What's the hold up, NSC?

Saturday, February 27, 2010

YARMOUTH, Maine - Score one for the little guy. Provider Brad Watkins got word on Wednesday that his Medicare billing number had been reinstated.

"It's a huge relief," said Watkins, president of Rick's Medical Supply in Roseburg, Ore. "We are reinstated all the way back to Sept. 30, 2009."

Based on CMS recommendations, Watkins voluntarily revoked his number in September 2009, when it became apparent that he wouldn't be able to get accredited by the Oct. 1, 2009 deadline. Providers who didn't voluntarily revoke their numbers risked being barred from the Medicare program for one year.

Unfortunately, many providers who have since become compliant with accreditation and surety bond requirements still have no billing privileges, and no idea when the National Supplier Clearinghouse (NSC) will reinstate them.

"There is no timeframe for getting your number back," said Joan Cross, chair of the National Supplier Clearinghouse Advisory Committee (NSCAC). "Providers can't go without income for months and keep employees. They are causing harm to these people."

Adding insult to injury: Providers were told that once they were reactivated, they could go back and bill to the date they became accredited. In December, CMS said "no go."

"The NSC was telling us as late as September that they would go back to the date they actually got accredited if they did a voluntary revocation," said Rose Schafhauser, operations administration for NSCAC. "CMS came back in December and changed their minds."

But one industry stakeholder said he had heard that providers who get their lawmakers involved are having some success in getting their numbers reinstated retroactively.

That's what Watkins did.

"We had our representative and then a senator both make inquiries into it," said Watkins. "That's what got the ball rolling."

CMS will not say how many providers voluntarily revoked their numbers, but the number of active DMEPOS suppliers dropped from 106,707 on Sept. 1, 2009, to 92,629 on Dec. 1, 2009, according to data obtained by HME News. At press time, neither CMS nor the NSC had responded to requests for comment.

It's clear the NSC is "overwhelmed with work," said Cross.

"I think that these analysts are giving providers the best answers they can," she said.

Answers would be nice, said provider Pat Shannon. He revoked his number September 29 and passed his accreditation survey in January.

"They are not providing any information," said Shannon, owner of United DME in Omaha, Neb. "The only thing they are saying is that they get about 1,000 requests for activation per day right now and that they are many days behind. But they are not telling me if they are 40 days behind or 60 days behind."

In the meantime, Shannon's got rental items out in the field that he's unsure whether he will ever be paid for.

"I couldn't just take my beds back," he said. "I couldn't do that to the patients. That's not what we are in business for."

Besides contacting lawmakers, providers should contact their state associations or the NSCAC (www.nscac.org) to alert them to problems.