We’re still one of the good guys

Sunday, November 30, 2008

So the GAO set up a couple of sham DMEPOS operations and blew them by CMS the way a Nolan Ryan fastball used to whizz past opposing batters. The GAO’s report detailed the process that one must go through to set up a scam operation. It’s hardly a daunting challenge to put one over on the federal government.

There are thousands of honest, hard working people in the DMEPOS industry. Most of them are no different than the men and women who hold jobs in retail, the service industry or government agencies. They’re no different really than farm workers or people doing shift work in factories.

Except for this: They work in an industry that is constantly being scrutinized by Congress, Health and Human Services, government oversight committees and the like.

In every walk of life there are people creating schemes to steal money and treasure from their rightful owners. The American people rightfully reserve their most virulent disdain for those that steal money meant to care for the sick and disabled.

Such anger is perhaps felt more by those of us working in health care. Those of us on the front lines of patient care or on the periphery making the tools that ease people’s pain and suffering know the joy and satisfaction of sleeping well at night. Above everything else our life’s work is built on the desire to do something good for others. We don’t appreciate it when an impostor makes our jobs harder.

And yet, the DMEPOS industry can’t seem to get a break. Recently Congress rushed through legislation that would avoid reducing payments to physicians under the Medicare program. In the process, a substantially flawed piece of legislation known as competitive bidding was rightfully squashed. Passing the legislation required the override of a veto by President Bush, which stemmed not from the president’s concern over DMEPOS fraud and abuse, but a reduction in payments to managed care organizations participating in the Medicare Advantage program.

Our concerns for our patients and yes, our businesses, were hardly the centerpiece of this particular legislative battle. But you would have thought we were the raison d’être of the battle based on the comments made by HHS and CMS leaders suggesting that fraudulent practices in our industry were being allowed to go on unchecked.

We’re not a perfect industry. Yet, I get exasperated when an entire industry is accused of playing fast and loose with the people’s money when the vast majority of us just want to do what’s right. How do we defend ourselves when the government agency responsible for oversight of our industry can be bamboozled as easily as the GAO report clearly indicates?
People who have no business providing health care to anyone obviously can slip through the cracks. Does that mean we’re all crooks? That’s like saying if the governor of a large eastern state commits a salacious act and a felony to boot, the governors of all 50 states are bums.

Is anyone as tired of this hypocritical posturing as I am? I have spent 38 years in health care, working in hospitals and non-profit Blue Cross Plans. I had no idea when I joined the homecare industry in 1991, that I was no longer one of the good guys.

Over the years, I have worked for homecare provider organizations and a manufacturer of products for home use. I’ve met with scores of manufacturers that wanted me to buy their products. Whether I was meeting with a local sales representative or the CEO of a multi-national corporation, not once did I encounter an inappropriate offer.

I have also met and worked with hundreds of managers, clinicians, drivers and technicians engaged in providing quality homecare services. I cannot recall even one example of a provider that deliberately did something that might be harmful to a patient. I have experienced firsthand the way respiratory therapists demand proof of clinical efficacy before they will use a service or device. I have had to sit still for a tongue lashing from a manager that needed a product for a patient that arrived a day late. People who work in home care get it: A healthcare career is a privilege that comes with enormous responsibility.

It’s readily apparent that those who would judge us are far from perfect. I for one will not apologize because the homecare industry isn’t perfect. Neither should you.

Our jobs are simple. We’re here to make a meaningful difference to people that need health care. Hold your head high while you’re doing it.

Len Serafino is vice president of sales for CHAD Therapeutics.