CMS not doing enough to alert beneficiaries

Sunday, June 15, 2008

YARMOUTH, Maine - John Gallagher was not surprised when, at a meeting of the American Lung Association in Wisconsin earlier this month, the audience of patients and clinicians had no idea what competitive bidding would mean for them.

"They were clueless," said Gallagher, vice president of government relations for The VGM Group.

Hopefully, that will change. During a conference call last week, CMS said it planned to start mailing packets to beneficiaries by June 20 containing a cover letter; a brochure; a list of Medicare-approved suppliers in the first 10 competitive bidding areas; a question-and-answer sheet; and beneficiary tip sheets on specific equipment. A similar packet is planned for contract providers, with tip sheets for referral agents and fliers for beneficiaries.

That might not be enough, said Raul Lopez, director of operations for Miami Lakes, Fla.-based Bayshore Dura Medical

"They are thinking in their minds that patients read literature that's sent to them," said Lopez. "I think they are also trying to throw this on suppliers."

Gallagher agreed that the burden of education seems to fall on providers who both won and lost contracts--a risky plan, he says.

"Non-contracted providers are not going to run out and scare away existing customers until the last minute," he said.

Chris Rice, marketing manager for Riverside, Calif.-based Diamond Respiratory, has focused efforts on referral sources.

"We haven't had much contact with the beneficiaries," he said. "They probably don't know much about it."

Contract winners are also wary of stepping on the toes of fellow providers, concentrating on their existing customers first.

"We're spoon feeding it to them," said Randy Freeman, owner of Fort Worth, Texas-based Mediwell. "We don't want to appear overzealous. There are a lot of alliances that referral sources have with particular companies and some of those are going to be broken. We want to earn the business, but in gradual increments."

There have been reports of contract winners "jumping the gun," said Gallagher.

"They are mailing to referral sources, saying that they are a contract winner and to go ahead and start sending them patients," he said.