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Are you flabbergasted?

Are you flabbergasted?

I think I heard the camel's back break last month; at least I hope I did. Notice of the break came in the form of a long e-mail I received from Steve Landau, an HME provider in New York City. I'll stop short of saying that Landau speaks for most providers, but I think he speaks for many. The question is: Does he speak for you? Landau's e-mail reminded me, to mix metaphors, of the anchorman in the movie "Network" who proclaimed: "I'm mad as hell and not going to take it anymore." CMS's latest sally against the industry--a major, ill-considered reduction in reimbursement for power wheelchairs and scooters--left Landau flabbergasted. "If it wasn't crystal clear before, it should be clear now: CMS's real intent has always been to put as many HME providers out of business as possible," he wrote. "No doubt, these allowables will do just that, and they'll force manufacturers to sell poor-quality items at cut-rate prices. I call it the 'Wal-Martization' of the HME business." He just as easily could have been referring to other equipment and services CMS has targeted for cuts over the past few years. In equally livid language, Landau called the new mobility allowables "cruel and shortsighted." Sure, they may curb spending, but they'll also land beneficiaries in inappropriate equipment. He expressed unmistakable anger at the National Supplier Clearinghouse for helping to drive up power chair utilization by "giving out new billing numbers like raffle tickets." He slammed CMS for using the sins of a relative few scoundrels as an excuse to punish all providers with an onerous reworking of the power mobility benefit. "I don't see why I have to go out of business because of shady Harris County, Texas, Wheeler Dealers and other unethical providers. If these cuts go through, I'm very concerned and heartbroken that I may have to lay off half my employees at Christmas time. Even worse, I may have to close my doors for good." He called changing the PMD codes "a ploy by CMS to cut our allowables in half--it has nothing to do with addressing changes in PMD technology." Inspired by his ire, Landau said a lot of things, including: "I have never seen an industry that has allowed itself to be so viciously maligned for such a prolonged period of time." In a follow-up e-mail, Landau implied the obvious: If industry lobbying efforts are to succeed, more providers need to get involved. He also said, and I could almost hear the uncertainty in his voice, "I hope it's not too late." HME

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