You cannot bid the life of my mother

Friday, October 31, 2008

Last year my aunt died from pulmonary fibrosis. Recently, my mother was diagnosed with the disease. While one can lament such happenings, one cannot prevent them, and therefore I must try to make a deadly disease tolerable for my mother.

Given the fact that she was immediately prescribed oxygen, I knew full well that a reputable accredited oxygen provider would bring her oxygen and alleviate her shortness of breath. I was wrong.

Unfortunately my mother is in an HMO that uses the lowest bidder to supply its patients. So it begins. The oxygen was prescribed on a Friday and it was delivered on a Monday night. I was not home at the time of delivery. When I asked my mother to start using the equipment, she asked me, “How? I don’t know how.”

Wait a minute. We all know that a licensed, accredited provider must provide instructions and leave documentation with the patient informing them of, amongst other things, how to use the equipment (rate and frequency would help). Not for my mother. She was given an old, dusty PB590 without an elbow or humidifier, two cannulas and one e-tank. All she was told was: “Turn this on here.” When I arrived at her house, I asked to see the paperwork she was given. It was a pink transaction ticket. Nothing more. No instructions, no Medicare standards, no rights and responsibilities, no HIPAA notice of privacy practices, nothing explaining how to use the e-cylinder. Nothing. It never occurred to this provider that there was a hurricane nearby and that perhaps some minor conversation should have been had about an “emergency plan.”

Once I got over my anger and my desire to throw the concentrator out the window, I cleaned the concentrator, drove to one of my client’s offices who gave me an elbow, humidifier and some cannulas. Then I stood there looking at my mother on oxygen, helpless and wondering how, after so many years fighting to make DME right, could this be so wrong? Then it hit me. It must be the curse of the lowest bidder.

It is time that we all realize this fundamental truth. You can’t bid so low that you are forced to become an HME prostitute. You cannot, for the sake of expediency, grant deemed status to anyone who chooses to become an accrediting body. And you cannot bid the life of my mother.

The disgusting truth is evident in the failure of competitive bidding. CMS knew full well that many of the winners were not qualified and that they were accredited in summary fashion. That many had no experience, licenses or even a remote clue on what it really means to care for a patient. When CMS Administrator Kerry Weems told Congress that he would change nothing about the bid he either lied or is dumb beyond imagination.

I don’t want anything special for my mother. I want what she deserves. She deserves a healthcare system that cares more about the patient than the money. She deserves a provider that cares. I will make sure of that.

Javier Talamo, attorney, Kravitz & Talamo, Hialeah, Fla.