CMS fields hme questions at open-door forum

Sunday, June 26, 2005

BALTIMORE -- A CMS Open Door Forum last Thursday addressed a variety of provider concerns, including questions on the National Provider Identifier (NPI) program, power mobility claims and capped rental items.

More than 200 people listened in on the 45-minute call, with several in attendance and on the phone stepping up to ask questions of their own.

Eric Sokol of the Power Mobility Coalition asked when suppliers could expect the revised CMN and the face-to-face evaluation requirement for power mobility products. He also commented on alleged DMERC audits that the PMC says are in violation of the Paperwork Reduction Act. CMS officials had no comment regarding the audits and said the CMN and other regulations were in clearance and should be released soon.

Another provider expressed frustration with the DMERC for recouping seven months of capped rental payments. He questioned if the DMERC could do this since it paid the first six claims, but decided after the seventh month that the claim was not medically necessary. CMS officials hesitated to comment because they did not know the specifics of the case.

CMS also offered updates and clarifications on questions asked during previous forums. An official from the Office of E-Health Standards and Systems gave a general update on the NPI. She said more than 32,000 NPIs have been assigned since May 23, the first day they were available. Providers can apply for an NPI online and through a paper version available July 1.

Another official talked about some of the specifics regarding the adult day care demonstration project mandated by the Medicare Modernization Act. The project, which is currently soliciting participants, will evaluate the feasibility to replacing in-home health services with an adult day care program. It will last three years and include 15,000 beneficiaries.

The next Open Door Forum is scheduled for July 21 at 2:00 p.m.