HME News

JUL 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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VOLUME 24 — NUMBER 7 JULY 2018 $7.00 HME NEWS POLL ■ Enter the new age of interoperability, says Brightree's Nick Knowlton. See page 9. ■ Product Spotlight: This month we feature mobility products like the Stimulite Slimline XS Cushion from Supracor. See page 20. ■ Do you keep a credit card on fi le for all or most of your customers? See results on page 22. N E W S ■ Post-IFR, stakeholders cast wide net. PAGE 3 ■ Newspoll: Extended bid contracts? Either way, you lose. PAGE 3 ■ FAHCS retains legal counsel. PAGE 4 D E PA RT M E N T S PROVIDERS ■ Providers, Medicaid reach compromise. PAGE 13 ■ Q&A: Doug Coleman, AAHomecare/Mal Mixon Legislative advocate. PAGE 13 MOBILITY ■ RESNA has packed agenda. PAGE 16 ■ Q&A: John Zona, Simon Margolis Fellow. PAGE 16 RX & SPECIALTY PROVIDERS ■ Acentus looks for like-minded companies. PAGE 18 ■ Ascensia revamps app. PAGE 18 VENDORS ■ ResMed, Xealth share data. PAGE 21 ■ Invacare's Monaghan 'confi dent.' PAGE 21 W W W . H M E N E W S . C O M Industry stays focused WHO KNOWS THE COST? Tricare transition creates nightmare Manufacturers evalute impact of tariffs Super troopers AAHomecare's Jay Witter preps attendees of the Washington Legislative Conference for their Capitol Hill visits on May 24. See story page 3. CBO, OMB differ on cost estimates for bid expansion C O M M E N TA RY ■ Hone in on three key areas—fee schedules, terms and claims payments—to help you get profi table payer contracts in place, says Steve Selbst of Healthcents. PAGE 9 BY THERESA FLAHERTY, Managing Editor WASHINGTON – A huge variance in cost esti- mates for a proposal to expand the com- petitive bidding process to all areas of the country may be eye-catching, but indus- try stakeholders remain focused on the big picture. The Congressional Budget Offi ce esti- mates that the proposal, included in the president's fi scal 2019 budget, would cost $1.3 billion over 10 years; The Depart- ment of Health and Human Services says it would save $6.5 billion over the same time period, according to an article in Inside Health Policy. "This happens all the time," said Jay Wit- ter, senior vice president of public policy for AAHomecare. "The CBO is bound to Congress and the OMB is bound to the administration. They do it differently and they don't communicate with each other." Under the proposal, CMS would expand BY LIZ BEAULIEU, Editor WASHINGTON – CMS says a demonstration project requiring prior authoriza- tion requests for power mobility devices in 19 states will become permanent and will expand to all states. CMS announced June 1 that it will transition nearly all of the codes included in the demo project, which was set to expire on Aug. 31, to its national prior authorization program on Sept. 1. Currently, the agency has two codes in the national program: K0856 BY THERESA FLAHERTY, Managing Editor HAMPTON, Va. – Ever since Tricare transitioned to a new contract administrator, providers say their claims aren't getting paid at all, or very slowly. "It's been a nightmare and we haven't been getting any real response from them," said Matt Russell, vice president for ABC Health Care in Hampton, Va. Humana Military took over the Tricare East contract from Health Net Services on Jan. 1, when Tri- care consolidated from three to two regions, East and West, and outsourced the billing to Wiscon- sin Physician Services. Wisconsin Physician Services seems to have been unprepared for the volume of claims, say providers. "I feel their infrastructure was set up to be a secondary proces- sor," said Justin Miller, CEO at ABC Health Care. "This was supposed to BY LIZ BEAULIEU, Editor A AHOMECARE, ON behalf o f i t s m a n u f a c t u re r members, has asked the U.S. Trade Representative to exempt 48 product categories from proposed 25% tariffs on imported materials and prod- ucts from China. In a letter to the USTR in May, CMS shifts mobility codes to natÕl prior auth program and K0861, two complex rehab codes. "This is something the industry has been strongly advocating for with CMS and Congress," said Seth Johnson, vice president of government affairs for Pride Mobility Products. Thirty-one codes— K0813 through K0855— will transition into the nationwide program; six codes—K0800, K0801, K0802, K0890, K0891, K0898, scooter and pedi- atric codes—will not, due to low utilization. Stakeholders still await sub-regulatory guidance on the national program, but they expect CMS to hold itself to responding within 10 business days for initial requests and within 20 business days for resubmitted requests. "There's broad support, with one caveat," said Don Clayback, execu- tive director of NCART. "We think there's a good system in place in the demo states, but for the addi- tional states, we hope that Medi- care contractors also have a system and adequate staff in place to meet timeframes." Two things that will go away along with the demo: an option for providers not to submit requests, in AAHomecare President and CEO Tom Ryan said the tariffs would "adversely affect the health and well-being of seniors, chronically ill individuals and persons with disabilities" and "adversely affect the fi nancial condition of mem- bers of the home medical equip- ment industry." Among the product categories that would be affected by the tar- iffs are elec- tro-diagnostic patient moni- toring systems used in blood pressure mon- itors; ozone, o x y g e n a n d aerosol ther- apy, artificial Seth Johnson Don Clayback S. Wilkinson B I D E X PA N S I O N PA G E 4 P R I O R A U T H O R I Z AT I O N PA G E 1 7 T R U M P ' S TA R I F F S PA G E 2 2 T R I C A R E N I G H T M A R E PA G E 1 4 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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