Round 1 providers get sit-down with CMS official

Wednesday, February 23, 2011

ORLANDO - CMS official Jonathan Blum said he wanted to hear firsthand how HME providers were faring under competitive bidding and yesterday he got an earful.

"No one expressed confidence in the program," said Sean Schwinghammer, executive director of the Florida Alliance of Home Care Services (FAHCS).

Blum, deputy director of CMS and director of the Center for Medicare, was in Orlando, a Round 1 competitive bidding area, on other business and suggested the meeting, said Schwinghammer.

"Initially, he told us he wanted to meet with bid winners to see how it was going, but we thought it was important to hear from everyone who was affected," he said. "We made sure to have a member who won in all categories, members who won in one category and members who won in zero categories to really provide some perspective."

During the hour-long meeting, which was also attended by two Medicare ombudsman, HME providers offered a frank assessment of the program.

"One winner admitted they submitted suicide bids because they thought the program would go away," said Schwinghammer. "Now (they can't survive)."

Provider Tim Bates, who didn't win any contracts, is worried about the number of out-of-area providers who won oxygen contracts in the Orlando area. On Monday, a local hospital asked him to provide a portable oxygen concentrator to a Medicare beneficiary so they could discharge the patient.

"We told them they needed to find someone else," said Bates, owner of Orlando-based Premier Home Health Care. "I got a call the next afternoon from an out-of-area provider asking if I would be willing to set this same patient up a day later. So, this patient spent another night in the hospital for something I could have taken care of the day before. Medicare just spent (the equivalent) of a year's worth of service for one night."

While there were no Medicare beneficiaries at the meeting, FAHCS, which has been collecting complaints from beneficiaries, told Blum about beneficiaries receiving outdated diabetes equipment and being uneducated about the program, among other problems.

Blum took no questions during the hour-long meeting and asked very few questions. He did take copious notes, said Schwinghammer.

"He did ask for suggestions for how to make it better," he said. "He seemed really intrigued by some points. Still, I would never want to play poker with the man."