“It’s a torpedo for all small businesses that do durable medical,” is how Brennen Garry, president of Unimed II Inc., explained the impact of competitive bidding on small business. Garry spoke to Mike Sherry at the Kansas City Business Journal this past week, providing background and details about the bidding program.
The article quotes AAHomecare’s view that the revised competitive bidding rules did not make sufficient changes to address the flaws in the program and mentions the Associations belief that internet prices don’t factor in service and quality provided by local providers.
View the complete article at: http://kansascity.bizjournals.com/kansascity/stories/2009/03/30/story6.html?b=1238385600^1801988
More articles detailing the flaws in the bidding program appeared in the:
Silicon Valley / San Jose Business Journal
(see http://sanjose.bizjournals.com/sanjose/stories/2009/03/30/story3.html) and the
Buffalo (New York) Business Journal
(see http://buffalo.bizjournals.com/buffalo/stories/2009/03/30/story4.html?b=1238385600^1800705)
Subscribe to:
Post Comments (Atom)
2 comments:
What most providers fail to realize about competitive bidding is that the design of the program is not to reduce fee schedules exclusively. If that was the purpose, CMS could just reduce the fee schedules again like they have at the beginning of this calender year for certain items. The purpose is to ELIMINATE AS MANY PROVIDERS POSSIBLE! Just ask CIGNA, who also manages the current CMS DMEPOS program. Why do they only have ONE durable medical equipment provider in their network? For the same reason competitive bidding is place, to eventually have as few providers as possible. DME Medicare expenses are not only from inflated fee schedules, but for excessive administrative costs incurred by so many providers.
CMS is putting a financial hardship on DME providers by requiring all these new costly regulations such as accrediation and surety bonds. I know CMS boasts that accrediation only cost approximately $1500 per year but they are WRONG. CMS failed to add in the additional costs of required training, additional costs of required certifications and continuing eds, the additional cost of administrative duties, etc. The total cost for 3 years for my small company is estimated at approximately $5000 per year. Then add on another $1500 for surety bonds. And, if your a DME provider that hasn't been eliminated by those additionals costs, just wait, because competitive bidding will finish slashing your throat. But wait there is more, after speaking with several companies in many states who have went through the accrediation process the first time, I have found it was basically a joke. These surveyors are calling to schedule their unannounced surveys, passing every company regardless of their findings with the assumption that in 2 or 3 years DME companies will be in compliance, not visiting sites, not interviewing employees or owners, and the list goes on and on. Basically it is like CMS themselves who create rules constantly but they never enforce any of them. Look, for example, at the Theraputic shoe requirements for DME companies. You must have a written order with specific detailed items on it, you must have a certifying order meeting local coverage determinations, you must have the physicians notes to back up everything from their diabetic treatement to every callus on a patient's foot, you must be a certfied fitter (well, this one depends on who you ask and what day it is), you must have documentation that patient is wearing the shoes, and etc and etc. Basically, DME providers are the fall guy for everyone from CMS to physicians because if everything is not in line, CMS wants their money back. In a nutshell, they constantly create rules that no provider, or patient for that matter, can understand so when the kitchen gets hot in Washington, they can come in and say "blame it on the DME companies" and with their wildly created rules that are not logical in the "real world" they can always find something that is not right. I don't understand how a DME provider can take the blame financially for any physician who prescribes items and doesn't keep proper documentation. This should fall back on the physician...oh but wait...they have been exempted!!!!!!! What is the point? Why exempt certain professions from the DME requirements--it don't make sense at all which is typical of CMS.
Post a Comment