HME News

NOV 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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No Medicare Market Marker The eSolutions Denial Tracker SOURCE: ESOLUTIONS the eSolutions denial tracker is an index of the percentage of Medicare and commercial claims rejected on a monthly basis. The most recent month's data repre- sents an analysis of approximately 1,289,534 Medicare claims and 4,121,652 commercial claims adjudicated between September 1, 2017, and September 30, 2017. The index is a categorized and weighted analysis of claims fi led by eSolutions customers. HMENEWS.COM 12/16 1/17 3/17 6/17 9/16 9/17 8/17 4/17 2/17 5/17 7/17 10/16 11/16 Most viewed stories in September 1. All eyes on new bid-related rule 2. Aerofl ow Healthcare named top HME provider 3. Hurricane Harvey: Providers begin clean up, question CMS policy 4. Bid relief: Time to rack up co-signers, stakeholders say 5. SuperCare Health makes it work 6. Disaster relief: Stakeholders press for policy changes *The Medicare Market Marker provides a monthly look at the number of Medicare benefi ciaries for whom the four MACs have allowed a claims payment. SOURCE: PDAC (number of allowed benefi ciaries) E 1 3 9 0 : O X Y G E N C O N C E N T R A T O R E 0 2 6 0 : S E M I - E L E C T R I C H O S P I T A L B E D (number of allowed benefi ciaries) E 0 6 0 1 : C P A P (number of allowed benefi ciaries) K 0 0 0 1 : S T A N D A R D W H E E L C H A I R (number of allowed benefi ciaries) (number of allowed benefi ciaries) K 0 8 2 3 : P O W E R W H E E L C H A I R * * HME NEWS POLL HMEDATABANK.COM The HME DataBank has the latest Medicare reimbursement data for the top 1,000 HME providers nationally in 103 key product cat- egories, as well as for all of the products in the NCB program. You can determine your market share, look for new product opportu- nities and check out your competition using the latest available Medicare data. Go to to learn more. data! data! **We are now tracking K0823 claims with certain modifi ers (NU, UE or RR/KH) to better refl ect the actual number of new allowed benefi ciaries under the 13-month capped rental. 7/16 4/17 3/17 5/17 6/16 8/16 9/16 1/17 2/17 10/16 11/16 12/16 "We have policies and procedures in place and require annual employee training on HIPAA." —Tammy Barch, COO, PCMStexas "No, but we utilize a third-party EMR and billing sys- tem that does." — Anonymous 129,507 Region D 115,350 Region B 83,123 Region A 31,956 Region C 18,341 Region A 8,165 Region D Region B 16,256 Region B 57,224 Region D 72,392 Region C 108,379 Region A 48,807 238 Region B Region D 327 874 Region C Region A 127 46,095 Region C 19,128 Region B 16,836 Region D 19,040 Region A Month Percent denied Source: The Braff Group, 412-833-5733. The Braff Group M&A Insider Rehab (15.2, 18.5) DME (14.3, 15.5) Respiratory (11.1, 10.3) 7/16 4/17 3/17 5/17 6/16 8/16 9/16 1/17 2/17 10/16 11/16 12/16 7/16 4/17 3/17 5/17 6/16 8/16 9/16 1/17 2/17 10/16 11/16 12/16 7/16 4/17 3/17 5/17 6/16 8/16 9/16 1/17 2/17 10/16 11/16 12/16 7/16 4/17 3/17 5/17 6/16 8/16 9/16 1/17 2/17 10/16 11/16 12/16 NewsPoll based on 26 respondents. 230,714 Region C HME NEWS / NOVEMBER 2017 / WWW.HMENEWS.COM Databank Does your program have a written security and risk analysis that you update regularly? 30 Do you have a documented HIPAA compliance program in place that addresses administrative, physical and technical safeguards? With an aggregate of 68 transactions, the second quarter of 2017 was the lowest tally of healthcare service deals over the past three and a half years. It would be easy to assign blame to the uncertainty around "repeal and replace," however this would be inconsistent with what we're generally hearing from buyers. Although they are most certainly keeping a watchful eye over the proceedings, most are confi dent that the overarching theme of coordinated care—which has largely informed dealmaking over the past 18 to 24 months—is here to stay. A deeper dive shows that much of the fall-off was due to the virtual absence of activity in pharmacy services. And for this, we can likely blame recent and proposed changes in reimbursement that are challenging the home infusion therapy and specialty pharmacy markets.

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