Issue link: https://read.dmtmag.com/i/48253
■ The NHIA's Nancy Kramer says benchmarking data will help the home IV industry push for legislative changes. See story this page. Survey: Rx will stop providing diabetes supplies. . . . . . . 27 NCPA keeps eye on industry ....................... 27 CarePoint Partners conducts annual drive ............ 27 Support surfaces: 'Do the right thing' ................ 28 Rx and Specialty Providers WWW.HMENEWS.COM / DECEMBER 2011 / HME NEWS 27 BRIEFS Lawmaker seeks answers WASHINGTON – Rep. Marcia Fudge, D-Ohio, has called on CMS officials to investigate complaints from physicians and beneficia- ries who had problems obtaining diabetes supplies in Round 1 of competitive bid- ding. In a letter to CMS Administrator Don- ald Berwick and Michael Keane, director of the Chronic Care Policy Group, Fudge expressed her concerns about problems in the Cleveland competitive bidding area, including: confusion about the program; patients being pressured to switch brands; and contract suppliers not carrying brands they list as covered. Activa ramps up RALEIGH, N.C. – Online CPAP provider Activa Medical announced Oct. 3 that it has opened three new offices—in Los Angeles, Chicago and Houston—and a distribution center in Louisville, Ky. Activa, which launched in Au- gust, plans to expand its reach internation- ally, and the new offices will allow it to do that, said CEO Vince Cole in a release. Under review in Jurisdiction B: CPAP WASHINGTON – A widespread prepayment review by National Government Services, the Jurisdiction B DME MAC, revealed an 81% error rate for CPAP devices (E0601KJ), according to a recent bulletin. Out of 100 claims reviewed, 19 were al- lowed. The top reasons for denial: lack of or insufficient medical record documen- tation of a face-to-face evaluation prior to the sleep study (32); lack of or insuffi- cient documentation of the re-evaluation between 31 and 90 days of therapy; no documentation received (27); and lack of or insufficient documentation of adherence to therapy (27). The review is ongoing. AASM seeks to update home testing classification DARIEN, Ill. – The American Academy of Sleep Medicine (AASM) has proposed a new home testing device classifica- tion system. The proposed system, called SCOPER (sleep, cardiovascular, oximetry, position, effort and respiratory), categorizes home sleep testing devices based on mea- surements of those parameters, according to an article in the Nov. 2 Sleep Report, a weekly digital newsletter from the Sleep Review, a journal for sleep specialists. Nan- cy Collop, AASM president, said there have been many testing devices developed that do not fit within the original classification system, which was created in 1994. STL Medical revamps website ST. LOUIS – STL Medical Supply launched a new e-commerce site, it announced in Oc- tober. The site offers a streamlined shop- ping experience and will allow the provider to replace mail-order catalogs with online shopping, it said in a press release. STL Medical Supply specializes in ostomy, uro- logical, incontinence, skin and wound care. Association (NHIA). "The data will help us tell our story from a legislative perspective; and providers had a need for data that would allow them to perform internal benchmark- ing and comparisons with the industry as a whole." The 2010 NHIA Provider Survey Comprehensive Anal- ysis Report is the first phase of a multi-year data gathering providers to hospital-based infusion providers. One key finding: In 2008, 730 NHIA member provider locations administered 1.24 million therapies to an esti- mated 829,000 patients. "The data shows the size and viability of the industry," said Kramer. "Private pay- ers have seen value in home NHIA SEE PAGE 28 Infusion data offers yardstick BY T. FLAHERTY, Managing Editor ALEXANDRIA, Va. – It's been more than a year in the making, but the first major study of the home infusion industry was released in October. "We had a need for data," said Nancy Kramer, vice president of clinical affairs at the National Home Infusion initiative launched in 2010 by the NHIA. The survey sought informa- tion like revenue by therapy and payer type; staffing lev- els; and number of patients by age and therapy catego- ries. The survey was sent to NHIA members, who range from one-location infusion pharmacies to large national Percentage of revenue by payer for typical infusion provider Medicaid VA/Tricare Self pay Medicare Commercial insurance/HMO/PPO Other Survey: Bid program has real consequences 84% of community pharmacies say they'll stop providing diabetes supplies BY THERESA FLAHERTY, Managing Editor ALEXANDRIA, Va. – The National Community Pharmacists Asso- ciation (NCPA) can now back up its claim that competitive bidding is bad for community pharmacies and their patients. The association in October released the results of a survey on the impact of competitive bidding on diabetes testing sup- plies. A whopping 84% of the more than 800 pharmacies that took the survey reported they would stop providing supplies to Medicare beneficiaries if they were required to bid or forced to accept bid pricing. "We believe this will help to inform the super committee members of the impact of apply- ing the bid rate to us and how it would affect patient access," said John Coster, senior vice president of government affairs for NCPA, during a media call. "We ask members of Congress to take a look at those results as they consider what to include and not to include in their rec- ommendations to the super committee." In May, Reps. Aaron Shock, R-Ill., and Peter Welch, D-Vt., introduced the Medicare Access to Diabetes Supplies Act, which seeks to exempt community pharmacies with 10 or fewer locations from having to com- petitively bid for diabetes testing supplies. The bill also seeks to allow those pharmacies to con- tinue delivering supplies. It cur- rently has 12 co-sponsors. The NCPA is discouraged that, despite numerous com- plaints about Round 1 of com- petitive bidding, CMS is mov- ing forward with its mail-order program for diabetes supplies. In August, CMS announced NCPA SEE PAGE 28 NCPA keeps eye on host of issues BY THERESA FLAHERTY, Managing Editor L A toyous occasion Cincinnati, Ohio-based CarePoint Partners kicked off its third annual Toys for Tots campaign on Halloween. The home infusion provider wanted to partner with its communities to make the holidays happier for under- privileged children. The toy drive is spearheaded by the U.S. Marines. "Like the Marines, we too think there is no greater cause than to help kids," CEO Dana Soper stated in a release. This year, CarePoint has 26 locations, like its New Orleans branch, pictured, accepting donations. IKE HOME medical equipment providers, community phar- macists battle with reimbursement cuts, audits and a host of other issues, says Doug Hoey, CEO of the National Com- munity Pharmacists Association. On the heels of its annual conference, which was held Oct. 8-12 in Nashville, Tenn., Hoey spoke with HME News about the year's successes and some other issues that the association is keeping its eye on. COMPETITIVE BIDDING In May, Reps. Aaron Shock, R-Ill., and Peter Welch, D-Vt., intro- duced the Medicare Access to Diabetes Supplies Act, which seeks to exempt small community pharmacies from having to competi- tively bid for diabetes testing supplies. "We are optimistic that this will get passed and we can get them exempted for good," said Hoey. "We are pushing to get a companion bill and we've had a lot of interesting conversations. With Congress at an impasse, we don't have a sponsor yet, but we have received interest from a couple of senators." WASTE NOT The push toward mail order for diabetes supplies has created a wasteful system that borders on abuse, and it's a problem that needs to be addressed sooner rather than later, Hoey says. "We have heard stories of boxes and boxes of strips being sent to patients, charged to Medicare and the patient can't use them fast enough," he said. "Or the patient is deceased and the supplies continue to mount up at the home. Is that really what the taxpayer wants to pay for? We think the answer is 'no.' Now, as we are try- ing to really stretch each dollar and look for efficiencies, I don't know how anyone can turn a blind eye to this waste." HOEY SEE PAGE 28