HME Business

Industry Meets With Lawmakers, Regulators

AAHomecare meets with House Committee Chairman’s staff, Florida associations and providers parlay with CMS’s Blum.

• By David Kopf
• Feb 24, 2011

American Association for Homecare staff met with senior staff from the House Oversight and Reform Committee this week about the Committee’s effort to examine various that negatively impact the industry. New chairman of the committee, Rep. Darrell Issa (R-Calif.) is investigating existing and proposed regulations that the association says will result in lost jobs.

“It’s in the interest of every American that we create a regulatory environment that fosters economic growth and makes U.S. companies globally competitive,” Issa has said

The Association said it discussed with Issa a number of regulations related to competitive bidding, respiratory therapy (including home oxygen and sleep devices), power mobility devices, diabetes testing equipment and supplies, and Medicare audits.

AAHomecare said Rep. Issa’s staff expressed interest in the association’s concerns and was particularly interested in examples of how CMS has not followed the proper regulatory process relating to HME issues. The Association says it will continue to work with the House Oversight and Reform Committee in its investigation of Medicare regulations.

Other meetings with lawmakers included AAHomecare President Tyler Wilson, who attended an association executives’ forum with Rep. Jason Altmire (D-Pa.); and Jay Witter, AAHomecare’s senior director of government affairs, who met with Rep. John Shimkus (R-Ill.), freshman Rep. Bill Keating (D-Mass.), and staff of Senators Tim Johnson (D-S.D.) and Kent Conrad (D-N.D.).

Meanwhile, members of the Florida Alliance of Home Care Services and members of the Florida Association of Medical Equipment Services (FAMES) also met with Blum participated in a listening session this week with Jonathan Blum Director of the Center for Medicare Management, which oversees competitive bidding in DMEPOS.

Also in attendance from CMS were Robert Foster, special assistant for the Office of the Regional Administrator of CMS; Elaine Hensley, chief ombudsman for CBIC; and Letisha Davis, CBIC ombudsman for the Miami area.

The meeting was, according to FAHCS, a last-minute effort by Blum to get feedback from bid winners and others about what has happened in Round One competitive bidding areas since its Jan. 1 implementation.

FAHCS said it attended with bid winners in multiple categories, winners in single categories, and non-winners, each with their own perspective on the program. The association added that none of the providers had a positive perspective.

FAHCS said Blum’s first question was, “How is it going” and the responses were not positive. The first reply, from active FAHCS member Fino Randazzo, who is a bid winner in Oxygen, was that because he won in only one category he is not getting any calls, because hospitals normally discharge patients who need oxygen and a hospital bed or other items, which he cannot provide.

“Winning in one category is the same as winning in none, we are getting no business and that is the same with everyone who won in only one or two items” Randazzo said.

Various providers at the meeting that they fear for their business, with one stating that “AMEPA and VGM told us not to, but we did suicide bid in the hope we could float our businesses long enough until this program went away. Now it looks like we may not survive.” 

Various points were raised for one hour, including the affects of audits and paperwork; the imbalance of CMS cutting payments while increasing the cost of paperwork by audits and prepay review; the problems with diabetic supplies, and how the new prices only allows old technology to be affordable; and oxygen delivery delays that have kept people in hospitals for days at a time, when patients were previously released in hours.

FAHCS says Blum expressed he was under the impression that the bidding process itself was much improved over 2008, and that association representatives “responded vigorously” that the lack of transparency and the fact that providers still do not know who set the bid has created doubt in that process.

“We have information that over 90 percent of bid winners are being reimbursed less and sometimes substantially less than they bid. The question was who set the bid,” said FACHS president Sean Schwinghammer. FAHCS said all the providers confirmed they are paid rates much lower than they bid.

“It remains to be seen what will result from this meeting, but it should be clear to the panel that CB is not the resounding success that is being touted by Administrator Berwick,” noted a statement from the National Association of Independent Medical Equipment providers.

AAHomecare urged providers and patients, as well as family members, caregivers, hospital discharge planners, and clinicians to call Congress regarding the program’s negative impact, as well as share their complaints by calling 1-888-990-0499 or visiting www.biddingfeedback.com.

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