We have been foolish to resist credentialling

Monday, November 3, 2014

I’m happy to see a new study that quantifies our proposition that the therapies we provide are a bargain (“Medicare saves with HME, study says,” www.hmenews.com). We have known this for decades. This study shows clearly that CMS, in its zeal to defund DME services, would prefer to pay exponentially higher costs to other sectors rather than compensate DME providers fairly for economical services.

First, rentals were capped, then CMS allowed maintenance payments every six months. Then they stopped maintenance payments. Next came cessation of reimbursement for services such as oxygen, for 40% of the duration of service. Then CMS’s relentless harassment of DME continued with the imposition of unreasonable documentation requirements, punishing audits, wanton lack of accountability themselves when they impose new regulations retroactively and delay response for years in the audit process—all demonstrating clearly that they are on a campaign to eliminate the DME benefit. 

We all know that provision of DME services before competitive bidding was marginally profitable at best, what with the onerous regulatory requirements that slowly began mounting in the 1990s. Now competitive bidding is killing hundreds of U.S. businesses.

Organizations such as The Scooter Store that get away with more than 20 years of abuse through over-utilization of one or two codes are the cause of bitter frustration by the government because there is no identifiable responsible party. These companies have phalanxes of intermediaries to protect them from the regulators, a situation that is very depressing to heads of compliant companies who have fought the good fight for so long in full compliance with all federal, state and local laws and regulations.

We are unique in that the credentialing of the DME “person-in-charge” is nonexistent. Every other healthcare sector protects itself by restricting practice (provision) of the service to highly credentialed “professionals.” Orthotists, prosthetists, pharmacists, pedorthists, RRTs, CRTs, RNs, RCPs, PTS, OTs, polysomnographers, etc. 

The DME industry has foolishly resisted licensing of its members. I now wonder if credentialing of the person-in-charge, be it an owner, a pharmacist, an RT, an RN, a degreed person (BS or BA) or an individual with a certain time period as head of an operation, would be something to consider pursuing.

—Kathleen Weir Vale, Hope Medical Supply, San Antonio