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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News 4 www.h M e N ew S . COM / july 2018 / h M e N ew S Increase Consistency, Efficiency and Credibility with DMERT-Certified Repair Tech Training � 800.987.7342 For available courses and pricing, visit The DMERT Group is a non-profit certification body for repair technicians made up of stakeholders from across the DME and CRT industry. Learn more at VGM and U.S. Rehab have partnered with FIOS DME repair training to offer a new online repair technician program with standardized guidelines. BENEFITS OF DMERT-CERTIFIED TRAINING EMPLOYERS can reduce costs by limiting repeated repairs and transportation of equipment TECHNICIANS set themselves apart from other techs CONSUMERS can maintain their lifestyles knowing their equipment was properly repaired START TRAINING WITH DMERT LEVEL 1 Level 1 covers basic medical equipment from walkers and manual wheelchairs to hospital beds, scooters and Group 2 consumer power chairs. the bid process to all non-bid areas, including rural areas. The agency would also pay con- tract providers using their actual bid prices, not the median bid prices. The proposal, first announced in February, caught stakeholders off-guard, but they say, ultimately, they don't think it has legs. "At this point, we don't believe there's a huge appetite for it (among lawmakers)," said Cara Bachenheimer, chair of the newly formed Government Affairs Practice, Brown & Fortunato. "It's our mission to make sure they maintain that lack of appetite." The industry's strongest arguments against expanding the bidding process come from CMS's own comments in the recently pub- lished interim final rule, where it acknowl- edged for the first time there are problems with the program. "I think the IFR gave (us) tremendous credibility because lawmakers have been told for years and years that there are no problems and now finally the federal gov- ernment has acknowledged the problems," said Witter. "We'll use the rest of the year to build on that." Stakeholders will continue to push H.R. 4229, a bill that would provide broader relief from the bid program. It picked up an additional five co-sponsors following the AAHomecare Washington Legislative Con- ference, for a total of 152. HM e By Theresa F L aher T y, Managing e ditor TA l l A H A S S e e , f l a . – F e a r i n g a n o t h e r Univita debacle, the Florida Alliance of Home Care Services has retained legal counsel to ensure that the state's Medicaid managed care contracts are aboveboard. In April, the Agency for Health Care Administration awarded contracts to 12 health plans in 11 regions, effective Jan. 1, 2019. Of concern to FAHCS and its members: Who will act as the third-par- ty administrators, if any, for the health plans, and who will provide DME equip- ment and services for the TPAs? "We want to work closely with the Agency for Health Care Administra- tion to gain transparency on entities that are accepting contracts," said Chris Townsend, FAHCS president. "Our con- cern is a monopoly could be formed." That's what stakeholders say hap- FAHCS lawyers up pened back in 2014, when Univita gained control of a huge share of the managed care market, contracting with 10 of 14 health plans to administer their HME programs, even though they were an HME provider themselves. Univita's model proved unsustain- able. AHCA terminated the compa- ny's contracts in July 2015 and the company filed for bankruptcy shortly thereafter. "One thing that causes heartburn is we are seeing the trend of the differ- ent plans all beginning to use the same network manager," said one provider. "With Univita, it was referring to itself. That really locked out the DME business for other providers." As the new contracts are implement- ed, FAHCS wants to make sure AHCA honors a requirement whereby health plans must identify all subcontractors and subcontractors must identify any further subcontractors, the association stated in a bulletin to its members. "FAHCS is working on a formal inqui- ry to assure that the 'non self referring subcontractor' language survives in the contract," it stated. HM e b I d exp ANSION c o n t i n u e d f r o m pa g e 1 p I l OT pr OG r A m c o n t i n u e d f r o m pa g e 3 devices and oxygen therapy for two of the three pilots it will conduct. As for the third? It probably won't be DME-related, Combs-Dyer said. "The other payers felt like I did, that DME was a good place to start," she said. "But I have a feeling they're going to want to move into other provider types, maybe home health or skilled-nursing, or maybe a certain hospital procedure." Based on a schematic that Combs- Dyer shared, an exchange based on Fast Healthcare Interoperability Resources or FHIR will connect the prescribing provid- er's EHR or practice management system with "rules libraries" built by payers—not only Medicare, but ideally, some Medicare Advantage plans and private payers. "We're hopeful (this will improve docu- mentation)," she said. Making required paperwork easier to find is one of a number of strategies CMS has for reducing the burden on provider compliance, Combs-Dyer said. Others: simplifying paperwork ("There's some stupid stuff that's out there and we're try- ing to eliminate that stuff," she said) and improving the audit process ("I believe the Targeted, Probe and Educate Program is quite promising," she said). HM e 'We are seeing the trend of the different plans all beginning to use the same network manager'

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