e-CMN vendors face political hurdles

Tuesday, April 30, 2002

ALEXANDRIA, Va. — Although the program memorandum that paved the way for e-CMNs was issued Sept. 18, 2001, the road between that CMS memorandum and DMERC acceptance is anything but a straight shot and may be fraught with more challenges than developing the architecture of an e-CMN itself.

"The technical part [of the Rotech-Apria-developed e-CMN solution] leaves my hands on April 22," said Albert Prast, Rotech's chief technology officer, referring to the day at Medtrade Spring that he anticipates transferring ownership of the architecture to AAHomecare. "We'll help with the political part, but we're really going to be looking to [AAHomecare] to lead this forward at CMS."

In the Sept. 18 memorandum, CMS states that the DMERCs "should accept faxed, copied and electronic orders and CMNs on review of claims." So what's the big deal? Why the daunting political process?

"At the DMERCs, there are very different interpretations about what that program memorandum means," said Asela Cuervo, AAHomecare's vice president of government relations.

Cuervo said rumored reaction to the PM at the DMERCs has ranged from opposition to acquiescence, but only if it's okay for the DMERC, on audit, to request an original signature on a paper CMN.

"Right now, it's not consistent from DMERC to DMERC what the rules are or what you are expected to produce," said Cuervo.

In February, Trac Medical demonstrated its solution to Region D medical director Robert Hoover.

"I walked away from that meeting feeling pretty positive," said Randi Neal, director of field operating systems for American HomePatient, who has tested Trac Medical's CareCert e-CMN. "It was apparent to me that Hoover and others in the room were on the e-CMN bandwagon."

In mid-April, Trac Medical was set to demonstrate its solution at the Region B DMERC.

Having to go from DMERC to DMERC bothers Cuervo, who wishes that CMS were more assertive about what the DMERCs need to do. That assertiveness may be a while in coming. Questions are still lingering about HIPAA's final standard for e-signatures. As soon as the DHHS adopts that standard — and it's expected later this year — all the obstacles toward the adoption of e-CMNs should be cleared out.

"When that happens, I don't see how anybody can say with a straight face that you still need to get a piece of paper," said Cuervo. HME