Georgia Association of Medical Equipment Suppliers
NEWS & NOTES


July 13 | 2017

In this issue:

  1. DME Licensure in GA
  2. GAMES Call for Nominations
  3. Higley's New Education Session!
  4. Isakson signs on!
  5. Healthcare in the News
  6. TRICARE News
  7. Continued Decrease in Suppliers
  8. 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
Kimberly Williamson



VGM Group
Gil McCall
Pat Aydelott


Gold

BREAS
Todd Tyson

Brightree
Melinda Mahoney

CAIRE

Lanier Hogan

Fisher & Paykel
Gregg Stahl

Cryogenic Inventory Solutions
Anne Holcombe
Travis Caulk

Mediware
Michelle Caldwell

ResMed
Jamie Griffis

The Compliance Team, Inc.
Jack Haire
Sandra Canally

The MED Group
Ted Metcalf

Silver

ACU-Serve
John Stalnaker

Allegiance Group

Bruce Gehring

Barbara's Billing & Consulting
Barbara Penzien

Compass Health
Joe Toth

Linde Healthcare
Clay Stalnaker

McKesson Medical Surgical
Chip Wooten

Medical Specialties Distributors
Pat Burke

Medline

Brian Topchik

Medtronic
Chris Arapoff

Pharmacists Mutual Insurance
Hutton Madden

Verus Healthcare
Rachel Dobyns


Bronze

Medtrade

Keving Gaffney

Pride Mobility Products
Steve Joyce

DME Licensure in GA

Yesterday (July 12, 2017) the Georgia Board of Pharmacy held their monthly public meeting in Atlanta. While not on the printed agenda, DME licensure was discussed briefly. The Board members referenced some internal communication discussing possible rules to be published. (These rules were not made available to attendees, only Board members) During the course of discussion, the Board members noted that there were still to many "holes" and the rules are not ready to be posted for public comment. The Board decided to move this agenda item to their August meeting.

One small nugget of insight though was verbally stated by Board members: Based on requirements for public comment as well as time for the Governors office to review, the likely implementation date for DME Licensure will be March 2018.

GAMES representatives will continue to attend meetings, engage with the Pharmacy Board and keep our members updated!

GAMES Call for Nominations to the Board of Directors

On August 28, 2017, GAMES will hold our election at the Annual Meeting. Due to the nature of individuals coming on and rolling off every 3 years (directors) or 2 years (officers), for 2017 GAMES will only have one opening for an Associate Member Director.


Please consider nominating an associate member to be contacted by the nominating committee!

CLICK HERE to nominate a GAMES associate member to serve on the Board of Directors! 

VGM's Mark Higley returns to GAMES Annual Meeting!


Mark your calendar now and make plans to attend the GAMES 2017 Annual Meeting - Everything you need! being held August 27-29 in Jekyll Island, GA!

HME/Rehab Best Practices and Benchmarks: Analysis & Commentary from Mark Higley

Buckle your seat belt as Mark shares with GAMES attendees a synopsis of the most recent financial and operational survey results from hundreds of HME & Rehab providers, sourced from VGM's membership (of both small and large supplier samplings) as well as data obtained  from his collaboration with merger/acquisition entities and other industry sources.  

Mark Higley is Vice President of Regulatory Affairs with responsibilities including corporate business development, market research and industry analysis. His current projects include analysis of governmental, regulatory and compliance issues affecting the DMEPOS industry, including national competitive bidding, accreditation, health care reform, oxygen benefits, and other recent provider issues . Higley sits on the AAHomecare Regulatory Council, on the board of the Healthcare Quality Association on Accreditation, and is a regular speaker/panelist/consultant at numerous HME industry events. 


CLICK HERE for agenda and registration information!
 
Don't Wait! Make your hotel reservation today!
 
The Jekyll Island Club Resort
371 Riverview Drive  
Jekyll Island, GA 31527

The Jekyll Island Club Resort offers Victorian charm with modern conveniences in the center of the Historic District. Guests enjoy restaurants, bars, bicycle rentals, a swimming pool, gift shops, a fitness room, history tours, croquet, a private beach club, and more.


Call 912-635-2600 to make your reservation today!
 
GAMES discounted rates:
Traditional Room: $139
Deluxe Room: $169
Hotel Suite: $239

But Hurry! Call before July 21st because this rate is limited!

Senate to HHS and CMS Letter Closes With 46 Supporters!

From VGM July 12, 2017

We are extremely pleased to share that a letter being sent to the Department of Health and Human Services (HHS) along with the Centers for Medicare and Medicaid Services (CMS) gathered 46 signatures. The letter details much needed reform within the DMEPOS competitive bidding program and acts as continued pressure for the governing agencies to fix the highly flawed program. There are few bipartisan legislative efforts on Capitol Hill when it comes to healthcare, but getting nearly half of the Senate to support a letter over a holiday recess is not an easy task. Of the 46 senators that supported the letter there were 28 republicans, 17 democrats and 1 independent. Below is a map of the final sponsors by state:

CLICK HERE for a list of cosigners.

CLICK HERE
to view and download the letter.

You can send a thank you note to Senator Isakson's office here:

Senator Johnny Isakson
Phone: (202) 224-3643
William Dent, Legislative Correspondent 

Healthcare in the News

These news clips were shared with GAMES by our state lobbyists, Southern Strategy Group:
 

 

Study finds doctor differ on government monitoring of opioids
Physicians who work in emergency rooms generally are more supportive of prescription monitoring programs than doctors in other specialities, a new Georgia State University study reports.

New health bill scheduled for introduction Thursday
President Donald Trump said Wednesday he will be "very angry" if the Senate fails to pass a revamped Republican health care bill and said Majority Leader Mitch McConnell must "pull it off," intensifyingpressure on party leaders laboring to win over unhappy GOP senators and preserve the teetering measure.


Isakson Pledges To Protect Funds Supporting People With Disabilities
Just hours after Republican leaders in the Senate announced they'd unveil a new health care bill Thursday, U.S. Sen. Johnny Isakson, R-Georgia, took questions from constituents on a conference call, pledging to protect federal funding to services for people with developmental disabilities.

More and better medicines - and often staggering costs
Alpharetta resident Robert M. Stevens has become all too familiar with the rapidly increasing cost of cancer drugs since 2006.

Blue Cross Blue Shield Of Ga. President Discusses New ER Policy
Georgia's largest health insurance company, Blue Cross Blue Shield of Georgia, has started a new rule: it will deny coverage to individual policyholders for emergency room visits the company deems to be

GOP health care divisions multiply as Trump pressures Senate
Republican divisions over health care multiplied Monday as President Donald Trump pressured GOP senators to act quickly, and Vice President Mike Pence suggested they might have to revert to a straightforward "Obamacare" repeal if they can't agree on an alternative.

State's Public Health chief picked to run CDC
The Trump administration has named Dr. Brenda Fitzgerald, commissioner of the Georgia Department of Public Health, as the new director of the Atlanta-based CDC.

A renewed Johnny Isakson on health care's 'individual mandate'
We were 15 minutes into our lunchtime discussion when Johnny Isakson got to the crux of what Senate Republicans face this week when they renew their attempt to repeal the Affordable Care Act.

Trump's Surgeon General Pick Built Name Fighting HIV And Opioids In Indiana
Several weeks before President Donald Trump nominated Indiana's state health commissioner Jerome Adams to be the next U.S. surgeon general, Adams toured the Salvation Army Harbor Light detox center in Indianapolis, the only treatment facility in the state for people without insurance.


GAMES Members Receive Good News from TRICARE

TRICARE is issuing its first official acknowledgements that they will reprocess claims from July 1 through December 31, 2016 to reflect adjustments to the fee schedule mandated by last December’s CURES bill.  In THIS LETTER to a GAMES member  TRICARE states:

You are correct TRICARE uses Medicare’s DMEPOS fee schedule, Medicare reduced their rates in the second half of 2016, and a subsequent resolution (the 21st Century Cures Act) delayed that reduction, and retained the original, higher rates for claims with dates of service between July 1 and December 31, 2016.  TRICARE followed suit and we suggest you resubmit any claims adjudicated under the reduced rates to the Managed Care Support Contractor (MCSC) in your region for reprocessing.

Laura Williard, AAHomecare’s vice president for payer relations and GAMES Board Member, suggests that providers who have not already done so should submit their own letter to the DoD on CURES-Mandated TRICARE Reimbursements. CLICK HERE for a sample provider letter that you can edit by adding your company name and information.  By doing this, you should receive a similar response letter to the example noted above in case any questions arise from your TRICARE contractors.

Willard also advises providers to consider first resubmitting a small batch of claims to ensure they are reprocessed correctly prior to sending all claims. This approach would eliminate the need to resubmit all your claims multiple times if the contractor happens to deny or process the initial claims incorrectly.  

From AAHomecare:

AAHomecare and HME Stakeholders Nationwide Work Together to Secure a Big Win for Providers Who Serve TRICARE Beneficiaries

This development is the culmination of a sustained 6-month effort led by AAHomecare that included researching and securing legal opinions that confirmed that TRICARE was obligated to follow the CURES provisions, direct outreach and education to TRICARE and its contractors, and marshaling the community to raise the issue with TRICARE themselves.  We thank the many providers and other stakeholders who took part in these efforts and helped spur TRICARE to formally adopt the CURES provisions. 

One provider who reached out to TRICARE on the issue and just received the good news is Tyler Riddle, vice president of MRS Homecare and also the current president of the Georgia Association of Medical Equipment Suppliers.

"I am ecstatic to see that TRICARE is aware of the CURES-mandated adjustments and is ready to implement them,” remarked Riddle. "Now the HME community needs to keep making the case to TRICARE and other third-party payers that the current bidding-derived rates are unsustainable going forward and need to be adjusted on a long-term basis.”
 
"This is a great example of what we can accomplish through persistent advocacy and outreach efforts,” Riddle continued.  "I hope this win encourages HME providers everywhere to redouble their efforts to advocate to CMS and Congress for much needed relief on Medicare reimbursement rates.” 

Supplier Numbers Continue to Drop
From AAHomecare July 12, 2017

Every quarter AAHomecare pulls the Medicare Supplier Directory to identify the number of "traditional” DME suppliers currently providing services to beneficiaries. Our most recent review of the data found that the supplier numbers are steadily decreasing. According to AAHomecare’s estimates, there are roughly 6,086 unique suppliers and 9,810 locations nationally. Compared to 2013, the number of suppliers has decreased by about 42%.
 
Providers in mainline product categories such as hospital beds, NPWT, support surfaces, wheelchairs & accessories, respiratory products, and oxygen are included in this analysis.
 
Details on state by state counts can be found here.


Save These Dates!
 
DME Comprehensive Workshop
August 9, 2017
Atlanta, GA

GAMES 2017 Annual Meeting
August 27 - 29, 2017
Jekyll Island, GA

Medtrade
October 23-25, 2017
Atlanta, GA