NCB, fraud agendas move forward

Wednesday, December 31, 2008

ARLINGTON, Va.--AAHomecare’s task force to develop an alternative to national competitive bidding has gone to work.

“Without an alternative, the bidding program will start up again,” said Michael Reinemer, AAHomecare’s vice president of communications and policy.
The association announced in October that it would create the task force, comprised of about 25 representatives, including providers, manufacturers, buying groups and state associations.

The task force hopes to present ideas to members of Congress in early January.

“I think we need to highlight the problems from a quality and service perspective,” said Don Clayback, vice president of government relations for The MED Group and a representative of the task force. “Without competition, there’s no patient choice and there’s nothing to make sure beneficiaries get the right equipment and service.”

But the task force must first determine the cost of eliminating competitive bidding.

“AAHomecare has a statistician on retainer looking at some of the different costs, because until we know the cost to eliminate competitive bidding, it’s difficult for us to talk in any kind of detail,” said Seth Johnson, vice president of government affairs for Pride Mobility Products and a task force member.

If the task force can persuade Congress to carve out products from the program, as it did with complex rehab in July, the cost of eliminating competitive bidding will continue to decrease. Possible future changes to reimbursement and policy for oxygen, for example, could lead Congress or CMS to carve out the product, representatives say.


AAHomecare in December hired Rational PR, a Washington, D.C.-based public relations firm, to help combat misconceptions about fraud and abuse in the HME industry.

“We need to make sure the public and policymakers are aware that we’re in front of the issue and that the homecare sector is trying to solve this problem,” said Reinemer.

Rational PR will focus on generating news articles that highlight efforts to combat fraud like AAHomecare’s 13-point plan. The plan outlines steps like establishing a Medicare anti-fraud office and implementing real-time claims analysis.