Courageous article

Thursday, October 31, 2002

Congratulations on your courageous article on the K0011 billing situation and Medicare. Whether or not any "laws or rules" are being broken is not for me to decide. However, we hear from many of our members who believe that Medicare recipients are not well-served by providers who deliver product without evaluating patients for fit and environment and do not provide service after the sale. VGM has already verified several reports involving companies shipping K0011 chairs direct to customers without any fitting whatsoever.

Quite frankly, I am surprised the media didn't investigate this situation earlier. However, after reading the research and quality information in your piece, I want to commend you for being right on target. Again, you've shown leadership in the industry and this shows why HME NEWS is No. 1.

All users of medical equipment deserve to have their equipment fit properly, meet their needs according to their abilities and environment, and have service readily available when needed. To offer anything less will surely bring more negative publicity for our industry. Thank you for bringing attention to a problem that will ultimately impact us all.

— Ron Bendell is president of VGM & Associates
Loan closets
Editor's note: Last month, HME News erroneously attributed a letter to the editor headlined 'Loan Closets' to Tom Antone. The letter that should have run is printed below.

Your June 15, 2002 issue reported on OIG Advisory Opinion 02-4 permitting placing portable 02 systems in hospitals and physicians' offices PROVIDED certain safeguards are followed. An understanding of background may address some of the questions and comments subsequently received.

My client is a successful independent with a reputation for quality. Certain hospitals asked multiple suppliers to place portable systems in the hospitals to facilitate discharges. My client initially declined; however at least two competitors agreed to the hospitals' request. Thereafter my client experienced a sharp reduction in referrals, consulted with me, and asked if I could prepare a written opinion asserting that the arrangement violated the anti-kickback statute.

I explained that, unfortunately, such arrangements might not provoke OIG PROVIDED anti-kickback safeguards were incorporated; however the only way to get a definitive read was to seek a formal Advisory Opinion. I further explained that OIG might condemn or accept the practice outright, or accept the practice PROVIDED multiple anti-kickback safeguards were incorporated. My client decided to proceed with the request reasoning that whatever the outcome an Advisory Opinion would level the playing field by eliciting a definitive written statement of the rules applicable to all. The full text of OIG Advisory Opinion Number 02-4 is available at Click on Fraud Prevention and Detection; click on Advisory Opinions; and scroll to Number 02-4.

— Tom Antone is a former president of NAMES and attorney who retired from Mintz, Levin et al in D.C.No difference twixt rehab & Medicare
No difference twixt rehab & Medicare
About your rehab coverage last month, my company serves both rehab and Medicare clientele. Personally, I think drawing a difference between the two is absurd. ANY company selling mobility and seating products should be a "Rehab Company." When manufacturers make statements attempting to differentiate between the two, they are basically saying they encourage ripping off the elderly, defrauding the government and see no need for professionalism for "Medicare patients." Oh, it is okay and encouraged to be a CRTS, an ATS or experienced professional when doing Rehab, but when working with Medicare folks it is acceptable to be just a sneaky salesman and have enough money to start a business.

We have pushed so hard for credentialing and professional ethics! Saying it is OK not to know what you are doing if all you serve is Medicare patients is wrong. Medicare patients deserve professional, ethical and certified specialists, just like any other member of society. Anything less is classifying them as second class citizens. Any company working with people requiring mobility and seating equipment should operate within guidelines that assure consumers and payors will be provided with the very best of care.  Everyone deserves equal and impartial treatment, be they one year old or 100.

— Jeff L. Day is president and CEO of Freedom Fighters of Texas in Abilene, Texas