Issue link: https://read.dmtmag.com/i/36987
■ CPAP providers like Lisa Feierstein are looking at partnerships with payers and IDTFs in the home sleep test market. See story page 1. Big deal: Insulet acquires Neighborhood Diabetes ..... 27 Infusion, breast form bills introduced ................ 27 Neb-med consolidation continues. . . . . . . . . . . . . . . . . . . 27 Express Medical upgrades website. . . . . . . . . . . . . . . . . . 28 Rx and Specialty Providers WWW.HMENEWS.COM / AUGUST 2011 / HME NEWS 27 BRIEFS AAHomecare seeks CPAP change ALEXANDRIA, Va. – AAHomecare has asked CMS to allow HME providers to use an ad- vanced beneficiary notice (ABN) on the first day of CPAP therapy if they think the patient has a high likelihood of noncompliance. Currently, providers must wait until day 60 of CPAP therapy before they can give the patient an ABN. In a June 24 letter to CMS, AAHomecare states: “beneficiaries who are noncompliant in the first eight weeks of therapy typically are disinclined to pay out- of-pocket for the CPAP. Most refuse to sign an ABN so far into the trial. This process creates a difficult situation for the provider who is left without recourse and is a dis- service to beneficiaries who fail to invest themselves in the therapy from the start.” CarePoint acquires ArTex Medical infusion business CINCINNATI – Infusion provider CarePoint Partners has acquired the infusion busi- ness of Texarkana, Texas-based ArTex Medical, the company announced June 16. ArTex has locations in Texarkana and Dallas, as well as Shreveport, La. The deal is CarePoint’s 13th in less than four years. The provider now serves more than 3,000 patients daily at 25 sites in nine states. Terms of the deal were not disclosed. Apria opens infusion pharmacy WICHITA, Kan. – Apria Healthcare opened an infusion and specialty pharmacy here June 27. The new pharmacy covers about two- thirds of the state, according to an online article in the Wichita Eagle. It is one of three that the Lake Forest, Calif.-based Apria is opening this year. The other two are in Pen- sacola, Fla., and Charleston, S.C. Status quo for neb-med pricing BALTIMORE – Average sales price figures for most nebulizer medications haven’t changed much since last quarter. Alb- uterol (J7613) inched up to just under 17 cents per dose; levalbuterol (J7614) was up to 74 cents per dose; and ipratropium (J7644) stayed flat at 26 cents. However, budesonide (J7626) reversed last month’s sharp plunge, rising 35 cents to $4.50 per dose. Also getting a boost: arformoterol (J7605), which was up 16 cents to $5.45 per dose; and Perforomist (J7606), which was up 6 cents to $4.76 per dose. Generex pulls plug on GMD acquisition WORCESTER, Mass. – Generex Biotechnol- ogy’s plan to acquire a majority stake in Global Medical Direct (GMD), a provider of mail order diabetes supplies, is off the ta- ble. In October 2010, Generex announced that it planned to buy 51% of the Lenexa, Kan.-based GMD’s business in an effort to gain a platform for its over-the-counter and diabetes products as they come to market. Insulet likes the Neighborhood Deal gives both companies room to grow BY THERESA FLAHERTY, Managing Editor WOBURN, Mass. – Talk about a sweet deal. Insulin pump manufacturer Insulet in June acquired Neighborhood Dia- betes for $63 million. There are a lot of synergies between the two companies, said Tom Cronin, CEO of Neighbor- hood. Insulet, which makes the tubeless OmniPod, has 25,000 customers for its pumps; Neigh- borhood provides testing sup- plies, insulin and other items to 60,000 customers. “This is a good opportunity Tom Cronin for Insulet to increase their sales by add- ing that on,” he said. “And for us, it’s like growing 50% overnight in terms of being able to offer them the add-on products.” Neighborhood, which offers a high-touch service model that includes education and support, is no stranger to insu- lin pumps. In addition to the OmniPod, the provider also offers pumps from Medtronic, Animas and Roche, and it will continue to do so. DIABETES SEE PAGE 29 Consolidation continues in neb-med space TEXARKANA, Texas – Neb-med industry insiders are remaining mum about the sale in June of Senior Respiratory Solutions to Med4Home, Lincare’s nebulizer medication business. Senior Respiratory confirmed the sale, but had no further comment, so we combed through our archives to see what we had written about these companies before. Senior Respiratory was one of the largest remain- ing independent providers of nebulizer medications. In 2009, according to the HME Databank, it was the sixth largest Medicare biller for inhalation drugs. Senior Respiratory billed for 14,227 beneficiaries. Lincare and Med4Home ranked Nos. 1 and 2, bill- Senior Respiratory positioned itself as partner to indie providers ing for 169,823 and 61,964 beneficiaries respectively. Over the last several years, Senior Respiratory had been quietly acquiring patients from other HME providers who, frustrated by low margins and a roller coaster fee schedule, wanted to get out of the market. In 2008, the provider added nearly 11,000 new neb-med patients, picking them from Praxair and other providers. Because Senior Respiratory positioned itself as a part- ner to indie HME providers, rather than as a competitor, they were an attractive buyer compared to Med4Home. Providers feared Med4Home would go after their oxy- gen patients. Med4Home, Lincare’s nebulizer medication business, made a splash in August 2008, when it acquired 20,000 patients from the Dallas-based Independent Home Phar- macy, whose parent company, the Dallas-based Soporex, filed for Chapter 7 bankruptcy protection. HME Supporters of a bill that seeks Medicare payment for home infusion therapy say it is much more cost-effective to pro- vide the therapy in the home. Infusion industry tries again BY THERESA FLAHERTY, Managing Editor WASHINGTON – Home infusion stakeholders are back with another bill that seeks to close a gap in how Medicare pays for the therapy. “We’ll continue to knock on the doors of Congress until this legislation is passed,” said John Magnuson, vice president of legislative affairs for the National Home Infu- sion Association (NHIA). “It’s needed, it fixes the problem and it’s good for Medicare and Medicare patients.” Sponsored by Sens. Olym- pia Snow, R-Maine, and John Kerry, D-Mass., and Reps. Eliot Engel, D-N.Y. and Tim Murphy, R-Pa., the Medi- care Home Infusion Ther- apy Coverage Act of 2011 INFUSION SEE PAGE 28 Bill would require Medicare to pay for BY THERESA FLAHERTY, Managing Editor WASHINGTON – A bill that seeks to get custom breast forms paid for under Medicare was reintroduced June 16. “Medicare covers custom prosthetics for every other body part except the breast,” said Rhonda Turner, execu- tive director of the Ameri- can Association of Breast Care Professionals (AABCP). “There’s a level of inequity there that we haven’t figured out.” Medicare already has a custom breast forms There is already a code and an allowable in place for the device code and an allowable for custom breast forms, but local coverage determinations (LCDs) down code them as “not medically necessary.” But, when appealed, Medi- care has usually reversed its decision. “Through appeal, we have been able to (prove) medical need and get the device paid for,” said Turner. With the cost of a custom form around $3,000 com- pared to $450 for an off-the- shelf product, many women will go without if Medicare doesn’t pay, said Turner. That’s especially troublesome because not all breast cancer survivors are candidates for CUSTOM SEE PAGE 28