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by: Theresa Flaherty - Thursday, February 2, 2017

CGMs are all around me. Ads for the Dexcom G5, in particular, keep popping up on websites. I am guessing this is because I Googled it while writing a story about Medicare’s recent decision to start paying for certain CGMs (the Dexcom currently being the only one that meets the criteria at this time).

I also met with a new CDE at the diabetes center this week. “Have you ever considered getting an insulin pump?” asked Sarah the CDE.

(Syringes are so 1980s.)

I get asked this every year or so. My reasons so far for deciding against the technology have been that I didn’t want to be tethered to it constantly; I wanted to wait a generation or so and see how much the technology improved (re: how much smaller the devices would get), and the costs.

Guess what? The devices are getting smaller and the technology has improved—most now seem to come with integrated CGM technology. Alas, I have a feeling the pricing for the device (hello, high deductible!) and the ongoing supplies would still be cost prohibitive for me.

I told all this to Sarah the CDE, but then we somehow (I may have brought it up) got on the topic of how Medicare is looking to cover CGMs, which could (possibly, maybe) ultimately lead to lower pricing across the board for diabetes tech.

When I got into the office, I Googled OmniPod because that’s what has interested me most in the past, and now I am getting pop-ups for that, too.

Unless Big Brother really is watching and somehow knows what I am thinking.

In the meantime, there are lots of details to be worked out for the Dexcom to get paid by Medicare. One interesting point (and correction, we transposed some numbers here) came to light today, from Greg at Applied Policy who has been working with Dexcom on this.

CMS has proposed a one-time payment of $236 - $277 for the CGM receiver.

I emailed him back to ensure I had understood correctly, and added that seems like an extremely low payment.

“That was our impression as well,” he told me.

Greg said it seems that CMS may have used historical data (they do love that historical data, don’t they?) for traditional glucose monitors. Those monitors cost far less than the thousands a CGM costs. For that matter, they also cost far less than $236 - $277, but I’ll save my rant about insurance pricing for another day.

As Greg told me, it’s a curious pricing mechanism, to say the least.

Finally, a story to put a smile on the face of anyone who uses insulin: a lawsuit was filed this week against the manufacturers accusing them of price fixing.

Stay tuned on all of the above.

by: Theresa Flaherty - Tuesday, January 3, 2017

I’m back in the office after two (glorious!) weeks away. For Christmas, Mom, I and Aunt Patti went to a little burg known to many as Sin City.

As an HME provider, you more likely know it as the site of Medtrade Spring.

Now, Las Vegas tends to mean a lot of walking around (I broke my daily walking goal of 60 minutes every day by many minutes and many steps). At the conclusion of our first full day traipsing the strip (The Bellagio, Caesars Palace), Mom realized if she and her bad knee were gonna keep up with me, she’d better get a cane.

Not only did the cane, indeed, make it easier for her to get around, this simple stick wielded an unexpected power: everybody and their brother offered her their seat. On the tram. On the bus. On the monorail. It was funny to me because mom is one of the most active people I know and really isn’t the proverbial little old lady. 

She may get that attitude from her mother, whose biggest complaint upon Grampy backing over her in the driveway with the big beige Buick was that the local newspaper referred to her as “elderly.” She was in her 80s.

Exploring Vegas with a person that is slightly mobility challenged opens the eyes to how difficult it must be for some people to get around. The walking distances, the sheer volume of people and the broken escalators everywhere highlighted this for me. 

The cane also let Mom get thisclosetotheedge at the Grand Canyon. 

I had to look away.

Here's to a healthy, mobile and Happy New Year!


by: Theresa Flaherty - Tuesday, December 20, 2016

If you’re like me, you’ve been frantically trying to wrap things up at the office so you can get the hell out of dodge for the holidays.

For the past week or so, I’ve been pounding out stories and freelance assignments, soliciting products for the February Product Spotlight (complex rehab, send ‘em in), and flattering people into writing Smart Talk columns (OK, that last one isn’t so hard, it’s arguably the best unpaid writing gig in the industry).

The year behind us has been a crazy one and to it I say, good riddance! I think most of our readers would say the same. The phase in of bid pricing, the continued onslaught of audits—you’ve heard this story before.

The question is what will 2017 bring? The election of Donald Trump as our next president (I still cringe when I read, write or say that), and the nomination of Tom Price as DHHS secretary seem to be infusing providers with new excitement and boosting their hopes for the future.

I’m cautiously optimistic, because what’s the alternative otherwise?

Anywho, as the clock ticks down today (my last before I leave on vacation), who am I kidding? I’ve got one mental foot out the door. Work? Meh, I’m clearing up piles of notes and press releases that have accumulated on my desk over a busy fall and I’m trying not to think about the fabulous chocolate mint cookies in the break room (thanks, Erika!). And, as I write this, I can overhear editor Liz discussing cinnamon rolls with Heather from marketing. Tis the season, after all.

To all, have a Merry Christmas and/or other assorted holidays and I’ll see you back here in 2017.

by: Theresa Flaherty - Friday, December 2, 2016

In my position as both an editor covering diabetes supplies but also, as a person with diabetes, I am well attuned to all the diabetes news and announcements that come out.

Sometimes, as in the case of headlines about insulin sticker shock, I am tempted to duck my head.

Other times, when I hear about the latest innovation, I’ll think, “meh.” That’s especially true when it comes to so-called ouchless technology. If you have to prick your finger with something sharp, it’s gonna hurt.

However, a recent press release heralding success with a breathalyzer device to measure blood sugar caught my attention. THAT, I thought, would be truly pain free.

I spoke with one of the researchers, Dr. Ronny Priefer, who’s been working on this device.

Folks have been looking for a solution to finger sticks for nearly 40 years and the list includes wristbands, earlobe sensors and contact lenses. Even Google has jumped into the fray, teaming up with Novartis to research methods of using tears to check blood sugar.

The impetus behind all this activity? So that more people with diabetes will actually check their sugars. The fear of pain keeps many from doing so. Preifer himself doesn’t have diabetes, but as a guinea pig, he pricked his finger 25 times in one day.

“It’s not a pleasant feeling,” he said. “I’m not volunteering to do it again.”

I feel his pain. When I landed in the ICU with my diabetes diagnosis, I had my sugar checked hourly by the nurses to establish, I guess, some sort of baseline. That’s roughly 24 x a day for 2 to 3 days. Fortunately, my fingers were kinda numb from the high sugars.

Until. Day 4, when they’ve brought me much more under control and moved me to a regular room (on a ward with a lot of old people). My breakfast arrived and when I went to whip off the plate cover, I felt the sting of all those fingersticks. I may or may not have inadvertently flung it at the wall.

Fast forward to today, I am and have always been fairly diligent about finger sticks. (But yes, sometimes I just don’t do it. I guess at what I need.)

It gives me hope that, despite many sexier or higher profile diseases to work on, plenty of researchers are still looking for ways to make life with diabetes a little easier.

My interview with Dr. Preifer is slated for the January issue of HME News.


by: Theresa Flaherty - Friday, November 11, 2016

When Editor Liz offered up her monthly list of suggestions for the front page of our next issue she included a photo, submitted by the Friends of Disabled Adults and Children, of Santa and Mrs. Claus. Perfect timing for December, right?

Then she (briefly) backtracked, wondering if maybe we should go with a photo of Congressman Price taken at Medtrade.

“I think we could all use a little Santa on the front page,” I said.

For while Dr. Price is indeed, a true HME champion, this conversation took place the day after the most brutal presidential election unlike anything anyone—no matter what side of the color line you fall on—has ever seen.

Frankly, I'm sick of the election, politics and politicians.

Now the country must move forward, preferably together. Despite my fear and disappointment, I tell myself to remain positive (not the most natural state of being for me in the best of circumstances).

I spoke with several industry stakeholders this week to see what impact a Trump presidency could have on the industry. While it’s certainly too early to know with any certainty, they all agree that a pro-biz prez could be a good thing for HME.

Speaking of remaining positive: that seemed to be the general mood of folks who attended Medtrade in Atlanta last week. While there are always the doomsayers, I think, for the most part, people know they have to figure out new ways to make it work. Like the turmoil the election has cast upon America’s political system, the HME industry as we know it is long gone.

Ironically, this year we celebrated the Year of the Women: women were honored with the industry's two major awards, one the inaugural HME Woman of the Year. I actually cringed as I typed that headline on page 4 of hte December issue because Hillary.

You can either curl up into a whimpering ball (something I know many women contemplated on Wednesday morning) or you can pull yourself together, paste on a smile and get to work.

Either way, hang on folks, it’s going to be a bumpy ride.

by: Theresa Flaherty - Monday, October 31, 2016

I touched down in Atlanta Sunday afternoon. Helloooo summertime temps. (I had to break down and commit to turning up the thermostat at home last week so the warm weather was most welcome).

Downtown Atlanta was crazy with tailgate parties and people walking around with large cheese wedges on their heads. Apparently, there was some sort of football game happening? Just kidding. Even I figured out it was the Green Bay Packers and the Atlanta Falcons—Jay Witter, I hope whoever you were rooting for won!

But I’d never seen a Cheesehead in the flesh before. They really do exist!

There was also some sort of Walking Dead Convention. No, that’s not what we’re calling Medtrade 2016 although one could be forgiven for thinking so. With all the drastic reductions in pricing, not just to Medicare, but other payers, 2016 has been a dark year indeed.

Pale-faced zombies were actually afoot in our fine hotel lobby. Which is appropriate, considering it’s also Halloween.

Still, while one could have a morbid attitude toward all things HME, I, for one, am excited to be here. The energy levels tend to be high and it’s fun to chat with people in person, rather than speaking to a disembodied voice over the phone. I hope all those who come to the show find what they are looking for, be it new products, new ideas, new connections or tons of leftover Halloween candy.

by: Theresa Flaherty - Wednesday, September 28, 2016

As a reporter I try to stay away from talking about politics outside my inner circle.

But, with the 2016 presidential election looming, I think politics is very much on everyone’s mind.

We recently ran our once-every-four-years news poll about the election.

After much handwringing and discussion on our parts over whether we should include all candidates and all parties; and whether voters could select undecided, none of the above or some other options, we went with Clinton/Trump/undecided & Republican/Democrat or none/independent.

Several readers wrote in with their vote for Gary Johnson and took us to task for not being more inclusive, but frankly, most providers skew, and have always skewed, Republican.

I was still surprised by how many providers said they would vote for Trump.

But I respect the right of you all to vote for the man. I’m sure you have your reasons and, judging from your comments, you’ve made carefully considered decisions.

As a Bernie supporter, I will cast my vote for Hillary Clinton, though she raises many, many concerns for me (her email server, however, is not one of them).

I always find it an interesting conundrum that providers face. As business owners, they are rightly concerned about onerous regulations and I don’t disagree that in that sense, they are better off voting Republican. But as business owners who make much of their living off of programs like Medicare/Medicaid they should be voting Democrat, no?

Back to that news poll: I think Lisa Wells, admittedly a consultant, not an HME provider, summed it up well when she said: “I’m always shocked to see how polar opposite that many of our industry leaders are with their choice of political party vs. the majority of the wheelchair users I serve. It’s mind boggling.”

by: Theresa Flaherty - Thursday, August 25, 2016

Things have been tough for the HME community for the past few years but this summer has taken it to a whole ‘nother level. Not only has the Medicare reimbursement for DME been decimated, other payers have begun to follow suit.

AAHomecare has tasked itself with gathering anecdotes about the impact on businesses as well as beneficiaries and I know I’ve heard my own share of horror stories. The best thing providers can do right now, say stakeholders, is amplify that message.

Meanwhile, over in the fantasyland that is Big Pharma, Mylan execs are backing down a little from plans to increase the price of the EpiPen once again—since 2007, the price has been jacked about 500% for no reason other than they can. To add insult to injury, its execs aren’t even owning their responsibility in this mess. The only person on this planet who defended Mylan? Martin Shkreli.

Don’t even get me started on how much those same execs increased their pay especially after speaking with provider Chris Smythe yesterday who told me: “You can’t pay me $26 for a commode that cost me $25. It just doesn’t work.”

Or check out this convoluted tale of Optum, the PBM for United Healthcare, overcharged customers for prescription medication (often, more than what the drug itself cost) and then clawed back the “overpayment” from the pharmacist.

I’d say nice work if you can get it, but frankly, I prefer to sleep at night.

And finally, a headline that strikes fear in my diabetic little heart: "Soaring insulin prices have diabetics feeling the pain."


by: Theresa Flaherty - Tuesday, August 2, 2016

I’m a bit famous for my excellent memory.

For example, favorite childhood memory: my parents put bootprints, sleigh tracks and a carrot top on the roof outside my window the Christmas I turned 4 so that I would know where Santa landed.

That memory has come in handy more than once lately, as I’ve had a few providers reach out looking for various articles that dated back 8 to 10 years. Found ‘em! When Mike Moran (you all remember Mike, right?) left several years, I think there was some fear on the part of Liz and I that we were losing his institutional memory. Fortunately, we muddled through just fine.

I will mark 11 years here at HME News this month and these days, I’m the institutional memory (well, Liz too). Like when competitive bidding got delayed after 14 days in Round 1 back in 2008. And contracts were sent by FedEx. I didn’t have to look any of that up.

Of course, it doesn’t hurt that I have been writing about much the same stuff since day 1 (competitive bidding, audits), just from the other side of the issue.

It helps to have a good memory when you are a writer: you can recall facts, quotes, etc., to flesh out the story. Or the blog (see above: Santa). Memory also aids in spelling words correctly (Liz hollers over the cube wall because frankly, it’s just faster to ask me most of the time).

Of course, neither memory nor superior spelling skills prevent plain old typos. Typos that totally change the meaning of a word or sentence are likely to send me into giggles (trust me, I’m not a giggler).

This week’s winner: I tweeted a link to a Q&A with Bob Soltis, but called him Bobo. While I am sure there are Bobos in the world, I doubt most of them are former ALJs who now author books on Medicare hearings. If there are, I doubt they are taken seriously.

Fortunately, we caught it and dropped the Bobo.

by: Theresa Flaherty - Wednesday, June 15, 2016

Did you know that if you hold a session called “Women & Wine” men automatically know it’s not meant for them?

It’s true, and it was kind of a nice change of pace. Beth Cox-Hollingsworth reminded us all to take a moment to find the calm in our lives, something that is especially true in the hectic HME industry.

I am happy to report I regularly make time for some quiet calm, often with glass of (white) wine in hand; I have to. With Type 1 diabetes, I am well aware that stress is the enemy of us all.

The event also served as the setting to announce the new VGM HME Woman of the Year Award. The award is the brainchild of none other than new-ish CEO Mike Mallaro, who recognizes that women are often under-recognized and under-rewarded. Mike made an appearance—in video—at the session to talk about the award and its importance.

Know someone you’d like to nominate? Yourself? Do it here.

The new award and the new session are just two ways in which the folks at VGM are keeping Heartland fresh. The event is in its 15th year and it’s still pulling in first time attendees. I spoke to a few at lunch today, including an RT (48-year career so far) who is newer to the industry and needed CEUs. Another is a 23-year manager of a medical supplier who has recently taken on the mantle of sales manager—something that hadn’t existed previously at her company. She was here to learn anything and everything she could about sales and marketing.

Although VGM is a big deal in Waterloo, and the Heartland Conference is a big deal in the industry, shockingly my cab driver was in the dark.

“What are you in town for?” asked he.

“Heartland,” answered I, using the industry shorthand.

“Is that a church?” asked he.

Anyhow, today was our final day here at the conference and one thing we couldn’t find? Postcards! Anywhere!