Some providers struggle in aftermath of new requirements

Wednesday, December 30, 2009

BALTIMORE – Delaware Valley Medical Supply, like hundreds if not thousands of HME providers, has been without a Medicare supplier number for months now, despite meeting CMS’s accreditation and surety bond requirements in time.

The Margaretville, N.Y.-based provider received a letter from the National Supplier Clearinghouse (NSC) on Nov. 17, stating that its number had been revoked because it hadn’t obtain a surety bond by the Oct. 1 deadline. Long story short: After numerous phone calls, the NSC agreed the provider had obtained a bond before the deadline and passed that information along to a liaison that was supposed to pass it along to CMS.

But that hasn’t happened, says Dee Baker, Delaware Valley’s general manager

“On Dec. 8, I tried using the interactive voice response (IVR) system and couldn’t,” she said. “I freaked out. I called CMS and asked them, ‘What’s the story; we’re a small company; are you trying to get rid of us?’ They said, ‘Oh no, no, no, there’s a computer glitch.’ I’ve been told there are many of us in this situation.”

Delaware Valley Medical Supply has been assured that the computer glitch “is being worked on,” but that’s not much comfort. Without a number, it can’t get reimbursed, and it’s beginning to wonder how it’s going to pay the bills, Baker says.

Wayne Stanfield, president of the National Association of Independent Medical Equipment Suppliers (NAIMES), says he’s heard from numerous providers whose numbers are in limbo.

“This is the unseen crisis in the industry right now, and it’s a crisis that the NSC and CMS has created,” he said.

It’s clear that the NSC and CMS haven’t been able to handle the increased workload associated with the accreditation and surety bond requirements, industry sources say.

“There’s an awful lot of dysfunction with regard to the NSC’s ability, in particular, to get everything done that needs to get done these days in a manner that’s fair to the providers who do everything right,” said attorney Neil Caesar, president of the Health Law Center. “That’s not even getting into the issue of providers who have done small things technically imperfectly, leading to drastic consequences.”

Instead of penalizing providers, industry sources say the NSC and CMS should be giving them the benefit of the doubt.

“This is a perfect example of the NSC and CMS refusing to manage the process with a certain amount of civility,” Stanfield said. “If you’ve been a provider for years and you’ve become accredited and you’ve obtained a surety bond, it makes sense, in my mind, to let them keep their numbers. If they find there’s a problem, they can take the number and their money back. Why punish providers unnecessarily for being caught up in something that’s not their doing?”

Galaxy Medical in Fort Lauderdale, Fla., knows what it’s like to be in Delaware Valley Medical Supply’s shoes. The provider also received a letter from the NSC wrongly stating that its number had been revoked because it hadn’t obtained a surety bond.

“I sent them a copy of the bond and they said, ‘This doesn’t guarantee that we’ll put your number back in,’” said Carl Wallman, president. “I said, ‘It better guarantee it; otherwise, I’m getting a lawyer. I can prove you got it.’ They redid it.”