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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furnished from August 1, 2017, through December 31, 2018." That's a shorter duration than proposed in H.R. 4229, which would extend the transition peri- od from Jan. 1, 2017, to Dec. 31, 2018. The OMB also included a new IFR in the Unified Agenda, this one to amend the methodolo- gy for establishing single payment amounts for items furnished under the bid program. In a double-pronged strategy, the indus- try continues to gather support for H.R. 4229, which has collected 94 co-sponsors ■ MedPAC plans to recommend adding products to bid program, says Cara Bachenheimer. See story this page. Industry's eyes turn to Medicaid . . . . . . . . . . . . . . . . . . . . . 1 OMB provides additional details on IFR . . . . . . . . . . . . . . . 3 NewsPoll: Remote monitoring for 02 lags . . . . . . . . . . . . . 3 CMS rolls out new settlement option . . . . . . . . . . . . . . . . . 4 News Briefs Part B premiums, deductibles remain stable WASHINGTON – The standard monthly pre- mium for Medicare Part B enrollees will be $134 for 2018, the same as 2017, CMS has announced. Some beneficiaries who were protected from Part B premium increases in prior years will have increases in 2018, but they will be offset by the increases in their Social Security benefits next year, CMS says. The average monthly premium for Medicare Advantage enrollees will drop to about $30 in 2018, about a 6% decrease compared to 2017, CMS estimates. More than 77% of Medicare Advantage enrollees remaining on their current plans will have the same or lower premiums for 2018, the agency says. Trump to nominate 'star' to lead HHS WASHINGTON – President Donald Trump will nominate former pharmaceutical executive and industry lobbyist Alex Azar to the top post at the Department of Health and Hu- man Services, according to news reports. Trump tweeted on the day of the announce- ment: "He will be a star for better health- care and lower drug prices." The nomina- tion follows the resignation of Trump's first HHS secretary, Tom Price. Price left HHS in September amid an investigation into his use of charter flights instead of cheaper commercial flights. Currently, Azar is the chairman and founder of Seraphim Strate- gies, which provides strategic consulting and counsel on biopharmaceutical and health insurance industries. Previously, he was president of Lilly USA, an affiliate of Eli Lilly, from January 2012 to January 2017. Azar has worked at HHS before: From 2005-07, he was a deputy secretary in the department, and from 2001-05, he was general counsel. FAHCS hosts successful conference FORT LAUDERDALE – The Florida Alliance of Home Care Services welcomed Madeline Delp, Ms. Wheelchair USA, to its Fall Confer- ence, held Nov. 8-9. As the conference key- note speaker, Delp shared her experiences and illustrated why it's important for the HME industry to assist patients as best as they can, said FAHCS in a release. AAHomecare shuffles leadership WASHINGTON – Joel Mills, CEO of Advanced Home Care in Greensboro, N.C., has been appointed treasurer of AAHomecare's Ex- ecutive Committee. He replaces Jeff Hall, president and CEO of Reliable Medical Sup- plies in Brooklyn, Minn. Gary Sheehan, president and CEO of Cape Medical Sup- ply in Sandwich, Mass., will fill Mills' at-large seat on the board of directors. In other lead- ership changes, Missy Cross will take over as chairwoman of the HME/RT Council, and George Kucka, CEO of Fairmeadows Home Health Center in Schererville, Ind., will fill her at-large seat on the board. www. H me N ew S . C om / J AN u A ry 2018 / H me N ew S 3 By Theresa Flaher T y, Managing e ditor WASHINGTON – The Medicare Payment and Advisory Committee offered a mixed bag of observations about the competitive bidding program at a recent meeting, but they likely won't lead to any significant changes, say industry stakeholders. MedPAC plans to recommend that CMS shift more products away from the "exces- sive" fee schedule to bid rates. "There were different opinions among the various commissioners, with some saying it was great, but all they are doing is looking at the decrease in prices," said Cara Bachen- heimer, senior vice president of government relations for Invacare. "No one was talking about access issues or anything like that." The committee plans to recommend CMS By l iz Beaulieu, e ditor R e MOT e PATI e NT monitor- ing appears to be permeat- ing the sleep therapy mar- ket, but not so much for the oxy- gen therapy market, according to the most recent HM e Newspoll. e ighty percent of poll respon- dents report they use the tech- nology in their sleep business, but only 15% say they do in their New details emerge on interim final rule bid-relief By l iz Beaulieu, e ditor WA S H I N G TO N – CMS is considering expanding a demonstration project to jurisdictions A and B that allows provid- ers to speak with reconsideration pro- fessionals by phone to try and resolve their appeals at the second level, stake- holders say. After hearing testimony from Ronda Buhrmester at a recent Small Business Administration hearing, CMS respond- ed in a letter, saying it "concurs with the noted initial benefits of this demon- stration and is in discussions regarding possible expansions to jurisdictions A and B." "I feel like, when something is this successful, using two jurisdictions as a control group and not including them is the easy way out," said Buhrmester, a reimbursement specialist with VGM Group. "This is a way to further reduce the backlog if they want to." C2C Innovative Solutions, the Quali- fied Independent Contractor, kicked off the five-year demo for oxygen equip- ment and diabetes testing supplies in jurisdictions C and D in 2016. It expanded the demo to other product categories in the two jurisdictions in February and March 2017. The beauty of the demo: If the QIC issues a favorable opinion on a claim— and it does about 80% of the time—it can analyze similar pending claims at the third level, the administrative law judge, and "remand them back," says Wayne van Halem. "The QIC has been able to pull back Stakeholders: We're monitoring MedPAC expand the bid program to include other product categories, including off-the-shelf orthotics and urological supplies, says Kim Brummett, vice president of payer relations for AAHomecare, which is developing a white paper on why urology and ostomy, in particular, are not good candidates for the program. "When you competitively bid, you are bringing it down to the lowest common denominator and patients have such differ- ent needs," she said. AAHomecare will continue to monitor MedPAC, but Brummett says she doesn't think there is immediate cause for con- cern. For one thing CMS doesn't believe it has the authority to expand the bidding program without a statute. For another, Remote patient monitoring lags for oxygen oxygen business. "Really, we only use remote monitoring for CPAP compli- a n c e , " w r o t e Josh Turner, bill- ing manager and compliance offi- cer for McAbee Medical in Deca- tur, Ala. "With reimbursement the way it is and compliance for oxygen usage not being required, we have to look for the best value in oxygen equipment." CMS has required compliance as a condition for reimbursement for CPAP therapy since 2008. W i t h m a r - gins razor-thin, remote patient m o n i t o r i n g allows providers to prove CPAP patients are com- pliant with their therapy in the most efficient and cost-effective way possible, respondents say. "It is a really valuable tool and saves staff time and (results in) fewer patient interactions in the office," wrote Kim Wonsick, the compliance officer at J&B Medi- cal in Niceville, Fla. "Typically, if a patient has to come in to bring an SD card, it will turn into a 15- or 20-minute discussion that needs to be directed to their sleep doctor." For oxygen patients, in addi- tion to the lack of a compliance requirement, cost seems to be a big barrier to providers adopt- ing remote patient monitoring, according to the poll. Pressure mounts to expand phone demo H me NEWS POLL Barriers include lack of requirement and cost, poll respondents say b I D r e l i e f s e e pa g e 1 8 m E D p A c s e e pa g e 4 p H O N E d e m o s e e pa g e 1 8 O 2 m o n i t o r i n g s e e pa g e 4 Tom Ryan By Theresa Flaher T y, Managing e ditor WASHINGTON – New details have pushed to the forefront a competitive bidding-relat- ed interim final rule that's been held up at the Office of Management and Budget since August. "We continue to ask members who have relationships with the OMB to put calls in," said Tom Ryan, president and C e O of AAHomecare. The industry in mid-December gleaned new information about the under-wraps IFR when the OMB included it in its semi-annual Unified Agenda. The OMB states: the IFR "amends the regulation to resume the transition period for items

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