Open Door Forum: How many CMS officials does it take to answer a question?

Thursday, March 11, 2010

BALTIMORE - If you tuned in to last week's Open Door Forum to find out whether you can use an advanced beneficiary notice (ABN) for a Medicare beneficiary whose ordering or referring physician refuses to register with PECOS, you were disappointed.

Three HME providers asked that question during the Q&A portion of the forum, and each time, CMS officials told them: Give us your phone number; we'll give you call.

The third provider asked, "Can't you share that here?" Nope.

The question was first asked during an Open Door Forum on Jan. 20. CMS officials told providers during that forum that they would have an answer at the next forum.

The good news: One of the providers who asked the question during last week's forum told HME News that he did get a call from, not one, but two CMS officials shortly after the forum ended.

The first official told him "the reason he didn't want to respond to the question during the forum was that he wanted to make sure he understood the question correctly and that he could route it to the right person," said Victor Lopez, an intake coordinator at Hartmann Brothers Medical in Montrose, Colo.

The second official told him "using an ABN in that situation wouldn't be appropriate."

"I anticipated that they were going to say that," Lopez said. "However, knowing there are some hard-headed providers out there who plan on using it, I wanted to know for sure."

During the forum, Lopez told CMS officials: "We have some cantankerous, old-country docs that, flat-out, don't think they need to do this"—not by the Jan. 3, 2011, deadline, not ever.

Providers can take some consolation in this: The second official who called Lopez told him that CMS is preparing a "fairly stern letter" that will be distributed to physicians explaining they must register with PECOS or risk losing their privileges of ordering or referring DME.

"It sounds good politically, but we'll see what happens," Lopez said.

The next Open Door Forum: April 14 at 2 p.m. EST. Dial 1-800-837-1935 and use the ID 61772075.