WASHINGTON – NCART has submitted a HCPCS coding application to formally appeal CMS’s decision to only increase the fee schedule for seat elevation systems by about $13 to $2,013.96. “While we appreciate CMS’s willingness to listen to our concerns and review the follow-up information we provided, they indicated it could not be considered, since it was not part of the public meeting process last year,” said Wayne Grau, executive director of NCART. “In addition, we will highlight the problems using Internet pricing, which does not reflect the additional significant costs to comply with Medicare requirements compared to that retail model.” Previously in March, CMS established a new code, E2298, for seat elevation systems and set reimbursement to about $2,000 effective April 1. On an interim basis prior to April 1, CMS was paying about $2,800, on average, for seat elevation systems.

WASHINGTON – CMS will require prior authorization for all power mobility devices being replaced within the five-year useful lifetime effective June 2, NCART reports. Providers should submit prior authorizations as an expedited request and the agency will process them within two business days. For wheelchairs being replaced due to loss, theft or irreparable damage, the following should be included with the request: information and/or detailed reports that explain the reason leading to the need for replacement, such as policy report when the PMD is lost or stolen; and a physician’s written order prior to delivery (WOPD) for the new replacement items. If CMS affirmed the original prior authorization, the DME MACs will not review for medical necessity. Once the request is affirmed, providers should submit the claim with the RA modifier. For wheelchairs being replaced due to change in medical need or reasonable useful lifetime met, the following should be included with the request: a new face-to-face evaluation, WOPD and documentation from the medical record that supports the need for the item and documentation to support the change in condition, if applicable.

CLEARWATER, Fla. – REMSleep Holdings has been awarded 510(K) clearance from the U.S. Food and Drug Administration for its new Deltawave CPAP Pillows Interface mask. With the clearance, the company has begun preparing the Deltawave for market by updating its website and ordering a large inventory. REMSleep has also announced a strategic marketing plan for Deltawave that includes identifying key distributors, providing comprehensive training to those distributors, expanding its reach, and launching marketing and awareness campaigns. "We are incredibly excited about the future of REMSleep  and the tremendous potential of Deltawave,” said CEO Tom Wood. “Our journey ahead is filled with immense opportunities, but we recognize that it will require both strength and patience to achieve our corporate goals. We are committed to identifying and collaborating with the best distributors to ensure that Deltawave reaches those who need it most. Our team is dedicated to advancing our technology, expanding our market presence, and ultimately improving the lives of countless individuals affected by sleep apnea.” Deltawave’s features include the ability to support normal breath rate and a reduction in the need (or no need) for humidification. 

ALEXANDRIA, Va. – The American Orthotic and Prosthetic Association (AOPA) has announced the recipients of the 2024 Howard R. Thranhardt Award are Andreas Kannenberg, MD (GER), PhD, Shane Wurdeman, PhD, CP, FAAOP (D), Tyler Klenow, MSPO, MBA, CPO, FAAOP, and Russell Lundstrom, MS. The award, established in 1996 through a gift from J.E. Hanger in memory of Howard R. Thranhardt, CP, has become one of the most distinguished honors in the orthotics and prosthetics profession, annually recognizing the strength in clinical research. “Their work will contribute to the profession’s clinical base, helping to improve and further the care provided to the individuals we are privileged to serve,” said Mitchell Dobson, CPO, FAAOP, president, AOPA.  “Their presentations are just two of the informative and exciting educational sessions you will experience at this year’s National Assembly. We look forward to congratulating and honoring them for these accomplishments.” The award and presentations will be given Sept. 14 in conjunction with the 2024 National Assembly in Charlotte, N.C. Kannenberg and Wurdeman will present “Assessing Outcomes with Microprocessor Knee Utilization in a K2 Population (ASCENT K2): Findings from a Clinical Trial of 107 Individuals with Above-knee Amputation.” Klenow and Lundstrom will present “Reduction in Falls and Fall-Risk with Increased Walking Speed Found Following 1 Year of C-Brace Use: Interim Results from the C-Brace Registry.”

TROY, Mich. – AmeriCare Medical has received recognition from thestate of Michiganfor its exceptional work in home care. Leaders from thestate'sHouse of Representatives delivered a tribute that honored and commended AmeriCare Medical's team of registered nurses and their commitment to excellence in health care. "At AmeriCare Medical, our nurses are the heart and soul of our organization," saidGreg Jamian, president and CEO. "They embody the values of compassion, integrity and expertise, delivering personalized care that enhances the quality of life for our patients every day." For more than four decades, AmeriCare Medical has provided the gold standard in home care, employing a team of more than 250 health care professionals who serve across hospitals, government facilities and private residences statewide.

FRISCO, Texas – Soleo Health has been named a limited distribution specialty pharmacy partner for GC Biopharma USA, Inc. to dispense ALYGLO (Immune Globulin Intravenous, Human-stwk) 10% Liquid for adults with primary humoral immunodeficiency (PI). "Our partnership with GC Biopharma underscores our shared commitment to enhancing patient care and showcases Soleo Health's unparalleled expertise in managing patients with complex conditions,” said Drew Walk, CEO. “We are honored to be chosen as a partner for ALYGLO, highlighting our ability to provide individualized patient services across various care settings.” Soleo Health has deep clinical knowledge and experience in the provision of immunoglobulin (IG) services and its ability to collect real-world evidence clinical outcomes through SoleMetrics, its proprietary clinical outcomes program.  HME News recently interviewed Walk and Craig Vollmer about Soleo Health’s map for the future. 

RICHMOND, B.C. – HME Home Health has received the CAOT Seal of Recognition for its award-winning HME Signature Series Dove Mattress. “Since the 2023 launch, the HME Signature Series Dove Mattress has won multiple awards, including the BC Care Providers Safety Product Innovation Award, and now we are thrilled to have received the CAOT Seal of Recognition,” said Robert Boscacci, co-founder and CEO. “The HME Dove is now the leading low air-loss mattress in B.C. and is leading the market in safety and innovation.” HME Home Health offers a wide range of mobility and accessibility devices and medical equipment, including wheelchairs, walkers, hospital beds, lifts, ramps and other installed products. Read about why HME Home Health began making products in response to supply chain disruptions.

NEW YORK & CORAL SPRINGS, Fla. – Sumitomo Corp. has made an investment in Vast Medical Holdings, the parent company of Quest Health Solutions, a provider of continuous glucose monitors and other diabetes supplies. Quest Health, through its sister companies Quest Health Remote Care and Quest Health RPM Services, integrates CGM data with clinical support such as patient education, meal planning and exercise guidance to improve health outcomes. “The confidence shown by Sumitomo, and its alignment with our vision for the industry, adds tremendous momentum to our growth plans,” said Adam Nadler, CEO and co-founder of Quest. “Finding a partner who believes in our model was critical to our priorities and our quest for continued improvement in patient care. The transaction marks Sumitomo’s entry into the U.S. health care market and expands its network of health insurers and medical institutions. “We have found an ideal partner to mark our entry into the U.S. health care market,” said Jeremy Yap, general manager of the Healthcare Group and Business Development Group at Sumitomo. “The scope of Quest Health Solutions operations aligns well with our business strategy and supports our focus on improving health outcomes and providing greater access to health care resources.” Adam Nadler is also co-founder and CEO of CompliantRx, an AI/ML-powered platform that automates medical record review for HME providers by identifying the necessary coverage criteria and highlighting any missing information.

MODESTO, Calif. – Home Oxygen Company’s recent acquisition of the DME division of a local hospice provider will boost its patient census in California’s Central Valley and position it to grow into 2025, says CEO Andrea Ewert. Home Oxygen Company in June announced it had finalized a deal to acquire the DME business from Modesto, Calif.-based Community Hospice & Health Services, a company that it already had a good working relationship with, says Ewert. “We supported Community Hospice & Health Services with patient equipment outside of their normal service area,” she said. “We also worked with them during times of equipment or staffing shortages.” Home Oxygen Company started in 2007 as a home oxygen provider, before expanding into sleep apnea therapy equipment and supplies, and nebulizers. As part of the deal, it now provides Homefill systems, POCs, Group 1 pressure relieving mattresses and a “robust educational support system” to patients of Community Hospice & Health Services, says Ewert. The company has also moved its warehouse to a larger, 10,000-square-foot facility to accommodate the purchase and serve as a regional distribution enter for its warehouses in Sacramento and the San Francisco Bay area, she says. “Our new warehouse allowed our acquisition of Community Hospice & Health Services distribution center products and personnel, which also allows Home Oxygen Company to support our distribution centers in the San Francisco Bay Area & Sacramento,” she said. “We also use this space for storing and shipping soft goods as we handle resupply shipping in-house.”  

PHILADELPHIA – Dynamic Healthcare Services and Hometown Oxygen Pittsburgh on July 15 filed a lawsuit against Philips Respironics, DeLage Landen Financial Services and Philips Medical Capital for cutting off access to financing and leasing programs that the providers say are necessary for them to compete. According to the lawsuit, filed in the U.S. District Court for the Eastern District of Pennsylvania: Prior to the Philips recall, DHS purchased thousands of respiratory devices from Respironics, financing those purchases through PMC. After the recall, however, the company was unable to monetize its inventory of recalled devices and, therefore, unable to make payments to PMC. In August of 2022, PMC declared DHS in default. Respironics and PMC then shared this confidential, commercial information with DLL, which informed ResMed and HOP that it would no longer do business with HOP until DHS paid PMC for the recalled devices DHS had purchased from Respironics. "Defendants are engaged in an ongoing conspiracy, in violation of Section 1 of the Sherman Act, to cut off access to financing and leasing programs necessary for respiratory device suppliers in the U.S. to compete,” the lawsuit states. “DLL and PMC used their affiliation, market power and exclusivity agreements with respiratory device manufacturers to offer 0% interest financing. Defendants then shared commercially sensitive information about their customers as part of an anticompetitive scheme to foreclose competition from other lenders and respiratory device manufacturers and raise prices for patients in the U.S.” DLL is the leading financier of respiratory devices in the U.S., holding about 30% market share, according to the lawsuit, and PMC is a joint venture between DLL and Philips North America and is the exclusive financier of devices manufactured by Respironics. DHS and HOP seek to recover all damages and obtain injunctive relief available under federal antitrust law. Access Infusion buys Big Sky I.V. Care CHICAGO – Access Infusion Care, a portfolio company of Chicago-based New Harbor Capital, has completed its acquisition of Big Sky I.V. Care, a provider of home and specialty infusion services in Kalispell, Mont. This marks Access Infusion Care’s first add-on deal as part of New Harbor and is a key part of its broader strategy to partner with high-quality infusion providers in underserved areas with diversified therapy offerings and delivery settings, and outsized growth potential. “We are excited to add another high-quality infusion business to the Access family,” said Bo Mlnarik, principal at New Harbor Capital. “The combined resources, culture and experience of the teams, as well as the added scale, diversification and growth avenues make this a great fit for our infusion strategy.” Big Sky offers a wide range of infusion therapies, including specialty medications, antibiotics and total parental nutrition for chronically ill patients in their homes and at infusion sites. Founded in 2005 in Kalispell, Mont., by Julie Lyon, BSN, and Dave Grady, BA, Big Sky I.V. Care operates a 503A compounding pharmacy and a state-of-the-art ambulatory infusion center facility with a dedicated team of more than 15 professionals, including pharmacists, technicians and nurses. It is accredited by ACHC for home infusion therapy and features USP and USP compliant clean rooms for sterile compounding.  “We are thrilled to announce our new partnership with the Big Sky I.V. Care team,” said Bruce Kutinsky, CEO of Access Infusion Care. “Julie and Dave have built an impressive and innovative business with a diverse array of service offerings and world-class facilities. This acquisition is a significant step forward in fulfilling our vision of bridging the access gap in healthcare. By improving access to specialized infusion therapies in underserved markets, we are making a tangible difference in the lives of patients who need these services the most.  We are excited about the future and the potential to transform the infusion care landscape through this strategic partnership with Big Sky I.V. Care.” Access Infusion Care was formed in January 2024 through the acquisition of AIC North and JLS Infusion Nurse Staffing Services. New survey: Denials tops list of challenges CHARLOTTE – The No. 1 billing and revenue cycle management challenge for HME providers is preventing or reducing denials and appeals, according to the results of a new survey sponsored by Prochant and conducted by in90. The No. 2 challenge: Hiring, training and retaining qualified intake, billing and collections staff. “In response to these challenges, 60% of respondents have outsourced at least one RCM function in the past year, with over 70% attributing this decision to resource limitations and cost concerns,” Prochant stated in a press release. “The difficulty in managing RCM effectively, coupled with the high cost and scarcity of local talent, drives many to seek external expertise. For those that have chosen to outsource, about 50% of respondents reported that they were likely to outsource payment posting, claims scrubbing and denials and appeals. For those choosing an outsourcing partner, respondents value revenue capture and real-time performance tracking/visibility.” To conduct the survey, in90, an independent third-party consulting firm, interviewed 100 HME executives directly involved in RCM. Forty percent were CEOs or owners. The survey also found that more than 80% of respondents reported dissatisfaction with their current RCM approach, citing accounts receivable over 90 days overdue and excessive write-offs due to billing errors and complexities. Check out the full report here. MediWound raises $25M YAVNE, Israel – MediWound has entered into a definitive purchase agreement with several new and existing investors, including Mölnlycke Health Care, a medtech company specializing in solutions for wound care and surgical procedures. MediWound plans to use the $25 million in gross proceeds from the private investment in public equity (PIPE) to advance EscharEx pre-commercial activities and support general corporate purposes. “We are proud to have the strong support of Mölnlycke, and of our new and existing investors in this financing,” said Ofer Gonen, CEO of MediWound. “This significant investment will enable us to further strengthen our strategic plans for EscharEx, creating substantial long-term value for our stakeholders and help improve the standard of care for patients.” Concurrently with the PIPE offering, Mölnlycke will be granted specific rights, including a representative to attend meetings of the company's R&D Committee, and will be able to participate in potential strategic partnership discussions and M&A processes under certain circumstances. Mölnlycke's ownership, however, will be limited to no more than 9.99% of the company's issued and outstanding ordinary shares. MediWound says it has developed a strong R&D pipeline, including the company’s lead drug under development, EscharEx, a Phase III-ready biologic for the debridement of chronic wounds that offers significant potential advantages and an opportunity to expand the market. New bill expands coverage for monitors, supplies in Illinois SPRINGFIELD, Ill. - A bill sponsored by Democratic State Sen. Julie Morrison to expand insurance coverage for medically necessary glucose monitors and related supplies was signed into law on July 1. “High costs that come with managing diabetes can put an unnecessary economic burden on families,” said Morrison, Majority Caucus Whip. “This law will ensure people with any type of diabetes receive crucial medical care.” Senate Bill 3414 requires insurance companies to cover glucose monitors, related supplies and training for individuals diagnosed with any form of diabetes. Previous law required coverage for individuals with Type 1 and Type 2 diabetes. Additionally, individuals who obtain a prior authorization for a CGM prescription will have cost-sharing waived on a one-month's supply of CGMs and a transmitter, if needed. VGM names Dan Bunting as senior advisor WATERLOO, Iowa – VGM Group has announced that Dan Bunting, who was most recently COO and strategic advisor to the CEO of AdaptHealth, has joined its team as a senior advisor. In this role, Bunting will help VGM develop long-term strategies to promote and support its customers and the HME industry. “I don’t think there’s anyone in the United States who knows more about our industry than Dan,” said VGM Group CEO Jeremy Stolz. “The health care industry, and HME in particular, is constantly evolving. And I am thrilled to have Dan’s experience and expertise with us as we continue to shape the future of VGM and the industries we serve.” In all, Bunting’s career spans 40 years, with experience in nearly every aspect of HME, including product development and manufacturing. Born and raised in Manchester, Iowa, less than an hour east of VGM’s headquarters, Bunting has been close to VGM throughout his life and career. He first met Van Miller, VGM’s founder, while attending the University of Iowa. At that time, Miller had an HME business where Bunting worked for two years while getting his degree. Later, when Bunting set out to start his own HME business in Iowa City, Miller and a few of his friends helped finance it. Bunting’s HME business, which sold to Rotech in 1996, was one of VGM’s earliest members. “I have dedicated my entire career to helping advance the HME industry, and I’m honored to continue that work with VGM,” Bunting said. “VGM, in many ways, feels like a return home for me. I am excited to do my part to help VGM in its mission to make a difference—both in the industry and in the communities it calls home.” DME Service Solutions partners with NAHC WASHINGTON – DME Service Solutions, a provider of B2B outsourcing solutions specializing in health care, has partnered with the National Association for Home Care & Hospice to connect with a network of professionals focused on effective home care solutions. "We are honored to collaborate with NAHC, whose dedication to providing affordable care aligns with our mission at DME Service Solutions,” said Ryan Holbrook, president of DME Service Solutions. “We look forward to working alongside NAHC and its members to make a meaningful difference in the lives of those we serve." DME Service Solutions offers HIPAA-compliant workforce solutions, including document management, revenue cycle management, multichannel customer engagement and tech support. The NAHC represents the interests of more than 35,000 home care and hospice organizations, their 2 million nurses, aides and therapists, and the 14 million patients they serve annually. CMS announces flexibilities in Texas WASHINGTON – CMS on July 12 announced that additional resources and flexibilities are available in response to Hurricane Beryl in Texas. President Biden on July 12 determined an emergency in the state beginning on July 5, and HHS Secretary Xavier Becerra on July 12 determined a public health emergency in the state beginning July 5. The agency says it will permit Medicare beneficiaries who have lost or realized damage to their DMEPOS as a result of the hurricane to receive replacements for such items and services to ensure beneficiaries can continue to access what they need. “CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by consequences of the hurricane,” the agency stated. CMS will also provide waivers, make available special enrollment periods for the Federal Health Insurance Exchange, activate the Kidney Community Emergency Response program and take other measures. FMI, go here. 

HME stakeholders have been fighting Medicare Advantage for some time, particularly when it comes to these plans not following Medicare policy and coverage for complex rehab technology and non-invasive ventilators, two product categories for patients with the greatest needs. At the Heartland Conference in June, there was even a panel discussion titled “Dealing with Medicare DISadvantage Plans - Are You Ready, Martha?”Stakeholders continue to take it up a notch. AAHomecare announced in July, for example, that it has engaged Dobson Davanzo & Associates to conduct a study quantifying the differences in outcomes and overall treatment costs for patients with significant respiratory challenges who receive NIV therapy vs. those who don’t. Their rationale, I’m guessing: If they can show that NIV improves outcomes and reduces costs, it’ll be another two nails in the coffin of MA plans that deny claims for this therapy without good reason – some to the tune of 86 out of every 100 times. As is often the case for the HME industry, which represents less than 2% of overall Medicare spending, it’s a David vs. Goliath situation, with the companies behind most of these MA plans the biggest names in health care. UnitedHealthcare and Humana, which had the most Medicare Advantage enrollees in 2023, have large footprints across the country, offering plans in most counties, according to the Kaiser Family Foundation. UnitedHealthcare is offering plans in 87% of counties and Humana is offering plans in 90% of counties in 2024, roughly the same as in 2023, KFF reports. But week by week, it seems, the HME industry, as well as the National Community Pharmacists Association, is getting more company in trying to keep these Goliaths in check. The Federal Trade Commission published an interim report in July that details how increasing vertical integration and concentration has enabled the six largest pharmacy benefit managers (PBMs) – Humana among them – to manage nearly 95% of all prescriptions filled in the United States. The NCPA called the report “scathing.” The Department of Justice announced in May that it had formed a Task Force on Health Care Monopolies and Collusion (HCMC) within its Antitrust Division to guide its enforcement strategy and policy approach, including by facilitating advocacy, investigations and, where warranted, civil and criminal enforcement in health care markets.Health care attorney Jeff Baird says the task force has the potential to rein in the PBMs that are having a significant negative impact on independent pharmacies and could help prevent a similar scenario cropping up in the HME industry (See story page 2). Additionally, at press time in July, the Wall Street Journal published an investigation of MA claims that showed big insurers have pocketed $50 billion from Medicare for diseases that no doctor treated. Call me anxious, but that’s the kind of attention that I think would make even UnitedHealthcare and Humana  nervous.

PHILADELPHIA – Dynamic Healthcare Services and Hometown Oxygen Pittsburgh on July 15 filed a lawsuit against Philips Respironics, DeLage Landen Financial Services and Philips Medical Capital for cutting off access to financing and leasing programs that the providers say are necessary for them to compete. According to the lawsuit, filed in the U.S. District Court for the Eastern District of Pennsylvania: Prior to the Philips recall, DHS purchased thousands of respiratory devices from Respironics, financing those purchases through PMC. After the recall, however, the company was unable to monetize its inventory of recalled devices and, therefore, unable to make payments to PMC. In August of 2022, PMC declared DHS in default. Respironics and PMC then shared this confidential, commercial information with DLL, which informed ResMed and HOP that it would no longer do business with HOP until DHS paid PMC for the recalled devices DHS had purchased from Respironics. "Defendants are engaged in an ongoing conspiracy, in violation of Section 1 of the Sherman Act, to cut off access to financing and leasing programs necessary for respiratory device suppliers in the U.S. to compete,” the lawsuit states. “DLL and PMC used their affiliation, market power and exclusivity agreements with respiratory device manufacturers to offer 0% interest financing. Defendants then shared commercially sensitive information about their customers as part of an anticompetitive scheme to foreclose competition from other lenders and respiratory device manufacturers and raise prices for patients in the U.S.” DLL is the leading financier of respiratory devices in the U.S., holding about 30% market share, according to the lawsuit, and PMC is a joint venture between DLL and Philips North America and is the exclusive financier of devices manufactured by Respironics. DHS and HOP seek to recover all damages and obtain injunctive relief available under federal antitrust law. 

CHARLOTTE – The No. 1 billing and revenue cycle management challenge for HME providers is preventing or reducing denials and appeals, according to the results of a new survey sponsored by Prochant and conducted by in90. The No. 2 challenge: Hiring, training and retaining qualified intake, billing and collections staff. “In response to these challenges, 60% of respondents have outsourced at least one RCM function in the past year, with over 70% attributing this decision to resource limitations and cost concerns,” Prochant stated in a press release. “The difficulty in managing RCM effectively, coupled with the high cost and scarcity of local talent, drives many to seek external expertise. For those that have chosen to outsource, about 50% of respondents reported that they were likely to outsource payment posting, claims scrubbing and denials and appeals. For those choosing an outsourcing partner, respondents value revenue capture and real-time performance tracking/visibility.” To conduct the survey, in90, an independent third-party consulting firm, interviewed 100 HME executives directly involved in RCM. Forty percent were CEOs or owners. The survey also found that more than 80% of respondents reported dissatisfaction with their current RCM approach, citing accounts receivable over 90 days overdue and excessive write-offs due to billing errors and complexities. Check out the full report here. 

YAVNE, Israel – MediWound has entered into a definitive purchase agreement with several new and existing investors, including Mölnlycke Health Care, a medtech company specializing in solutions for wound care and surgical procedures. MediWound plans to use the $25 million in gross proceeds from the private investment in public equity (PIPE) to advance EscharEx pre-commercial activities and support general corporate purposes. “We are proud to have the strong support of Mölnlycke, and of our new and existing investors in this financing,” said Ofer Gonen, CEO of MediWound. “This significant investment will enable us to further strengthen our strategic plans for EscharEx, creating substantial long-term value for our stakeholders and help improve the standard of care for patients.” Concurrently with the PIPE offering, Mölnlycke will be granted specific rights, including a representative to attend meetings of the company's R&D Committee, and will be able to participate in potential strategic partnership discussions and M&A processes under certain circumstances. Mölnlycke's ownership, however, will be limited to no more than 9.99% of the company's issued and outstanding ordinary shares. MediWound says it has developed a strong R&D pipeline, including the company’s lead drug under development, EscharEx, a Phase III-ready biologic for the debridement of chronic wounds that offers significant potential advantages and an opportunity to expand the market. 

SPRINGFIELD, Ill. - A bill sponsored by Democratic State Sen. Julie Morrison to expand insurance coverage for medically necessary glucose monitors and related supplies was signed into law on July 1. “High costs that come with managing diabetes can put an unnecessary economic burden on families,” said Morrison, Majority Caucus Whip. “This law will ensure people with any type of diabetes receive crucial medical care.” Senate Bill 3414 requires insurance companies to cover glucose monitors, related supplies and training for individuals diagnosed with any form of diabetes. Previous law required coverage for individuals with Type 1 and Type 2 diabetes. Additionally, individuals who obtain a prior authorization for a CGM prescription will have cost-sharing waived on a one-month's supply of CGMs and a transmitter, if needed. 

FORT LAUDERDALE, Fla. - Lincoln Health Supply recently highlighted the American Diabetes Association's 60-second Diabetes Risk Test to underscore how the provider can help educate and empower consumers to manage their health. The ADA diabetes risk test is a risk score based on seven criteria that predict the risk of developing diabetes, including age, gender, family history of diabetes, blood pressure, ethnicity, physical activity and BMI and was promoted as part of Diabetes Alert Day in March. “We need to have those important conversations and support these organizations,” said Maximiliano Rojas, CFO. “Diabetes is an incurable disease—it’s not going anywhere—but, managed with proper tools, like the ones we offer, we can help the community.” Founded in January 2019 by a group of five investors, Lincoln Health Supply aims to provide a seamless experience for people with diabetes using continuous glucose monitoring (CGM) systems. It operates in five locations in Florida and served more than 71,000 patients last year. As one example of its commitment to the community, Lincoln Health Supply has partnered with local universities on educational seminars and webinars on nutrition, physical health and CGM usage.  For its part, Lincoln Health works to stay abreast of the rules and regulations of the quickly evolving diabetes market, says Rojas. “It’s a very complex field with a lot of red tape and compliance requirements,” he said. “We have our own dedicated compliance team and a compliance attorney to ensure we adhere to all the evolving regulations going on with Medicare and the industry overall.” While titans like CVS, Walgreens, Publix and Walmart offer the same products online, they don't offer the type of service that Lincoln Health offers, says Rojas.  “We really like to walk the patient through, hold their hand and explain everything to them,” he said. “A lot of people call us and give us great reviews because nowadays when you contact these big companies, they don't have anybody picking up the phone. They don't have time for that, and I think that's what’s really helping us grow.”

Tyler Mahncke estimates the demand for mobility equipment is growing at a 5%-9% annual rate, with approximately 60% paid for by public and private insurance. “There is still a strong retail component to the market, specifically for scooters and wheelchairs,” said Mahncke, president of U.S. Rehab at Waterloo, Iowa-based VGM. “People want a backup and travel device.” Functional Mobility Assessment data reveals that more than 15,000 clients use a mobility vehicle, from manual to power wheelchairs. The fastest growing conditions requiring mobility equipment are stroke and osteoarthritis, followed by spinal cord injuries, neuromuscular disorders like multiple sclerosis and amputation. With mobility clients increasingly part of the baby boom generation, John Wright, vice president of sales management and business development for Torrance, Calif.-based Shoprider, credits them with the rise in demand and retail opportunities. “I have seen a shift to retail purchasing versus (third party) reimbursement as these traditional channels have become more difficult to work through,” Wright said. “Just getting the proper documentation needed from physicians is very problematic. Often, out of frustration many users or family members are accessing these mobility products via Amazon and other internet-based sellers.” Power mobility and scooters remain in high demand, said Jeff Distasio, vice president of Duryea, Pa.-based Pride Mobility. “The makeup of the consumer remains basically unchanged, but their expectations have changed given all the new technology in the market,” Distasio said.“The ability to meet the demands of the consumer in the various environments that they want to explore is key to ensuring the consumer is satisfied.” What users want Desire equates with demand, so knowing what customers want is paramount in delivering the type of products and technologies that match the most popular preferences, sources say. “Every client is different,” Distasio said.“They have different wants, needs and expectations. Providers can position themselves favorably by taking the time to assess those needs on an individual basis.Asking the right questions and having a variety of options across the power wheelchair and scooter categories for a client to test while they are visiting is a crucial part of ensuring client satisfaction and the referrals that can come along with it.” Mahncke says technology is at the heart of what users are asking for – from power chair seat elevation to outdoor vehiclesto electronic accessories. “Power chair seat elevation is disrupting the industry because it hasn’t happened before, he said. “It offers the ability to transfer appropriately instead of just upper body, and the ability to stand and reach things on the counter.” Electronic accessories are in high demand, especially additions that revolve around charging smartphones, tablets and other personal devices, Mahncke said. The integration of carbon fiber into mobility products is making them lighter and easier to transport, spurring demand for this equipment, said A.J. Donatoni, Pride marketing and communications coordinator “More robust suspension systems and the ability to safely achieve higher speeds allow consumers to traverse a wider variety of terrain,” Donatoni said.“The proprietary EZ Turn technology in the Go Go Elite Traveller scooter gives a consumer the ability to enjoy the turning radius and maneuverability of athree-wheelunit but with the stability and control of a four-wheel unit.” A long wait Seat elevation’s arrival has been a long time coming because “third-party payers are historically very slow to recognize benefits derived from either technological or materials advances,” Wright said. “The industry has been fighting for seat elevate functions for many years because it would allow users to be far more independent in an indoor setting and yet Medicare will not approve a power chair if necessary for outdoor activities. This indicates that power chair users are then confined to indoor activities only, which is puzzling.” Even so, Wright said seat elevation “will vastly increase independence for indoor confined users – it is a huge win for them. But how many years has it taken for CMS to recognize the need?” STEADY GROWTH Rolling forward: Wheelchair and scooter growth is expected to grow at an annual rate of 5%-9%, with approximately 60% paid for by public and private insurance. There is still a strong retail component in the market, specifically for wheelchairs and scooters. TECH WISH LIST Spurring demand: Boomers are at the heart of mobility sales and they want technology to accommodate their preferences. From power chair seat elevation, to outdoor vehicles to electronic accessories, customers want elevation to give them the ability to stand and reach, navigate different terrains as well as accessories that revolve around charging smartphones, tablets and other personal devices. PATIENCE REWARDED Time has come: Seat elevation has finally arrived after a long wait. Third-party payers have been historically slow at recognizing the benefits of the advancement and the independence it grants to power chair users.

Recently, I talked to a sleep medicine specialist about the possibilities of AI-enabled technology for that patient population; the next I was talking to a diabetes company about the AI-enabled technology for those patients. I can’t open my inbox without multiple daily pitches on the latest AI technology. It’s all very heady stuff for this writer who, until recently, found my eyes glazing over every time I heard the word algorithm.  But, the more people use it, the more it’s starting to make sense. Take Dr. Anuja Bandyopadhyay, who chairs the Artificial Intelligence in Sleep Medicine Committee for the American Association of Sleep Medicine. She told me that even four or five years ago, when it came to AI’s usefulness, skepticism reigned.  No more. It’s no longer “aliens and robots,” she told me. “I think once people saw how this can be beneficial – it's helping me save time, save resources and improving access to care – then it became a natural solution to quite a few of our problems and that's how people start accepting it more,” she said. More exciting, from my point of view, is how technology empowers patients. Editor Liz spoke with Sam Rusk at EnsoData about that company’s recent partnership with Aeroflow Health (see page 1) to use its predictive tools to identify patients struggling with therapy. By looking at data that includes everything from leaks to AHI, its technology will help providers manage scare resources and, ultimately, improve patient adherence, he says. Even without the AI factor, technology has been growing by quantum leaps over the past few years.  Look at so-called “wearables.” While the U.S. Food and Drug Administration recently approved the Samsung Galaxy Watch to detect signs of OSA, consumers have been using wearable to track everything from steps (remember the pedometer) to heart rates to blood glucose numbers. Really, if you aren’t wearing some sort of wearable at this point, are you even alive? If ever there was a population that tracked data, it’s the diabetes patient. I recently upgraded to the Libre FreeStyle 3. The company has reduced packaging by about half and the latest generation sensor is also much smaller – both great things! But the biggest change (and if I would just read directions for once I would have known this) was that I no longer have to wave the reader (in this case, my phone) over the sensor to get a reading. After two days of confused waving of the phone over my arm, it dawned on me: Just press home and the number is … there. It might seem like a small thing, but it’s one less barrier on the road to better outcomes. Mind-boggling.

WATERLOO, Iowa – VGM Group has announced that Dan Bunting, who was most recently COO and strategic advisor to the CEO of AdaptHealth, has joined its team as a senior advisor. In this role, Bunting will help VGM develop long-term strategies to promote and support its customers and the HME industry. “I don’t think there’s anyone in the United States who knows more about our industry than Dan,” said VGM Group CEO Jeremy Stolz. “The health care industry, and HME in particular, is constantly evolving. And I am thrilled to have Dan’s experience and expertise with us as we continue to shape the future of VGM and the industries we serve.” In all, Bunting’s career spans 40 years, with experience in nearly every aspect of HME, including product development and manufacturing. Born and raised in Manchester, Iowa, less than an hour east of VGM’s headquarters, Bunting has been close to VGM throughout his life and career. He first met Van Miller, VGM’s founder, while attending the University of Iowa. At that time, Miller had an HME business where Bunting worked for two years while getting his degree. Later, when Bunting set out to start his own HME business in Iowa City, Miller and a few of his friends helped finance it. Bunting’s HME business, which sold to Rotech in 1996, was one of VGM’s earliest members. “I have dedicated my entire career to helping advance the HME industry, and I’m honored to continue that work with VGM,” Bunting said. “VGM, in many ways, feels like a return home for me. I am excited to do my part to help VGM in its mission to make a difference—both in the industry and in the communities it calls home.” 

WASHINGTON – DME Service Solutions, a provider of B2B outsourcing solutions specializing in health care, has partnered with the National Association for Home Care & Hospice to connect with a network of professionals focused on effective home care solutions. "We are honored to collaborate with NAHC, whose dedication to providing affordable care aligns with our mission at DME Service Solutions,” said Ryan Holbrook, president of DME Service Solutions. “We look forward to working alongside NAHC and its members to make a meaningful difference in the lives of those we serve." DME Service Solutions offers HIPAA-compliant workforce solutions, including document management, revenue cycle management, multichannel customer engagement and tech support. The NAHC represents the interests of more than 35,000 home care and hospice organizations, their 2 million nurses, aides and therapists, and the 14 million patients they serve annually.