Edward Vishnevetsky: Call him the 'middle man'

Monday, March 1, 2010

DALLAS - With so many Medicare regulations to keep track of and the government all-too-ready to brand the HME industry fraudulent, providers need attorneys to have their backs. That's why the Texas Alliance of Home Care Services (TAHCS) named Edward Vishnevetsky and John Browning as its general legal counsel in February. Here's what Vishnevetsky, an associate attorney who specializes in HME at the Dallas-based law firm Thompson Coe, had to say about helping to save the industry from audits and national competitive bidding.

HME News: What role will you play at TAHCS?

Edward Vishnevetsky: Most recently, we had a phone call with members about the ZPIC audits. We were able to tell them that we initiated a dialogue on their behalf with the general counsel at Health Integrity (the contractor conducting the audits), which they hadn't been able to do. We were able to tell them what the audits are about and how they can both deal with them and avoid them in the future.

HME: What else is in the works?

Vishnevetsky: We're holding a seminar with TAHCS in March in Dallas. We're going to have industry leaders and attorneys speaking and perhaps congressional representatives. We're trying to do free or inexpensive events to give members both an industry perspective and legal perspective on what's going on--audits, competitive bidding, HIPAA.

HME: What are the roadblock providers face right now?

Vishnevetsky: On a daily basis, it's the overpayments and potential recoupments from the ZPIC and RAC audits. It's like the contractors feel if they push these companies out of business by putting them on pre-pay audits, they'll be winning the battle, because the companies they push out of business were fraudulent.

HME: That's where you come in?

Vishnevetsky: It's always good to have a legal representative to speak on your behalf, but that's especially true for DME. The government has potentially inappropriately deemed the industry to be fraudulent. Most are not intentionally fraudulent. There are just so many regulations with DME that it's difficult to follow all of them. The government comes out with regulations every day and as soon as it comes out with them, it's going to try and enforce them, whether providers know about them or not, which is why we're there to be a middle man between the provider and the government.

HME: If audits are the day-to-day roadblock, what's the big picture roadblock?

Vishnevetsky: Competitive bidding. Everyone is scared right now, because they don't know if they're going to get contracts or if H.R. 3790 is going to go through. We've had talks with various organizations about, well, if it doesn't go through, will we try for injunctive relief? We're talking about doing that as a last-case scenario because competitive bidding is going to cripple the industry and the people who it's going to hurt are the beneficiaries.

HME: Any predictions on how this is all going to turn out?

Vishnevetsky: There are so many companies now that are getting out of the business. The good thing is the ones that remain are ready fight this thing. The problem that we've had with this industry is fragmentation; we don't have a unified voice. That's what I'm hoping to help provide at TAHCS. Providers in Texas, while they're competing against each other, they need to be united to fight competitive bidding and promulgate regulations that will be beneficial to the entire industry, something they can't do on their own.