Wheeler Dealer? Forget “sad.” It’s time to get MAD

Friday, October 31, 2003

Because of what may be one of the greatest continuing streaks of administrative negligence in our nation’s history, and a near unbelievable amount of sheer gall on the part of CMS, the HME provider community is again under attack.

Unless something has changed unexpectedly by the time this is published, CMS and the other demigods and demagogues in DC are applying a new slew of “corrective measures” on HME providers. The overwhelming majority of these people have done nothing wrong other than help patients and the rest of the medical community try to figure out how to get and pay for much-needed medical equipment.

CMS just recently noticed what everyone else in the industry knew was starting at least two or three years ago: That intense, unethical marketing, bleeding-edge interpretations of fuzzy Medicare laws and outright fraud were driving mobility sales through the roof. Didn’t they see it coming?

A 189 percent increase in overall power chair sales between 1999 and 2002 isn’t noticeable? OK, but how about a 1,000 percent increase in ONE YEAR in one Texas county? This is the same county where one single doctor signed more than 25,000 certificates of medical necessity for wheelchairs. How much do we pay for government data analysts and computers? CMS’s chief honcho Tom Scully says, “This abuse is an insult to all Americans who pay taxes.”

It would have been nice if he had added that “CMS’s continuing negligence and inaction are an unforgivable insult to all taxpayers, beneficiaries and suppliers and I have terminated the employees responsible and am immediately submitting my own resignation.” Maybe Nobel Prize-winning economist Milton Friedman was right when he said, “If you put the federal government in charge of the Sahara Desert, in five years, there would be a shortage of sand.”

One provider called us at VGM and related that he found this latest crisis to be a “sad” situation. Well, we disagree. It is more than a “sad” situation. It is a travesty compounded by a near conspiratorial reaction from the media, CMS, the OIG and their congressional stalwarts to blame it all on the provider community.

It is ironic that we have the very people who are primarily at fault - CMS and their contractors - calling press conferences to blame OTHERS. They ought to be calling a press conference to announce that they are all resigning. If they were a private corporation, the stock would be down to under a dollar, the lawyers circling and heads rolling.

Imagine your guard service calling you to complain, or blame you, because of a burglary while they were on the job. Or how about your bank blaming you, as a depositor, for a successful robbery? CMS has been paid billions of dollars to protect beneficiaries and taxpayers. Their job is to be sure that crooks do not take money that should go to paying fair compensation for quality medical equipment that people need. They have failed miserably at this year after year and it is well past time to call them to task for it.

Why should CMS be allowed to continue as administrator of this vital public program? Did HCFA think that by changing its name the public would forget who it was who let this happen time and time again in the past? Reasonable consumers would have long ago gotten a different guard service or moved their money to a different bank.

But we let CMS get away with “the HME guys did it” time and time again. NOT SO! The reason you have guards is because you know that there are crooks. The guards are supposed to be the experts and know how to protect you and prevent losses. CMS does not. There is no longer any question about that, and we can’t let them get away with trying to blame someone else for their failure. We need change, and we won’t get it by being sad. We need to get mad.

My suggestion is that HME providers quickly and loudly take the initiative in their communities. You need to let your neighbors, referral sources and government representatives know that you are mad and simply are not going to let them put the blame on you again. Write letters to the editor, write referral sources and patients directly, speak before civic and service clubs. Do whatever is necessary to get this message across. You are an ethical business person employing people in your community and providing a valuable needed service. You have an absolute right to protection from the government agencies that are paid huge sums to do that job. It isn’t happening, and they and you are going to suffer if change doesn’t occur soon. Get mad and get vocal or learn to live with the consequences.

- Van G. Miller is CEO and founder of The VGM Group.