I have been reporting that Medicare has more than sufficient dollars available to take care of those people who qualify. I also believe that for every legitimate buck spent another additional dollar is stolen from the system. So the object is to get the crooks out.
The largest scam I’ve seen was the Hospital Corporation of America, which paid a fine of about $7.5 million. This may be the highest fine ever levied for Medicare fraud.
Well, the thieves who sell drugs or by other nefarious means for “making a living,” usually end up in jail when they get caught. But when they see the president of a company that paid a gigantic fine was able to save enough money to become elected a governor of a state, they try to play “Can You Top This.” Today, I read of another scam.
A group of gangsters set up a national “franchise” for their associates using phantom health clinics. Information was garnered in New York. They stole the IDs of physicians (some dead) and merrily submitted bills to Medicare for services rendered (I assume their major expense was postage). They set up 118 clinics in 25 states! In New York alone, they submitted invoices for $100 million and Medicare has already paid out more than $35 million.
We have not seen the dollar figures for other states, but this is what you, HME providers, have to watch for. You must report any of this you suspect. The police, the prosecutors and the FBI will follow up. This raping of the system must be stopped. This is the chicanery that has lead to the competitive bidding legislation. It is why Medicare does not have sufficient money to reimburse hard working providers.
If you would like to speak about any local problems, please e-mail me at shelly.prial@att.net or call me at (877) 553-5127. I have had conversations with a number of providers about this problem. Protect your business and your employees – and never forget you have to protect your clients.
For more information on Medicare fraud, please visit: www.mymedicarefraudreporting.com
SHELLY SOUNDS OFF: Advice. Solutions. Practical Ways to Improve your Business by HME Expert and Medtrade Ambassador.
Tuesday, December 28, 2010
Tuesday, December 14, 2010
Preparing for the New Year
I am very upbeat about the future for our industry. Yes, I am aware of how few dealers were awarded contracts on the “competitive bid.” David Russell, in the U.K., had this bid described as: “Competitive bidding is an oxymoron. There is nothing competitive about it and it’s not bidding.” But, I am most excited by the great number of providers with whom I spoke at Medtrade who told me they are all gearing up to change how they operate their companies.
There is no question that the small number of bid winners will not be able to provide service correctly. I anticipate a great uprising by the beneficiaries. But we all know how slowly our government moves, so rather than wait to see what happens make your changes now. What can you do?
My first recommendation is that no matter whatever you plan, it must be realistic. You know your customers and their needs and also appreciate all your referral sources and their needs. These will always be present and so they are to whom you will direct your efforts. A very careful review of where your sales come from and then armed with this information hold a staff meeting. Tell all your employees what you are contemplating. Then ask each for any ideas they have. After all, they work face-to-face with your clients. When I spoke to entrepreneurs who have done this, I am amazed at the many ideas recommended by staff members. They are a great source and must be included in your plans.
The next step in your preparation for 2011 is to sit down with each member of your staff to discuss how to put their ideas to work. A provider from Minnesota told me his talks with employees made it very clear to him that they know a great deal.
It is never easy to change an operation that has been functioning well. Do not depend as much on third-party business as in the past. Now is when more of your efforts have to be to find new ways of running your company. Efforts must be developed for new OTC cash sales. There were many opportunities at Medtrade. Take advantage of them.
If you have any ideas to share, please call me at (877) 553-5127. I am aware that 2011 will see a great deal of changes, but I also believe more and more providers will use change to their advantage.
There is no question that the small number of bid winners will not be able to provide service correctly. I anticipate a great uprising by the beneficiaries. But we all know how slowly our government moves, so rather than wait to see what happens make your changes now. What can you do?
My first recommendation is that no matter whatever you plan, it must be realistic. You know your customers and their needs and also appreciate all your referral sources and their needs. These will always be present and so they are to whom you will direct your efforts. A very careful review of where your sales come from and then armed with this information hold a staff meeting. Tell all your employees what you are contemplating. Then ask each for any ideas they have. After all, they work face-to-face with your clients. When I spoke to entrepreneurs who have done this, I am amazed at the many ideas recommended by staff members. They are a great source and must be included in your plans.
The next step in your preparation for 2011 is to sit down with each member of your staff to discuss how to put their ideas to work. A provider from Minnesota told me his talks with employees made it very clear to him that they know a great deal.
It is never easy to change an operation that has been functioning well. Do not depend as much on third-party business as in the past. Now is when more of your efforts have to be to find new ways of running your company. Efforts must be developed for new OTC cash sales. There were many opportunities at Medtrade. Take advantage of them.
If you have any ideas to share, please call me at (877) 553-5127. I am aware that 2011 will see a great deal of changes, but I also believe more and more providers will use change to their advantage.
Tuesday, December 7, 2010
Heard at the Medtrade Expo
One of the many benefits of attending Medtrade is the ability to meet with peers. More information is shared in brief conversations at this venue than at any other place. I realize this happens because the showroom floor is a neutral arena. West coast and East coast business people shared ideas with those from the Deep South and the frozen North and they all learn from one another.
The largest concern from those I spoke to was what will happen to them when the awards from the competitive bids become a reality. Will they be able to survive? Not one of the two dozen or so principals with whom I spoke was negative. When I questioned them further, the consensus was that change is always taking place and they accepted that as a fact. They said in all the years they have operated their companies they faced many difficult challenges and yet they still continued to grow.
All did not submit the competitive bid. Others who did thought they would not be successful. They came to Medtrade to get ideas for rebuilding their business approach for the future. They came to meet vendors seeking new and different OTC cash sale opportunities. They told me they found many potential sales opportunities for their operation on the showroom floor.
Safety products, especially for those with disabilities, were sought and found. Lifts for the house or for the car, ramps, emergency response products, hampers and grab bars, transport products, and sports medicine and exercise equipment displays were all destinations for these entrepreneurs. Footwear and foot care was another segment being looked at. The basic standards such as ADL, apparel, wheelchairs and other ambulatory products, chairs and accessories, all saw attention from attendees. There was so much available this year and I spoke to many people who said that they found what they came for. That is what Medtrade does.
In the 30-odd years I have been attending Medtrade, never have I seen more dedicated attendees. Those HME providers who took the time to locate new business directions are ready to bring them to market and will continue to grow and expand.
The largest concern from those I spoke to was what will happen to them when the awards from the competitive bids become a reality. Will they be able to survive? Not one of the two dozen or so principals with whom I spoke was negative. When I questioned them further, the consensus was that change is always taking place and they accepted that as a fact. They said in all the years they have operated their companies they faced many difficult challenges and yet they still continued to grow.
All did not submit the competitive bid. Others who did thought they would not be successful. They came to Medtrade to get ideas for rebuilding their business approach for the future. They came to meet vendors seeking new and different OTC cash sale opportunities. They told me they found many potential sales opportunities for their operation on the showroom floor.
Safety products, especially for those with disabilities, were sought and found. Lifts for the house or for the car, ramps, emergency response products, hampers and grab bars, transport products, and sports medicine and exercise equipment displays were all destinations for these entrepreneurs. Footwear and foot care was another segment being looked at. The basic standards such as ADL, apparel, wheelchairs and other ambulatory products, chairs and accessories, all saw attention from attendees. There was so much available this year and I spoke to many people who said that they found what they came for. That is what Medtrade does.
In the 30-odd years I have been attending Medtrade, never have I seen more dedicated attendees. Those HME providers who took the time to locate new business directions are ready to bring them to market and will continue to grow and expand.
Monday, December 6, 2010
"New" Year Approaching
What does the New Year hold for our industry? I have given this question a great deal of thought. How will 2011 be different from this year?
I do not have an accurate figure of how many providers submitted bids nor how many have been awarded. I do know that there will not be an adequate number of providers available to supply all the recipients. I also am concerned and have some serious questions about some of the providers who were winners.
Here are some of the doubts that I have. Will there be a sufficient number of providers located in many of the smaller villages and towns whose patients have always been receiving excellent service locally? One answer I received is that beneficiaries can get their supplies from providers outside their home base, such as prescriptions being provided by mail order. Won’t that be a comfort for senior citizens and their family caregivers?
Another is how many of the winners have gone out of business since they submitted their bids and others who are now contemplating bankruptcy? There is another side to this coin. Do many existing providers face such a dire future in 2011? Is there any logic in limiting the number of companies to supply every needy patient? There is a schedule of fees (HCPCS) for all providers to receive a “fair” reimbursement. Why reduce the number of dealers?
I can go on and on. There should be a license to become a provider, which can be suspended or revoked. There must be inspections showing the providers meet specific standards. There should be training, such as that pharmacy techs obtain, for employees. These are some of the controls, which should be in place.
The country now suffers with nearly 10% of the work force unemployed. How many more people will be put out of work? Small businesses, like HME providers provide jobs and are taxpayers.
Now is the time for providers and dealers to march in unison to change these negative considerations. That can be done in conjunction with AAHomecare and your state HME association. Build OTC cash sales, become aggressive merchants! I am always available to answer any questions (877-553-5127). I want to see every provider grow in 2011.
I do not have an accurate figure of how many providers submitted bids nor how many have been awarded. I do know that there will not be an adequate number of providers available to supply all the recipients. I also am concerned and have some serious questions about some of the providers who were winners.
Here are some of the doubts that I have. Will there be a sufficient number of providers located in many of the smaller villages and towns whose patients have always been receiving excellent service locally? One answer I received is that beneficiaries can get their supplies from providers outside their home base, such as prescriptions being provided by mail order. Won’t that be a comfort for senior citizens and their family caregivers?
Another is how many of the winners have gone out of business since they submitted their bids and others who are now contemplating bankruptcy? There is another side to this coin. Do many existing providers face such a dire future in 2011? Is there any logic in limiting the number of companies to supply every needy patient? There is a schedule of fees (HCPCS) for all providers to receive a “fair” reimbursement. Why reduce the number of dealers?
I can go on and on. There should be a license to become a provider, which can be suspended or revoked. There must be inspections showing the providers meet specific standards. There should be training, such as that pharmacy techs obtain, for employees. These are some of the controls, which should be in place.
The country now suffers with nearly 10% of the work force unemployed. How many more people will be put out of work? Small businesses, like HME providers provide jobs and are taxpayers.
Now is the time for providers and dealers to march in unison to change these negative considerations. That can be done in conjunction with AAHomecare and your state HME association. Build OTC cash sales, become aggressive merchants! I am always available to answer any questions (877-553-5127). I want to see every provider grow in 2011.
Friday, December 3, 2010
Medtrade Report II
It was very interesting to tour the Medtrade NextGen Accessible Home display on the Medtrade showroom floor. Today most HME providers are seeking cash sale OTC items. This was clearly visible as the attendees made their rounds to visit as many vendors as possible.
Most senior citizens want to live in their own homes. This is a major consideration for our industry. The bulk of the senior Americans today have available the discretionary dollars to obtain those items for their comfort! Family caregivers are making every effort to see that all aids to daily living items are there for Mom and Pop. They do not want to see their parents institutionalized or placed in a long-term care facility.
The NextGen team put together a fabulous display. There was a real house set up on the showroom floor! A map was provided to guide the guests through the house. About forty manufacturers of specialty items had their products set up in the appropriate room. Everything displayed was ideal for OTC cash sales.
Starting at the outside entrance and exit were special ramps. Whether the homeowner needed a wheelchair or a walking aid, there was something available for them. Then, starting in the living room, going to the kitchen, checking the master and guest bathrooms, seeing the utility room and finishing in the master and guest bedrooms, they were all filled with great potential cash sales.
Visiting the NextGen home, attendees saw products ranging from lifts, monitors, bath safety, beds and mattresses, telephones, dispensers, footwear and more. This was one of exhibits that dramatically showed how to go after new cash sales!
If you can rearrange your company showroom to set up display “rooms,” they will become magnets to bring in new traffic. Promote OTC products and make your company a Mecca, a place where people will want to go!
Most senior citizens want to live in their own homes. This is a major consideration for our industry. The bulk of the senior Americans today have available the discretionary dollars to obtain those items for their comfort! Family caregivers are making every effort to see that all aids to daily living items are there for Mom and Pop. They do not want to see their parents institutionalized or placed in a long-term care facility.
The NextGen team put together a fabulous display. There was a real house set up on the showroom floor! A map was provided to guide the guests through the house. About forty manufacturers of specialty items had their products set up in the appropriate room. Everything displayed was ideal for OTC cash sales.
Starting at the outside entrance and exit were special ramps. Whether the homeowner needed a wheelchair or a walking aid, there was something available for them. Then, starting in the living room, going to the kitchen, checking the master and guest bathrooms, seeing the utility room and finishing in the master and guest bedrooms, they were all filled with great potential cash sales.
Visiting the NextGen home, attendees saw products ranging from lifts, monitors, bath safety, beds and mattresses, telephones, dispensers, footwear and more. This was one of exhibits that dramatically showed how to go after new cash sales!
If you can rearrange your company showroom to set up display “rooms,” they will become magnets to bring in new traffic. Promote OTC products and make your company a Mecca, a place where people will want to go!
Medtrade Report I
Wow! As the Medtrade meeting drew to a close, I took the opportunity to speak with many HME providers from all parts of the country. Everyone was excited and pleased with the new opportunities they discovered on the showroom floor. They all gave me basically the same message: “This year, Medtrade was not just another meeting but one where we found OTHER new ideas and are able to make plans for the future of our company.” Both the attendees and the exhibitors were all well aware of how the economy is changing and the need for the health care industry to adapt to remain viable.
The opening speaker, Dr. Clifford Schorer, Columbia University Business School, laid the groundwork as he discussed the challenges to the industry. He emphasized using current technology and developing new ideas. He gave several examples of how companies have done this. Dr. Schorer told the attendees that they, too, must take advantage of the fact that people today have i-pads and other technological means of communication. What an eye-opener! What an opportunity!
This year most attendees came by themselves or with a key employee. Attendance was up and all of the providers and their staff were busy viewing the exhibits to find new means of increasing their OTC cash sales.
The NextGen Medtrade Accessible Home, located in the corner of the exhibition hall, attracted almost every attendee. The flow of providers walking through saw more 40 exhibits showing new OTC cash sale appliances. How they can bring these to their elderly and disabled customers when they returned to their home base was accomplished. Travelers from all over the country just to see this “Accessible Home” thought it made the worthwhile. All enjoyed the tour and each came away with new ideas!
There is much more to report and the next few blogs I will talk about these. I would like to know what you took home from Medtrade this year. Please contact me
(877-553-5127 or shelly.prial@att.net) and share some of what you discovered at the meeting, some highlights and perhaps how you can implement these thoughts. Every provider has to work together and then I will be able to see you all again next year at Medtrade! Yes, all I can say is “wow.”
The opening speaker, Dr. Clifford Schorer, Columbia University Business School, laid the groundwork as he discussed the challenges to the industry. He emphasized using current technology and developing new ideas. He gave several examples of how companies have done this. Dr. Schorer told the attendees that they, too, must take advantage of the fact that people today have i-pads and other technological means of communication. What an eye-opener! What an opportunity!
This year most attendees came by themselves or with a key employee. Attendance was up and all of the providers and their staff were busy viewing the exhibits to find new means of increasing their OTC cash sales.
The NextGen Medtrade Accessible Home, located in the corner of the exhibition hall, attracted almost every attendee. The flow of providers walking through saw more 40 exhibits showing new OTC cash sale appliances. How they can bring these to their elderly and disabled customers when they returned to their home base was accomplished. Travelers from all over the country just to see this “Accessible Home” thought it made the worthwhile. All enjoyed the tour and each came away with new ideas!
There is much more to report and the next few blogs I will talk about these. I would like to know what you took home from Medtrade this year. Please contact me
(877-553-5127 or shelly.prial@att.net) and share some of what you discovered at the meeting, some highlights and perhaps how you can implement these thoughts. Every provider has to work together and then I will be able to see you all again next year at Medtrade! Yes, all I can say is “wow.”
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