Georgia Association of Medical Equipment Suppliers
NEWS & NOTES


April 5 | 2018

In this issue:

  1. State Issues Committee call for members
  2. Register today!
  3. E-prescribing for DME
  4. Court says No
  5. Healthcare in the News
  6. DME Licensure
  7. Save these dates!

GAMES Platinum Members!









GAMES Associate Members
Support the associate members who support GAMES. If your vendors aren't on the list, ask them why!


Platinum


Airgas Puritan Medical
Christa Forrester
Mark Bradshaw



Drive DeVilbiss Healthcare
Joe Gessner
Steve Wakser




Philips Respironics
Susan Yenney


ResMed 
Jamie Griffis


VGM Group
Gil McCall
Pat Aydelott


Gold

BREAS 
Todd Tyson

Brightree
Melinda Mahoney

CAIRE

Lanier Hogan

Fisher & Paykel
Gregg Stahl

Mediware
Michelle Caldwell

O2 Concepts NEW Member!
Ed Marlowe

The Compliance Team, Inc.
Jack Haire
Sandra Canally

The MED Group
Ted Metcalf

Silver

ACHC
Randy Hughes

Allegiance Group

Bruce Gehring

Compass Health
Jim Mahon

Integrated Medical Systems (IMS)
Bo Lanier

McKesson Medical Surgical
Chip Wooten

Medical Specialties Distributors
Pat Burke

Medical Supplies Depot
Charles Simpson

Merits Health Products
NEW Member!
Elizabeth McKinley

Pride Mobility Products
John Storie

Quality Medical Inc.
Jim Worrell


Bronze

Medsolve Health Systems
Shane Morrison

Medtrade
Keving Gaffney

Pharmacists Mutual Insurance 
Hutton Madden



Committee Member Volunteer Opportunity!

The GAMES Medicaid and State Issues Committee needs you! Over the years this committee has experienced many successes, not the least was the recent communication with DCH resulting in the decision not to match the Medicare Bidding fee schedule for Medicaid patients.

Members of this committee have recently been discussing the Medicaid policy on enteral feeding. If you serve enteral patients, or have any input to offer on this topic, would you consider joining this esteemed committee?

GAMES Medicaid Policy and State Issues Committee

Purpose:

To provide leadership on current state issues including Medicaid, Managed Care, and other state issues affecting DME suppliers. Make recommendations to the Georgia Department of Community Health and other state agencies as appropriate.

This committee will meet quarterly via conf call (more often as needed). Committee members will be responsible for reviewing policy as it is posted / communicated from the Georgia Department of Community Health. When there is an opportunity to offer comments, this committee will draft and/or present comments in person. Committee members will share updates with GAMES members.

Key goals:

To understand and clarify (when needed) DCH policy as it applies to DMEPOS
To improve communication with DCH
To offer proactive suggestions to policy

Chairperson:
Charlie Barnes IV, 
Barnes Healthcare Services

CLICK HERE to contact the GAMES office with suggestions, questions, or to volunteer.


GAMES 2018 Spring Meeting: Back-Seat Driving! 
 
Wednesday, May 9, 2018
Embassy Suites, Perimeter Center
Atlanta, GA

This educational content is presented for owner / operator, senior staff, compliance, and billing supervisors.

Bringing Your Back Office to the Forefront of Success!

Presented by Laura Williard, AAHomecare and Kim Cook, MED Group

We all know the payer environment is shifting away from traditional Medicare and fee for service Medicaid.   Contracts with managed care and commercial payers has become increasingly important to the success of your company.  This session will discuss strategies on building and maintaining these payer relationships which will ultimately help in initial and ongoing contract negotiations.  Learn what things beyond price should be included in your contract discussions and what data you should be prepared to present.



Laura Williard is the senior director of payer relations for the American Association for Homecare. She has served in the HME community for more than 24 years.


Kim Cook is payer development and contracting at The MED Group. She has served in the HME/Home Health/Home Infusion industry since 1997.  


Attend this session and more at the GAMES Spring Meeting!!

CLICK HERE
to register online now! 


CLICK HERE
for a registration form to print and mail or fax. 

AAHomecare to Evaluate E-Prescribing Platforms

From AAHomecare’s Wednesday in Washington, April 4, 2018

At their recent meeting at Medtrade Spring in Las Vegas, AAHomecare’s Executive Committee approved plans to go forward with a project to examine electronic prescription (e-prescribing) platforms and to help promote adoption and acceptance of e-prescribing within the home medical equipment community.

"It’s time for the HME community to move away from the fax machine and individual paper prescriptions and fully embrace e-prescribing,” declared Steve Ackerman, AAHomecare chairman and president of Spectrum Medical. "Companies that invest in e-prescribing will be able to fill orders more efficiently to the benefit of patients and caregivers, while also reducing documentation errors and audits.”

"At Spectrum Medical, we are constantly trying to reduce the number of ‘touches’ involved in an order while still maintaining regulatory compliance," added Ackerman. "This should be a goal for all HME suppliers."

AAHomecare staff and leaders will study leading e-prescribing platforms in terms of their suitability for the HME sector with the end goal of recommending the best solutions to its membership and the industry at large. AAHomecare will subsequently work with companies supplying these platforms to provide additional guidance related to e-prescribing for HME, and will also promote the industry’s utilization of this technology.

"The healthcare field is rapidly moving towards increased usage of electronic communications and record keeping, and HME suppliers need to keep up,” noted Ackerman. "While our companies will always rely on dedicated professionals to make sure that our patients are receiving a high standard of care, we also need to automate processes wherever it makes sense to do so.”


Court Says No Recoupment Until After ALJ Hearings

Reprinted with permission from Elizabeth E. Hogue, Esq

The U.S. Court of Appeals for the 5th Circuit issued an opinion on March 27, 2018, in Family Rehabilitation, Inc. v. Azar, No. 17-11337 (5th Cir. Mar. 27, 2018) that says that monies cannot be recouped from a home health agency until after hearings have been conducted by an administrative law judge (ALJ).

Family Rehabilitation received a notice of overpayment from the Medicare Program in the amount of $7.6 million. It appealed under what the Court described as "Medicare's Byzantine four-stage administrative appeals process" and "the harrowing labyrinth of Medicare appeals." After requests for reconsideration were denied, the Agency was subject to recoupment. The Agency filed timely requests for hearings before an ALJ.

The notice of overpayment was based on a ZPIC audit conducted in 2016 of 43 claims. An extrapolation resulted in the $7.6 million overpayment.

ALJ's are required by statute to hear cases and issue a decision within 90 days. "Yet," said the Court "an ALJ hearing is not forthcoming-not within 90 days, and not within 900 days." In fact, it will likely be at least another 3-5 years before an ALJ hears the Agency's appeals.

READ MORE...

Healthcare in the News

These stories are straight from the headlines in Georgia this week! 

Plan for Georgia rural hospital's future has as many twists as a mountain road
The proposed purchase of a hospital in rural North Georgia is anything but simple, even though the system that wants to buy the facility is headquartered only about 20 miles away.

Georgians Anxious As No Deal Reached Between Piedmont And Blue Cross
Hundreds of thousands of Georgians are now out of network with Piedmont doctors and hospitals after Blue Cross and Blue Shield of Georgia and Piedmont Healthcare failed to reach a new contract agreement over the weekend.

Stopping elder abuse is the goal of Georgia legislative measures
Georgia lawmakers this year handed seniors and their advocates several victories in their fight against the growing problem of elder abuse.


Medtrade 2018 Call for Presentations Deadline is tomorrow!

Medtrade experienced such an overwhelming response to the new, interactive and crowd-participating panels introduced in 2017 that we are continuing it for 2018. Join us in Atlanta at Medtrade and share your story and expertise on a panel, or lead a panel. We all know the more we work together, the better the results. Why not work together moreas an industry? Let’s share our successes and challenges, working as a team to bring more insight and knowledge to the masses by presenting information we’ve gathered while out there fighting the good fight

CLICK HERE to learn more about the program guidelines and evaluation process.


Georgia Board of Pharmacy Issues DME Licensure Notification 

From the GA Board of Pharmacy:

IMPORTANT NOTICE REGARDING LICENSURE REQUIREMENT FOR DURABLE MEDICAL EQUIPMENT SUPPLIERS

Please be aware that effective July 1, 2017, per Official Code of Georgia Annotated ("O.C.G.A.”) § 26-4-51, all DME suppliers that provide direct to consumer service and seek third party reimbursement, unless otherwise exempt by this law, must apply for a Georgia DME license.  Please also note that the Georgia Board of Pharmacy ("Board”) has decided that licenses will be required for Medicare enrolled out-of-state manufacturers and wholesale distributors under the same conditions.  These out-of-state providers are exempt from the in-state office/place of business requirement. 

CLICK HERE to download the complete notice.


Save These Dates!

Medicaid Fair
April 25, 2018
Tifton, GA

GAMES 2018 Spring Meeting
Back-seat Driving!
May 9, 2018
Atlanta, GA

GAMES 2018 Annual Meeting
September 9-11, 2018
The DeSoto 
Savannah, GA