‘Draconian’ NSC drives stake into HME’s heart

Wednesday, March 31, 2004

I want to comment on your recent article, “NSC Takes ‘draconian’ approach to compliance” in the February issue of HME News. After working in the orthotics industry for over 13 years - seven years with my own small company - I am out of business. The inspector came to visit my company and because the hours were not posted and the sign was missing, my number was revoked. Let me explain before people jump up and down about the sign: In all my years as a provider, I always visited my patients; no one ever came to me,  I am a one person operation. So basically, all I have is a billing office with patient files. All is done by the rules with HIPPA compliance. 

I had no way of knowing that the inspector visited until my payments from Medicare stopped dead. When I called I was told that I should wait 7-10 days for a letter explaining everything and I could re-apply for my number. No letter ever came. No money came in and my business is now defunct. There was no way for me to rectify this situation in a timely manner so I had to send my patients elsewhere for treatment. NSC has basically taken away my livelihood for a small infraction which could have and should have been easily fixed.

In the real world, this doesn’t happen. How can a government entity shut people down without as much as a letter of notification? How much more difficult can it get to comply with NCS rules, many of which don’t apply to some of us? The system is a mess and the fallout is severe and is getting much worse. I am at a point in my life where as difficult as it is losing this hard fought battle with NSC, losing a business and being penniless with no income, it is not worth doing business with Medicare. The cutbacks are unrealistic for the amount of work involved. I tried to go the extra mile for my patients, but who can afford even doing what needs to be done at the minimum?

I have a dialogue with my congressman and I intend to push forward to educate state representatives. I will work with others in my position to push for legislation that makes sense. Medicare is a joke. The way to combat fraud and abuse is not punishing honest providers. What don’t they get it at NSC? Power wheelchairs in Texas have impacted my little business in Connecticut in a way I never dreamed. Our senators and representatives in Congress need to perk up and stop fooling around or the system is in danger of imploding. Small companies with provider numbers don’t stand a chance in this climate; there just isn’t enough manpower to comply with every little nuance and no chance to explain yourself. Reminds me of Nazi Germany...sad but true.

- Karen Gaskell owns Barnell Medical in Thompson, Conn.

No comparison between Rx & DME components
I just finished reading your editorial on the Prescription Drug Act. While as a member of all four DAC advisory boards and a DME supplier, I agree with your basic premise that DMEs provide a lot of service. But your snide comment about pharmacists doing little more than popping pills in a bottle was not only uncalled for but showed your lack of knowledge of a pharmacist’s roll in dispensing and advising patients of medication adverse effects.

How many DME dealers have to attend college for six years to get their doctorate in pharmacy, then pass a national board test to be able to practice their profession.

If, along with your medication, your pharmacist only gives you a printout of additional information, you are trading at the wrong pharmacy. You should be getting advice about contraindications, drug-drug interactions, drug-food interactions etc. As someone who has run both businesses, for every DME call at 2 a.m, I received 500 calls in the middle of the night for emergency prescriptions. You owe an apology to every practicing pharmacist in the country. Yes I am fighting to get the Prescription Drug Act changed, but I’m not doing it by making snide comments about the most trusted profession in the country (according to the Gallup Poll for the last 10 years).

- Herb Langsam works at Medicare Recoveries in Oklahoma City, Okla.