What's driving increase in provider complaints?

Thursday, March 3, 2011

YARMOUTH, Maine - Sandra Canally can't quite put her finger on why, but she's noticed an increase in the number of complaints she receives about home medical equipment providers this year.

Canally, president of The Compliance Team, says her accrediting organization has been receiving a handful of complaints each month for the past couple of months compared to "next to nothing" last year.

"Some of the complaints are about bid winners and some aren't, so whether or not it's truly driven by competitive bidding, I don't know yet," she said. "Is there an increase because providers, in general, are trying to tighten their belts by cutting staff and reducing services? There could be all sorts of reasons, but it's being driven by something."

The complaints Canally has received have come from Medicare beneficiaries (Accrediting organizations require that providers share their names and contact information with beneficiaries). They're usually upset that their equipment isn't working or they don't know how to use it.

Tim Safley says the number of complaints that ACHC has received has also increased slightly this year. But he says the complaints are coming from not only beneficiaries but also CMS and its contractors.

"They're all about competitive bidding," said Safley, the HME clinical adviser.

Mary Nicholas says the number of complaints that HQAA has received has remained "light to moderate--two to three per month, that's all." But she has noticed a new consistency in the type of complaints received this year.

"I had an elderly woman call me the other day and she said, 'I don't know where I got this diabetic meter and I don't know how to work it,'" said Nicholas, executive director. "There have been more complaints about mail order."

When an accrediting organization receives a complaint, it must investigate. Depending on the findings of that investigation, a provider may, for example, receive another unannounced visit or he may be put on a "corrective action plan."

"The majority of providers do a good job on a daily basis," Canally said. "Those are the providers who take complaints seriously, respond appropriately, give information when needed and move on."