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
Issue link: https://hme.epubxp.com/i/944166
Rx and Specialty Providers 18 www. H me N ew S . CO m / m A r CH 2018 / H me N ew S complex reviews for E0465 (invasive) and E0466 (non-invasive) for claims on or after Jan. 1, 2016. It will be look- ing to see if coverage criteria and/or medical necessity requirements were met. With no local coverage determina- tions for vents—only a broad nation- al coverage determination—it will be interesting to see what, exactly, audi- tors are looking for. "I don't know if they are simply going through detailed written orders and making sure that there are things such as a start date, or if they are look- ing deeper into coverage criteria such as whether a BiPAP was ruled out," said Kelly Grahovac, a senior con- sultant with The van Halem Group. "They don't have any black-and-white requirements (to follow)." As long as providers follow the NCD, they should be OK, Brummett said. "I think most people are fairly com- fortable with where we are on vents today," she said. hme This year's event, scheduled for April 23-26 in Phoenix, features a mix of educa- tional tracks, workshops and preconference sessions that brings back "fan favorites" like roundtable sessions. The event also includes two new certificate programs: a "Sterile Compounding Clinic," and "Home Infusion RN Essentials." "Our membership often relies on home health agency partners to perform nurs- ing visits for our patients," said Charron. "Attendees will be able to practice some stan- dard education skills, like dressing changes and port access—all the basics." The compounding clinic is equally hands- on, with attendees practicing skills like garb- ing, hand washing and testing in an area right on the expo floor, says Marilyn Tretler, vice president of communications. "The USP is continuing to raise the standards for compounding, so we need to make sure everyone is making sure their facilities are in alignment with those stan- dards," she said. Reimbursement is always a hot topic for healthcare providers and home infusion is no exception. The reimbursement track includes sessions on payer point of care optimization and copay assistance programs, says Charron. These sessions reflect the crossover she's seeing between clinical and reimbursement teams each learning what the other does. "A nurse, a pharmacist or a tech needs to understand how it gets paid, how you code it," said Charron. hme CONFERENCE c o n t i n u e d f r o m pa g e 1 7 Rademacher: The pipeline of new drugs is robust for infusible products. We work close- ly with a manufacturer on a new product for ALS, Radicava, that we are their primary home infusion provider for. We are in con- tinuous conversations with other innovators and pharmaceutical manufacturers for the introduction of additional products that we RADEMACHER c o n t i n u e d f r o m pa g e 1 7 think will continue to drive growth in home infusion and growth. hme : What are some challenges you see ahead for the home infusion industry? Rademacher: As the healthcare industry shifts from fee-for-service to value based, we need to make certain that we are in a position to articulate that value and the overall reduction in the cost of care. We are focusing on mak- ing certain we are data driven and are driving superior clinical outcomes. hme VENT A u DITS c o n t i n u e d f r o m pa g e 1 C p A p Store eyes 50 retail stores by 2020 LAS VEGAS – CPAP Store USA has opened its fifth retail store in Agoura Hills, Calif. It has also announced ambitious plans to open 45 more retail stores across the country by the end of 2020. "The growing CPAP-user community is expanding and becoming a great niche for those interest- ed in franchising, helping us to expand our reach and help those in need," said Marina BerBeryan, spokeswoman and ambassa- dor of CPAP Store USA. who suspects many will have issues with access to equipment and medication. "We want to ask patients to share their story," she said. "We want to learn and grow with them, hear what their challenges are. We want share encouragement and we want them to know this is doable." S O l ICI t IN g COO per A t ION Because patients often don't want to talk about their sleep disorders, the alliance also ties in healthcare providers who can play a key role in getting them back to health, says Van Landingham. hme ALLIANCE c o n t i n u e d f r o m pa g e 1 7 med T rade boo T h 454 NOW SERVICING THE ENTIRE U.S.A. VALUE ANALYSIS FREE NOW SERVICING THE ENTIRE U.S.A. VALUE ANALYSIS FREE DIVERSE PRODUCT LINE • CREATIVE PRICING STRUCTURES COST-EFFECTIVE • VALUED VENDOR PARTNER TraceMedical.com | 888.627.0950 *Offer valid for new customers only. A Better Ventilator Rental Solution Trace Medical is a national leader in ventilator rentals working closely with customers to develop innovative rental programs that deliver desired clinical and fi nancial outcomes.