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Audit notebook: CNN, legislation and an olive branch

Audit notebook: CNN, legislation and an olive branch

YARMOUTH, Maine - In the wake of the Feb. 12 forum on audits, the big question is: Where does the HME industry go from here?

From a legal perspective, one of the few options is a constitutional challenge that argues the backlog in processing appeals and the delay in assigning cases to the administrative law judges (ALJs) are obstructing due process, says healthcare attorney Edward Vishnevetsky.

“But that's an uphill and costly battle,” said Vishnevetsky, an associate with Munsch Hardt. “There are national and state groups that want to make it happen, but they don't have the financial resources. Individual providers and manufacturers have to come up with a way to do it.”

In light of that, Vishnevetsky believes there are three keys to leveraging the momentum from the forum to forge real change: 1.) HME stakeholders need to align themselves with other Medicare Part B providers to come up with a “concerted effort”; 2.) When lobbying lawmakers, they need to make clear that they seek relief legislatively because the courts have lack of jurisdiction legally; and 3.) they need to take their case to the national media.

“If this story went on CNN, what's happening to providers would get a lot more traction,” he said.

AAHomecare's Tom Ryan says the association is working on all of that and more, including legislation.

“We're trying to come up with legislative language that we can get several groups to sign on to—it's becoming such an issue for home health, as well,” said Ryan, president and CEO. “We're getting the final draft reviewed and then we plan to go to the executive committee with it.”

AAHomecare is also trying to arrange a sit-down meeting with stakeholders, Chief ALJ Nancy Griswold and CMS officials, Ryan says.

“While we have to be prepared with legislation, we want the olive branch out and we want to try and work within the agency,” he said.


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