Legislative update: Hot seat, PR machine and caught on camera

Friday, April 27, 2012

WASHINGTON – It looks like Medicare fraudsters have moved on from home medical equipment.

At a hearing before the Senate Finance Committee on April 24, Health and Human Services Inspector General told lawmakers that efforts to push fraud out of the HME have been successful. Now in the hot seat: home health and community mental health.

"In the past, we've been more of the focus, with (lawmakers) asking questions about DME," said Stacey Harms, manager of government affairs for AAHomecare, who attended the hearing. "I didn't hear anything about DME this time. I hope that means we are making progress."

One area where there hasn't been much progress: the market-pricing program (MPP), which remains stalled at the Congressional Budget Office (CBO) awaiting a score.

"We are still where we were," said Wayne Stanfield, president and CEO of NAIMES. "We can't get a score partly because the CBO is tied up with the federal budget. We understand we are at the top of the list, but how long it takes to finish the budget, I don't know."

Meanwhile, the industry continued to battle back against the "Medicare PR machine" touting the $202 million in savings from the first year of competitive bidding and the lack of a negative impact on beneficiaries from the program. The report was widely picked up by mainstream media outlets.

"I was amazed at how many papers picked it up and regurgitated it," said Cara Bachenheimer, senior vice president of government affairs for Invacare. "We are doing what we can to try to illuminate what's really going on."

The VGM Group and People For Quality Care plan a series of short videos that feature beneficiaries in competitive bidding areas describing the problems they've had obtaining needed equipment. The plan is push out one of these videos each week to lawmakers and media outlets.

"We want to go to Middle America and say, 'CMS has told you there are no issues,’" said John Gallagher, vice president of government relations for VGM. "'Well, ‘Here's a patient with an issue,' and then let the patient tell their story."