What changed in this filing

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Item 1. Business

2021-03-11 compared with 2020-03-05 · 32 added, 21 removed, 170 unchanged (24% of the section changed)

23 unchanged sentences

The Company also provides payers with utilization and outcome data to evaluate therapy effectiveness.

• Physicians .

The Company provides physicians with timely patient clinical support by providing care management related to their patients’ pharmacy needs and improving compliance with therapy protocols.

The Company eliminates the need for physicians to carry inventories of high cost prescriptions by distributing the medications directly to patients’ homes.

The Company either bills the payer directly or assists the patient in the submission of claims to the payer.

• Pharmaceutical Manufacturers .

12 unchanged sentences

The Company administers a wide variety of therapies and services, including the following:

• Anti-Infectives Infusion.

The Company provides comprehensive home infusion services to combat serious infections in patients of all ages.

The Company’s anti-infective therapy and services help avoid hospitalizations for many infections that can be safely treated at home.

• Heart Failure.

The Company administers home infusion services to treat heart failure, either in anticipation of cardiac transplant or to provide palliation of heart failure symptoms.

• Chronic Inflammatory Disorders .

The Company treats chronic inflammatory disorders, which include Crohn’s disease, plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, ulcerative colitis, and other chronic inflammatory disorders.

• Immunoglobulin Infusion.

2 unchanged sentences

Intravenous IG infusions are concentrated antibodies that have been purified from large numbers of human blood donors.

Anti-Infectives Infusion.

The Company provides comprehensive home infusion services to combat serious infections in patients of all ages.

The Company’s anti-infective therapy and services help avoid hospitalizations for many infections that can be safely treated at home.

Nutrition Support Infusion.

The Company delivers comprehensive nutrition support across pediatric, adult, and geriatric patients.

The Company’s expert team provides home parenteral nutrition and enteral nutrition support for numerous acute and chronic conditions negatively affecting nutritional status, such as stroke, cancer, and gastrointestinal diseases.

• Bleeding Disorders Infusion.

5 unchanged sentences

The length of treatment depends on the severity of the bleeding episode, and the need for treatment continues throughout the life of the patient.

The Company offers a range of other infusion therapies to treat a variety of conditions, including heart failure, pain management, chemotherapy and respiratory medication.

• Nutrition Support Infusion.

The Company delivers comprehensive nutrition support across pediatric, adult, and geriatric patients.

• Women’s Health.

The Company offers therapies that women need to survive and thrive through high-risk pregnancies.

Personalized programs in prematurity, nausea and vomiting hyperemesis, diabetes in pregnancy, and hypertension help meet the needs of each mother.

• Neurological Disorders.

The Company provides an array of treatments to manage the progression of neurological disorders such as Amyotrophic Lateral Sclerosis (“ALS” or “Lou Gehrig’s disease”) and Duchenne Muscular Dystrophy.

The Company offers a range of other infusion therapies to treat a variety of conditions, including pain management, chemotherapy and respiratory medication.

The Company also provides nursing services to support the above therapies, comprised of its nursing team of approximately 1,300 employees, and through its network of sub-contracted nursing agencies.

3 unchanged sentences

(2) establishing, maintaining and strengthening relationships with local and regional patient referral sources;

and (3) establishing, maintaining existing and developing new relationships with pharmaceutical manufacturers to gain distribution access as they release new products.

and (3) maintaining existing and developing new relationships with pharmaceutical manufacturers to gain distribution access as they release new products.

The Company’s sales structure is focused on maintaining and expanding its relationships with drug manufacturers to establish its position as a participating provider when they release new products.

5 unchanged sentences

(a unit of Cigna), Briova (a subsidiary of OptumRx, which is a unit of the United Healthcare Insurance Company) and various regional and local providers.

The Company believes that its reputation for providing quality services, the strength of its growing national presence and its ability to effectively market its services at national, regional and local levels places it in a strong position against existing and potential competitors.

The Company believes that its reputation for providing quality services, the strength of its national presence and its ability to effectively market its services at national, regional and local levels places it in a strong position against existing and potential competitors.

The Company believes that the value created by the Merger has put the Company in a unique position to efficiently capture market share through its expanded footprint and synergies.

11 unchanged sentences

These relationships provide the Company the opportunity to become a selected partner in the launch of their new products.

The Company may receive fees, which it records as other revenue, from certain biotech manufacturers for providing them with clinical outcomes data.

The Company’s continued growth will be dependent on maintaining its existing relationships with manufacturers and establishing new relationships with additional manufacturers as the Company launches new specialty products.

The Company may receive fees, which it records as revenue, from certain biotech manufacturers for providing them with clinical outcomes data.

For the year ended December 31, 2020, approximately 70% of the Company’s pharmaceutical and medical supply purchases are from three vendors.

9 unchanged sentences

Nursing services are typically billed separately, while other patient support services, such as pharmacy compounding service, delivery service and ancillary medical supplies are reimbursed either separately or on a per diem basis, where applicable.

The Company’s largest payer is with United Health Group, which represented approximately 16% of its revenue for the year ended December 31, 2019.

The Company’s largest payer is United Health Group, which represented approximately 15% of its revenue for the year ended December 31, 2020.

No other single payer represented more than 10% of its revenue.

The Company also provides services that are reimbursable through government healthcare programs such as Medicare and state Medicaid programs.

year ended December 31, 2019, approximately 12% of the Company’s revenue was directly reimbursable through governmental programs, such as Medicare and Medicaid.

The Company also provides services that are directly reimbursable through government healthcare programs such as Medicare and state Medicaid programs.

For the year ended December 31, 2020, approximately 15% of the Company’s revenue was reimbursable through direct governmental programs, such as Medicare and Medicaid.

Governmental Regulation

20 unchanged sentences

Matters Affecting Drug Prices

Pricing benchmarks in the pharmacy industry are periodically published by third parties such as First DataBank, Medi-Span, RJ Health, and CMS, and the benchmark reimbursement varies by payer contract.

Pricing benchmarks in the pharmacy industry are periodically published by third parties such as First DataBank, Medi-Span, RJ Health, and the Centers for Medicare & Medicaid Services (“CMS”), and the benchmark reimbursement varies by payer contract.

The most commonly used benchmarks are AWP and ASP.

40 unchanged sentences

Medicare Home Health CY 2020 Home Health Prospective Payment Systems Rate Update .

On October 31, 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services.

On October 31, 2019, the CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services.

The final rule set forth routine updates to the home infusion therapy services for calendar year 2021 and subsequent years, and solicits comments on options to enhance future efforts to improve policies related to coverage of eligible drugs for home infusion therapy.

3 unchanged sentences

In addition to the Stark Law, many of the states in which the Company operates have comparable restrictions on the ability of physicians to refer patients for certain services to entities with which the Company has a financial relationship.

Certain of these state statutes

mirror the Stark Law while others may be more restrictive.

Certain of these state statutes mirror the Stark Law while others may be more restrictive.

The Company attempts to structure all of its business relationships with physicians to comply with the Stark Law and any applicable state self-referral laws.

5 unchanged sentences

Any person or entity participating in a circumvention scheme to avoid the referral prohibitions is liable for civil monetary penalties, and additional fines may be imposed for failure to comply with reporting requirements regarding an entity’s ownership, investment and compensation arrangements for each day for which reporting is required to have been made under the Stark Law.

Human Capital Resources

As of December 31, 2020, the Company employed 5,146 persons on a full-time basis and 706 persons on a part-time basis.

The majority of its part-time employees are clinicians due to the nature and timing of the services the Company provides.

Our business relies on our ability to attract and retain nursing staff, pharmacists and other professionals who possess the skills, experience and licenses necessary to meet the requirements of their job responsibilities.

Our ability to attract and retain personnel depends on several factors, including our ability to provide them with engaging assignments and competitive salaries and benefits.

Available Information

1 unchanged sentence

The Company maintains a website at http://www.optioncarehealth.com.

The information contained on our website is not incorporated by reference into this Annual Report and should not be considered part of this report.

Our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and our Proxy Statements are available through our website at https://investors.optioncarehealth.com/, free of charge, as soon as reasonably practicable after they are filed with or furnished to the SEC.

The information contained on its website is not incorporated by reference into this Annual Report and should not be considered part of this report.

The Company’s Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and Proxy Statements are available through the website at https://investors.optioncarehealth.com/, free of charge, as soon as reasonably practicable after they are filed with or furnished to the SEC.

The SEC maintains a website that contains reports, proxy and information statements, and other information regarding issuers that file electronically with the SEC at www.sec.gov.

Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.

What changed 10-K

Item 1. Business