Friday, August 29, 2014

October 21-23

These few days will enable your company to consider making a few dramatic changes in how you approach the market. To date, your company has been an efficient operation. You have developed an excellent staff, built a following of clients, and are recognized as a premier source for DME/HME supplies.

CMS and Medicare are trying to lower the reimbursements dealers receive for the supplies and services they perform. This is happening because the criminal element finds it easier, and less risky to take advantage of our industry because there are no standards or any license issued when becoming a DME/HME provider. How tempting that is for the “quick buck” thieves! Just read the newspapers to see how many of these have been uncovered. But when I hear that it can be as much as 40% (or even more) being stolen from these reimbursements, I am appalled.

You must do something to change what is happening to protect your livelihood!

You can no longer stand-alone; your voice must be heard. The state DME associations, AAHomecare, industry magazines, VGM, MED, and all the major providers will participate at Medtrade. The schedule of classes, seminars, lectures, and meetings is immense. So many opportunities for DME/HME providers and dealers will be found there. Your future will be there, so must you!

I am one of the very few people left who have watched how Medtrade has developed since its inception. Fantastic!

Never has the need for Medtrade been as important as it is today. With the pressure from CMS and Medicare to reduce reimbursements and the “fast buck” operators moving in, many dealers have the threat of being forced to downsize or even close their doors hovering over their heads.

All of the above will be addressed at Medtrade. You must attend if you plan to stay solvent and grow. Register now and get your hotel room before prices rise, and bring with you as many members of your staff as possible.

I will be there with Thelma. We know what it means to be at Medtrade. Please don’t miss this year's exhibition, October 21 – 23 in Atlanta, because there is too much of a stake to sit by and wait.
If you still need to register for Medtrade, please use the promo code, SHELLY, to get a Free Expo Pass.

Monday, August 25, 2014


I have very carefully shied away from discussing politics in these blogs. Everyone has a different view and each is to be respected. This is called democracy and it is how things have always been done in the U.S.A.

It matters little if you are registered with one party or the other. The key is that you vote. Your family and friends do, and so that places you in a very excellent position to share your ideas and influence others to join with you.

What is so important is that you have a business with employees. You and your company contribute a great deal to the health and goodwill of your clientele. This places you in a unique position. There are many things involved with how good health care is delivered in the U.S.A. These things need to be adjusted and some eliminated! Since this is so vital a goal to meet, you must get involved.

DME/HME dealers provide service and supplies to their clientele. They depend on CMS and Medicare for reimbursement. This system is currently under attack, and if reimbursements become any lower, many dealers may be forced to close. The basic problem they have is survival.

This is how I personally have addressed this situation for more than 65 years. For a period of time, I was Director of Government Affairs for a major company. I have always done my best to support AAH, and they do such a superb job for the industry. They and the state associations are your partners. Be sure you are on board with them.

Politics is not belonging to a party; it is for you to vote for the candidates who will support your requests and industry!

Meet the person in charge at your congressman and senator’s local office. Usually the local office is close by. The senator may have more than one office. In their local office, you can sit down either with the person in charge or the health related staff member. They will carry your message and get you an answer. Here in the district where I live, there are several DME dealers who have banded together and established a fine working relationship with their congressman, Bill Posey. This could be done in every District!

More of this will be discussed at Medtrade in Atlanta. I hope to see you there.
Remember to use the promo code SHELLY to get your Free Expo Pass when you register for Medtrade. It's coming up this October 20-23 in Atlanta, GA!

Thursday, August 21, 2014

Thank You, Mr. Wallace

Norris Wallace III is the president and CEO of one of the finest DME/HME companies (American Medical Systems). They are located in Macon, GA, one of our favorite cities. For many years, when Thelma and I drove to the Medtrade shows, we usually stayed in Macon the evening before we had to set up in Atlanta.

Mr. Wallace is correct in saying: “…accreditation is no longer voluntary, but required by CMS to build the system or maintain a Medicare Provider number.” Mr. Wallace pointed out that his company is in their 32nd year; he follows their directions carefully but feels it adds additional cost (around 25%) to his operations. I agree with him 100%.

The weakness in the system is that it does not have teeth. I am a Registered Pharmacist, and my pharmacies had to be very carefully inspected before I could open the door. I was then subject to unannounced visits to determine that I am maintaining everything required by law. To earn a license, the principal should be a professional (e.g., RN, PT or Registered Pharmacist).

The first step to receiving licensure is accreditation. Without strong teeth, any rules or regulations are valueless. Over the years, I have visited too many companies that should not have been in the system! It is active companies, like American Medical Systems, that beneficiaries require. They are the key to continued success in Medicare and homecare.

When all standards have been met, the license should be awarded. It can then be suspended or revoked if the company does not abide by all regulations.

Mr. Wallace sent me one of the most interesting letters I have received since writing these blogs. I have to agree with many of his comments, such as: “We don’t need more government regulation,” or, “Capped rental is blatantly unfair and has been a crippling blow to the industry.” Yes, these things are true, but we have to make licensure the method of monitoring and maintaining our industry.

American Medical Systems has deserved the recognition as a premier operation, as a well established and community oriented DME dealer! This is what I see in every excellent company.

I look forward to meeting Mr. Wallace, in person, at Medtrade this fall in Atlanta. Perhaps time will allow us to join for a libation and get to know each other at the show. Thank you very much, Mr. Norris Wallace.

Readers, please do not hesitate to send me a message ( I promise to answer ASAP.

Monday, August 18, 2014


It seems to me our 2014 Congress is putting off passage of any constructive legislation. Why?

AAHomecare and the state DME associations, acting on behalf of not only the industry but also all citizens, have been working, writing, calling and pleading for passage of several bills. They have not received an answer. Why?

When something is left undone, the consequences can be very serious. By putting off all pending legislation for a future time, far too many people, dealers, providers, senior citizens and bed-ridden patients all will suffer. The congressmen must get of off their derrieres and pass the pending legislation to eliminate the competitive bid legislation currently in force.

I am renaming the current Congress as the #1 “PROCRASTINATING CONGRESS” ever in DC. How much have they let slide by and remain undone? Representative John Boehner should not have allowed them to take a “holiday” with so much work pending. I get the distinct impression that we have a Congress which does not care about their constituents. They are so divided that when a Republican recommends new legislation, the Democrats say “NO” or when a Democrat introduces anything new, the Republicans will not support it.

As a senior citizen, I recall our congressmen, in committee, both parties, ironing out pending legislation which would benefit everyone!

Every DME/HME provider should contact AAHomecare and their state DME association to obtain all the necessary material to present to our congressmen. They are at home right now. Do not PROCRASTINATE. Do it STAT. Your future depends a great deal on how effectively you deliver your message.

Thelma and I, as senior citizens, still send e-mails, letters, and make calls. As an active DME/HME principal, you are well known to all your customers, as well as in your community. This is a great strength you have, so please use it, and do not procrastinate.

Thursday, August 14, 2014

Senior Citizens

“Birds of a feather flock together.” That is true! Thelma and I live in a very nice community in Florida, and it is interesting to realize how many peers we have as neighbors. The best thing is that we all watch out for one another.

I spoke with many of the couples we know, all about the same age bracket as ours, the mid to late 80s. My concern was to see where and how they obtain their supplies. I wanted to know who their primary sources are. Their responses were obvious: Medicare. No surprise there! I am sure this is the same throughout the country.

Each couple also had a secondary policy to help with some of the costs not covered by Medicare. This is exactly how things should be, just as planned when these regulations went into effect. The problems are not with the dealers; it is with “quick buck” dishonest people trying to move into the industry. Many of these thieves decided it was easier to enter health care as “providers” to reap a harvest.

In the community where Thelma and I live, there are more than a half dozen independent pharmacies, as well as Walgreen and CVS stores, and some very fine DME/HME locations. I discovered that each of the DME operations, though similar, were somewhat different. Oxygen and related supplies were featured by several independents. OTC items, walkers, wheelchairs, etc. was also a major offering of some dealers, but they each made everything available. Again, they are  all running in the black and each is very concerned how this could change unless we all work together.

These are the very dealers I have often written about. They made it a point to meet with their congressman. At the Spring Medtrade, they arranged a meeting with several of Congressman Bill Posey’s staff. If everyone in the districts throughout the US would band together like they have, we will succeed. (I am very sad to report that one of these friends was obliged to close). No one else should ever be forced to step aside; this is why we must all work together. A team is always better than standing alone.

The senior citizens I speak with in my community all want to maintain local sources, working with the dealers and pharmacists they know so well and consider friends. We cannot allow this to change. AAHomecare and your state association will help you to stay active. Continue serving these senior citizens!

Tuesday, August 12, 2014


Simply stated, a compliment is a word of praise. I want to point this out because in the last few days I have heard very few words of praise for some of the hardest working people in our industry.

The heads of the 40 plus state DME associations are doing everything possible within the borders of each state to protect their members (all the dealers!). AAHomecare is giving so much effort to get the pending legislation passed into law! I hope they will succeed!

I would like to see more “thank you” or “we appreciate” comments directed to these diligent folks.

When you realize what a tremendous task it is to bring about changes in the current legislation, it can be frightening! In 2013 and 2014 there were bills waiting each year to get onto the floor of Congress to be passed. However, this did not happen! Why? This is because too many dealers and providers will NOT allow themselves to get involved.

Penny-wise and pound-foolish! The big excuse is, “We can not afford to spend any money!” How much money will they be able to afford if their company folds under this pressure.

The supreme compliment you can give is to become a dues paying member of AAHomecare and your state DME association. These costs are a normal part of a business operation (your accountant will tell you the same).

Invest in your future, and your clientele will benefit. Invest so that your family and your employees will be able to continue the team you have built. You will compliment many years of hard work when you complement the DME/HME industry and your peers.

Friday, August 8, 2014

Medtrade - An Exhibition (Part 2)

Legislation, both in force and pending, is one of the main reasons to attend Medtrade this fall. As an industry, DME/HME dealers are under many forms of attack.

If Congress and Medicare decide to lower reimbursements farther, this will be very damaging! New legislation has been introduced, but is still in committee. AAHomecare and the State DME Associations are leaving no stone unturned in their battle to protect the industry and get these bills onto the floor and be voted into law. We failed twice; we cannot afford to fail again! This new legislation must be passed, and AAHomecare is diligently working with members to get the politicians to work on our behalf.

AAHomecare is raising many dollars just to fight this alone; they have set a goal to reach. I hope they get all the support necessary to be successful.

To keep many companies in our industry from having to close their doors, it is so important that every dealer get involved with the effort AAHomecare is making. After all, when “every dealer” is at risk, then every dealer must give his or her support.
The best way to protect your company is by becoming a dues-paying member. This small fee will be a great deal less than being forced to close, wouldn’t it?
Don't miss the New Product Pavilion at Medtrade this Fall!
Tom Ryan, President, AAHomecare, will give the opening talk. At the spring Medtrade there was a standing room only to hear him. Please be sure you attend and listen to what he tells us.

Then, AAHomecare will sponsor another “STAND UP FOR HOMECARE” reception. This has always been a high point for Thelma and I. We get to meet all of our friends there, and it is a pleasure seeing and catching up with them, enjoying a drink and some tasty “noshes”. Somehow there is never enough time to greet everyone.

Also at the show, all the industry magazines will have displays where you will meet the editors and staff. We are so fortunate to have access to the high quality publications you all receive (free), so say “thank you!”

Another highlight is the NEW PRODUCT PAVILION - Make sure you visit that area of the floor. New products, which can fit seamlessly into your operation, are often difficult to find, but will be right at your fingertips - isn’t that great? What is so pleasing for me is to visit my many friends with the VGM and MED buying groups. They are such a tremendous support for our industry.

By the way, you will also find a number of Consulting and Management Services. Stop by their booths and hear what they can do for you.
When you register for Medtrade, don't forget to use the promo code: SHELLY for a Free Expo Pass. I'll look forward to passing you on the showroom floor!

Thursday, August 7, 2014

Medtrade - An Exhibition (Part 1)

Over the past 30 years, the Medtrade Exhibitions have become more than just a place where vendors display their wares! Indeed this is a very important part of the exhibition; however, there are many newer and equally important reasons for DME/HME providers and vendors to attend Medtrade.

For the average DME principle, the ability to see so many vendors in just a single day at Medtrade is unsurpassed. For the vendors, they are able to sign deals with many new clients. Everybody wins! When I chat with vendors, they bubble with excitement about how many NEW customers placed an order! Even more exciting, is the large number of dealers who are thrilled by the multitude of opportunities they uncovered on the exhibition floor.

The DME/HME industry is under attack by a government that is panicking at the rising costs of providing Medicaid and Medicare support! Rather than make the obvious changes in the legislation, they find it easier to reduce the fees earned by dealers, which only affect legitimate operations. The others continue happily committing fraud until they are caught. I have spoken in DC and at many state meetings about the necessity of changing how one qualifies to become a provider (see my past bog entry, Licensure).

Are there standards? Other than accreditation, which is the first positive step forward made, the answer is no. At Medtrade, each of the associations who offer this will be present. If you have not earned accreditation, make the arrangements at Medtrade.

I get very excited as I watch dealers running from one vendor to another seeking suitable products for their companies. This is most rewarding because I see the same excitement with the vendors.

Other major benefits obtained by attending the Medtrade Exhibitions are the ability to attend several seminars every day. Topics include more than one talking about Medicare Updates, Legislative and Regulatory rules, Rehab, Assisted Living, Reimbursements, Oxygen, Retail, and Marketing etc.!

In one trip to Medtrade, your company can cover everything a DME dealer must know to remain solvent and prosper. These classes have recognized experts leading the discussions and giving the lectures. They are usually filled, and I recommend bringing staff members. These educational lectures and seminars alone are worth the time to attend.
Get a Free Expo Pass when you use the promotional code: SHELLY. >Click Here to Register for Medtrade Now!

Friday, August 1, 2014


Return on investment! I often feel that too many DME dealers are not fully aware of what a good ROI can mean for their bottom line. Basically, every penny you spend has to create a return. When you ran an advertisement in your local newspaper, how many extra sales did that bring? Did the extra revenue from those sales more than cover the cost of the ad?

Some time back, I was working with two dealers serving very similar communities. Their companies each were in a strip mall, almost in the center of the village. Their competition was much further than walking distance.

To determine what to offer, we arranged a three-way conference call. We reviewed a number of products to promote and decided to offer a “heating pad”. Both dealers told me they were only sold when a physician or PT ordered using one. Dealer A said he averaged selling one heating pad a month and dealer B echoed that.

After some discussion, we selected a vendor to contact and made the following arrangements: Each dealer ordered three dozen units and had the price secured for two months. The vendor provided the ad and all the dealer had to do was include his business name, phone number, and address. The “SPECIAL” price was the MSRP. The ads were scheduled to run for three weeks on the Saturday newspaper obituary page.

There was also a bonus: Each heating pad purchased also included several other items.
How much of an ROI did they receive?

I was amazed. They found the results to be far better than they anticipated. I recall how hesitant they were when I suggested this, but they listened. The result was that each sold more than three dozen heating pads during the three-week period. A nice ROI!

At Medtrade in the fall, you should speak with vendors about working together with you on this type of promotion. The reality is that these will be rather small investments which can bring you a hefty return. Isn’t that why you opened your company, for the ROI?
Register for Medtrade using the promotional code, SHELLY, and get a Free Expo Pass. Why wait?

See you in Atlanta!