Thursday, April 28, 2011

Invacare posts 'solid' first quarter


Invacare posts 'solid' first quarter
No significant impact from competitive bidding, company says

ELYRIA, Ohio - Invacare this week reported net earnings of $7.45 million for the first quarter ended March 1, 2011, compared to $3.1 million for the same period last year.

It reported net sales of $428.5 million vs. $402.2 million, a 6.5% increase.

"Invacare is off to a solid start in 2011," stated President and CEO Gerald Blouch in a release. "Invacare is confident that the momentum from this quarter will continue to deliver positive results for its shareholders in 2011."

Net earnings were positively impacted by net sales growth and reduced interest expense. That growth was partially offset by a reduced gross margin, higher selling, general and administrative expenses and a higher effective tax rate on adjusted pre-tax earnings.

Helping to boost net sales was the North America/HME division. Earnings before income taxes were $13.3 million for the first quarter of 2011 compared to $11.5 million for the same period in 2010. Net sales were $185.6 million vs. $175 million. Growth was driven by increases in rehab, respiratory and standard product lines.

Also helping: Invacare Supply Group. Net sales were $74 million for the first quarter of 2011 compared to $69.7 million for the same period last year, a 6.2% increase.

As part of its earnings report, Invacare provided the following outlook:

* The company is "actively managing" exposure to commodity pressures with adjustments to pricing and freight, including for certain products in its North America/HME division.

* The company is closely monitoring the tragedy in Japan. It's developing "supplier and component alternatives to be implemented if necessary."

* The company is providing updates to the Food & Drug Administration regarding compliance concerns raised in 2010. "The company is in the process of adding resources to its regulatory affairs and corporate compliance departments and engaging outside experts to accelerate implementation of its corrective actions," the release states.

* The company has not seen a significant impact on its business in the first quarter due to Round 1 of competitive bidding. It continues to work with the industry to implement changes to the program.

Invacare's guidance for 2011 includes organic net sales growth between 3% and 4% (narrowed from original 2% to 4%); adjusted earnings per share between $2.05 and $2.15; free cash flow between $85 million and $95 million; effective tax rate of about 30% on adjusted pre-tax and annual earnings; and adjusted EBITDA between $145 million and $155 million.

Monday, April 25, 2011

Next in line for competitive bidding: Vents and manual wheelchairs?


Next in line for competitive bidding: Vents and manual wheelchairs?

BALTIMORE – Because CMS thinks Round 1 is going so well, industry stakeholders wouldn’t be surprised if the agency expands more than the number of competitive bidding areas in Round 2.

“The fear is that they see such incredible success that they’ll take the product categories in Round 1 and add to them in Round 2,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Earlier this month, CMS officials shared with members of the Program Advisory and Oversight Committee (PAOC) a list of the 20 product categories under consideration for Round 2. The list contains the nine product categories in Round 1 plus infusion pumps and related drugs; manual wheelchairs; off-the-shelf orthotics; negative pressure wound therapy devices; nebulizers; ventilators, TENS devices; commode chairs; patient lifts and seat lifts; blood glucose monitors; and lymphedema pumps.

The product category on the list that’s particularly worrisome to industry stakeholders: ventilators.

“I don’t know how you would competitively bid vents, because it’s such a clinically and service intensive product,” said Wayne Grau, vice president of supplier relations and government affairs for The MED Group.

A product category that industry stakeholders are fairly certain CMS will try to slip into Round 2: manual wheelchairs.

“CMS plans to improve coding for manual wheelchairs, but they put that on hold, so that’s a pretty good indication that they’ll be in,” Bachenheimer said. “The question is whether they will exclude some of the higher-end chairs. The expenditures there aren’t significant, so CMS may be receptive to excluding those.”

Industry stakeholders were able to get complex power wheelchairs (Group 3) excluded from Round 1, but it took an act of Congress.

A product category that raised eyebrows: patient lifts and seat lifts. Providers often consider these products cash items.

Unfortunately, at the end of the day, money, not quality of care, will drive CMS’s decision, industry stakeholders say.

“CMS is charged with targeting the product categories with the highest price tag or those where the beneficiary co-pay is the most,” said Walt Gorski, vice president of government affairs for AAHomecare.

Tuesday, April 19, 2011

What’s the fuss?

HME News

I hear CMS wants to hear from consumers about competitive bidding. Here’s one.

Tuesday, April 19, 2011 12:04
Posted in category Wheels in motion

Joel Solkoff wrote a guest commentary for our February issue commending HME providers for all the work they do to help people like him live as independently as possible.

Joel turned up on my radar again last week when John Shirvinsky, the executive director of the Pennsylvania Association of Medical Suppliers, sent me the link to Joel’s latest blog entry, which derides the competitive bidding program.

I’m going to include the blog here in full, because Joel makes some good points and, like John, I think you’ll get a kick out of it:

What’s the fuss?

I originally created this blog as a convenient way for readers to have access to my monthly column in Voices of Central Pennsylvania, published from October 2009 to February 2011. While recovering from minor cardiac surgery where the medical standard of “do no harm” was once again violated, I decided to quit my column rather than continue to be a person unable to change Medicare and thus always angry all the time. I wanted to love.

I am a frequenter of hospitals for pneumonia, rehabilitation to a right shoulder that cannot be repaired, diabetes, etc.—invariably released by Medicare dictate before it is necessary; frequently saved by homecare agencies now foolishly required to reduce their services.

In writing my column for February (the one below that begins with bull riding), I opted to reject anger.

Similarly, the once favorable economic conditions in downtown State College, PA where I live had given me the hope that government favorable to the disabled and elderly might provide us with the infrastructure, training, and understanding required to develop and benefit from the talent of those of us who are broken in body but sound in mind.

It is foolish to be angry at my fellow-town mates (in a place that is rapidly turning into a Bruce Springsteen song) who are so beset with troubles of their own.

So, I gave up the column to work with engineers, architects, and designers who are planning a future that follows the Americans with Disabilities Act (ADA) and where segregation of the sort I experience daily at Ye Olde College Diner and the like (whose lack of access is grandfathered ) does not exist.

What does exist is that I continue to live an independent life. I cannot get from my bed to the bathroom without a scooter or other mobility device. Yes, there is a point where reality requires that I cannot engage in submission, cheerful or otherwise.

I must have access to mobility devices. President Obama, for whom I worked and voted, should be ashamed of himself for not only tolerating, but personally advocating a competitive bidding program for durable medical equipment.

This plan, which the President inherited from President Bush (who used it as part of an effort to gut Medicare) is already, in Pittsburgh and other locations, so altering the process of providing medical supplies such as oxygen, wheelchairs, power chairs, scooters and other mobility devices that local suppliers, such as the three here in State College, would only be able to serve the rich.

The rest of us are or would be at the mercy of often out-of-state suppliers of dubious reputation who would take their sweet time providing batteries and maintenance, resulting in people like me falling and going into assisted living facilities. Thus savings in Part B of Medicare would result in large costs in Part A.

Last year’s measure to end competitive bidding received the bipartisan support of so many members of the House that if the Democratic leadership had called it up for a vote it would have passed. The Senate followed the lead of Senator Robert Casey, Jr. (D-PA) and no member of the Democratically-controlled senate endorsed the legislation.

While Sen. Casey publicly dithered about his position on the subject, his real position appeared to become clear. Sen. Casey is reportedly a friend of the President. The President, for reasons of his own, an informed source told me, personally believes in competitive bidding. Sen. Casey is not going to take a position that would make his friend angry.

Two columns below express the views of Rep. Jim Langevin, a liberal Democrat from Rhode Island, and Rep. Glenn Thompson, a conservative Republican who represent me here in the Fifth Congressional District of Pennsylvania, expressing their opposition to competitive bidding. Their specific advocacy was to the legislation introduced last year, but this year’s legislation is déjà vu all over again.

My friends who meet regularly at the Corner Room in this sliver of left wing political power here in the small borough of State College (surrounded on all sides by Republicans; Republicans to the north; Republicans to the south; Republicans to the east, and Republicans to the west) cherish the liberal’s dream that someday these evil Republicans will turn into progressive Democrats.

My fixation on competitive bidding has made me a source of jest and some mistrust. My support of Rep. Thompson, especially, has made some Democrats suspect my loyalty to the party.

I am a loyal Democrat who believes in the party of Eleanor Roosevelt and Adlai Stevenson. I have no trouble picturing Eleanor Roosevelt shaking her trademark index finger at President Obama and Senator Casey. If they want my vote, they had better start acting like Democrats. Democrats don’t treat people who cannot walk in a way that causes us to feel like cripples.

Shame on you President Obama. Shame on you Senator Casey.

I will pray that you find your way back to the ideals of the Democratic party.

Shame. Shame. Shame.

Liz Beaulieu

Monday, April 18, 2011

Riding 4 a Reason Course Fly-Through

Thursday, April 14, 2011

Mothers Day Vein Screening



Mark your calendars! May 7th at the Provo Marriott, Alpine Home Medical Equipment and the Intermountain Vein Center will host a vein screening day. Come and see how to relieve your or your mother's leg pain due to varicose and other unsightly and painful veins.


Tuesday, April 12, 2011

Sami the Seal

Compressor Nebulizer System

The Philips Respironics Sami the Seal pediatric compressor is shaped like a seal to appeal to children, their parents and pediatricians, and to support aerosol therapy compliance. The compressor partners with our highly efficient SideStream nebulizers to provide fast and friendly treatment to pediatric patients in the home.

Features

The Sami the Seal compressor nebulizer system is available in two configurations—one for use with the SideStream disposable nebulizer only, and one with the SideStream disposable and SideStream reusable nebulizers. Both nebulizers feature venturi technology that provides air flow in addition to that supplied by the compressor, resulting in faster drug delivery and shorter treatment times. Sami also partners with the Tucker the Turtle pediatric character mask. Made of a soft, flexible material, Tucker contours to the face for comfort and fit. It also incorporates a vent design that directs medication away from the eyes, reducing undesirable aerosol eye deposition.

  • Reliable, economical and easy to use
  • Bottom-weighted for stability
  • Pediatric appeal
  • Fast treatment times*
  • Convenient handset dock

Monday, April 11, 2011

H.R. 1041 FAIRNESS IN MEDICARE BIDDING ACT

H.R. 1041
FAIRNESS IN MEDICARE BIDDING ACT

AAHomecare President Tyler Wilson with Reps. Glenn Thompson (R-Pa.) and Jason Altmire (D-Pa.) announcing H.R. 1041Repealing "Competitive" Bidding

On March 11, 2011, Congressman Glenn Thompson (R-Pa.) and Congressman Jason Altmire (D-Pa.) officially introduced the bipartisan House bill to repeal “competitive” bidding, H.R. 1041.

75

CO-SPONSORS

Keep track of which states are adding cosponsors to H.R. 1041 below. See which members of Congress have signed on by viewing the full cosponsor list.


arrowTOP 5 CO-SPONSOR STATES (BY #)

  1. Pennsylvania
    9 OUT OF 19 CO-SPONSORS
  2. Ohio
    8 OUT OF 18 CO-SPONSORS
  3. Florida, New York
    6 CO-SPONSORS
  4. Illinois, North Carolina, Tennessee
    4 CO-SPONSORS
  5. Georgia, Iowa
    3 CO-SPONSORS

arrowTOP 5 SMALL* STATES (BY %)

  1. Vermont
    1 OUT OF 1 = 100%
  2. Nevada, West Virginia
    2 OUT OF 3 =66.7%
  3. Iowa
    3 OUT OF 5 = 60%
  4. Maine, Rhode Island
    1 OUT OF 2 = 50%
  5. Tennessee
    4 OUT OF 9 = 44%

arrowTOP 5 BIG* STATES (BY %)

  1. Pennsylvania
    9 OUT OF 19 =47.4%
  2. Ohio
    8 OUT OF 18 =44.4%
  3. North Carolina
    4 OUT OF 13 =30.8%
  4. Florida
    6 OUT OF 25 = 24%
  5. Georgia
    3 OUT OF 13 =23.1%





Wednesday, April 6, 2011

CMS Delays Round Two of Bidding

CMS Delays Round Two of Bidding

Rep. Glenn Thompson (R-Pa.) announcing H.R. 1041

A delay in Round Two of the bidding program was announced at the meeting of the CMS competitive bidding Program Advisory and Oversight Committee (PAOC). Under the revised timeline, contract winners will be announced in Spring 2013 and the prices and contracts would be implemented in the Summer of 2013.

Both lead sponsors of the bidding repeal bill, H.R. 1041, applauded the delay announcement. Congressman Glenn Thompson (R-Pa.) noted that, “Auction and bidding experts have resoundingly agreed that the program does not work. Delaying round two only kicks the can to a future date. While this is an indication that the Fairness in Medicare Bidding Act (H.R. 1041) is gaining momentum, we must continue efforts to educate policy makers here in Washington about the disastrous affects this program will have on our communities and Medicare beneficiaries.”

Tuesday, April 5, 2011

Competitive bidding: Bill picks up sponsors but program continues to snowball

Competitive bidding: Bill picks up sponsors but program continues to snowball
By Theresa Flaherty Managing Editor -

BALTIMORE – Even as H.R. 1041, the bill to repeal competitive bidding, picks up steam, members of the Program Advisory and Oversight Committee (PAOC) are looking ahead to their meeting tomorrow.

“This big snowball is rolling downhill and crushing everything in sight,” said Tom Milam, an industry consultant and PAOC member. “We would like to be involved in the discussion of what’s wise given what is transpiring right now.”

On the agenda for the daylong meeting: a discussion of the product categories and the timeline for Round 2, and an update on “real time” claims monitoring in the nine competitive bidding areas in Round 1.

That last item is information that Milam said he and some other PAOC members had requested in advance—but didn’t get.

“They have the tool (to track) changes in utilization patterns, not just in Part B but also in Part A,” he said. “We wanted to digest it and discuss it.”

That seems to be in keeping with CMS’s method of keeping things close to the vest, said Milam.

“They wait until the last minute to make announcements and frequently delay and postpone (others),” he said. “Then, they spring it on everyone with short timelines so nothing can be done to improve or amend whatever has been decided.”

Meanwhile, with lawmakers back in session last week, H.R. 1041 officially picked up an additional 23 sponsors, bringing the total to 53.

That’s great, but there’s a long way to go yet, cautioned NAIMES president Wayne Stanfield.

“We’ve got to have many, many more sponsors and a Senate companion bill if we expect to make an impact on Congress,” he said. “That’s going to require grassroots efforts at the state and district levels to make this happen.”

The co-sponsors are split fairly evenly between Republicans and Democrats, and they comprise supporters of last session’s H.R. 3790 and freshman lawmakers, said Jay Witter, senior director of government relations for AAHomecare.

As to those who haven’t signed on yet:

“I think it’s the usual members saying they’d like to see (the program) be given a chance, or telling us they are not hearing about problems,” said Witter. “They are basically repeating what CMS is telling Congress.”