Thursday, April 25, 2013

DO IT NOW; HR 1717

Breaking news from AAHomecare: 
"MPP Bill Introduced Late Last Night"
Now it's time to get cosponsors
"H.R. 1717, the Medicare DMEPOS Market Pricing Program Act of 2013, has been introduced to the House thanks to the bipartisan efforts of Rep. Tom Price, M.D. (R-Ga.) and Rep. John Larson (D-Conn.) The two Congressmen, senior members of the House Ways and Means Committee, introduced the bill to prevent CMS from implementing Round 2 of the controversial national bidding program and to replace it with the market pricing program."

There are about 500 elected representatives in Washington, one from every district in the United States. There are about 15,000 DME companies, which means every congressman can be reached by our efforts. Simply put, if each DME dealer will call their representative and request their support to get this bill (HR 1717) passed, we will win.  They MUST hear from each of you and as you make your requests, it will build up in force.

On April 24, Rep. Tom Price, GA, introduced HR 1717, the MPP Bill:  “To amend title XVIII of the Social Security Act to establish a marketing program for durable medical equipment, prosthetics,  orthotics, and supplies (DMEPOS) under part B of the Medicare programs.”

This is the most important opportunity ever to occur in our industry. We must, each and every one of us, get on board, and speak to all our clientele, customers, friends, and family caregivers to get this bill out of committee and onto the floor of Congress and then passed.

There already are 25 co-sponsors, so your (our) work is lined up for instant action. We had an opportunity last year to get this accomplished, but we ran out of time. WE ALL MUST ACT AT ONCE! There is no tomorrow! There is too much at stake! My Congressman, Bill Posey, will get more than 20 calls and he has already co-sponsored HR 1717.

When you speak to the HLAs (health legislative assistants) or the office managers, whether in DC or local office, remind them of how many customers you service.  DO THIS ASAP. Now, while things are spinning, make the contact. We will be very effective when each and every one of us joins the fray.

DO IT NOW ! ! ! !

Tuesday, April 23, 2013

Opportunities Galore #1

You have so many things on your plate, which must be accomplished, and I know it will be done. Thank you! We all have serious concerns about the competitive bid and are working to bring MPP to the industry. But we can never lose track of running our company on a day-to-day basis.

Visiting Nurse Associations are in every community and should be one of your best friends. Please make it a point to meet with the local VNA and invite them to visit your location. At Medtrade I had a chat with a dealer and he told me what he did.

He made arrangements to offer two types of nurse bags, one an over the shoulder bag, and the other a handbag. These were good leather bags and the company he bought them from agreed to put the initials of the nurse on each bag they purchased. Selling them was the secret!

This entrepreneur filled two bags with every item he had that a VNA would need. On each item he put a price tag with an ID #. The prices reflected a nice discount from list price. He included an order form and brought this to the president of the local group.

He asked her if she would be responsible for the bag and show it to all the nurses. He told her that each bag and any supplies ordered would be delivered in two to three weeks (time to have the name added). She also asked that the nurses attach a check with each order. What a surprise! They had about 30 nurses in that group and he got orders from a dozen of them.

A few weeks later, he received a phone call from another VNA just a few miles away. They wanted to see what he offered. Word-of-mouth was how this flourished! Orders kept flowing in!

The VNAs invariably bought their needs from him. He was a friend! This was such a success that he did an “Open House” for all the VNAs in the county. You, too, should consider this as a new opportunity.

Friday, April 19, 2013


At Medtrade in Las Vegas, one thing became perfectly clear. Both exhibitors and dealers recognized that more profits are created by “turnover”.

This is nothing new. Turnover means that you buy what you sell, and then as you sell them, you buy them again. It does not mean purchasing enough of any item to keep as inventory for any period of time. Since most invoices are 2%, 10 days, net 30 days, this should be your guide for restocking.

In this fashion, you are not tying up dollars to pay for a bulk purchase, and you will have the cash available and earn the 2% discount. If you doubt what I just said, please speak to your accountant, and then you will understand. Better profits are created by “turnover.”

I recall meeting with a very aggressive dealer in a large town. He was very proud of his reputation as a #1 wheelchair company. He took me into his warehouse and showed me how many chairs he had. He told me that he received superb extra discounts and thought he was brilliant.

As we walked through the storage area, we discovered many boxes broken and when we opened some of these, a few chairs were damaged. We also discovered that in a corner of the warehouse, rain had dripped though the ceiling and had damaged some merchandise.

I asked him how long he thought it would take to sell all of them? His answer, anywhere from 5 to 7 months. I was appalled. By not having free cash available a dealer will miss may opportunities to add new OTC cash sale items.

This applies to everything you sell. So make this a rule when you order anything: 2%, 10 days, net 30. That 2% adds up to 24% a year.

Wednesday, April 17, 2013

Your Reputation

There is nothing better for any business, whether DME/HME or other industry, than a good reputation! You are known by your reputation in the community, so it is imperative that you be very careful not to allow it to become besmirched.

DME/HME dealers or providers are in a very risky business. You are constantly dealing with senior citizens, bed-ridden patients, and very nervous family caregivers. They share their problems and look to you for help! 

You can do ninety-nine things wonderfully and get loads of accolades, but if you make one small mistake, everyone will remember it.

There are many good things that a DME/HME provider can do that will enable them to build a good reputation. I reported this a few years ago. I met an old friend from the Midwest at Medtrade and he told me about one of his successful undertakings. 

He made a deal with the local newspaper to write a “Good Health” article for the paper's Sunday edition. The editor thought it would be a good idea and offered to publish these articles for the following three Sundays. It has now been almost two years since the first one was published, and they have become a great feature in their hometown. His name appears only on the by-line, not that of his company!

When you attend meetings of your state and national associations and show copies of your column, the other DME/HME members will tell you of some things that they did. People love to share their successes! Other dealers may duplicate what you do. This will bring good both to you and our profession!

There are many things one can do to build a good reputation, but there is one caveat:  Be very careful not to make a misstep, which can sully all the good work you do!

Monday, April 15, 2013

Speak Up!

I have been very diligent in getting out the message about the pending MPP legislation. The problem which we must clarify is that some people seem to have the wrong impression. It appears that the average citizen believes this is a way for us to raise prices and increase the reimbursements paid by CMS and Medicare.

This is not true! Reimbursements, when MPP is passed, will not be any higher; basically, they will remain at the same levels created by the “competitive bid.” The key is that the bids awarded will be binding and cash deposits from the bidders will be required. Currently, under the existing flawed “auction” system, beneficiaries have little choice in finding a vendor and often will "do without” so as to not have to travel a long distance. Passage of MPP will allow them to remain with their current supplier! Your customers along with their family caregivers must be notified of this.

I repeat: Every DME/HME provider has to make it very clear to all their clientele; patients, family caregivers as well as their staff, that not only will recipients be getting better services than what they currently receive under the competitive bid, they will not have to go to different locations for specific items. They will not lose their current dealer who has also become a friend. Equally important is that dealers will not be forced to close their doors.

Passage of MPP will allow smaller companies to continue their service as long as they can provide product at the bid price! This will certainly allow access for people with disabilities and senior citizens to obtain supplies as needed without leaving their communities.

By proving to your clientele with the knowledge that passage of the MPP bill will protect them and it will also allow them to choose where they wish to shop, this will build good will for your company. Treat every customer and their family caregivers as your #1 customer!

Use your membership in both your state and national association to provide you with the necessary material to make this work. Speak up and say it loud and clear!

Friday, April 12, 2013

Benjamin Franklin

“We must, indeed, all hang together or most assuredly, 
we shall all hang separately.”

Have you ever seen anything said so perfectly so that you could not refuse to join the fray?

Benjamin Franklin was able get everyone involved with one simple sentence.

Things have not changed! To exist and survive today, we too have to work together. Heed the words of Ben Franklin. I ask that every DME/HME dealer or provider join with their state and national associations STAT. They are working for every DME/HME company in the fight to eliminate the competitive bidding program, 45% reductions for reimbursements, pass MPP and other onerous efforts by CMS and Congress.

If the associations cannot get close to 100% participation, who will suffer?

Need I say more?

Wednesday, April 10, 2013

First Aid

For many years, my company held an Emergency First Aid Day in our showroom. We had enough room after moving things around for about 36 seats. We announced there would be two speakers, one an EMT, and the other an Emergency Room nurse. When we placed an ad with their pictures in the local newspaper, the editor invariably wrote an article about the speakers. We did this two or three times a year.

It was amazing the amount of interest these talks created. What was even more satisfactory was the number of new sales we made that day. As a consequence, we established a section of the showroom identified as “First Aid.” The important thing was to display as many first aid items we stocked.  Every item displayed had a price tag!

Another thing we did was to print, on a business card size, all the local emergency phone numbers. Everyone took several of these cards home to keep in their pocketbooks and near their telephones. Yes indeed, the feature of the card was our phone number and address.

We never had a problem finding speakers. There was an active EMT squad in town and every emergency technical staff member offered to speak. From the two local hospitals, the emergency room nurses loved to be invited in their white uniforms and caps.

This program proved so effective that the after a few years we made arrangements at a local church where there was a large room available to hold the class. We added a physician and PT to the speaker list. The sessions ranged from 10:00 AM to noon with a break for lunch and the second session was held from 1:00 PM until 3:00 PM. The fee we charged (8 dollars) was to cover the lunch.

You can all do something similar. This is another easy way to build a specialty for new OTC cash sales! It certainly did for me.

Monday, April 8, 2013

A Special Congratulations to Medtrade's Kevin Gaffney

No one ever thinks about the amount of work involved to make Medtrade happen. Our industry is so fortunate to have Kevin F. Gaffney keeping it at such a high level.

Kevin F. Gaffney, Group Show Director, Medtrade

Georgia State University (GSU) was very aware of how much Kevin has accomplished - more than 25 trade conventions in 19 years!

The School of Hospitality at GSU named Kevin as one of their 40 outstanding alumni. An entire industry seconds this choice and sends their congratulations to him. Thank you, Kevin!


It is amazing how newspapers can take what they hear and then twist it into something different. Occasionally that will work in our favor. Let us make that happen!

Our local newspaper (Florida Today) reported on the meeting held in Melbourne (FL) with Congressman Bill Posey. The DME dealers, all from this county, explained the problems the recipients and we have with the competitive bidding program today. The reporter misinterpreted what he heard and reported it as if we were looking to raise reimbursements. USA Today did the same.

Representatives Tom Price (GA) and Renee Ellmers (NC) took action. 

The new competitive bidding process imposes artificial prices, permits non-binding bids, and shifts the costs to other Medicare categories – thereby nullifying any of the supported savings.” This sums it up perfectly!

As for the MPP Program being introduced, it will make things truly competitive.

The goal of this program is to save money and allow the free market to determine prices so that people receiving benefits from Medicare will have the best, most efficient care possible.”

I am asking every DME/HME provider and dealer to please get involved right now. Unless you all send the messages, get your clientele involved and work very closely with the state and national associations, we all face a dire future. But when we all work together, we become the voice of the people (VOX POPULI) and insure that our future will be bright. Yes, I know we can do it. There are more than 15,000 DME/HME companies in the USA. They each have a following of customers, patients and family caregivers who want to maintain the status quo. Make it happen!

It can be done! But it will not be successful without everyone participating! Do it now!

Tuesday, April 2, 2013

How to?

There are about 450 Electoral Districts in the United States and the citizens of each elect their representative. Most legislation start in the House and then go to the Senate before they can be passed.

I live in District 15 in Florida whose representative is Bill Posey, and we have some very active DME providers. They arranged to meet Congressman Posey’s Director of Community Relations, Pam Gillespie. A date was chosen and to everyone’s surprise Rep. Posey met with us (the providers invited me to attend). Stuart Burns, his Chief of Staff in DC, was on the phone for the entire meeting.

The providers came to discuss how Part 1 of the Competitive Bid failed and what Part 2 would create when it is activated. The dealers spoke of how the threatened reimbursement reductions would force many to close their doors. The new reductions are often less than the dealer’s cost of the product.

Senior citizens, patients and their family caregivers were greatly affected by Part 1. They were unable to get supplies and care locally from the dealers who have been their source (and friend). A number said they had to do without what was ordered, because it was too difficult for them to seek products at other locations.

Reimbursements have to be in a range based on things like quality, etc., not one price.  The dealers then explained how fraud and abuse has created this monster. There currently aren’t standards. Patient walkers range in price. The difference between a Lumex and an offshore knock-off is tremendous. The reimbursement schedules should reflect not only the price. The cheaper units will not last very long, and often break or even injure the patient. I repeat, providers and dealers have to be reimbursed based on standards and quality!

There are no requirements to become a DME/HME provider. A pharmacist, nurse, physician, dentist, therapist, and all other health care professionals must have a license or a degree in their specialty. Our industry is taking a giant step toward that accomplishment with the accreditation program.
Unhappily, CMS and Congress have not recognized accreditation. To be effective, accreditation must have teeth. Only when providers earn it will be able to participate in both Medicare and Medicaid. If a dealer is found to be dishonest, his certification can be revoked. Otherwise they would be unable to participate in Medicare.

When a crook is caught selling drugs, playing numbers, or other crimes, they go to jail. But when the quick-buck operators are found to be sending phony bills they are closed and may be fined. This is a lot better than prison! I read in my local newspaper when several “companies” were caught, the principals went back to Croatia with millions of dollars.

When asked, CMS told us it would be too expensive to prepare standards and they did not see the need to have inspectors. They could not absorb the cost, but the fraud and abuse is taking out so much more. The good health, the care and welfare of the recipients, patients, senior citizens and family caregivers are not a consideration to them.

I know this is rather time consuming, but in order to survive we must all get involved and work diligently to maintain our industry and profession.

Please make an appointment to see your representative.