Issue link: https://read.dmtmag.com/i/56191
■ Nancy Kramer says this year's NHIA conference offers plenty of education and networking for infusion providers. See story below. Study points to ripple effect of bid program. . . . . . . . . . . 25 Sleep: NPR story focuses on costs, not compliance .... 25 CPAPPeople ventures into home testing ............. 26 Q&A: Linda Secher ............................... 27 Rx and Specialty Providers WWW.HMENEWS.COM / MARH 2012 / HME NEWS 25 Arriva Medical buys Direct Diabetic CORAL SPRINGS, Fla. – Mail-order diabetes provider Arriva Medical has acquired Sun- rise, Fla.-based Direct Diabetic Source for $5 million. Terms of the deal, which was announced Jan. 12, included a cash payment of $2.5 million and contingent payments expected to total another $2.5 million. Direct Diabetic Source had about 25,000 active customers. In February, Nashville, Tenn.-based AmMed Direct an- nounced it planned to sell assets to Ar- riva. In local news reports, AmMed said it would lay off 223 employees. Home infusion, HME providers partner up FAIRFIELD, N.J. – Aperture Health plans to form a joint venture between its subsid- iary Triad Therapeutics, a home infusion provider, and Reliable Medical, a respira- tory and home medical equipment pro- vider, it announced Jan. 27. The deal will allow both companies to increase market presence. Triad serves patients through- out New York, New Jersey and Connecti- cut. Neb-med claims: More than half denied WASHINGTON – From September 2011 through December 2011, J7626 had an error rate of 59% and J7605 had an error rate of 58%, according to a widespread review of nebulizer drugs by Noridian, the Jurisdiction D DME MAC. The top reasons for denial included: requested documen- tation not provided within the allotted timeframe; no proof of medical necessity; no beneficiary evidence of exhaustion submitted for refills; and no proof of de- livery or invalid proof of delivery. AABCP ups legislative efforts, forms coalition HOUSTON – The American Association of Breast Care Professionals has tapped the lobbying firm of McGuireWoods Consult- ing to boost the efforts of a new breast care coalition. The coalition will work to get H.R. 2233 and S. 1217, The Breast Cancer Patient Equity Act, passed. The bills would require Medicare to pay for custom breast forms. Short takes American Diabetes Wholesale in Janu- ary donated $5,000 worth of diabetes test- ing supplies in support of the "National Diabetes Mall Testing Tour." Celebrity chef Charles Mattocks planned to tour the coun- try to offer free diabetes screening and blood pressure monitoring…Aggressive Medical celebrated the grand opening of its new location in January. The Alexandria, La.-based provider offers CPAP, mastec- tomy products and infusion pumps…The global sleep apnea diagnostic systems mar- ket was valued at $205.6 million in 2010 and it's expected to grow at a compound annual growth rate of 4.7% to reach $284 million in 2017, GlobalData reported in January. This growth will be driven by the home sleep testing market. THE RIPPLE EFFECT The Diabetic Shoppe's success—or failure— affects local community Study finds that for every $1 generated by the provider, 27 cents is added to local economy BY THERESA FLAHERTY, Managing Editor CHARLESTON, Miss. – Through a combination of luck and persistence, provider Robert Salmon has "grown a nice" diabetes supply business in rural Tallahatchie County, Mississippi. But it's more than just a nice business, he's learned. It turns out that his company, The Diabetic Shoppe, has a large impact on the local economy, according to a recent econom- ic impact study by Mississippi State Univer- sity graduate students. The study found that for every dollar generated by the provider, it adds an additional 27 cents, or $2.1 million annually, to the local economy. It also gener- ates local and state tax revenues of $576,339. "We were really surprised that a company the size of ours can have such an impact on the community," said Salmon, president and Stark: Auditors dip toes into home infusion BY THERESA FLAHERTY, Managing Editor of audits rise. "As the auditors are getting their toes in the water, they are adding more to the list," said Andrea Stark, a reimbursement consul- tant for MiraVista, a billing and consulting firm in Columbia, S.C. A Andrea Stark Stark will give a pre- sentation at the National Home Infusion Associa- tion's annual conference, held April 23-26, called, "Medicare Reimbursement Audits: Understanding the Types, Trends and How to Prepare." What's on the audit radar? Lots, says Stark. The Office of Inspector General has its eye on pricing for enteral and parenteral nutrition, while some Recovery Audit Contractors have set their sights on additives and premix solu- tions. Other product categories include STARK SEE PAGE 26 S AUDITORS wade into home infu- sion documentation, providers can expect to see the scope and volume PROVIDERS mingle at the start of last year's home infusion confer- ence in Orlando, Fla. NHIA's 'transcendental' event BY THERESA FLAHERTY, Managing Editor ALEXANDRIA, Va. – It's been two years since the healthcare reform bill became law, but home infusion providers, like most providers, remain uncertain what the future holds. To that end, the National Home Infu- sion Association (NHIA) has built its annual conference around the theme of "Transcending Uncertainty." The event takes place April 23-26 in Phoenix. "Health care is a moving target as far as what the shape of it will look like in the future," said Nancy Kramer, vice president of clinical affairs for NHIA. "The idea is to bring our industry together to network and collaborate on what that future should look like and how we can shape it." New approaches to managing care, like accountable care organizations, and an increasingly hostile reimbursement environment mean that providers need to speak out—or get left behind. "There's really a call to do more with less," said Steve Jurich, vice president of operations and chief operating officer for NHIA. "We want to get out ahead of and engage key stakeholders, including the government and including payers, so that we can find the best possible approaches to deliver quality care." NHIA SEE PAGE 27 founder of the Charleston-based company. The study also highlights the impact the provider has on jobs in the region. The Dia- betic Shoppe, the third largest employer in this county of about 15,000, has 60 employ- ees. Another 85 jobs are dependent on the provider by way of those who sup- ply directly to the provider and those who supply to its suppliers. "If we reduced (our workforce) by 10, then there's another 24, more or less, that would ultimately Robert Salmon be laid off," said Salmon. "(For instance) we have a printer. They are almost in business just because we are. We are not their only customer, but without us, they probably wouldn't exist for very long." In addition to diabetes testing supplies, The Diabetic Shoppe does therapeutic shoes RIPPLE SEE PAGE 27 Story casts poor light on sleep testing, say providers BY THERESA FLAHERTY, Managing Editor YARMOUTH, Maine –When National Public Radio in January ran a story about the booming sleep apnea business, it caught the ear—and ire—of CPAP providers. That's because the four-minute story focused on the increasing costs to the healthcare system associated with testing for sleep apnea, using phrases like "lucra- tive" and "wildly over-prescribed." Lost, say providers, was the benefit associated with getting people tested and treated. "I think the tone of it was, there's abuse, and there certainly is abuse, but I think they failed to make the case that there's appropriate use of therapy," said Scott Lloyd, president of Extrakare in Norcross, Ga. "This made it sound like there's a bunch of crooks running around between the doctors and the equipment guys." Although figures for private insur- ers were not cited, the story did say that Medicare payments for sleep STORY SEE PAGE 26