It's time to bridge the gap with CMS

Wednesday, July 31, 2002

If you're not persuaded that the government wants to do something about reimbursment for durable medical equipment, if you think this year's competitve bidding threat is a one-off, or, worse, a damnable consequence of BBA '97, look back to the 1980s when competitive bidding started to shout boo in the president's budget every year.

It ain't going away, even if AAHomecare's right-minded appeals to members of Congress results in the exclusion of competitive bidding from this year's prescription drug bills, or the bills fail to pass muster for other political reasons. It'll come back, and the industry might launch defensive measures to buoy reimbursement for another year.

But how long can this go on? The industry's advocates have been manning the ramparts for years and that must get tiring. You could hear the exhaustion in Mike DeCarlo's voice when he talked about how the issues he started tackling when he came into the industry in 1991 -  competitive bidding, CMNs, etc. - are the issues he was handling until last month when he announced his departure.

If the industry gets a pass this year, maybe now's the time to launch another coalition, this one dedicated to the task of reconciling the grudge that politicans have against the HME industry with the grudge the industry has against arcane administrative burdens and dim-witted investigatory practices.

Historically, this has not been the industry's strong suit. As lawyer Tom Antone notes on the next page, the industry doesn't do counter-proposals. And who can blame it? Them? Us? Impicit in any negotiation with the government is reimbursement reducation on the HME side. Resignation may be called for. Not today, not while a CMS-driven competitive bidding program is whispering in the ears of legislators. Sooner rather than later, the industry must admit that the government is going to do something to reimbursement. Implicit in that admission has to be a decision to reach consensus on a plan to keep the competitive bidding whispers from articulation next year.

I'm not convinced that national providers of HME are going to lead this charge. Lincare has garnered the largest share of the oxygen business in Polk County, Fla. While they may not like the size of the monthly oxygen reimbursement checks, no doubt they like the increased volume.

If competitive bidding gets rolled out nationally, independent providers go down first. Which is why they need to rise up first and lead the charge on a brand new day in Medicare reimbursement. 2002-2003 needs to be a pivotal year for the HME industry; it needs to be the year everyone remembers, not like 1997, but as the year that everything got better. HME