Providers continue to press issues

Thursday, February 11, 2010

WASHINGTON - Things were quiet in the nation's capital last week, after heavy snow basically shut down the federal government for several days. That doesn't mean, however, that issues facing HME providers have been buried, say industry stakeholders.

The biggest priority for the industry right now is H.R. 3790, the bill introduced by Rep. Kendrick Meek to repeal national competitive bidding.

"Nothing else really matters if that bidding program goes into effect," said Cara Bachenheimer, vice president of government relations for Invacare.

Providers should be pushing the bill every chance they get, agreed Wayne Stanfield, president of the National Association of Independent Medical Equipment Suppliers (NAIMES), which has declared Feb. 12 to Feb. 22 "SOS Week."

"I encourage every supplier to make a push to call and encourage their members of Congress to sign onto H.R. 3790," he said. "We desperately need to move this forward."

While it was originally hoped that the Meek bill would be included as part of a larger health care reform package, that option appears all but dead as lawmakers have turned their attention to jobs. Despite last week's winter woes, the Senate on Tuesday managed to release a bipartisan jobs bill, the HIRE Act, but by Thursday, Senate Democrats, led by Senate Majority leader Harry Reid, had proposed a stripped down version of the bill. While the original version contained a provision that would exempt pharmacies from mandatory accreditation--the only HME related provision--the second version contained no health care-related provisions, according to industry sources.

For now, that means time's up for unaccredited pharmacists, who must discontinue providing covered DMEPOS services to Medicare beneficiaries on or after March 1. Pharmacists had previously received an extension to Jan. 1, and CMS had not immediately enforced that deadline once it passed.

"CMS has said it can no longer hold off," said John Norton, associate director of public relations for the National Community Pharmacists Association (NCPA). "They've been given a mandate to go after Medicare fraud, so even though we are not perpetrators of fraud, they can't have that mandate (go unfulfilled)."

Meanwhile, AAHomecare has continued to work with CMS on a couple of hot-button issues: the OIG special alert on telemarketing that would prohibit providers from calling beneficiaries to make delivery arrangements; and ongoing concerns with the Provider Enrollment Chain and Ownership System (PECOS).

"We are still hearing that providers are having an extremely high level of warnings and we don't' believe that the system will be able to be up and running in April," said Walt Gorski, vice president of government affairs for AAHomecare. "When 50% of claims have the potential to stop being paid--that will cause huge cash flow problems that will undermine every HME provider."

As to the OIG alert, he is more optimistic.

"CMS has indicated they would publish an FAQ," said Gorski. "We believe they will provide clear guidance to providers on the issue."