The HME industry had some clues about what to expect from CMS. They were hidden in plain sight: Congressional testimony.
Kerry Weems, the new CMS administrator, gave members of the Senate Finance Committee a clear picture of his priorities when he appeared on Capitol Hill July 25. A reading of his brief remarks to the committee reveals his concern for beneficiaries, his understanding of the power CMS has to affect providers, and his intolerance of fraud.
Weems, a career civil servant in the Department of Health and Human Services, condemned “fraudulent equipment providers” and cited his belief that “CMS must exercise its oversight responsibilities to protect the beneficiaries.” He specifically committed to increase CMS’ oversight activities.
Specifically mentioning durable medical equipment providers, Weems remarked that members of the Finance Committee have talked to him about CMS’ effect on various kinds of providers. “As CMS flexes its regulatory muscle, we need to be cognizant of these consequences to individual providers. Indeed, many on this Committee have urged me to be sensitive to the consequences of CMS regulations on pharmacists, ambulatory surgical centers, durable medical equipment providers, and rural providers to name a few.”
Weems said he wants providers to understand CMS’ priorities and the reasons motivating its actions. “CMS needs to ensure that these businesses have a good understanding of what CMS is trying to achieve and what it means for them and the beneficiaries they serve. . . . CMS is working to improve quality and to find an evidence-based method of paying for quality. . . .
You can read Weems’ entire statement at www.cms.hhs.gov/apps/media/testimonies.asp.
Here are excerpts from the testimony that are of most interest to HMES:
“My vision for Medicare, Medicaid, and children’s health insurance is one in which our beneficiaries are protected. Whether it is from unsafe nursing homes, unscrupulous insurance salespeople, fraudulent equipment providers or bad medicine, CMS must exercise its oversight responsibilities to protect the beneficiaries. If confirmed, I will intensify CMS oversight activities, and I expect this Committee to hold me responsible for acting on abuse or inefficiencies discovered in the course of program oversight. CMS needs to be a reliable and trusted partner to the beneficiaries we serve. . . .
“The regulatory power of CMS is enormous. Small changes in payment rates, conditions of participation, or allowable expenses can have large consequences to individual providers. As CMS flexes its regulatory muscle, we need to be cognizant of these consequences. Indeed, many on this Committee have urged me to be sensitive to the consequences of CMS regulations on pharmacists, ambulatory surgical centers, durable medical equipment providers, and rural providers to name a few. Our beneficiaries depend on these providers every day — the corner pharmacy, the home health agency, the community health center. As we work to make our payment systems and these providers more efficient, CMS needs to ensure that these businesses have a good understanding of what CMS is trying to achieve and what it means for them and the beneficiaries they serve. All of things I have discussed are on the immediate horizon. CMS is working to improve quality and to find an evidence-based method of paying for quality. . . .
“I have devoted my entire professional career to public service and rather than listing my accomplishments for you, let me tell you what I have learned. I have learned to seek out experts and listen to them, to seek all those with equities in the issue and listen to them, to follow the law; to weigh the evidence and the facts, and render a decision. My pledge to you today is that I will pursue the facts and the law to guide my decisions and leadership.”
