Hold CMS accountable

Sunday, February 29, 2004

I have been in the DME field for almost 17 years now, and the nonsense I see regarding the power chair fraud in Texas strikes me as a new low in foolishness.

Again and again, I read (and hear) how we must work ever harder to reduce fraud in our industry; how reputable providers must make every effort to spot abuse and report it, and blah, blah, blah.

Except for a very few voices (VGM comes to mind) almost no one is placing the blame and the anger, AND the demand for consequences, where it truly belongs. Instead of bowing abjectly, and reciting mea culpas, we should be unified in demanding of our representatives and senators a full investigation into CMS and Palmetto.

Let’s look at a scenario in the business world in which the government is not involved. Let’s pretend that I am a CEO of a publicly held company. I, the board and the corporate officers have all agreed to subcontract with another company to fulfill our supply requirements. The company selected is a large one, and bid successfully for the contract.

Two years later, an outsider comes to me and tells me that the subcontractor, through its subcontractors, has managed to pay millions of dollars of our money for equipment that was never delivered, or was below standard, or was fraudulently ordered. Do you really think that my first action would be to call my customers and tell them that they were going to be punished by making it harder to get my product? Would that make sense? Or would I go to the other companies that my subcontractor used, the ones that played it honestly, and tell them they are in trouble for not watching over the crooked ones? Does that seem logical?

And what on earth do you think would happen when the next stockholders meeting occurred? Would I, and the board, and the officers of the company really be able to get away with saying that it wasn’t our fault? How would we possibly explain away the lack of oversight? And how long into that meeting could we “dance” before the stockholders would demand our resignations - and get them?

So why, as an industry, and as individuals, aren’t we shouting for accountability where it really should be sought? Why aren’t we all screaming for an investigation into the poor business practices of Palmetto or CMS? How can any of us be responsible for a group of people determined to scam, and who obtained a provider number for that very purpose? Isn’t that what CMS is supposed to check out before issuing a number? So why is their inaction our fault? Let me be clear: DME dealers will never, ever, be able to police our industry effectively against scam artists. And we shouldn’t have to. After all, that is presumably why some people in CMS are pulling down salaries. And it’s about time we started holding them to their responsibilities.

Right or wrong, the fiasco in Texas happened on their watch, and they should have to shoulder some of the blame. Not us.

In January, I emailed Senator Dole about this issue; I received a call back from her “health expert” and we had a 20-minute talk on what I have conveyed here. If I can take the time from my schedule, so can every other worker in this field. Perhaps, just once, if we emulated Peter Finch in Network, and made it clear that using us as a punching bag this time isn’t going to work, we just might make them back off.

I have also made out a sheet with contact information (senators, reps) for my area. And every time I am forced to tell a beneficiary that a power chair is not possible for them because of the cowardly way CMS is handling this matter, I give them the sheet and tell them to get mad and call. Every one of our dealers should be doing the same.

Quit pretending this is our fault - it’s not. This occurred because the people holding the purse strings were asleep at the wheel, and it’s time they were held accountable for their poor stewardship.