Monday, February 4, 2013

You must be heard...NOW

Jonathan Temple, OxyMed  (Birmingham, AL), expressed his feelings about the Round 2 CMS competitive bid.  I am sure that Jonathan’s thoughts are the same for every DME/HME provider.  After I carefully read what he wrote, I realized even more than ever before how important it is for every dealer to make his or her voice heard NOW.

He compared the situation to a prize fight (not bad)!  CMS is telling dealers they are getting too much money for what they do and the industry is explaining how they perform to actually save CMS healthcare dollars. (And, let's not forget how much pro-bono work is done).

He goes on to caution other providers to not make “suicide” bids. I couldn't agree more. I am repeating his warning about bidding your services into a level that will be fatal for your company.

There is a great deal more to this problem, which must be considered.  Let’s start with CMS.  They feel  that the cost of the services billed for is excessive, but that is completely incorrect.  If CMS could only eliminate 90% of the current fraud and abuse (F & A), there will be sufficient cash available at the current reimbursement schedule. Unfortunatley, we can never rid the system of all the F & A, but we can really eradicate much of it.

The one thing that I am very proud of is the very small number of DME/HME providers who have been found guilty of any F & A!  The basic problem CMS has is a lack of controls for the services they are billed.  For example, what a hospital can bill by upgrading or for services not performed. The average patient does not know what CMS has been billed.  I have spoken to many of my peers and only found one who studied the monthly report they received and found it difficult to understand.  I am of that, but still questions should always be asked.

What can you do? This is something I have repeated over and over. Join your state and national associations now. Your added dollars (their modest fees) will keep you viable and in business. Don’t commit suicide! Get on the team and fight back. Draw all of your customers into the fray. All of this will be discussed at Medtrade in Las Vegas, so please be there.  Do it NOW!

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