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OIG Report Confirms AAHomecare's Position that Power and Wheelchair Documentation Rules Are Flawed
A December 2009 report released last week by the HHS Office of Inspector General (OIG) confirms AAHomecare's position that the Medicare documentation rules for power wheelchairs are deeply flawed and must be improved.
"The study does not illustrate a problem with provider compliance but rather it reflects problems with the Medicare documentation requirements and the great difficulty of meeting confusing, shifting paperwork burdens," commented Tyler J. Wilson, President of the American Association for Homecare.
The report, which 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," is consistent with the experience of power wheelchair providers who have worked with the flawed Medicare process.
AAHomecare is developing a full statement about the OIG report and will distribute it to Congress, to the media, and to our members. AAHomecare will continue to work with CMS and the OIG to address critical problems with the regulatory compliance process for the HME sector.
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Report Your "Meek Week" Success, Tell AAHomecare about Your Meetings
AAHomecare is spearheading "Meek Week," a grassroots campaign to increase the number of cosponsors for H.R. 3790, legislation introduced by Rep. Kendrick Meek (D-Fla.), to eliminate the HME competitive bidding program. AAHomecare believes that this week is an excellent opportunity for you to speak with your legislator about home medical equipment and strongly urge him or her to support H.R. 3790.
Members of the House of Representatives are expected to be in their home districts until the House resumes business on January 12. The Senate returns on January 19.
It is imperative that you contact your Representative and set up an in-district meeting regarding H.R. 3790 as soon as possible. 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.
Don't forget to pass along information from your meeting! Please let us know if you schedule a meeting with your member of Congress by emailing Stacey Harms at staceyh@aahomecare.org.
It is also important for you to provide AAHomecare with feedback from your meeting. Please fill out a congressional meeting feedback form. This information will help AAHomecare's seven registered lobbyists to follow-up on these important in-district meetings.
AAHomecare is also encouraging HME providers to use "Meek Week" to organize facility tours for members of Congress and their staff. HomeCare Magazine reports that Richard Lerner, president of Allcare Medical in Sayreville, N.J., is using this week as an opportunity to host a visit from the legislative director of the office of Congressman Frank Pallone (D-N.J.). The magazine quotes Lerner, "We will be giving her a tour of our facilities on Jan. 7.... Our clinicians and managers will be attending, as well as an oxygen and power wheelchair patient. Our goal is to have her leave with a better appreciation for what we do, have an ally in Congress and have her recommend to Rep. Pallone that he cosponsor H.R. 3790."
AAHomecare knows that your story is critical to changing the perception of the competitive bid program. Speak face-to-face with your Representative and explain how the competitive bidding program will drastically cut reimbursement rates and the number of home medical equipment firms allowed to participate in Medicare. These cuts will cripple the nation's homecare sector - the most affordable, cost-effective form of health care available to Americans.
The following are AAHomecare talking points you can use for your Congressional meeting:
Sacrifices Care for Seniors and People with Disabilities
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Competitive bidding reduces patient access and choice for quality HME items and services.
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The program selectively contracts with a very restricted number of homecare providers based on the lowest-bid prices.
Eliminates Businesses and Jobs (Anti-competitive)
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The bid program is actually anti-competitive because it reduces the number of market competitors.
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90 percent of qualified home medical equipment and service providers would have been barred from providing HME items and services to Medicare beneficiaries in the first round of bidding.
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The Medicare bid program will result in job losses and business failure for thousands of small providers, which runs counter to the President's February 24 speech to Congress when he pledged to "do whatever it takes to help the small business that can't pay its workers."
CMS Did Not Correct the Fundamental Flaws in the Program
- The bid program is fatally flawed. The program was postponed by Congress in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), but CMS did not correct the chief flaws before reissuing regulations to restart the bidding.
Bidding Is Not a Cost-effective Solution for Medicare
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Competitive bidding will increase Medicare costs because it will lead to more expensive, longer hospital stays, shifting costs from Medicare Part B to Part A.
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Home medical equipment and services already provide a cost-effective alternative to expensive institutional care and a solution for controlling spending growth in Medicare. For instance, under Medicare, a day of oxygen therapy costs less than $7 per day. A day in the hospital costs more than $5,500.
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Home medical equipment is the most cost-effective form of care. |
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AMA Warns Physicians to Enroll in PECOS
As we have reported, AAHomecare has been expressing alarm about the Provider, Enrollment, Chain and Ownership System (PECOS) issue since it quietly arose in October. AAHomecare immediately established a dialogue with CMS on PECOS and met with senior CMS officials to raise concerns about how this program would negatively affect Medicare beneficiaries and HME providers. In a formal letter to CMS, the Association also requested a lengthy delay so patient access to HME would continue and provider cash flow would not evaporate when the program was implemented on January 5. On November 23, 2009, CMS announced that PECOS would be delayed until April 5, 2010.
This week the American Medical Association (AMA) released information estimating that as many as 200,000 doctors need to re-enroll in PECOS. That represents about 30 percent of those who are required to register with PECOS. Many of these physicians enrolled in Medicare before 2003, when CMS began using the new system.
In a January 4 editorial titled, "More Medicare Paperwork," in American Medical News, the AMA warned their members that doctors who provide services under Medicare or who refer patients for such services have until April 5, 2010 to determine whether they are up to date in PECOS. CMS recommends that all physicians ensure their enrollments are up to date and are compliant by contacting their Medicare contractors or viewing their records online.
Medicare will stop payments to Medicare contractors who are not properly enrolled in PECOS as of April 5, 2010. The AMA notes they have asked CMS for more time to comply with the PECOS enrollment requirement and that April 5 could be a tight timeline for a larger practice that needs to sign up multiple doctors. AAHomecare will continue to work with the AMA and CMS to address this critical issue.
Visit the AMA website to read the full article on PECOS.
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