HME News

APR 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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Rx and Specialty Providers The second provision would codify the anti- switching rule, requir- ing suppliers to, among other things, verbally inform beneficiaries of their right not to be incentivized to switch brands of testing sup- plies. Although both rules were implemented several years ago, surveys by the AADE have found that they're not being enforced, says Anderson. "Legislators don't like it when they pass laws and then the body or agency doesn't do a very good job of enforcing it," he said. "It's the will of Congress that this issue be taken care of." Now the AADE plans to conduct a member survey to assess what impact, if any, the closure of Arriva Medical has had on beneficiary access. The largest provider of mail-order diabetes supplies closed its Lymphedema bill inches closer to finish line . . . . . . . . . . . 1 Congress pulls through with mail-order changes . . . . . . 14 Q&A: Todd Eagen on respect . . . . . . . . . . . . . . . . . . . . . . . 14 Moneyline: Insulet, SoftTouch Medical . . . . . . . . . . . . . . . 15 ■ Patient support groups allow members to share ideas, says provider Todd Usher. See story this page. 14 hme news / april 2018 / www.hmenews.com By Theresa Flaher T y, Managing e ditor A NE w group dedicated to sleep dis- orders could pack a lot of value for patients, say C p A p providers. "There's value in any support group," said Todd u sher, co-founder of Home o xy- gen Company in Modesto, Calif. "They can get ideas. They get to feed off of other folks and how they are managing." In January, the American Academy of Sleep Medicine announced it had launched the American Alliance for Healthy Sleep, a membership organization that seeks to connect anyone with an interest in sleep health to share ideas and get tips and sup- port for living with a sleep disorder. Having the nationally recognized AASM spearheading the alliance, rather than say, a C p A p provider or manufacturer, will give potential members that the information is unbiased, say providers. "I think when people see it's AASM vs. us doing it, they might feel like o K, it's not affiliated with any one company," said r obyn p arrott, president of Troy, Mich.- based Sleep Solutions, who said she will probably join the alliance, which is active- ly seeking input and encouraging conver- sation from all stakeholders in the sleep community. "It's in its infancy, but let's see what's out there and lets see if we can help anybody." The alliance also seeks to build aware- ness and advocate for better policies relat- ed to sleep disorders. For C p A p patients, worsening payment policies have weak- ened the ability of providers to service patients, says u sher. " w e see a lot of patients transitioning over to us because they can't get the equip- ment they need or want," he said. "That's the direct result of polices over the last five years. They are having trouble getting it when they need it." hme By Theresa Flaher T y, Managing e ditor WASHINGTON – r equiring CMS to enforce its own rules for the mail-order diabetes program will help to preserve beneficiary choice, say stakeholders. "This certainly is a good first step in try- ing to rectify a bad program," said Kurt Anderson, director of advocacy for the American Association of Diabetes Educa- tors. "There were some loopholes in the law that suppliers took advantage of." The budget for the Department of Health and Human Services for fiscal year 2019 included two provisions. The first would strengthen the 50% rule, by requiring, among other things, that bidders attest to their ability to maintain an inventory of strips consistent with their bid, and requir- ing CMS to establish and maintain a sur- veillance program to ensure suppliers are complying with the rule. Mail-order changes a 'good first step' CPAP providers embrace support Kurt Anderson By Theresa Flaher T y, Managing e ditor WASHINGTON – Todd Eagen is not an o & p prac- titioner, but in his role as president of the o rthotic p rosthetic g roup of America, he advocates as much for recognition of the important role they play in patient care as he does for regulatory chang- es to improve the profes- sion. Case in point: the recent decision to include o & p providers' notes as part of the patient's medical record, which addressed a "Dear p hysician" letter in 2011 that changed the standards for approving a claim by disregarding the prosthetist's notes as part of the medical record. "That was a very big win for the profes- sion," he said. "That letter was the start of the onslaught of Medicare r AC audits, which had a very negative impact on a lot of legiti- mate, quality providers." Eagen spoke with HME News recently about his upcoming goals and why o & p professionals need to be viewed as medical professionals, not widget makers. hme N e WS: Many payers treat O&P provid- ers as equipment jockeys . Has that impacted patient access? Todd Eagen: It's a travesty that there are orga- nizations out there that would be satisfied with taking a once active individual, where there is an opportunity to restore a certain level of function to that patient, and deny that coverage and confine them to a life of O&P gets some respect Todd Eagen BLOOMFIELD, Conn. – Health insur- ance giant Cigna Corporation plans to acquire Express Scripts for $67 billion, it announced March 7. Express Scripts is the largest pharmacy benefits manager in the u nited States, according to news reports. "Cigna's acquisition of Express Scripts brings together two complementary custom- er-centric services companies, well-positioned to drive greater quality and affordability for cus- tomers," said David M. Cordani, president and CE o of Cigna in a press release. Cordani will assume the role of president and CE o of the combined company; Tim w en- tworth, president and CE o of Express Scripts, will assume the role of president of Express Scripts. w hile both organizations say the move will expand consumer choice and create better value, others disagree. "Consolidation among health care giants leads to fewer choices for patients and plan sponsors," said Douglas Hoey, CE o of the National Community p har- macists Association, in a press release. "In addition, companies make claims of cost savings that will benefit patients and health plan sponsors, but the available evidence from previous consoli- dations suggests otherwise." The deal is the latest sign of upheaval in the market. In December, CVS Health announced a planned merger with Aetna. The deal is expected to be finalized in December 2018. hme Cigna, Express Scripts plan merger AADE also plans a survey on impact of Arriva Medical closure T O D D e a g e n s e e n e x t pa g e M A I L o r d e r s e e n e x t pa g e Briefs h omeTown i nfusion expands service area NEW ERA, Mich. – HomeTown Infusion has opened a new location in Rockford, Mich. The new location, which offers home and alternate site infusion services, will serve the greater Grand Rapids area, accord- ing to a press release. Hometown Infu- sion is a division of HomeTown Pharmacy, a multi-subsidiary, multi-specialty health and managed services provider. In addi- tion to infusion services, HomeTown oper- ates pharmacy, HME and supply locations throughout Michigan and Indiana. Tandem Diabetes c are looks north SAN DIEGO – Tandem Diabetes Care, a manu- facturer of touchscreen insulin pumps, has submitted a medical device license applica- tion to Health Canada to market its t:slim X2 Insulin Pump with Dexcom G5 Mobile continuous glucose monitoring integration. The company plans to launch the pump in Canada in the second half of 2018, subject to regulatory approvals. "This application is another important step toward achieving our strategic goal of bringing the benefits of the t:slim X2 Insulin Pump to people outside of the United States," said Kim Blickenstaff, president and CEO of Tandem Diabetes Care. The company anticipates that the t:slim X2 Insulin Pump offered in Canada will be capable of displaying both English and French, will offer a 24-hour clock, and will display glucose readings in millimoles per liter (mmol/L). s hield h ealth c are expands into a rkansas VALENCIA, Calif. – Shield HealthCare has ex- panded into Arkansas, demonstrating its commitment to the "ongoing growth of the company as a nationwide medical suppler leader," it says. "We are excited to open up the Arkansas market," said Roger Miller, chief marketing officer. "We believe that Ar- kansas customers using medical supplies need exactly what Shield offers." Shield now operates in Arkansas, California, Colorado, Illinois, Texas and Washington. The compa- ny, which delivers incontinence, urological, ostomy, enteral nutrition, wound care and breastfeeding supplies, serves more than 180,000 patients. K ci to lay off 68 employees SAN ANTONIO – KCI USA, a subsidiary of Acelity, will lay off 68 workers in May, ac- cording to a notice filed with state labor regulators and reported by the San Anto- nio Express-News. No reason was given for the layoffs, and calls and emails to the company were not immediately returned, according to the newspaper. In 2016, Acel- ity, formerly Kinetic Concepts, said it was not awarded contracts for negative pres- sure wound therapy in the Round 2 re- compete of competitive bidding, due to a technicality.

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