PAOC fades to black

Thursday, December 29, 2011

BALTIMORE - The Program Advisory and Oversight Committee (PAOC), quietly disbanded Dec. 31, and committee members had mixed feelings about its legacy.

"I think there could have been much better opportunity between the (home medical equipment) industry and regulators on a program of this magnitude and importance," said Walt Gorski, vice president of government affairs for AAHomecare and PAOC member. "I think many PAOC members felt their hands were tied in making rational recommendations."

The 17-member PAOC, comprised of HME providers, physicians, manufacturers and consumers, originally formed under the Medicare Modernization Act to advise CMS on implementing the competitive bidding program. It was extended by two years--until Dec. 31, 2011--under the Medicare Improvements for Patients and Providers Act, which passed in July 2008.

While the original intent of the PAOC was to advise CMS, in reality, the agency didn't make it easy. The biggest sticking point: a lack of transparency, especially once Round 1 kicked off.

"CMS sees a lot of data that either substantiates or refutes the criticisms that were made about the program," said Gorski. "I don't understand why they are not willing to show the results of what they are seeing."

That lack of data, in turn, prevented the committee from being able to suggest changes to program so that it would have less devastating effects on providers and beneficiaries, he said.

The PAOC last met in April. Members requested to meet with CMS several times this fall, but got no response, said PAOC member Tom Milam. Still, he does feel the committee made some headway.

"I do think that behind the scenes some of our comments did move some of the rules in a better way," he said. "I think some of that will keep CMS accountable for more than just a low price. It will keep CMS accountable in the end for access and quality and service."



<br />
PAOC fades to black<br />
Problem in DME reimbursement is that the process is more based upon politics then factual numbers.<br />
Their are products which have 10% Gross profit and their are products which have 300% or more gross profit which makes to sense (based upon variable cost and fixed reimbursement)<br />
SIMPLE SOLUTION: Let Medicare negotiate the prices with approved manufacturers and then add some percentage for DME providers and that&#39;s it. It will make the system more efficient and the patient will be better serviced. Now DME suppliers will compete on service and not where to by at lower cost.<br />
You know what Medicare will say that this is not in Medicare mandate.<br />
Why does not Medicare negotiate drug prices??? Too political!!!<br />
God Bless AMerica and Medicare<br />
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Harry Brown is right. I spend 30 cents out of every dollar collected on billing and compliance costs. If CMS set up a more rational, less blindly punative means of running things then they could seriously drop reimbursements without cutting access to coverage for patients.