Readers: CMS proposal 'bad idea'

Monday, October 31, 2005

YARMOUTH, Maine - Everyone has their two cents when it comes to CMS's proposal to drop CMNs for power wheelchair and scooter claims and replace them with prescriptions and medical records.
More than 50 of the 244 respondents to October's HME News Poll chose to elaborate on the agency's interim final rule, which was scheduled to go into effect Oct. 25, and most of their comments were negative.
"It takes a full-time employee that is educated and very knowledgeable about the correct way to fill out a CMN that is basically a 'yes or no' document to walk a physician through the process," wrote in Michael Mayfield, vice president of operations for Signature Healthcare in Lutherville, Md. "Now CMS (stands for 'can't make sense') wants us to rely on the physician to supply his own documentation? Just what we need, a few more roadblocks to serving our patients and being reimbursed."
The majority of comments, like this one, focused on the difficulty providers predict they'll have collecting documentation from physicians. Another theme: under the proposed new rule, providers fear more responsibility will fall on their shoulders.
"The doctor is supposed to be the gatekeeper, but the supplier is taking all of the risk," wrote in Connie Hess, a rehab equipment specialist with HealthKeeperz in Pembroke, N.C. "Isn't it time we stood up as a group and simply said, 'No'?"
The poll revealed that 70% of respondents believe CMS's proposal is a bad idea. Moreover, 81% of respondents believe 30 days isn't enough time for providers to collect documentation from physicians; more than 40% believe 60 days is more reasonable.
If several providers had their way, CMS would have kept the CMN - with a few tweaks. One provider suggested the agency revise the CMN to include a new algorithm and a final question ensuring the physician conducted a face-to-face examination.
Only a handful of comments gave voice to the 30% of respondents who believe CMS's proposal is a good idea.
"I honestly don't know what all the fuss is about," wrote in one respondent who didn't submit his name. "Give me a break: a $5,000 collectible on an item that costs the DME $1,000 is practically highway robbery. It's about time CMS woke up."
Casting an eye toward the future, more than one provider commented that CMS's proposal might have the opposite effect and increase fraud.
"If the only opportunity for the DMERCs to see the documentation is upon request or audit, fraudulent providers can bill numerous PWCs without having to prove medical necessity," wrote in Andrew Ingram, owner of Home Assist Medical Equipment in Laurinburg, N.C.