CMS needs’s inside POV

Tuesday, December 31, 2002

If CMS wants to run trials of competitive bidding and its effects, perhaps the administration should consider an insider’s point of view. CMS should build a test HME company and monitor the effects of competitive bidding within. CMS must realize that we not only supply products, but the heart of the HME is in providing services. NCB will surely cut into our hearts and only a test company will demonstrate that.

- Sunil Kamath, president of MediHealth DME

Industry can prevail in fight to defeat NCB
The latest issue of HME News quotes me as saying “we have to stop playing the game and pretending that we can beat this thing.” [see story] You ignored the major thrust of my statement. I also said that “the industry must maintain its effort to kill NCB while positioning itself to be at the table when the rules defining how competitive bidding will work if NCB legislation passes.”

I would really appreciate it if you would not characterize me as giving up the fight to kill NCB but rather as suggesting that while the battle rages on, we have to make sure that we don’t burn any bridges that would leave us in a position where NCB is done to us rather than in consultation with us if it ever becomes the law of the land.

The fact is that recent developments cause me to be optimistic that the industry can defeat NCB. The increase in the Republican majority in the House will make that a trecherous battleground. Sen. Bob Graham (D-FL) is now saying that he no longer supports nationalizing competitive bidding (he supports continuing the demonstrations). seriously undermining the possibility the NCB legislation will pass in the Senate. I believe that if a vote were held today on legislation that only addresses NCB, it would fail to pass in the Senate because only one Democrat, Tom Harkin (D-Iowa.), supports NCB at this time and at least three Republicans - Voinovich (R-Ohio), Bennett (R-Utah) and Sen.-elect Talent (R-Mo.) - oppose it.

So, for the record, I believe that the HME industry can prevail in the battle to defeat nationwide competitive bidding. It won’t be easy and we must recruit significant consumer groups to join us in the fight. But we can win.

- David T. Williams is director of government relations at Invacare

No new Kaiser contract
Coloplast found some discrepancies in your article, “Coloplast Splits Providers,” (Oct. 15, 2002). There are three points that concern us and jeopardize the integrity of the Coloplast Authorized Network program.

1. “...announced a new agreement with the Kaiser Foundation Health Plan.” To date, there is no new contract with Kaiser.

2. “...women’s health providers furnish Kaiser patients with only Coloplast products...” Retailers are currently reimbursed for non-Coloplast products.

3. “...the payer will issue credits for new product purchases instead of cash reimbursement.” Currently, a credit for the retail amount is issued to the retailer’s account within 48 hours of receipt of the completed claim. Upon settlement of the account at month-end, checks for the balance due are issued to the retailers. Since credits are posted at retail, and purchases are at wholesale, numerous checks are paid out each month. However, going forward, retailers will have a choice of two methods of payment - either check or the offset method.

-   Sara Zywicki is a marekting manager at Coloplast

Editor’s note:

On point 2, Susan Brooks, who co-owns a Women’s Health Boutique in Torrance, California, stated that allowances are made if a patient is better served with a non-Coloplast product. “If on occasion a Camp product is more appropriate, they will make an exception,” she said.

On point 3, although not at the same level of detail, the article explains that “providers can get cash payments if their credits exceed the minimum inventory requirements.”

As for point 1, the providers who spoke to HME News were under the impression that the policy was part of a new agreement.