Reporter’s Notebook

Sunday, October 31, 2004

WASHINGTON - Lincare’s CFO Paul Gabos may be a household name to home respiratory providers, but for some people at CMS his name doesn’t ring a bell.

During CMS’s Aug. 25 open door forum, Gabos gave his name and asked the following question in a calm, even voice that betrayed no sense of potential calamity: How does CMS plan to roll out the DME price changes pursuant to the FEHBP provisions of MMA? Will it be through a notice of proposed rule making or through carrier instructions? And if it is through carrier instructions, will affected providers have a chance to comment on the proposed rates given concerns over Medicare’s modality neutral bundled rates with the unbundled approach you typically see in an FEHBP contract?

CMS official (politely): We don’t have an answer right here. Where are you calling from?

Gabos: Florida.

CMS: Are you a provider?

Gabos: Yes.

CMS: We’ll, I’m going to have to get back to you on that one. It is an interesting supposition, and I’m sure it’s not under the radar. That is the understanding we have. I just don’t under stand how. Can I call you back?

Gabos: Yes.

At the next Open Door Forum on Sept. 22, a CMS official said people can and have commented on the FEHBP cuts. Nevertheless, he added, as required by the MMA, the reductions are mandatory and will go into effect Jan. 1, 2005.