HME News

APR 2017

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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VOLUME 23 — NUMBER 4 APRIL 2017 $7.00 HME NEWS POLL ■ Take a road trip to improved collections, says Sarah Hanna. See page 9. ■ Product Spotlight: This month we feature orthotics, prosthetics and soft goods like the ITA-MED Posture Corrector for Women. See page 18. ■ Do you outsource any business functions out of the country? See results on page 23. N E W S ■ Spring renewal: '2017 is our year,' Tom Ryan tells Medtrade attendees. PAGE 3 ■ Newspoll: Providers cheer program delay. PAGE 3 ■ Phone demo expands. PAGE 3 C O M M E N TA RY ■ Despite Medicare policies that skim profi ts, savvy HME providers are tapping into market demand in different ways, says Ken Robbins. PAGE 9 D E PA RT M E N T S PROVIDERS ■ Q&A: Todd Usher. PAGE 12 ■ Providers share success tips. PAGE 12 MOBILITY ■ Stakeholders chase accessories fi x. PAGE 14 ■ Task force pushes curriculum. PAGE 14 RX & SPECIALTY PROVIDERS ■ BioScrip makes progress. PAGE 16 ■ Q&A: Ghentry Pace. PAGE 16 VENDORS ■ Invacare shifts into phase two. PAGE 20 ■ ROVI Bus makes fi nal stop after two- year road trip. PAGE 20 W W W . H M E N E W S . C O M Bid relief needs adjustment CareCentrix targets O2 payments Permobil gives back As of March 1, $50 from every Permobil sale, $10 from every TiLite sale and $1 from every ROHO sale wil go toward the Permobil Cares Foundation. See full story page 21. Inogen remains focused on DTC It's a bumpy start for prior authorizations BY THERESA FLAHERTY, Managing Editor C MS HAS said it plans to use the lower payment amounts that went into effect July 1 as part of its cal- culation for retroactive adjust- ments, but that's not what Con- gress intended, say industry stakeholders. "The intent was to use the same rates that were in effect from Janu- ary to June, for the rest of the year," said Cara Bachenheimer, senior vice president of government relations for Invacare. "Instead, they factored in the lower July BY THERESA FLAHERTY, Managing Editor HARTFORD, Conn. – A recently announced change to Care- Centrix's authorization pro- cess for oxygen patients cov- ered under a Medicare Advan- tage plan has stakeholders scratching their heads. The change, issued ear- lier this month, states that an initial request for oxygen will be approved for only one month, with subsequent months requiring additional authorization. "I'm trying to get to see why they are doing what they are doing and talk them out of it," said Laura Williard, senior director of payer relations for AAHomecare, who reached out to the health plan manager to seek clarifi cation. "A one- month authorization is crazy." It's unclear from the "Pro- vider Newsfl ash," stakeholders say, whether additional autho- rization would be needed on a BY LIZ BEAULIEU, Editor WASHINGTON – When CGS and Norid- ian began accepting prior authoriza- tion requests for K0856 and K0861 on March 6, complex rehab pro- viders said they didn't have all the information they needed to comply with the program. The contractors on March 6 began accepting requests for dates of delivery on or after March 20. "We're as prepared as we can be, with all the unanswered BY LIZ BEAULIEU, Editor GOLETA, Calif. – Inogen's B2B business keeps posting the largest numbers, but the com- pany has put a number of wheels in motion to boost its direct-to-consumer business in 2017. For the third quarter in a row, Inogen's domestic B2B sales were the strongest in the fourth quarter, with 69% growth compared to the same period in 2015. "We continue to see more traditional HME providers turning to portable oxygen concentrators to lower their operating costs in the face of reimbursement reductions questions," said Doug Wester- dahl, president a n d C E O o f Rochester, N.Y.- based Monroe W h e e l c h a i r , who, because of the uncer- tainty, planned to push out the door as many wheelchairs with those codes as possible before March 20. CMS is phasing in prior autho- rizations for the two codes, with this fi rst phase applying to Illi- nois, West Virginia, Missouri and New York. A national rollout is slated for July 17. Stakeholders aren't pleased that CMS moved forward with prior authorizations despite cancelling a Special Open Door Forum on the topic in January. The agency also included it as an agenda item for a general forum in February and dropped it at the 1 Round 2 re- compete num- bers in their calculation." A provision i n t h e 2 1 s t Century Cures Act that was signed into law i n D e c e m b e r rolled back that start date for cuts that went into effect in non-com- petitive bidding areas from July 1, 2016, to Jan. 1, 2017, paving the way for providers to recoup six months of payments. In guidance released to the DME MACs on Feb. 9, however, CMS stated: "To implement sec- tion 16007 for dates of service July 1, 2016, through Dec. 31, 2016, the 50/50 blend fee sched- ules have been recalculated so that the adjusted portion of the payment blend utilizes July 1, 2016, adjusted fees." "They are recalculating, not simply putting back in the rates they had before," said Kim Brum- mett, vice president of govern- ment relations for AAHomecare. That's not fair for providers who may have made planning B2B sales are great, but HME providers are too unpredictable, company offi cials tell investors Medicare Advantage UNDER REVIEW: K0856 and K0861 POWER WHEELCHAIRS Bachenheimer D. Westerdahl A D J U S T M E N T S E E PA G E 4 P R I O R A U T H O R I Z AT I O N S E E PA G E 1 5 I N O G E N E A R N I N G S S E E PA G E 2 1 C A R E C E N T R I X S E E PA G E 1 3 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

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