HME industry needs 'an army of Henry Claypools'

Monday, May 31, 2004

HME pundits have long said that in order to gain recognition as legitimate healthcare professionals, the industry must enlist the support of consumer groups. Getting testimonials from end-users on how Medicare reimbursement cuts have a punitive effect on beneficiaries puts a human face on correspondence with policymakers on Capitol Hill and in the Washington Beltway.

After years of outreach efforts, the industry has finally connected with someone who personifies that goal by combining eloquent oratory with a voice of conscience. His name is Henry Claypool.

On Wednesday, April 28, the industry spotlight shined on Claypool as he testified before the Senate Committee on Finance about how the federal fraud and abuse dragnet has ensnared unwitting Medicare beneficiaries as well.

“Developing more effective ways [to curb fraud and abuse] is something we all support,” Claypool told a panel led by Sen. Charles Grassley, R-Iowa. “But we believe that this must be done without barring beneficiaries from obtaining medically necessary wheelchairs they need to move about their home and communities safely and independently.

“Unfortunately, CMS is acting as if the only way it can combat fraud is to severely limit the benefit in ways that undermine health, independence and dignity of beneficiaries of all ages,” he continued. “We believe this is wrong and will prove extremely costly.”

Once an advisor for disability policy to CMS when it was HCFA, Claypool is co-director of Advancing Independence, an advocacy group for disabled Medicare and Medicaid beneficiaries. He also founded Independence Through Enhancement of Medicare and Medicaid, a coalition that includes more than 70 consumer groups.

He is well known among HME political veterans, who say the industry couldn’t find a better spokesperson.

“It would be great to have an army of Henry Claypools,” said Cara Bachen-heimer, vice president of government affairs at Elyria, Ohio-based Invacare. “He’s very articulate when speaking about how important it is that consumer access to HME not be impeded by CMS actions.”

Ironically, Claypool is also one of the industry’s chief critics. He emphatically states that he is not an HME industry booster, but supports many of its positions because they are in the best interest of those who need the equipment.

“The industry has some problems and some of the negative attention is deserved,” he said. “The problem is that there isn’t an internal mechanism to ensure that people who come into the industry are invested in serving people well. That’s what the HME industry needs to address – to show how they’re preventing people who don’t belong from getting in.”

Along with more vigilant self-policing, HME providers need to bond more tightly with their clients to overcome the mistrust that scandals like Wheeler Dealer have caused, Claypool said. The “good faith effort” made by the industry to expose the flaws in power chair sales is a good start, he said, but more attention needs to be placed on building bridges with consumers.

“If you’re going to spend time marketing product, that’s valid, but it’s important you support consumers in what they’re doing,” Claypool said. “Learn more about them. Show them that they’re not just buying a product from you, but that you’re invested in them. Work with their groups on the projects that are important to them. That will go a long way toward building trust.”

A wheelchair user himself, Claypool has been a paraplegic since he sustained a skiing-related spinal cord injury while a student at the University of Colorado in the early 1980s. His advocacy efforts started when he became director of the college’s disability services office. He also managed a home health agency for disabled people residing at independent living centers.

Claypool has firsthand experience with the Medicare program, having been a beneficiary from 1984 to 1994. Difficulties with coverage policies inspired him to personally contact the administrator about doing more for disabled constituents.

“He broke through the door and let them know that senior citizens aren’t the only Medicare beneficiaries,” said longtime industry lobbyist Dave Williams.

The restrictive provisions of the Medicare Prescription Drug Act will most certainly have a detrimental effect on disabled beneficiaries by limiting their choice of providers, said Claypool, who lobbied vigorously against it in the months leading up to its passage last fall. At the same time, he says he understands the motivation behind it.

“Congress thought they were paying too much, so they went ahead and did something about it,” he said. “Trying to get a reasonable price is a good thing – if the industry needs a higher reimbursement in order to be innovative with its product lines, they need to make that case. On the other hand, competitive bidding will likely drive down choice of providers and products and that’s not a good thing. But the train has already left the station, so now it’s about how we’re going to deal with it.”