New members ready to roll

Saturday, February 28, 2009

The new members of the Program Advisory and Oversight Committee come from a wide range of business backgrounds, but they have something in common: A sense of duty.

“I was motivated by the need to try to do what I can to make the system work for the industry and work better,” said provider Peter Amico, owner of Holtsville, N.Y.-based Prime Care Supplies.

The PAOC advises CMS on issues related to national competitive bidding. In October, CMS disbanded the existing committee - originally set to expire Dec. 31, 2009 - and began seeking new applicants. The 17 new members named in mid-January comprise of large and small HME providers, manufacturers, and business and insurance representatives.

Indeed, Round 1 of the flawed program, which kicked off July 1, 2008, only to be halted two weeks later, is still fresh on the minds of PAOC members.

Provider Esta Willman is located on the edge of the Riverside, Calif., competitive bidding area.

“Having direct experience with how the program was implemented inspired me to lend my voice to the committee,” said Willman, co-owner of Medi-Source in Yucca Valley. “I think CMS can benefit from the perspective of providers of all different sizes.”

Members will have their work cut out for them. CMS released an interim final rule on NCB Jan. 16. While it appears the agency is following the changes outlined in the Medicare Improvements for Patients and Providers Act (MIPPA), industry stakeholders do not believe CMS is committed to improving how the program will work.

“By getting the interim final rule out sooner, rather than later, CMS hopes to avoid having to go back through the notice and rulemaking process which would take a year at least,” said PAOC member Thomas Milam, COO of diabetes mail-order provider AmMed Direct in Nashville, Tenn. “I hope they will listen to what it takes to make NCB work in the business sense.”

There continues to be a lack of transparency in the process, said PAOC member Walt Gorski.

“This rule as published - without much of a comment period–and with program decisions made in the form of sub-regulatory guidance is of concern,” said Gorski, vice president of government relations for AAHomecare. “What I would hope is that there is more consultation with the PAOC and that the advice  is taken into consideration.”