Reporter's notebook: Burden intensifies for contract suppliers

Friday, March 28, 2014

When it comes to managing a Round 2 contract, the low single payment amounts aren’t the only obstacle to providing timely service. Onerous documentation requirements and shortsighted Medicare rules may present even bigger hurdles.

Provider Britt Peterson holds contracts for hospital beds throughout Texas but says that, due to prepay reviews and the new written order prior to delivery requirement, it’s a slow-moving process.

“We have hundreds of beds across Texas we can’t deliver,” said Peterson, CEO of Austin, Texas-based Longhorn Health Solutions. “We have to have the order before we can do anything. We have a patient trying to discharge today, but the physician only signs once a week. He’s going to have to change or that person is not moving.”

Another CMS regulation—the 36-month oxygen cap—can present different challenges, say providers.

Woody O’Neal had to have CMS intervene on an oxygen patient who was discharged from hospice and whose original provider refused to service him because he was past the 36 months on his equipment.

“The incumbent home oxygen provider—for lack of a better term—is legally responsible for that patient,” said O’Neal vice president of O2Neal Medical in Pelham, Ala. “My staff had to get CMS involved or we would not have been paid for an orphaned patient.”