Issue link: https://read.dmtmag.com/i/45026
■ The AASM wants sleep medicine to shift toward an outcomes-based model, says Dr. Nancy Collop, president. See story page 1. Draft LCD could complicate wound care ............. 33 ADW enjoys success with own product line. . . . . . . . . . . 33 Humana eyes diabetes supply market ............... 33 AABCP set to launch online magazine ............... 34 Rx and Specialty Providers WWW.HMENEWS.COM / NOVEMBER 2011 / HME NEWS 33 BRIEFS CCS Medical to pull up stakes CLEARWATER, Fla. – Mail order provider CCS Medical plans to relocate from its headquar- ters here to North Dallas, it announced Sept. 30. In a press release, CEO Dirk Allison cited the state's "superior business climate" as a factor in the move. CCS Medical will receive perks for relocating its headquarters, includ- ing up to $506,000 in training funding from the Texas Workforce Commission, and up to $37,500 in incentives—$250 per job cre- ated. The move is expected to create 230 jobs. CCS Medical currently has more than 1,500 employees in seven offices. CarePoint Partners adds another location CINCINNATI – Infusion provider CarePoint Partners announced Sept. 15 that it has acquired the Charleston, W.Va.-based Mountain State Infusion Services. It is CarePoint's 14th acquisition, according to a press release. The provider now offers in- fusion services to more than 5,000 patients daily through 26 locations in nine states. Fourth quarter neb-med allowables released BALTIMORE – Average sales prices for nebu- lizer medications remained fairly steady for the fourth quarter. Albuterol (J7613) was down slightly, to just over 15 cents per dose; ipratropium (J7644) was unchanged at 26 cents; levalbuterol (J7614) dropped 18 cents to 56 cents per dose; budesonide (J7626) slid 11 cents to $4.39 per dose; arformoterol (J7605) was down 7 cents to $5.38 per dose; and Perforomist (J7606) rose another 4 cents to $4.83 per dose. Provider publishes guide VOORHEES, N.J. – The CPAP Shop in Septem- ber launched an e-book for CPAP users. The free, 25-page book, "Useful Information for CPAP Machine Users," offers information about sleep apnea, common CPAP side effects, humidification, travel and a CPAP machine comparison guide. The book can be downloaded at thecpapshop.com. Care 1st Medical sells to NationsHealth CHATTANOOGA, Tenn. – NationsHealth in October acquired Care 1st Medical Solu- tions. The five-year-old Care 1st provides mail-order diabetes testing supplies to about 13,000 Medicare beneficiaries. Care 1st CEO Mike Eberly confirmed the deal and blamed competitive bidding. Nation- sHealth won several diabetes contracts in Round 1 of the program. Short takes UroMed will now offer FemSoft Supplies, it announced in October. The online provider offers a wide range of catheters, urologi- cal and continence care supplies…St. Paul, Minn.-based Pediatric Home Service re- cently earned a Certificate of Distinction in Disease-Specific Care for its Pediatric Asth- ma Program from the Joint Commission. Proposed change could complicate wound care BY THERESA FLAHERTY, Managing Editor BALTIMORE – Suction pumps and negative pressure wound therapy devices (NPWT) need consistent coverage criteria to ensure patient care, AAHomecare told the four medical directors in a Sept. 23 letter. In August, the DME MACs released draft local coverage determinations (LCDs) that would create separate coverage criteria for pumps. They would add a not reasonable and necessary statement for wound suc- tion pumps (K0473) and related supplies (K0744—K0746); and add new coverage criteria for gastric suction pumps. Such a move would effectively create a separate category for suction pumps. That, in turn, would make it difficult for phy- sicians to order the best device, and for HME providers to determine which prod- uct might work best. "We want to make it consistent for phy- sicians, for patients and for providers so that the patient can have the continuum of care with the full range of products," said Alex Bennewith, senior manager of govern- ment affairs for AAHomecare. Without that consistency, a patient would meet the coverage criteria for one device or the other, but not both. "Sometimes they may need NPWT for one part of their body, and a suction pump for another, or they switch from one device to the other after several months," said Bennewith. "To differentiate the cri- teria would make it more difficult from a healthcare perspective." In its letter, AAHomecare suggested also applying the new coverage criteria for suction pumps to other LCDs, includ- ing those for surgical and ostomy supplies, to further ensure care across the wound care space. "It is critical for home medical equip- ment providers and for Medicare patients to have consistent coverage criteria in the wound care space so that patients are able to obtain the preferred wound care device to match their medical needs," the associa- tion stated in its letter. HME Activa Medical proves there's life after audit, embraces cash sales BY THERESA FLAHERTY, Managing Editor RALEIGH, N.C. – After Medicare broke the camel's back in the form of a $1 million audit, provider Vince Cole decided it was time for a change. In August, Cole, along with Patrick O'Brien, launched Activa Medical, which provides CPAP machines and sup- plies and home sleep tests through www.activa-medi- cal.com. The pro- vider accepts no insurance. "We decided to go into an area that will hopefully be growing, where we can serve our patients better, and stick around for the long term," said Cole. "We don't have to work with insurance companies and deal with Medicare and Medicaid, or deal with the changing regu- latory landscape." It's no surprise Cole doesn't care to deal with Medicare. His previous company (he didn't want the name published) was a full line, $20-million DME company. When Medicare sought $1 million in repay- Activa Medical offers a wide range of CPAP machines and supplies for cus- tomers who prefer to pay out of pocket. ments from the company, he fought back and won. However, it took three years and cost more than $300,000 in legal fees. Cole sleeps better these days. "It's nice to not have to go to bed every night wondering what kind of changes are on the horizon with respect to anything that happens in Washington," he said. Most of Activa's customers—Cole estimates between 60% and 70% have some kind of insur- ance—are willing to pay out of pock- et to save money. Many of those cus- tomers are either already compliant with their thera- py and don't need costlier, download- able machines, or would prefer to just use CPAP when they want, say a few hours a night or a few days a week. The company offers 24/7 support by phone, email or electronic chat. Cole says the web-based business model will allow Activa Medical to expand more easily. The provider is already eyeing diabetes test- ing supplies, as well as the international market. HME ADW's new Diachieve product line. High achiever ADW enjoys success with own product line BY THERESA FLAHERTY, Managing Editor POMPANO BEACH, Fla. – It's not uncom- mon for mail order diabetes provid- ers to offer supplemental products for their customers, but American Diabetes Wholesale (ADW) took it a step further. The company in August debuted Diabetic Defense, an all-natural blood glucose-lowering supplement. It's the second supplement and fifth product that ADW has developed under its Diachieve brand, which it launched in 2010. "For this company to grow and prosper we needed a certain level of independence," said Larry Edelson, president and CEO. "We could no longer grow at substantial rates being ACHIEVE SEE PAGE 35 Insurer eyes diabetes market 'Money is just going in circles' BY THERESA FLAHERTY, Managing Editor viders crying foul. A In August, Humana announced that its mail order pharmacy, RightSource, would offer diabetes supplies to Medicare benefi- ciaries—both Humana members and non- members. "I can't think that's right," said one mail order provider who didn't want to be named. "Humana as an insurance company is telling their patients to use Humana's pharmacy, so that money is just going in circles." Right now, RightSource serves approxi- mately 600,000 plan members in all 50 states and Puerto Rico. With the rollout of a national mail order program for diabetes, it's not all that surpris- ing that Humana would want to get into the HUMANA SEE PAGE 34 NOTHER SOURCE for diabetes sup- plies has thrown its hat into the Medi- care ring—one that has diabetes pro-