Selling Medicare WAC Profits will end bad

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anonymous

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Word from industry insiders is that your company has been unsuccessful in attempting to go public and continues charging Medicare at inflated WAC prices to artificially inflate the company sales numbers.

That would explain the sweetheart price deals given out like candy left and right to offices around the country. What’s your internal company ASPs after all those sweetheart deals? Those deals will all come back home to roost. Like a game of Jenga. The Industry is betting on a 30-40% price correction when ASP hits your codes.

You will finally feel what it’s like to deal with price competition with the rest of us selling in this class. Your competitors are rubbing their hands in wait. Epic fall and upset customers ahead. We all know the customers that jumped for the numbers are usually the first to bail when it’s gone. Your company is putting you all at risk for big pain to look good for the short term. Nothing is forever including reimbursement.
 
























Thank you for making my point. The company is heavily exposing itself as a one trick pony riding on temporary inflated Medicare rates. When Medicare WAC goes, what do you have left?

How will your company pay you bonuses when the margins inevitably shrink significantly?
 












Don’t worry the compliance department will come after you looking for ways to fire you but trip over words when you ask them to explain the HA ‘strategy’. Has anyone heard this explained in detail? Sometimes feels like Washington DC. around here.

Selling of company more likely than IPO. AVPs clinging on and being shielded for the shares they were promised.
 






There is nothing wrong with letting providers know what their cost is on a product, and what the reimbursement is for a given plan. Every company does it, and will be asked for this information when presenting their HA or other buy and bill item to an office.
 






Adjusting acquisition prices from provider to provider to increase profit margin made from Medicare is. Using spreadsheets/ homemade marketing material to show profitability to be made of Medicare is not compliant behavior.
 






So leaving Explanation of Benefits copies with your offices is legitimate? There are reports of copies being left by representatives of this company. It is illegal to promote the profitability of Medicare, period.

Why else would this company not report Average Selling Prices? This company is exposing you to trouble. For what? To inflate their numbers for the short term to look good? To "kickback" offices with extra profits? There is an Anti-Kickback Statute in federal law. What is the rationale explanation for remaining on WAC? Why is the company giving price deals with anything with a pulse? That cannot be done with ASP reporting. It looks desperate. Is the company hurting financially? I read this company hasn't turned a profit since it went private in 2012. Since it's private, nobody can read their books.
 






anonymous said:
So leaving Explanation of Benefits copies with your offices is legitimate? There are reports of copies being left by representatives of this company. It is illegal to promote the profitability of Medicare, period.

Why else would this company not report Average Selling Prices? This company is exposing you to trouble. For what? To inflate their numbers for the short term to look good? To "kickback" offices with extra profits? There is an Anti-Kickback Statute in federal law. What is the rationale explanation for remaining on WAC? Why is the company giving price deals with anything with a pulse? That cannot be done with ASP reporting. It looks desperate. Is the company hurting financially? I read this company hasn't turned a profit since it went private in 2012. Since it's private, nobody can read their books.
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While I partially agree with what is being said here I also have to point out two glaring problems.
1) Medicare set the reimbursement amount off WAC not Bioventus. Could BV have inflated WAC sure but Medicare set the reimbursement.
2) Medicare allowed reimbursement to be set off WAC. Reporting ASP is not mandatory. If you report once you have to continue to report. If you never report reimbursement will be set off WAC. Until CMS changes that option of reporting it’s on them not on BV and not on the provider who is cashing in. Call it a loop hole call it what what you want it’s on CMS.

Side note, I don’t work here anymore and wasn’t exactly happy here either, I find CP amusing but someone grinding the axe as a current or ex employee needs to be called out in their ridiculous blaming of BV.
Happy I’m out for sure but come on dude, get over it and move on. Lots of good people at BV, quit trying to ruin their livelihoods because your mad.
 












anonymous said:
While I partially agree with what is being said here I also have to point out two glaring problems.
1) Medicare set the reimbursement amount off WAC not Bioventus. Could BV have inflated WAC sure but Medicare set the reimbursement.
2) Medicare allowed reimbursement to be set off WAC. Reporting ASP is not mandatory. If you report once you have to continue to report. If you never report reimbursement will be set off WAC. Until CMS changes that option of reporting it’s on them not on BV and not on the provider who is cashing in. Call it a loop hole call it what what you want it’s on CMS.

Side note, I don’t work here anymore and wasn’t exactly happy here either, I find CP amusing but someone grinding the axe as a current or ex employee needs to be called out in their ridiculous blaming of BV.
Happy I’m out for sure but come on dude, get over it and move on. Lots of good people at BV, quit trying to ruin their livelihoods because your mad.
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Sounds like company talking points. So pleading ignorance to the rules after countless manufacturers under the same system did the right thing is the answer. That is unethical at best. It's anti competitive and provides an unfair advantage in the marketplace and increases costs dramatically. The very thing the government rejects in business and has laws against. It will be feeding season soon enough for your customers coming back.
 






Must admit it’s concerning if something can change ahead and the company isn’t telling us. We have brought on a farm of ASRs which can also be argued could be used as a plan B sales footprint to save on commissions.
 






Bingo, just remember TB and JN are nice guys but they are just frontmen to the board. The board of investors call the shots. Word is some investors want to cash out due to poor market conditions but need new partners or funding in going public aint happening. Keeping ASRs as a backup in case company if currently being shopped and sold may not be bad idea from a business standpoint. Everyone is expendable.
 






BV is never going to go public, HA use will continue to go down, if they ever have to report and cannot sell on spread its game over. Exogen Medicare scandal could be really bad for business with IR now looking more closely than ever at the crappy orders with "90 day's" between x-rays.

Bad company in a bad business
 






This company would be a short sellers dream if it were publically traded today. Their sales model and growth is based on high WAC payouts from Medicare which is not sustainable and will collapse. A bubble in wait.
 






Couldnt disagree more. There will be no collapsing of the reimbursement model and competitors are kicking themselves for not doing this earlier.

Single injection is clinically superior to anything on the market and that is just a fact.

Good luck selling those HA products with crap reimbursement, no clinical data and ineffective pharma reps.
 






I would say equal to Monovisc? Don't forget the crappy surgical side of the business, they have knock off bone graft products (that established spine companies already have in hospitals) and struggle to get below average distributors to take the line.

I would be shocked if Bioventus does't pay large self reporting fine to Medicare for CMN BS, they will be lucky if Medicare doesn't dig deeper.

Not reporting is smart move, they figured out loophole so I give them credit, Hymovis following suit. Medicare will adjust soon and they will have to report, eventually Medicare will dump HA like many carriers are doing and its game over
 






anonymous said:
Couldnt disagree more. There will be no collapsing of the reimbursement model and competitors are kicking themselves for not doing this earlier.

Single injection is clinically superior to anything on the market and that is just a fact.

Good luck selling those HA products with crap reimbursement, no clinical data and ineffective pharma reps.
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Does everyone at Bioventus honestly think you can push out the rest of the competition and be left permanently standing alone at WAC? Leaving the government and taxpayers paying 3 times more per syringe (for products that are not new) over lower cost products that work just as well? What do your leaders tell you?

Its clearly anti competitive and monopolistic and the government will seize on it. Bioventus will end up paying back the government for this scam as changes in healthcare drug pricing arrive. Your company is seeking investment funds so it’s very likely the sales force will be hurt by this one in the end. A bubble that will surely burst. Bioventus is playing a risky game that is clearly in uncharted territory.
 






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