset the deep reim- bursement cuts produced by the bidding program over the last seven years," said Tom Ryan, president and CEO of AA- Homecare. AAH seeks payer relations professional, submits comments WASHINGTON – AAHomecare is looking to add to its payer relations team. The as- sociation is recruiting a director of payer relations to join Laura Williard, vice presi- dent of payer relations. "As enrollment in Medicaid programs and in Medicare Advantage plans continues to rise, AA- Homecare and our state association partners have been working non-stop to maintain sustainable reimbursement rates and to educate state legislators, regulators and plan administrators on the value of HME to their constituents," the association stated in a bulletin. The director will work with Williard to develop ongoing relationships with payers and key industry stakeholders, and to serve as a resource for AAHomecare members in their engagement with these payers… AAHomecare recently submitted com- ments to CMS on its proposal to include ventilators and off-the-shelf braces in the next round of its competitive bidding program, and on its Clinical Data Ele- ments (CDE) templates. Gaffney assumes vice president duties ATLANTA – Medtrade Group Show Direc- tor Kevin Gaffney's role will expand to include vice president and publication director duties. Gaffney has planned and executed more than 35 trade shows in a career spanning 25 years. In addition to Medtrade and Medtrade Spring, he is also group show director for four other shows: Environments for Aging; Construction Su- perConference; HealthCare Design; and Hospitality Design. "People thought the Internet would kill trade shows, but it's re- ally made them more important than ever," says Gaffney. "Social media and technol- ogy offer great ways to connect with peo- ple remotely and virtually, but people do business with people they know and like. You really can't get to know somebody unless you spend time with that person, preferably in person." www. HM e N ew S . C o M / febru A ry 2019 / HM e N ew S 3 By Theresa F L aher T y, Managing e ditor D ES p ITE THE large number of unknowns for the year ahead, the majority of respondents to a recent HME Newspoll say they're forging ahead with plans to grow their businesses. Expanding their footprint topped the list of priorities for 2019 for 26% of respondents. "We are going to be adding product lines and getting into new areas," wrote one respondent. Others say they'll grow by delving further into other payer markets. "Our main goal continues to be to increase hospice, retail and facility business to gain a larger share of our local market," wrote one respondent. "Our territory continues to expand simply because patients can't find suppliers closer to them." A number of respondents (17%) said they plan to ramp up marketing and social media to keep up with shifting trends in buying. "Such platforms will influence 80% of buying decisions," wrote one respondent. Another 17% of respondents said they plan to increase their use of technology as a way to better serve their customers. "Every need varies by patient and being able to fine tune offerings to meet their expectations in a meaningful way will bring greater satisfaction and deliver the intend- ed results," wrote John Specht, president of Specht & Associates in Ohio. "Staying cur- rent in trends and equipment will keep me on track." With reimbursement so low, 19% of respondents said they will prioritize reduc- ing expenses. "The only way to maximize profit is to control the things we can control," wrote Jason Jones, president of Jones Medical Sup- ply in Alabama. "We can't do anything about reimbursement, so fix what we can." For some, reducing expenses means tak- ing a hard line against unprofitable business. "Getting more business is the easy part," wrote one respondent. "Dealing with low reimbursement is the problem. We are start- ing to say no to more funding agencies." Another 17% said their top priority was selling their businesses. HME By Liz Beau L ieu, e ditor WASHINGTON – CMS has updated its "Targeted p robe and Edu- cate" program in two ways that could potentially make it eas- ier and more fair for HME providers. The agen- cy on Dec. 31 imple- m e n t e d t h e " T p E 10-Claim p review p ilot" to allow the MACs to select just 10 claims for review under Round 1. If a provider is found to be compliant, the N p I asso- Providers set priorities for 2019 HM e NEWS POLL 'We can't do anything about reimbursement, so fix what we can' TPE program: Work in progress ciated with those claims will be exempt from reviews for about one year for that service/item. "In some ways it's good," said Kelly Grahovac, a senior consultant with the van Halem Group. "If you have everything that you need, it's less of a bur- den, because you only have to respond to 10 files instead of 40 files." If the MACs detect errors during the pilot, a provider just goes through the usual T p E program. But the pilot may put HME providers, whose documenta- tion can sometimes be "subjec- tive," at a disadvantage, Graho- vac says. Hit TV show recreates Abilities Expo By Liz Beau L ieu, e ditor V GM' S R ONDA Buhrmester spent the last two weeks of 2018 taking fran- tic calls from HME providers wondering whether or not they should change their Medicare enrollment status for 2019. Her general advice: If you're a participating provider, change to non-participating. "There's a fear factor, because it's a change in enrollment status for a lot of providers, and they're afraid of how it's going to affect their patients and their refer- rals," said Buhrmester, director of reimbursement. "But it gives them the most options." p roviders had until Dec. 31, Consultant's corner Tackle enrollment, tech in new year 2018, to change their enroll- ment status for 2019 with Medicare's National Supplier Clearinghouse. Non-participating status means providers can take assign- ment on a claim-by-claim basis. With an any willing provider provision allowing all Medicare- enrolled providers to provide DME to beneficiaries expected to shake up the landscape, they need that flexibility. "They may want to wait a month or the first quarter before deciding what they want to do," Buhrmester said. If non-participating gives pro- viders more options, why have providers traditionally enrolled c O N S u LTA N T s e e pa g e 6 T P E p r o g r a m s e e pa g e 6 Kelly Grahovac Lisa Wells T V s h o w s e e pa g e 1 0

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