'It's part of doing business with Medicare'

Tuesday, July 31, 2007

WASHINGTON - In the days following the launch of a new two-year demo to crack down on home medical equipment fraud in the Los Angeles area and south Florida, providers appeared unruffled.
"I agree with what they're doing," said Steven Nelson, CEO and president of Okeechobee Discount Drugs in Okeechobee, Fla., near Orlando. "If CMS would have enforced its rules from the beginning, we might not be facing competitive bidding right now."
In the next few months, CMS will ask about 5,000 providers in the Los Angeles area and about 2,700 providers in south Florida to reapply for their billing numbers. The agency will then review applications and conduct multiple unannounced site visits to determine whether providers can continue billing Medicare.
Providers like Raul Lopez say they don't fear CMS's latest attempt to put the DME industry under a microscope, as long as the agency conducts the demo fairly.
"It won't be pleasant and it will mean increased paperwork, but anything that CMS can do to reduce and eliminate fraud, I'm for it," said Lopez, director of operations for Bayshore Dura Medical in Miami Lakes, Fla., and president of the Florida Association of Medical Equipment Services (FAMES).
To conduct the demo "fairly," CMS must not penalize providers for hiccups like their insurance running out in the time that it takes the agency to review their applications, Lopez said.
Overall, providers see the demo as another opportunity to separate the good, the bad and the ugly.
"Unfortunately, there are still companies out there giving us a black eye," said Rob Brant, general manager of City Medical Services in Miami Beach, Fla.
Rich King, CEO and president of ProMed DME in Los Alamitos, Calif., summed up the sentiments of several providers: "It's part of doing business with Medicare. The extra paperwork and site visits--we get them anyway. It's not a big deal."