In that area, the company also unveiled its prototype for a transportable oxygen concentrator that breaks the gap between a small pulse dose-only portable concentrator and a stationary concentrator. Invacare’s lightweight “TPOC” is slated for launch in early 2009.

OAMES Battles Medicaid 'Value Purchasing'
COLUMBUS, Ohio--Medicare competitive bidding is on hold nationally, but a similar Medicaid program called “value purchasing” is on the table in Ohio, and members of the Ohio Association of Medical Equipment Services are prepared for a fight.

Last week, OAMES Executive Director Kam Yuricich testified at a public hearing on the matter before the Ohio Department of Job & Family Services. Yuricich told officials the restrictive nature of value purchasing for incontinence supplies would create "inefficiencies and breakdowns in the continuity of care and the myriad of health care professionals serving Medicaid customers.”

Yuricich pointed to flaws in Medicare's national competitive bidding program and its recent delay by Congress. Ironically, she noted, the day after the House of Representatives voted to stop competitive bidding was the day the ODJFS filed rules to proceed with value purchasing in the state.

“ODJFS has frequently pointed to the Medicare program as one of the motives for implementing selective contracting in Ohio. They've reported that 'Ohio received an affirmative response to its selective contracting Request for Proposal (RFP) for incontinence garments from CMS on Nov. 2, 2007.' In light of CMS' own failure to launch its program successfully, having the federal agency's approval offers no reassurance that Ohio should move forward. In fact, for Ohio Medicaid to proceed with these rules and implement a contracting program when CMS' national model was just halted by Congress is irresponsible and completely unfair to our state's Medicaid beneficiaries,” Yuricich said.

Yuricich said that while value purchasing currently only affects incontinence supplies, OAMES is sure that additional DME will be added to the program.

“While today's proposed rule change only affects incontinence supplies, we expect ODJFS will proceed with other medical products as indicated by the blanket selective contracting rule earlier this year. Thus, we wholeheartedly believe that the careful coordination of a patient's care by HME providers today will unravel as more products are subject to competitive bidding and more providers are eliminated by value purchasing,” she said.

In 2005, a commission charged with drafting recommendations to reform Ohio's ailing Medicaid program recommended that the state implement selective contracting for DME. But according to OAMES, Medicaid programs in Pennsylvania, Idaho and Minnesota have all abandoned efforts to implement such contracting for DME products.

If Ohio chooses to go forward with its program, Yuricich said, the state could see disastrous results. Instead, she asked the ODJFS to pursue "true reform.”

“True reform can be achieved in an objective exercise between the industry and ODJFS without dismantling the HME community by auctioning selected health care services in a move that threatens Ohio jobs, disrupts continuity of care and wipes out personal and professional relationships between patients and health care providers in their local communities,” she said.

“If home-based DME services are reviewed in isolation to other Medicaid benefits, unintended consequences such as increases in medical transportation or emergency room visits or poorer health outcomes caused by decreasing patient compliance or delays in timely hospital discharges, are likely to occur. This is not 'reform' but simply reducing costs in one benefit by shifting it to another. We call it the 'silo effect' and it is a dangerous, short-sighted logic for developing public policy.”

Yuricich told the ODJFS that if the state decides to proceed with implementation of a selective contracting program, OAMES will prepare "to make a case to invalidate the rule ... We firmly believe a government-run contracting scheme is not in the best interest of the Medicaid program and its beneficiaries, the taxpayers, health care professionals nor Ohio’s small business community."

OAMES reported that after the Aug. 12 hearing, ODJFS changed the Medicaid incontinence supplies rule to 'To Be Refiled' status.

While this is a positive development, it does not mean the program has been removed permanently, OAMES cautioned. The organization said it would continue to fight the value purchasing program for Ohio Medicaid and “will reach out to ODJFS officials and request a meeting to openly discuss options to help the department achieve its objectives without the implementation of a controversial and anti-competitive contracting program.”

Written testimony was also submitted by the American Association for Homecare, The MED Group, the Ohio Pharmacists Association, the Ohio Provider Resource Association and the United Ostomy Associations of America.

To view OAMES' full presentation at the hearing, click here.

CMS officials said that would be possible. The next Open Door call is scheduled Sept. 17.

Medicare Begins Pilot Program for PHRs
BALTIMORE--In January, Medicare patients in Arizona and Utah will test a new CMS pilot program that allows them to maintain their health records electronically, CMS announced Aug. 8.

Under the pilot, a beneficiary may choose one of the personal health record, or PHR, vendors CMS selects, and Medicare will transfer up to two years of the individual's claims data into the PHR.

A PHR is a record of health information under control of the patient, so beneficiaries can also add other personal health information of their choosing. (An electronic health record, or EHR, is owned and controlled by a physician.)

According to CMS, PHRs can offer tools that help consumers manage their health, such as wellness programs for tracking diet and exercise, medical devices, health education information and applications to detect potential medication interactions.

Depending on the specific product, beneficiaries may be able to authorize links to other personal electronic information such as pharmacy data. The pilot would also allow family members and health care providers access to the beneficiary's PHR.

According to CMS Acting Administrator Kerry Weems, "This pilot is designed to evaluate how well PHRs meet the needs of our beneficiaries and whether PHRs can improve health outcomes and lower costs."

CMS launched a similar program in South Carolina in April (see HomeCare Monday, May 8).

For more information on the program, visit http://www.NoridianMedicare.com/phr/.

HME Company Newswire
HME Company Newswire
Arcadia Announces First Quarter Results
INDIANAPOLIS--Arcadia Resources reported net revenues of $37.4 million for the quarter ended June 30, 2008, down slightly from net revenues of $38.0 million for the same period a year ago. Sales in the company's HME segment, which includes home health equipment, Internet home health product sales and DME, increased to $5.5 million in the quarter versus $5.3 million for the same period a year ago.

In 2007, Arcadia--which had made more than 20 DME acquisitions and opened stores inside Sears and Wal-Mart--sold most of its DME locations and restructured operations. The company currently has 92 locations in 22 states providing home health care/medical staffing, DME and specialty pharmacy services including its DailyMed program, which organizes a patient's meds into pre-sorted packets marked with the date and time they should be taken.

Cardinal Considers Spin Off of Medical Products Biz
DUBLIN, Ohio--Cardinal Health reported an increase in fiscal 2008 revenue of 5 percent to $91 billion, and a fourth quarter increase of 3 percent to $23 billion. As forecasted, the company said its medical supply chain segment improved profit in the second half of the year, driven by double-digit growth in its core U.S. medical distribution business. Cardinal also said it is considering a spin-off of its clinical and medical product units into a publicly traded firm, and plans to announce its decision within 60 to 90 days.

Pride Attendees Gain CEUs, Get Look at Manufacturing, R&D
EXETER, Pa.--Last month, more than 160 providers attended a two-day seminar during a stop in Wilkes-Barre, Pa., part of Pride Mobility Products' 28-city national Seminar Tour. The July 15-16 seminar offered seven CEU courses, including “Advanced Wheelchair Electronics,” “Medicare Funding for PMD,” “RESNA Credentialing Preparation” and “Wheelchair Seating and Positioning,” among others. Attendees also got the opportunity to view the company's Duryea manufacturing facility as well as Pride's research and development and product testing departments.

“Pride stands behind our commitment to the end-user by investing in this Seminar Tour, the most comprehensive in the industry, as a means of enabling providers across the country to easily access the educational courses needed to maintain their RESNA-required certifications, and, equally important, knowledgeably recommend the most suitable products to accommodate the end-users' mobility and pressure-management needs,” Ted Raquet, the company's vice president of domestic sales, said in a release.

The seminar also included an update on competitive bidding by Seth Johnson, vice president of government affairs, and an address by Bryan Anderson, a decorated Iraq war veteran and Quantum Rehab spokesperson. Additional stops on Pride's Seminar Tour during 2008 include Greensboro, N.C., Sept. 18; Nashville, Tenn., Sept. 23; and, Atlanta, Oct. 24.

Record Results at ResMed
POWAY, Calif.--ResMed announced revenue for the quarter ended June 30, 2008, was a record $235.2 million, a 23 percent increase over the quarter ended June 30, 2007, despite a $3.1 million charge related to a an April 2007 voluntary recall of a previous series of S8 flow generators. For the year ended June 30, revenue was a record $835.4 million, an increase of 17 percent over $716.3 million for the previous year.

"Our industry received positive signals that it is poised for continued growth,” Kieran T. Gallahue, CEO, said in a statement. “Home sleep testing took another step forward as both national and local Medicare rulings were released and private insurers, such as the country's largest insurer, Anthem, issued updated coverage policies. Medicare competitive bidding implementation was delayed 18-24 months, a positive signal for the home medical equipment industry. Lastly, the International Diabetes Federation published an important consensus statement on sleep apnea and diabetes. The diabetes community now has an official recommendation to screen all type 2 diabetes patients suspected of sleep apnea. ResMed is well positioned to deliver strong growth in fiscal year 2009."

Roho Launches eLearning
BELLEVILLE, Ill.--The Roho Group has launched its Roho Institute for Continuing Education and Research eLearning program, which offers CEUs online. Previously, the Institute offered traditional on-site CEU programs only. “With the addition of online CEU programs, we now can offer a wider range of courses and immediate service for our clients,” Institute Director Darren Hammond said in a release. “Clients will no longer have to wait for a program to come to their area; they can complete their continuing education requirements on their time, even in their pajamas if they like.”

In Brief
VGM Names New COO; Florida Providers Prepare for Fay
VGM Group has appointed James L. Phillips COO effective Aug 29. He will report to CEO Van G. Miller. “Jim Phillips is well known to VGM. He started our leasing company in 1991, and I have great confidence in his ability to work well with all VGM divisions, and I and the other 400-plus VGM associates look forward to his assuming his new role,” said Miller. Phillips, 54, started work for VGM Leasing and grew the company until it was acquired by TCF, a large Minnesota-based banking and finance company. The TCF-owned medical equipment finance operations are still based at VGM headquarters in Waterloo, Iowa, and will remain there. Prior to VGM, Phillips worked at Chase Manhattan Leasing and Lease America Corp.

According to an emergency message from the Accredited Medical Equipment Providers of America, all oxygen providers in Florida should document requests for additional oxygen tanks and other oxygen systems in preparation for Tropical Storm Fay. Florida Gov. Charlie Crist declared a state of emergency Saturday as the storm continued its path toward the state. According to weather advisories, Fay could hit the Florida Keys and South Florida late Monday or early Tuesday as a strong tropical storm or a Category 1 hurricane. State officials issued a mandatory evacuation for Keys visitors starting at 8 a.m. Sunday and asked those who had not yet arrived to postpone their trips. AMEPA said South Florida oxygen providers had already begun receiving calls for additional oxygen tanks on Friday. According to President Rob Brant, after expiration of the 36-month oxygen cap, providers will not be required to provide additional tanks and may only be paid to fill the patient's existing tanks. During this tropical storm warning, Brant said, oxygen patients requesting additional tanks should be told about the change so they can contact their legislators now to make sure they will have access to oxygen during emergencies. "Every patient requesting additional oxygen systems in preparation for the storm should be documented," Brant said.

An assistant Los Angeles County district attorney has devised a program using the Internet and California tax law to track down and prosecute medical providers and others who have defrauded Medi-Cal, Medicare and other health insurers of millions of dollars, according to press reports. Begun in 2006, the Fraud Interdiction Program has identified more than 200 suspects who have made at least $300 million in bogus health, automobile and workers' compensation claims. In short, the program uses a network that includes thousands of insurance companies, self-insured entities, associations, Medi-Cal and Medicare offices to collect the gross amount paid to the suspect by each payer over the past six years, the statute of limitations under California tax law. The information is sent to California's Franchise Tax Board for criminal investigation. Assistant District Attorney Albert H. MacKenzie told media he is working with CMS in California on what he has dubbed "The 50 Crook Project," which has identified some 50 doctors to whom the Medicare program has paid $122 million in false claims in less than three years. Targets of the tax fraud/health care prosecutions have been sentenced to prison terms of up to 15 years and ordered to pay restitution of more than $20 million, he said.

Fifteen percent of home health agencies have been cited for the same deficiencies on three consecutive state surveys, indicating cyclical problems for some providers and a need for improved oversight, according to an HHS Office of Inspector General report released Aug. 7. In the report, “Deficiency History and Recertification of Medicare Home Health Agencies,” the OIG noted HHAs with repeat citations were concentrated in high population areas in six states--California, Florida, Illinois, Iowa, Michigan, and Texas. OIG said CMS could improve its oversight of HHAs and pointed out CMS has no sanction options, other than termination, for agencies with one or more condition-level deficiencies. Home health agencies must comply with 15 conditions of participation and 69 standards to participate in the Medicare program. In a response, CMS generally agreed with the recommendations. The report is available at http://oig.hhs.gov/oei/reports/oei-09-06-00040.pdf.

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