American Association for Homecare Objects to the Exclusion of Home Medical Equipment Sector from Discussions on Preventing Medicare Fraud

The durable medical equipment and service sector will not be included in discussions at a federal “summit” to identify ways of preventing Medicare fraud. The American Association for Homecare (AAHomecare), which represents that sector, objects to being excluded from the discussions, which are taking place today, January 28.

The event is being billed as a “National Summit on Health Care Fraud” that brings together “leaders from the public and private sectors to identify and discuss innovative ways to eliminate fraud, waste and abuse in the U.S. health care system.” Speakers will include U.S. Department of Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder.

Tyler J. Wilson, president of the American Association for Homecare, commented, “The national ‘summit’ on health care fraud, convened by HHS and DOJ, is going forward without the benefits of the perspective and insight of the home medical equipment sector and we object to being left out of the discussions. Our Association has proposed specific, concrete recommendations in an aggressive 13-point anti-fraud action plan which, if adopted, could further reduce the potential for unqualified providers to be granted Medicare supplier numbers in the first place and subsequently reduce the potential for fraud.”

Last February, the American Association for Homecare proposed to Congress a 13-point anti-fraud legislative action plan that calls for real-time audits and screens to catch fraudulent claims, more site inspections to ensure that Medicare allows only legitimate home medical equipment providers to file reimbursement claims, and a dedicated office at the federal government level to combat Medicare fraud. The Association has also recommended that more funding be made available to federal fraud fighters. See the Association’s full 13-point plan at www.aahomecare.org/stopfraud.

The American Association for Homecare also has endorsed the “Prevent Health Care Fraud Act of 2009,” S. 2128, which is designed to improve tools and resources available to prevent Medicare fraud. The bill was introduced by Sen. George LeMieux (R-Fla.) and it contains several provisions the American Association for Homecare outlined in its 13-point anti-fraud plan.

AAHomecare hopes Congress will incorporate the Association’s entire 13-point plan into law. The American Association for Homecare will continue to work with administration officials, key congressional committees, and members of Congress to find ways to curtail criminal activity within Medicare and at the same time preserve the ability of legitimate home medical equipment providers to serve Medicare beneficiaries.

Medical Equipment Providers to Donate Equipment to Haiti

All types of equipment are needed in Haiti to help the injured. The Florida Alliance of Home Care Services is working with the Accredited Medical Equipment Providers of America to gather equipment to send to Haiti. The Associations are working with medical missions and other non-profit entities to collect home medical equipment and identify the proper groups to distribute it.

HME providers are invited to check your warehouses for wheelchairs, walkers, hospital beds, commodes, oxygen concentrators and even nebulizers that are in good working order which could be donated. Collection points are being set up in South Florida. The Reef management Group has generously allowed the HME community to use an empty 1600 square foot warehouse, next to City Medical Services as a Central Collection Center for North Miami-Dade and South Broward Counties.

Items being collected include:

Bilevel–PAPs (Working)
Canes
Commodes
CPAPs (Working)
Hospital Beds (As long as the motors are intact and rise with hand cranks)
Oxygen Concentrators (With Oxygen Purity levels above 80%)
Suction Machines (Working)
Walkers
Wheelchairs

Please arrange drop off at:

City Medical Services
20815 NE 16th Avenue
Unit B-34
North Miami Beach, FL 33179
(305) 493-3744

Collection Centers in Palm Beach County and South Miami-Dade will open soon.

Lew Morris of HHS Office of Inspector General Displays Contempt for Oxygen Patients and the Facts on “Dan Rather Reports”

On a January 18, 2010 broadcast of “Dan Rather Reports,” Lew Morris, who is general counsel of the Health and Human Services Office of Inspector General, had this to say about recent activities by the home oxygen community:

“Those who supply these [oxygen] concentrators organized, even brought senior citizens dragging oxygen tanks behind them to go up on the Hill and beg their representatives not to cut their oxygen supply, not to let them die, not to let the price of this critically valued piece of equipment be reduced. And Congress heard. So, the Medicare program was stopped from reducing those prices.”

Of course, the idea that Medicare has not cut oxygen prices is not just inaccurate, it’s preposterous. The Medicare Improvements for Patients and Providers Act of 2008, for instance, included a 9.5 percent cut to Medicare oxygen reimbursement rates, which took effect on January 1, 2009. That came on top of a long series of cuts to oxygen that amount to reductions of approximately 50 percent over the past 10 years. Producers at “Dan Rather Reports” were informed of this by the American Association for Homecare well in advance of their January 18 segment, but they chose to ignore it.

Is it asking too much to expect accurate or fair reporting from Dan Rather, or the HHS Office of Inspector General?

Cosponsors for Meek Bill, H.R. 3790, Is at Least 124 and Growing

During last week’s “Meek Week,” the American Association for Homecare mobilized visits and contacts in congressional districts to build support for the Meek bill, H.R. 3790, that would stop the “competitive” bidding program. H.R. 3790 received six new cosponsors, pushing the official count to 124. Thanks to all who contacted their members of Congress!

New cosigners for H.R. 3790 as of today include:
Rep. Roy Blunt (R-Mo.)
Rep. Louis Gohmert (R-Texas)
Rep. Steve Kagen (D-Wisc.)
Rep. Allan Mollohan (D-W.Va.)
Rep. Jerry Moran (R-Kan.)
Rep. Nick Rahall (D-W.Va.)

Remember, the work of Meek Week is not over. A number of legislators have given verbal commitments but are not yet listed. If you received a commitment to support the bill from your Representative, please share the information with Alex Bennewith (alexb@aahomecare.org) at AAHomecare so we can follow up. If you had a meeting with your member of Congress or staff, please follow up with a thank you and press the lawmaker to commit to supporting the bill. Also, please fill out a meeting feedback form, which will help AAHomecare’s lobbyists follow up with the member and with Meek’s staff who collect information about cosigners.

Lawmakers Express Opposition to Bid Program during Meek Week

Last week, several members of Congress spoke out publicly against the “competitive” bidding program. At a town hall meeting conducted by Congressman Mike Ross (D-Ark.) last Friday, Ross touched on the competitive bidding issue. The January 11 Malvern, Arkansas Daily Record reported Ross’ answer to a question from the audience regarding the program: “I am against competitive bidding on home medical equipment. That is something I feel very strongly about. When the power goes out, do you want your grandmother’s equipment owned by the lowest bidder out of Houston or New Orleans, or would you want it owned and serviced by someone locally?”

The McAllen, Texas Monitor reported on January 8 about meetings between a member of Congress, CMS, and providers in several cities in Texas. The newspaper quotes a McAllen HME provider, Rene Ramirez, owner of SupplyBug, “Our concern is they’re trying to cut costs so much to the detriment of the small business and the patient. The general consensus is we don’t want (competitive bidding) down here because it will drive us completely out of business.”

The newspaper says Congressman Henry Cuellar (D-Texas) “also questioned the competitive bidding process” and organized the meeting between medical service professionals and a CMS representative. Read the full article here.

HHS Report Confirms that Complicated Medicare Documentation Requirements for Power Wheelchair Claims Obstruct Regulatory Compliance by Physicians and

A federal report released last week on Medicare claims for power wheelchairs confirms that the regulatory documentation requirements are confusing, onerous, and must be improved, says the American Association for Homecare, the nation’s largest association representing providers of durable medical equipment and services, including wheelchairs.

The December 2009 report released by the Health and Human Services Office of Inspector General (OIG) found that “three out of five claims for standard and complex rehabilitation power wheelchairs did not meet Medicare documentation requirements during the first half of 2007.” These findings are consistent with the experience of power wheelchair providers. They illustrate the fundamental problems that occur when confusing and contradictory policies are applied to the claims process and when standardized Medicare documents approved by the federal Office of Management and Budget are not used.

“The OIG study does not illustrate a problem with provider compliance but rather it reflects the obstacles providers face with Medicare documentation and its paperwork requirements,” stated Tyler J. Wilson, President of the American Association for Homecare. “The paperwork requirements are confusing, shifting, and inconsistent.”

“The OIG report actually confirms what wheelchair providers and physicians have said for the past three years: the Medicare documentation requirements for power wheelchairs are inconsistent, far too complex, and must be improved so both physicians and wheelchair providers can serve patients and successfully meet Medicare regulations. We obviously want to ensure 100 percent compliance. But the inequity and inefficiencies of this system are evident when, as the OIG found, only 7 percent of claims for complex rehabilitation wheelchairs meet Medicare’s documentation standards.”

To read AAHomecare's full statement on this report, visit the AAHomecare Newsroom.

This Is Meek Week! Contact Members of Congress, Ask them to Support H.R. 3790

AAHomecare is spearheading “Meek Week,” a grassroots campaign this week to increase cosponsors for Rep. Kendrick Meek’s bill, H.R. 3790, which would eliminate the Medicare “competitive” bidding program for home medical equipment. This is a critical time to meet with your members of Congress while they are in their home districts and ask them to support the Meek bill.

Officially, H.R. 3790 has 118 cosponsors so far – an impressive number, but far short of the number of supporters to make the impact we need to get this bill enacted into law.

The bidding program is misguided and will actually reduce competition in the home medical equipment sector, reduce choices available to seniors, and increase health care costs. By drastically cutting both reimbursement rates and number of HMEs allowed to participate in Medicare, the bidding program will cripple the nation’s homecare sector – the most affordable form of health care available.

Homecare is the most cost-effective form of care for both current Medicare and Medicaid beneficiaries and future beneficiaries, including the 78 million baby boomers who will prefer to stay at home with their loved ones.

You can find the phone number and location of every legislator’s district offices in the “Contact Me” section of each Member’s website at www.house.gov.

While there is no Senate companion bill to the Meek legislation, HME stakeholders should also contact their Senators’ district offices to briefly explain the importance of homecare in your state and emphasize that no further cuts should be made to durable medical equipment reimbursement rates.

Visit www.aahomecare.org for more information.