Discussion Forum

Editor’s Note:  CRE has long warned of CMS’ intent to massive expand competitive bidding.

From: The Seattle Times

Editorial: Feds make a hash of state’s mental-health system

An obscure federal auditing issue may require the state to quickly tear up its outpatient mental-health system.

Seattle Times Editorial
THE U.S. Centers for Medicaid and Medicare Services informed the state of Washington that the state’s outpatient mental-health system violated federal procurement laws, as articulated in OMB Circular A-87.

Hope that didn’t lose you. That accountant-speak is bone-dry.

But the consequences of the July 5 letter are huge, and will require immediate, focused attention by state … Continue Reading

From: HME News

Beneficiary told to travel 150 miles for power wheelchair

by: Theresa Flaherty

CHARLESTON, S.C. – It’s a scenario that’s likely playing out in competitive bidding areas (CBAs) across the country: Medicare beneficiaries that can’t get the equipment they need.

Richard Drake, a retired businessman who suffers from hereditary neuropathy in both legs, which has left him unable to walk or stand, is one of those beneficiaries. Just prior to the July 1 start date of the program, he learned he qualified for a power wheelchair.

Editor’s Note:  CMS’s uncompetitive bidding has been debunked and denounced by every independent scholar who has anlyzed the program.  Over 240 professors and researchers, including several Nobel laureates, at schools ranging from the University of Maryland and the California Insitute of Technology to Harvard, Stanford, Yale, MIT and many other have explained that,

it is now clear that the CMS design is not an auction at all but an arbitrary pricing process.

The scholars further explained that the Medicare program violates the Administration’s regulatory principle’s set forth President Obama’s Executibe Order on regulatory reform,

From: LehighValleyLive

By Express-Times Letters to the Editor

Obamacare has changed Medicare. As of July 1, “Durable Equipment and Supplies” has a new program to save you money and ensure quality services. That’s what it says on the front of the brochure Medicare sent us.

My husband is on a CPAP machine, which is partially purchased and partially rented. The provider he uses will now be noncontracted, but he is grandfathered in so the company will be able to supply parts and repairs. But he will no longer be able to get other things from the company. At the end … Continue Reading

From: The Hill

Liberal group CAP floats sequester replacement

By Erik Wasson

The liberal Center for American Progress on Thursday proposed a new way to  replace part of the nine years of automatic spending cuts enforced by  sequestration, which started March 1.

CAP, the think tank closest in many ways to the Obama administration, is  floating replacing sequestration for 2014, 2015 and 2016, essentially throwing  in the towel on the current fiscal year, which ends in October.

The group argues that the rest of the $1.2 trillion total sequester can be  replaced later and trying to replace it all now will likely lead to … Continue Reading

From: McDermott, Will & Emery

Article by Eric P. Zimmerman and Elizabeth K. Isbey

On April 10, 2013, President Obama released his budget proposal for fiscal year (FY) 2014 (the Budget). The President reiterated his long-standing goal of reducing the deficit by $4.3 trillion over 10 years and his willingness to do so in part by saving $400 billion from changes to federal health programs, including Medicare and Medicaid. According to the President’s budget document, these savings would be enough to cancel the sequestration required by the Budget Control Act of 2011, which went into effect in March 2013.

From: Home Care Magazine

The cherry blossoms were in bloom, the temperature was in the seventies, and Taylor Morris took off for a 45-minute ride through Rock Creek Park, leaving the group of guys in dress clothes and shoes following him in the dirt, so to speak. The occasion last Monday was the presentation of a new all-terrain Extreme 4 x 4 wheelchair, courtesy of Angola, Ind., manufacturer Innovation In Motion. IIM is a contracted vendor of U.S. Rehab, VGM Group, Inc.’s complex rehab division.

Taylor, a Cedar Falls, Iowa native, suffered horrific injuries May 3, 2012, in Afghanistan. As a … Continue Reading

From: CMS

CMS has announced the contract suppliers for Round 2 and the national mail-order program of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program.

A list of contract supplier names is available at www.dmecompetitivebid.com. Contract supplier locations for each product category in each competitive bidding area can be found in the Supplier Directory at www.medicare.gov/supplier.

For additional information:

• Press Release
• Fact Sheet

New Name for CBIC Ombudsmen

CMS is changing the name of the Competitive Bidding Implementation Contractor (CBIC) ombudsmen to CBIC liaisons. This change will help distinguish the CBIC liaisons from the CMS Competitive Acquisition Ombudsman.  … Continue Reading

From: Zanesville Time-Recorder

I have more than 30 years experience as a respiratory therapist and as a manager of a durable medical equipment companies specializing in oxygen and respiratory therapy services in the Zanesville area.

A recent USA Today editorial about Medicare bidding competition painted a grossly unfair picture of our industry.

When I started working in home oxygen the equipment was very cumbersome, required considerably more service and was more costly than today. Also the market dictated that in order to get referrals from physicians the customers needed follow ups by a respiratory therapist. Even with all this, respiratory therapist proved … Continue Reading

From: USA Today/Opposing View

Tyler J. Wilson

In 2003, Congress required Medicare to ensure that medical equipment and supplies used by beneficiaries at home (known as “durable medical equipment,” or DME) are procured through a system that increases competition and achieves market-based prices, but doesn’t diminish quality. Unfortunately, Medicare has completely mismanaged the design and implementation of its bidding program for home oxygen equipment, power wheelchairs, diabetic supplies and other critical home medical products.

More than 240 economists, two dozen consumer groups, almost 200 members of Congress and the National Federation of … Continue Reading

PRNewswire-USNewswire/ — The Medicare bidding program for Durable Medical Equipment (DME) is devastating small and large businesses in communities across the country. And Medicare beneficiaries—senior citizens and people living with disabilities—are being endangered because of delays in obtaining critical homecare equipment, such as oxygen therapy, power wheelchairs, and diabetic testing supplies.

Last month, the Centers for Medicare & Medicaid Services (CMS) announced an average cut of 45 percent in reimbursement rates for DME items when the dangerous and defective bidding program expands this summer to an additional 91 locations. Already, repercussions are being felt by the businesses that will … Continue Reading

By Terry Baynes

(Reuters) – A federal judge in Minnesota delivered a sharp rebuke to the government’s new competitive bidding program that affects who can supply certain medical equipment and how much they can be paid by Medicare.

U.S. District Judge Donovan Frank said in an order on Tuesday that while he lacked the authority to rule on the legality of the program, the government was ignoring the harm inflicted on people with disabilities.

“This is a sad day for those who believe that when a judge adheres, even-handedly, to his or her oath of office, justice will prevail and the public interest … Continue Reading

From: HME News

by: Theresa Flaherty

HOLLY SPRINGS, N.C. – Provider Ed Dressen found himself in the spotlight this week, just for doing his job.

On Jan. 12, right after the buzzer sounded on North Carolina State’s close win over No. 1-ranked Duke University, student Will Privette, along with hundreds of other fellow Wolfpack fans, rushed the court—in his wheelchair. Caught in the crush, Privette and his wheelchair were toppled.

“I was actually watching the game at home and saw him sitting out front, and then the announcers were saying, ‘Oh no, he’s going over,’” said Dressen, owner of Dressen Medical Supply.

From: Home Care Magazine

BETHESDA, Md., Jan. 2, 2013—The Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) announces that to reduce the potential of significant disruption to the health-care industry, it will not initiate enforcement action until March 31, 2013, with respect to HIPAA covered entities (including health plans, health care providers, and clearinghouses, as applicable) that are not in compliance with the operating rules adopted for the following transactions as required by the Affordable Care Act: eligibility for a health plan and health care claim status. Notwithstanding OESS’ discretionary application of its enforcement authority, the … Continue Reading

Editor’s Note:  Every independent expert who has examined Medicare’s “competitive bidding” program for home medical equipment has determined that it will fail.  Hundreds of economists, including Nobel laureates, and researchers working under a National Science Foundation grant and the Congressional Budget Office have all reached a similar conclusion.  HHS/CMS has been deaf to the science community and pursued their own deeply flawed plan.  Now the human toll is starting to be felt.  The article below explains why Congress must pass H.R. 6490 – The Medicare DMEPOS Market Pricing Program Act of 2012.

From: CBS/Miami

WASHINGTON, Dec. 18, 2012 /PRNewswire-USNewswire/ — The National Coalition on Health Care (NCHC), which describes itself as “America’s oldest, most diverse, and broadest based group working to achieve comprehensive health system reform” has proposed a major expansion of CMS’ competitive bidding program  “to the categories of durable medical equipment not included in the current program, including items such as nebulizers and ventilators.”  NCHC also supports “reducing the rate at which the federal government reimburses state Medicaid programs for DME” to Medicare levels.

Because the CMS bidding program has been castigated by every independent expert which has examined it for its … Continue Reading

From: Home Care Magazine

WASHINGTON, D.C., —As waves of audits continue to slam the home care sector, the AAHomecare Regulatory Council recently wrapped up a two-day work session at its headquarters in Washington. The top focus has been audit issues including lowering error rates, auditor oversight, and face-to-face exam educational materials.

Unless the error rate decreases, the home care sector will continue to be the target of congressional pressure and fraud charges. Dramatic measures are needed to bring the rate down. The HME community must also highlight the auditor error rate, which is the rate at which their claims denials are overturned … Continue Reading

From: Watchdog Watch

by Winston

The National Coalition for Health Care (NCHC), which describes itself as “America’s oldest, most diverse, and broadest based group working to achieve comprehensive health system reform,” has turned against America’s Medicare and Medicaid beneficiaries.

More specifically, NCHC has release a major policy statement calling for an expansion of CMS’ bidding program to include “categories of durable medical equipment not included in the current program, including items such as nebulizers and ventilators.” NCHC also called for applying CMS’ Medicare bidding prices to Medicaid.

Noted regulatory watchdog the Center for Regulatory Effectiveness (CRE) responded to the NCHC … Continue Reading

Editor’s Note:  CRE’s letter to the National Coalition on Health Care (NCHC) regarding their ill-conceived support for CMS’ competitive bidding program is attached here.

CRE will publish, verbatim, any response from NCHC in this space.

Below is the text of the letter to John Rother, President and CEO of the National Coalition on Health Care:

Re:      NCHC’s Support for Non-Competitive Bidding for Durable Medical Equipment

Dear Mr. Rother:

I am perplexed by NCHC’s decision to support expansion of CMS’ bidding-style acquisition program for Durable Medical (DME) in the “Curbing Costs, Improving Care” document. I do not question NCHC’s support for expanding the CMS program … Continue Reading

From: HME News

WASHINGTON – NAIMES has scheduled a virtual fly-in for Dec. 5 to build support for H.R. 6490, a bill that would replace the current competitive bidding program with a market-pricing program (MPP).

In what its calling “Operation STOP NCB,” NAIMES staff and board members will be in Washington, D.C., on Dec. 4 and 5 to visit the offices of key lawmakers. The association asks that providers follow up those visits with calls to their lawmakers on Dec. 5 from 8 a.m. to 5 p.m.

“Let’s make Dec. 5 our DME Day in Washington by ringing the phones and making a … Continue Reading

Editor’s Note: The Center for Regulatory Effectiveness stated that HHS was likely to “vastly expand” Medcare’s competive bidding to other types of medical equipment and services as explained here.  Now major organizations, in deeply misguided if well intentioned efforts to save money, are supporting an expansion of competitive bidding.  As previous noted, The National Coalition for Health Care is supporting an expansion of the program over 240 academicians called the antithesis of science.

More recently, the Center for American Progress has released its “Senior Protection Plan” (attached here) which states that the federal government should:
Expand competitive bidding … Continue Reading

Editor’s Note:  CMS’ Medicare Learning Network (MLN) Matters Number 8080 is attached here.  The document’s Key Points are printed below:

•  Beneficiaries may choose to pick up diabetic testing supplies in person from retail pharmacy locations or other local supplier storefronts or have them delivered to their homes. Once the program is implemented, only NMO contract suppliers will be reimbursed by Medicare Part B for providing diabetic testing supplies delivered to beneficiaries’ residences. If the supplies are shipped or delivered by any means to the beneficiary’s home, then the supplier that furnished the supplies must be a NMO contract … Continue Reading

From: United Spinal Association

Say No to Bidding– Support HR 6490

The bill with the funny name: HR 6490 – The Medicare DMEPOS Market Pricing Program Act of 2012, has some serious benefits for people with disabilities who cannot get critical equipment and services under Medicare’s current bidding program.

United Spinal Association needs your support to ensure HR 6490 is passed, so that Medicare beneficiaries––including wheelchair users and other people with disabilities––have access to high quality, durable medical equipment (DME), like wheelchairs, and other devices.

This type of equipment is far from a luxury, it’s a necessity! The right mobility equipment goes a long … Continue Reading

From: Home Care Magazine

When RACmonitor, a division of Panacea Healthcare Solutions, Inc., surveyed providers as to which topics they would like to see addressed in a webcast seminar, the number-one answer was infusion services. This is no surprise considering the variety and volume of questions there are regarding coding and documentation for infusion services. In response, MedLearn Publishing brings a brand new webcast seminar covering fundamentals of the outpatient infusion services revenue cycle. From patient registration and advance beneficiary notices (ABNs) to coding rules and sufficient documentation, this session covers a full spectrum of processes and protocols, helping you maintain … Continue Reading

From: Cedar Valley Business

ATLANTA — A number of VGM Associates will be presenting seminars at the Fall Medtrade exhibition Monday through Thursday in Atlanta.

Presenters include Mark Higley, “Coming This Fall: The Round One ‘Recompete'” and “Competitive Bidding: A Worksheet Tool for Post Round 2 Financial Projections”; Mike Mallaro, Ron Bendell, Rob Baumhover, Alan Morris, “New Growth Opportunities for HME Owners to Consider”; Jeremy Kauten and Matt Waller, “Moving HME Business Forward with Social Media”; Bill Stelzer, “Home Modification and Home Accessibility Business Opportunities”; Alan Morris, “Become the Solution Your Referral Sources Need: Bringing Value and Understanding Incentives”; Christina Throndson and … Continue Reading

The Center for Regulatory Effectiveness (CRE) has provided OMB’s Office of Information and Regulatory Affairs (OIRA) with massive and uncontradicted evidence demonstrating that the CMS competitive bidding program violated the Paperwork Reduction Act (PRA), see our comments to OMB here, our comments to CMS here, a peer reviewed analysis of the CMS program by CalTech researchers here, and a letter from over 240 economists to White House condemning the program here.

As the Congressional Budget Office and hundreds of independent experts have explained, without major reforms, the current CMS bidding program will fail. Thus, OMB’s refusal to … Continue Reading

Editor’s Note:  The complete text of the Medicare DMEPOS Market Pricing Program Act of 2012, a market-based replacement for CMS’s fatally flawed competitive bidding program, is available here. 

Please use the post your views in Leave a Reply box below on this important legislation.

From: Harrington Management Group

week ending September 21, 2012

by David Bargmann

There are weeks that I wish a blog didn’t need to be a summary. This week is certainly one of them!

Provider News On September 11, 2012, the Subcommittee on Healthcare and Technology held a hearing on “Medicare’s Durable Medical Equipment Competitive Bidding Program: How are Small Suppliers Faring?” Tennessee-based Lamberts educated followers on the entire proceeding via YouTube.

Lamberts HC ‏@LambertsHC Interested in last week’s Small Business hearing on Competitive Bidding? Watch it: http://fb.me/tzilujtU

Need a reason to celebrate? The President of Capital Healthcare Group … Continue Reading

From: Drug Store News

By Michael Johnsen

ALEXANDRIA, Va. — Louisiana pharmacist Randy Mire testified before Congress Tuesday that efforts to combat the diabetes epidemic in his home state and elsewhere would be significantly undermined if independent community pharmacies like his are forced to stop offering diabetes testing supplies as a result of Medicare’s competitive bidding program for durable medical equipment, according to a National Community Pharmacists Association release.

Mire appeared on behalf of NCPA before the U.S. House Small Business Subcommittee on Healthcare and Technology.

“My pharmacy is one of the very few pharmacies still in the area that provides these essential DME … Continue Reading

CMS finally admitted today what DME suppliers and independent experts have long known, the agency’s bidding system for home medical equipment “is not an auction.”  The admission was made by Laurence Wilson, Director of CMS’ Chronic Care Policy Group in response to a question at a hearing by the House Small Business Committee’s Subcommittee on Healthcare and Technology, Medicare’s Durable Medical Equipment Competitive Bidding Program: How are Small Suppliers Faring?

In response, Dr. Peter Cramton of the University of Maryland who also testified at the hearing, noted that the term “competitive bidding” is synonymous with auction and that, because the law … Continue Reading

From: The House Committee on Small Business/Subcommittee on Healthcare and Technology

Medicare’s Durable Medical Equipment Competitive Bidding Program: How are Small Suppliers Faring?

On Tuesday, September 11, 2012, at 10:00 A.M. the Subcommittee on Healthcare and Technology will hold a hearing titled, Medicare’s Durable Medical Equipment Competitive Bidding Program: How are Small Suppliers Faring? The hearing will be held in Room 2360 of the Rayburn House Office Building.

For years, Medicare’s benefit for durable medical equipment, prosthetics, orthotics and supplies has been plagued by a fee schedule with high error rates and above-market costs for the Medicare program, beneficiaries and taxpayers.  In response, … Continue Reading

From: HME News

by: Theresa Flaherty

WASHINGTON – Expect to see Rep. Tom Price, R-Ga., introduce a bill for the market-pricing program (MPP) soon after Congress reconvenes Sept. 10, industry stakeholders say.

“He’s indicated that he wants to move forward with the legislation since the congressional calendar is running short,” said Jay Witter, senior director of government affairs for AAHomecare.

Price indicated in late August that he was willing to take the lead on MPP, an alternative to the competitive bidding program. The bill is currently being drafted, and AAHomecare has been working with his office to line up a Democratic co-sponsor.

“Hi, this is Molly…and my husband Floyd…just got a walker, but we’re locked into one place to get it. We’d have to go to downtown Seattle or somewhere far away because now all of a sudden the government has put all these people out of business. But we’ve handled these things before and this is wrong, definitely wrong because how do you get there to get them?  It just really puts a real burden on the individual and I think this needs to be addressed, stopped. This competitive bidding is wrong.  …  Thank you, bye.”

From: Home Care Magazine

When faced with a Medicare audit, documentation can save the day

by Wayne H. van Halem

I’m often asked about how to avoid a Medicare audit. There is only one response I can think of, and that is to quit billing Medicare. Since that’s not a reasonable response, I suggest instead that you take the time to prepare for the inevitable audit. Whether it’s a widespread prepayment review or a provider-focused post-payment review, suppliers must take steps to ensure that they respond quickly and accurately. Your only defense in an audit is documentation, so for the purposes of this article … Continue Reading

Editor’s Note:  The Center for Regulatory Effectiveness’ comments to the White House Office of Management and Budget on CMS’ Information Collection Request for the home medical equipment bidding program is attached here. 

CRE’s comments document that the initial round of their program has “reduced the small business share of the Medicare home medical equipment market by almost half from CMS projections for 2012 and radically reduces the number of Medicare supplies by 85-95%.”

Moreover, “the overwhelming consensus by academic and federal experts” is that CMS program faces the “high probability of failure in the near future” and a “near certainty … Continue Reading

From: Home Care Magazine

NEW YORK, Aug. 7, 2012—United Spinal Association’s VetsFirst program played a key role in supporting the passage of legislation that improves access to service dogs, rehabilitation services and adaptive housing for veterans with disabilities that was signed into law by President Barack Obama on Monday, August 6, 2012.

The legislation, titled The Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 (H.R. 1627), includes several provisions that will help disabled veterans transition back into their communities and regain their independence. Key provisions in H.R. 1627 focus on:

Editor’s Note:  CAP should recognize that Medicare’s so-call “competitive” bidding is anythig but competitive.  Instead, as hudreds of Medicare experts have explained,  the CMS program is “the antithesis of science.”

The Center for American Progress on Wednesday (Aug. 1) recommended far-reaching proposals to cut health care spending that include allowing states to promote payment rates within a global spending target, requiring exchanges to be active purchasers and to offer at least one “tiered” product, using competitive bidding for all commodities in the federal health system and the insurance exchanges, expanding the ban of self-referrals to cover private insurers, requiring full … Continue Reading

From: Home Care Magazine

Philips Respironics, a unit of Royal Philips Electronics is pleased to announce their support of Mark Junge, a 69-year-old adventurer, cyclist and Chronic Obstructive Pulmonary Disorder (COPD) awareness advocate, as he embarks on a 225 mile bicycle tour to raise awareness for COPD and encourage oxygen-dependent people to stay as active as possible.

The Philips Respironics SimplyGo portable oxygen concentrator (POC) strapped to the back of Junge’s bike will help him breathe more easily on his journey. The approximate 10-day ride begins in Homer, Alaska on July 24. Junge ultimately plans to bike the Atlantic and Pacific coasts … Continue Reading

From: HME News

WATERLOO, Iowa – Home medical equipment revenues in Iowa could drop by $99.4 million once competitive bidding prices are implemented in 2016, according to a new study. The number of HME providers will also fall, says Ken Brown, a professor at the University of Northern Iowa, who put together the study for The VGM Group. The study also found that, as HME providers go out of business, the impact of competitive bidding will have a ripple effect. Companies that provide services to HME providers, including VGM and Medline, both of which are located in Iowa, will see their … Continue Reading

Written by NAPSI

Washington, DC (NAPSI) – Many Americans are taking their health care into their own  hands in a surprising way.

They’re calling Congress at (202) 224-3121 and asking their  representatives what’s being done about Medicare’s bidding  program for durable medical equipment and services. This type of equipment,  which includes oxygen, hospital beds and wheelchairs, helps to keep seniors  and people with disabilities safe and independent at home. The current system  has alarmed patients and policy experts alike.

Durable or home medical equipment and services also help control health  care spending by preventing costly stays in emergency rooms, hospitals and  nursing homes. … Continue Reading

The Center for Regulatory Effectiveness’ Statement, delivered at today’s CMS Public Meeting on:  “Inherent Reasonableness of Medicare Fee Schedule Amounts for Non-Mail Order (Retail) Diabetic Testing Supplies,” is attached in pdf here and reprinted below.  The Federal Register notice for the meeting is attached here.  Comments are due to CMS by July 30th although the date may be extended.

Statement of the:

Center for Regulatory Effectiveness

before the Centers for Medicare and Medicaid Services

Public Meeting Regarding Inherent Reasonableness of Medicare Fee Schedule Amounts for Non-Mail Order (Retail) Diabetic Testing Supplies

July 23, … Continue Reading

Editor’s Note: For more information about the HHS Inspector General report and its implications for comptitive bidding, please see CRE’s Competitive Bidding blog here.

KELLI KENNEDY

MIAMI (AP) – Firms that are paid tens of millions of dollars to root out Medicare fraud are bidding on contracts to investigate companies they are doing business with — sometimes their own parent companies, according to a government report released Tuesday.

Two-thirds of the companies that bid on contracts during a nearly year-and-a-half time period beginning in October of 2010 had financial ties to claims processors — and in some cases also processed Medicare claims … Continue Reading

Editor’s Note:  To Register to attend the CMS public meeting, click here.   The Federal Register notice with additional information about registering to attend the conference and for submitting oral and written comments to the record, is attached below.  For more information about CMS plans to use its “inherent reasonableness authority” cut payments for diabetic test strips, please see CRE’s DME Competitive Bidding Interactive Public Docket here. 

CMS Plans July 23 Meeting On Using IR For Diabetic Test Strips

CMS has scheduled a public meeting for July 23 to discuss whether it should use its controversial inherent reasonableness authority to … Continue Reading

From: Home Care Magazine

WASHINGTON, June 21, 2012—Three members of Congress have sent a letter to the Centers for Medicare & Medicaid Services (CMS) asking for a briefing on allegations that the Cuban government may be involved in HME fraud in South Florida.

The letter—by Sens. Orrin Hatch, R-Utah and Tom Coburn, R-Okla., along with Rep. Peter Roskam, R-Ill.—cited two cases of alleged Medicare fraud in the Miami area. One involved Oscar Sanchez, who is accused by federal authorities of funneling to Havana banks $32 million in Medicare funds obtained by billing the agency for fraudulent medical services. The other involves Miguel … Continue Reading

From: Home Care Magazine

WASHINGTON, June 21, 2012—An HME industry working group has asked the Centers for Medicare & Medicaid Services (CMS) to add practical guidelines for making claims on surety bonds. At issue is a recent decision by CMS to start making unannounced claims on surety bonds to collect relatively small overpayments from providers.

The working group—which includes AAHomecare, Bond Safeguard, Lexon Surety, The Wayne van Halem Group, US Rehab, VGM and VGM Insurance Group—made the following recommendations last week:

• Only allow DME MACs to trigger a surety bond if a threshold dollar amount is reached. • Provide better notice to … Continue Reading

PASADENA, Calif.—Medicare’s new method for buying medical supplies and equipment—everything from wheelchairs and hospital beds to insulin shots and oxygen tanks—is doomed to face severe difficulties, according to a new study by Caltech researchers.

The Center for Medicare and Medicaid Services (CMS) implemented the purchasing process—a novel type of auction—in nine metropolitan areas across the country last year and plans to expand it to 91 in 2013.

The competitive bidding process was designed to improve the efficiency of Medicare’s procurement system, potentially saving taxpayers hundreds of millions of dollars. But many experts have criticized the auction, pointing out fundamental flaws in its … Continue Reading

Editor’s Note:  Any program based on Medicare’s DME uncompetitive bidding program without taking into account the program’s fundamental flaws will not succeed.

From: Inside CMS

Researchers, an analyst and an industry expert said that while Medicare Part D has consistently fallen below Congressional Budget Office cost estimates, the program’s financial success does not directly correlate to financial models for larger Medicare reform using a premium support model. But others said during a recent panel discussion that Part D provides some good guidelines.

James Capretta, a fellow at the Ethics and Policy Center, said Part D could serve as a model … Continue Reading

A new study by researchers at the California Institute of Technology, attached below, blasts CMS’ “competitive” bidding auction for Durable Medical Equipment.  The study published in the Quarterly Journal of Economics, found that CMS’ decision to use non-binding bids and median bid pricing does NOT result in competitive prices.  Of particular concern to Medicare beneficiaries and their families, the paper also found that the auction “fails to satsify demand.”  Researchers has already shown based on CMS data that utilitzation of life-sustaining home medical equipment dropped sharply under the new acquisition program.  Specifically, the paper concluded that: “The CMS auction … Continue Reading

From: HME News

POTOSI, Mo. – CMS’s Jonathan Blum on May 21 visited Healthcare Equipment & Supply and participated in a roundtable discussion about competitive bidding issues in rural areas. Blum, deputy administrator of CMS and director of its Center for Medicare, heard concerns about Missouri’s rural Washington County being included in Round 2 of the program. The added expense of traveling more miles to serve patients for reduced rates under competitive bidding may mean patients will have to pay out of pocket, attendees told Blum. Rep. Jo An Emerson, R-Mo., arranged and attended the visit.

From Inside CMS

On the eve of a House hearing on the Medicare competitive bidding program for durable medical equipment, the Center for Regulatory Effectiveness last Tuesday (May 8th) sent John Holdren, assistant to the president for science and technology, a paper that recommended CMS pay for a laboratory simulation of the DME bidding rules to assess their efficiency and determine how they should be changed. The paper, which is critical of the bidding effort, analyzes the program and compares CMS’ design to that of auctions developed by the Federal Communications Commission (FCC). The purpose of such a trial, which is … Continue Reading

Editor’s Note: In the following release from CMS, the agency states that their contractor “is the official information source for bidders” and encourages industry members to “stay informed” by obtaining information from the contractor. CRE encourages industry members to stay informed by reading and posting on the Competitive Bidding Interactive Public Docket, by reading the trade press, and by following and participating in the activities of industry and patient advocates working to protect beneficiaries from the evolving impacts of CMS’ not-so-competitive bidding program.

From: CMS/Competitive Bidding Implementation Contractor (CBIC)
The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program … Continue Reading

One of the critical failings of CMS’ bid-based acquisition program for DME is that it prices only goods, not the services which are an integral part of life-sustaining home medical equipment.

The problems from CMS’s failure to include services as part of the DME they put out for bids started to become apparent at a hearing of the Health Subcommittee of the House Ways and Means Committee.

A member of the Committee, Rep. Gerlach asked a senior CMS official official whether the national mail order competition for diabetes testing supplies could mean that nursing homes may not be able to receive the … Continue Reading

CMS’ competitive bidding program for Durable Medical Equipment (DME) has, as has been explained by over two hundred economists including several Nobel laureates, two fatal flaws:

1. The bids are not binding B people can game the system by bidding low and then raising their price after the lower price was accepted.
2. Since the low-ball bids are not binding, CMS ends up setting DME prices, not bidders – a continuation of fee-for-service under another name.

The health community at large should be concerned about CMS’ covert price manipulation since, in this era of ever-tighter budgets, CMS is likely to expand their “competitive bidding” price-setting … Continue Reading

From:  Home Care Magazine

Federal fraud investigators testified last week said they are shifting focus from durable medical equipment to home health while implementing more methods and systems to prevent fraud.

Speaking to a Senate Finance Committee on April 24, Daniel Levinson, inspector general of the Department of Health and Human Services, said that federal officials are now focusing largely on home care fraud in South Florida—an area once known for DME fraud. He noted a recent case involving ABC Home Health and Florida Home Health in which 50 people were convicted in connection with $25 million in fraudulent billing.

From: Home Care Magazine

The American Association for HomeCare (AAHomecare) last week posted a rebuttal to a 16-page, glowing report from the Centers for Medicare & Medicaid Services (CMS) on the Competitive Bidding Program.

AAHomecare countered the report with a press release detailing the myths about the bidding program, numerous complaints and problems stemming from bidding, and benefits of the alternative Market Pricing Program (MPP).

The CMS report repeated many of the basic Medicare talking points on competitive bidding, and claimed the program saved $202 million in its first year of operation in nine metropolitan areas included in Round … Continue Reading

CMS data appears to show that Medicare beneficiaries in Pittsburgh who receive Durable Medical Equipment (DME) through CMS’ competitive bidding program have higher death rates compared to Detroit which does not yet have DME acquisition through the bidding program. As an article in Inside Health Policy observed,
For example, charts in the CMS report show that death rates were higher in Pittsburgh, where products are competitively bid, compared with Detroit, where there is no bidding.
Higher death rates of Medicare beneficiaries as a result of competitive bidding was also expected by Professor Peter Cramton of the University of Maryland based on … Continue Reading

“I think our healthcare benefits are regulated by the government, enough as it already is. I worked 50 years for the benefits I have now. They are regulated enough, the government just about runs my life as it is. I don’t get what I worked for already. I think this is just about as much dictatorship as I need. You’ve taken everything I’ve worked for all of my life. What are you trying to do, kill me? I think you’ve taken enough of what I already have. Don’t take anymore. You’ve regulated my life down to where I could barely … Continue Reading

From: Home Care Magazine

By Shelly Prial

I find it exciting to look back to the very first Medtrade show. It happened about 35 years ago in Atlanta, and it still feels like yesterday.

When I realize what Medtrade today means to DME/HME providers, I recognize that it has more than surpassed everyone’s wishes. The ability to meet and share information with peers has always been one of the driving reasons to attend Medtrade. There is no other venue where I, who live in Melbourne, Fla., can visit with friends from Seattle. This type of networking is one of the best reasons for … Continue Reading

From: RT Magazine

Many Medicare beneficiaries face obstacles that either delay or prevent them from obtaining critical durable medical equipment (DME) and services in nine regions of the country where a controversial procurement system was implemented a year ago, according to data collected by the American Association for Homecare (AAHomecare), an association representing DME providers nationwide.

Despite assurances from the Centers for Medicare and Medicaid Services (CMS) that the well-being of Medicare patients wasn’t compromised by the competitive bidding system, Medicare beneficiaries taking part in AAHomecare’s survey sharply contradicted those assurances.

From: HME News

By Theresa Flaherty, Managing Editor

YARMOUTH, Maine – Providers should be able to catch their breaths now that CMS has told a recovery audit contractor (RAC) to ease up on semi-automated CPAP reviews.

“The audit hasn’t been rescinded, but it’s still a huge win,” said Andrea Stark, a reimbursement consultant with MiraVista in Columbia, S.C., and a member of the AAHomecare HME/RT Council, which worked with CMS on this issue. “They will not send out any new request letters, but providers must still respond to any letters they’ve already received.”

“My name is Alice…. I get a neutralizer from Walson in Beaumont, Texas. I would like to continue with this service because I’m very satisfied with it. If you have any questions….”

Listen to complete call

From: Home Care Magazine

Many factors led to Medicare’s delay of PMD project
by Dave Parks

The HME industry achieved a rare victory on Dec. 29 with Medicare’s last-minute delay of a demonstration project requiring prepayment reviews of power mobility devices in seven states. Experts say the delay was the product of many factors, and predicted that the the reprieve would be temporary.

“It’s coming,’’ said James Herren, a consultant and executive director of the Association for Tennessee Home Oxygen & Medical Equipment Services. “Be prepared.”

In fact, at press time, officials announced a new timetable and restructuring for the … Continue Reading

From: HomeCare Magazine

Twenty-one Philadelphia-area Medicare beneficiaries sent a letter to Pennsylvania’s two senators last week expressing fear of competitive bidding arriving in Round 2 of the Medicare program.

Sent to Sens. Bob Casey, D-Pa., and Pat Toomey, R-Pa., the letter was the product of a recent Town Hall Teleconference call hosted by VGM Group’s Last Chance for Patient Choice, People for Quality Care and the Pennsylvania Association of Medical Suppliers. The 21 beneficiaries learned about competitive bidding during the teleconference.

The letter lists three areas of concern: the importance of receiving timely service, preserving access to local providers and protecting the … Continue Reading

From: Home Care Magazine

Medicare requires layers of documentation

by Sarah Hanna

For many providers, oxygen is the lifeblood of their revenue cycle. But Medicare is making it increasingly difficult to keep the oxygen cash flow in a positive state.

We have CERT, pre-pay audits, Additional Documentation Requests (ADRs) and also more complicated redeterminations and reconsiderations to validate a patient’s medical need. 

Remember the good old days when a Certificate of Medical Necessity (CMN) sufficed as proof of medical necessity? Unfortunately, our new reality involves chart note documentation from referral sources.

From: Home Care Magazine

An online petition against competitive bidding gained traction last week ahead of AAHomecare’s Washington Legislative Conference Feb. 15 and 16. The petition, which was the brainchild of an HME provider’s daughter, quickly attracted 1,500 signatures and support from 15 state and regional HME associations.

It originated with Peter Falkson and Eric Cohen of National Sleep Therapies, members of the New England Medical Equipment Dealers Association (NEMED), and started with a conversation Falkson had at home about competitive bidding.

“I was talking to my wife about competitive bidding telling her how it was so poorly aligned,” Falkson told the … Continue Reading

Current Bid System Replaces Cost-Effective Home Medical Equipment with ER Visits and Hospitalizations

WASHINGTON, Feb. 16, 2012 /PRNewswire-USNewswire/ — Citing the likelihood that Medicare beneficiaries are not receiving necessary medical equipment and services, the American Association for Homecare is urging Congress to adopt the Market Pricing Program (MPP) to replace the controversial bidding program for home medical equipment and services, or durable medical equipment (DME).

Data from the Centers for Medicare and Medicaid Services (CMS), which implemented the bidding program in nine test areas a year ago, shows that reimbursement claims for home medical equipment fell in those … Continue Reading

WASHINGTON, Feb. 14, 2012 /PRNewswire-USNewswire/ — The Center for Regulatory Effectiveness reports that the President’s Budget proposes to slash reimbursement to state Medicaid programs for beneficiaries who use home oxygen and other Durable Medical Equipment.  The proposed budget would cripple the ability of Medicaid beneficiaries to remain in their homes. Instead of protecting the viability of home medical care as a cost-saving alternative to more frequent hospital admittances and prolonged nursing facility care, the Budget proposes to extend a discredited payment system which is already reducing … Continue Reading

Editor’s Note:  The WSJ’s analysis and conclusions regarding CMS’ fatally-flawed competitive bidding progam with respect to negative pressure wound therapy also apply to the other home medical equipment and related services procured under the program.

From: Wall Street Journal

How Medicare rigs competitive bidding and hurts patients.

Americans may not be familiar with the medical innovation called negative pressure wound therapy, though it has helped hundreds of thousands of patients with complex or chronic injuries like burns or diabetic ulcer complications that could never heal on their own. Now President Obama’s Medicare team is about to severely damage this field, and many … Continue Reading

From: HME News

Economic impact study finds that for every $1 generated by The Diabetic Shoppe, it adds 27 cents to local economy

By Theresa Flaherty, Managing Editor

Through a combination of luck and persistence, provider Robert Salmon has “grown a nice” diabetes supply business in rural Tallahatchie County, Mississippi. 
But it’s more than just a nice business for himself and his employees, he’s learned. It turns out that his company, The Diabetic Shoppe, has a large impact on the local economy, according to a recent economic impact study by Mississippi State University graduate students. The study found that for every dollar … Continue Reading

From: Home Care Magazine

Idaho’s $35 million in Medicaid cuts have eliminated thousands of jobs, hurt disabled recipients and pushed mentally ill people into jails, says a panel that recently reported on the issue. The panel concluded that the cuts cost the state 4,000 jobs, and eliminated mental health services that were critical in keeping mentally ill people out of trouble with law enforcement. Police now must deal with more mental health issues, and suicide calls are up, said members of the study panel, which was sponsored by advocacy groups for Idahoans with disabilities.

From: HME News

‘They’re going to hate it at first, but they’re going to like it down the road’

By Liz Beaulieu, Editor

BALTIMORE – Even though CMS won’t implement ICD-10 until next year, home medical equipment providers should be familiarizing themselves with these new codes right now, industry consultants say.

At the very least, providers should be reviewing the “general equivalency mappings” or GEMs that CMS has already posted to its website that roughly translate ICD-9 codes to ICD-10 codes, they say.

“I think we’re all underestimating the vastness of where this will touch our daily processes,” said Andrea Stark, a reimbursement consultant … Continue Reading

Editor’s Note:  Healing at home requires a strong, vibrant home care industry.

From: PennLive/Body and Mind

Sure, we know where to shop for the hottest fashions, but when it comes to buying home medical equipment, our shopping savvy can drip away faster than an inverted IV bag.

Our doctor adds glucose meters, a commode, a wheelchair or a walker to our shopping list, and suddenly, we are foraging for products we never imagined we would need.

Experienced patients, such as Kelly Soule of Lower Allen Twp., reassure novice clinical consumers that they are not alone: There are services to help.

From: Home Care Magazine

The HME sector is losing its only public sounding board for discussing concerns about Medicare’s vast expansion of the Competitive Bidding Program, says the American Association for Homecare.

The Program Advisory and Oversight Committee (PAOC) expired on Dec. 31, 2011. The committee was created by the Medicare Modernization Act of 2003 to provide advice on the bidding program.

Meanwhile, Round 2 of competitive bidding is now being implemented in 91 metropolitan areas, and it makes sense to keep PAOC in operation at least until bid rates are announced, says Walter Gorski, vice president of governmental affairs for AAHomecare. … Continue Reading

From: HomeCare Magazine
by Larry Anderson

One wheelchair includes machine guns that look and sound like the real thing. Another includes a seat from a marine sea rescue helicopter and air brakes. It has a top speed of 24 miles per hour. A third wheelchair features ultra-bright LED head- and taillights. 

These are creations of Lance Greathouse, who transforms used wheelchairs into one-of-a-kind, colorful and “tricked out” pieces of art. He works out of a shop in the garage of his home near Phoenix, Ariz. Greathouse has channeled 30 years … Continue Reading

Editor’s Note:  The following article discusses Congressional deliberations on a new Medicare competitive bidding program without recognizing the proven harms to Medicare beneficiaries and taxpayers from poorly conceived “competitive bidding” programs that are neither competitive nor a true auction.

From: Inside Health Policy

The Medicare reform plan by Sen. Ron Wyden (D-OR) and Rep. Paul Ryan (R-WI) would give seniors the choice of staying in traditional fee-for-service or choosing a plan from a newly created Medicare exchange, but the duo deflected questions about how the plan would build on the insurance exchanges created by the Affordable Care Act, indicating that the … Continue Reading

From: HomeCare Magazine

Sen. Ron Wyden, D-Ore., and Rep. Edward Markey, D-Mass., have sent a letter to Marilyn Tavenner, acting director of the Centers for Medicare & Medicaid Services, asking that the Independence at Home program be given higher priority.

The program is included in health care reform and is designed to deliver home-based care to Medicare patients with chronic conditions. It was supposed to start as a demonstration project for up to 10,000 beneficiaries on Jan. 1, 2012.

“Yet with three weeks remaining in the year, CMS still has not released guidelines for providers that wish to apply for … Continue Reading

WASHINGTON, Dec. 12, 2011 /PRNewswire via COMTEX/ — Sustainable Market Pricing Program Corrects Flaws in Current Bidding Program, Preserves Access to Home-Based Care for Millions of Americans

The American Association for Homecare urges Congress to enact the Market Pricing Program (MPP), a reform of Medicare’s pricing system that is an alternative to the controversial bidding scheme for durable medical equipment and services.

“As it’s currently designed, Medicare’s bidding system reduces choice, access, and quality of care for seniors and people with disabilities who require home medical equipment and services,” said Tyler J. Wilson, president of the American Association for Homecare. “It also … Continue Reading

“Yes, I am calling in regards to this competitive bidding. I think this is very unfair. First of all I’d like to know what about Congress? All the money that they make and are they not getting any benefits taken away from them. They get the best healthcare, they get the best of everything. This is not fair to the American people.

Congress was to be built, was when it started, it was a voluntary thing and they had a certain term. Now why do we have to have these people paying top, giving these people top dollar for their money. … Continue Reading

From: Kaiser Health News

Jackie Judd talks with KHN’s Mary Agnes Carey what Medicare changes would be part of the latest proposal from super committee Republicans to strike a deficit reduction deal. Also in the background is the status of a $300 billion fix of the sustainable growth rate formula that determines how much Medicare doctors get paid.

Watch the video or listen to the audio.

Transcript:

JACKIE JUDD: Good Day, this is Health on the Hill. I’m Jackie Judd.
It’s still all about the super committee on Capitol Hill, and so that is what our focus is here once again. Republicans, who … Continue Reading

From: HME News

‘We walked away from 20% of our revenue’

By Elizabeth Deprey, Associate Editor
YARMOUTH, Maine – Reduced reimbursements, audits and paperwork requirements have pushed many HME providers to cut back on Medicare in the past year, according to a recent HME NewsPoll. 
 
More than half of the 108 respondents to the November HME NewsPoll (57%) reported decreasing their Medicare business in 2011.  
 
“Competitive bidding has really hurt our business,” said one provider. “The 32% reduction in reimbursement has been very tough on us.”  
 
When it comes to competitive bidding, however, one provider’s loss is another provider’s gain.
 
“We won the competitive bid in the … Continue Reading

“This is…at Batesville, Mississippi. I’ve been getting my medical supplies, like my diabetes stuff, from Med Mart Supply in Pontotoc and I’m just satisfied with them and I don’t care to change if I don’t have to.”

Listen to complete call

Editor’s Note:  CMS’ proposed regulatory reform rule is attached below.

From: HME News

The silver lining: Proposed rule opens door for stakeholders to have further discussions with CMS

By Liz Beaulieu, Editor

WASHINGTON – It seemed promising last week, when CMS published a proposed rule that outlines a number of steps to reduce regulatory burdens on healthcare providers. The agency’s press release even named DME providers specifically.

CMS stated in a release that its “Medicare Regulatory Reform” rule “would identify and begin to eliminate duplicative, overlapping, outdated and conflicting regulatory requirements for healthcare providers and suppliers…including durable medical equipment suppliers.”

“This is a call to tell you I do not approve of this competitive bidding bill y’all are trying to push through or have pushed through. This is supposed to be the United States of America:  freedom-of-choice. I don’t think this is part of the bill we bargained for when we pay for Medicare to be withheld from our checks for years and years and years or for Medicare assistance, so I just wanted to let … Continue Reading

From: HME News

MedPac wants expansion, lawmakers want review, CMS releases updated tools By Liz Beaulieu, Editor WASHINGTON – The Medicare Payment Advisory Committee (MedPac) voted last week to recommend that Congress repeal the current system used to set the physician fee schedule and pay for it with a mix of cuts to other providers, including HME providers.

MedPac in September released a draft list of offsets that included “apply the competitive bidding offset to all competition-eligible DME categories starting in 2012” for $2 billion in savings over 10 years, and “apply the competitive bidding offset to the DME categories never subject … Continue Reading

Editor’s Note: Minimally burdensome technologies are superior fraud-fighting strategies compared to mechansims which harm competition and patient choice such as CMS’ deeply-flawed concept of competitive bidding.

From: Information Week

By Ken Terry

The CMS pilot is being conducted by National Government Services (NGS), a WellPoint unit that is the Part B Medicare carrier for Indiana. The 12-month test, which began in July, focuses on durable medical equipment (DME), but could be expanded to other healthcare products and services if it proves successful.

Providers who voluntarily participate in the pilot swipe a special card through their credit-card … Continue Reading

“Good afternoon. I am calling because I get my [???] supplies, I have COPD, from a local distributor in a very small town called Pontotoc, Mississippi. I just received a letter about competitive bidding meaning that small businesses are actually losing out and I’m not sure what’s going on. ….I would like to know what I could do to keep this from happening because we’ve been losing our small businesses here in this small town for last 15 years but I have come back to live here.

I would like to know what I can do to keep our small business in … Continue Reading

“Hi I’m calling for my husband…. We got a letter from our supplier of his strips for diabetes that we’re going to lose our freedom to choose our equipment from them and it’s a local business and we don’t understand what we’re supposed to do, how he’s supposed to get strips now with his Medicare. I think this is wrong what they’re doing. Thanks.”… Continue Reading

“I need to be able to purchase the cushion for my C-PAP full face mask in the next town. It’s only a 15 minute drive to get it and I have to have a new one every month. I would be very unhappy to drive a long distance to be getting my equipment for my C-PAP. I am 74 years old and definitely need my C-PAP and the parts I need every month for this. Thank … Continue Reading

“Hi. I’m calling for my husband…. He is the patient.  And he is a bad diabetic and he has end-stage renal disease, cannot walk and he’s in a motorized chair. We bought our equipment through MedMart in Pontotoc, they service us with our syringes and our strips.  If they have to have repair on the motorized vehicle, then they come out and service it. I don’t feel like this new program that the government is presenting … Continue Reading

“Hello. So far I have had no trouble getting my oxygen but the thought of having trouble with it is enough to make me shudder. So, whatever anybody can do to help me to continue to get my oxygen, I would appreciate it. Good bye.”

 Listen to Complete Call

From: FrumForum

Eli Lehrer

On Friday, August 19, the Centers for Medicare and Medicaid Services (CMS) announced what may be the worst perversion of a good idea to come out of the government in quite some time: something called Round Two of “The Competitive Bidding Program for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.”

The new bidding process–read more about it here–governs the way Medicare pays for medical devices used mostly outside of hospitals (things like walkers and oxygen equipment) and, as designed, it will reduce spending on these items. That said, the rules are so poorly written … Continue Reading

“Hello.  … I’m calling about the home medical care and how it could change under the Obama healthcare system. I’m very upset about this because I’ve been wearing support hose for 40 years now and through the years I’ve tried different brands of the support hose and they vary very widely in cost and in quality, very  widely differences but I finally found a pair that I like and that work well for me which is … Continue Reading

From: WebWire

Raleigh, North Carolina,USA – With over 35 years of experience in business management, product development, medical equipment supplies combined with a passion for helping people lead happier, healthier and more active lives, Founders Vince Cole and Patrick O’Brien have launched Activa Medical Inc.

“Activa Medical’s launch is a cultivation of passion for its customers, the desire to provide superior patient care as well as a byproduct of changes in the national healthcare legislation.” said Vince Cole. Former DME (Durable Medical Equipment) company owners Vince and Patrick became tired of the competitive bidding programs, health insurance audits, Medicare and Medicaid reimbursement … Continue Reading

Editor’s Note:  Although the following article discusses competitive bidding with respect to Medicare Part D, a key issue relevant to DME is also discussed, the dangers of price controls.

From: Wall Street Journal

Price controls on Part D drugs would cripple medical innovation and undermine a successful federal entitlement program.

By TOMAS J. PHILIPSON

 Medicare Part D, the prescription-drug benefit program for seniors, has cost the federal government considerably less than was initially estimated. It’s also overwhelmingly popular among beneficiaries. But in Washington, Part D is now a prime target for overhaul. In the heat of debate over the debt ceiling, President … Continue Reading

From: Home Care Magazine

WASHINGTON — Rumors of HME cuts turned real last week as government officials continued to shuffle ideas around on the nation’s financial predicament. According to a leaked document, allegedly part of Vice President Joe Biden’s debt ceiling talks, three cost-cutting ideas targeting HME are on the table:

• Applying Medicare competitive bidding rates for DME to Medicaid in states where the program is implemented, which would save $5 billion over 10 years;
• Initiating a Medicare prepayment review of power wheelchairs, estimated to save $200 million over 10 years; and
• Reducing Medicare reimbursement for diabetic strips sold in pharmacies.

SPRINGFIELD, Ill., July 11, 2011 /PRNewswire-USNewswire/ — H. D. Smith, among the nation’s largest pharmaceutical wholesalers, today announced its support for H.R. 1041, also known as the Fairness in Medicare Bidding Act. Introduced by Representatives Jason Altmire (D-PA) and Glenn Thompson (R-PA), the bill seeks to repeal the Medicare Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) competitive bidding program included in the Medicare Modernization Act of 2003 (MMA).

The DMEPOS program created as part of MMA sought to reduce the Medicare excess product cost while assuring beneficiary access to quality care providers. However; the program’s … Continue Reading

From: The Hill
By Julian Pecquet 

Industry groups are lambasting a new government report that found “no significant changes in health outcomes” for Medicare beneficiaries since the agency started competitive bidding for durable medical equipment such as wheelchairs.

Competitive bidding was created by the 2003 Medicare reform law and seeks to replace standard fees with market competition among providers. The American Association for Homecare says patients are being hurt by the competitive bidding program because they’re losing access to the products and services they need.

“In contrast to yesterday’s CMS report that there have been no changes in beneficiary health outcomes … Continue Reading

“I have a good supplier of oxygen right here in Michigan and they do a very good job, an outstanding job of supplying me with oxygen.  I have no worries about running out.

I had a bad tank one night and they were here in a half-hour and replaced the tank even … Continue Reading

From: Home Care Magazine

SAN FRANCISCO — Adding its thumbs down to a growing list of studies and commentaries that slam national competitive bidding, the Pacific Research Institute weighed in last week with another damning review of the process, saying it “yields prices for equipment that are substantially lower than those that would emerge in a competitive market.”

In a study titled “Medicare Auctions for Durable Medical Equipment,” Benjamin Zycher, PhD, a senior policy fellow at PRI, wrote that under the “flawed auction system, prices for medical devices and equipment are likely … Continue Reading

From: HME News

By Theresa Flaherty, Managing Editor

WASHINGTON – Independent pharmacies are making another play at keeping themselves out of the competitive bidding program.

On May 23, Reps. Aaron Shock, R-Ill. and Peter Welch, D-Vt., introduced the Medicare Access to Diabetes Supplies Act, which seeks to exempt independent pharmacies with 10 or fewer locations from having to competitively bid for diabetes testing supplies.

“We think it has multiple wins for everybody,” said John Coster, senior vice president of government affairs for the National Community Pharmacists Association (NCPA). “It will save money for Part B, it will save beneficiaries on the co-pay, and it … Continue Reading

The Center for Regulatory Effectiveness welcomes the Obama Administration’s plan “to create a 21st-century regulatory system” including “an unprecedented government-wide review to eliminate tens of millions of hours in annual red-tape, and billions of dollars in regulatory costs…”  CRE will further congratulate the Administration when the plan yields tangible success.

As Jim Tozzi of CRE’s Board of Advisor’s recently noted at gathering honoring the 30th anniversary of the White House’s office for regulatory review, OIRA-the Office of Information and Regulatory Affairs, “Washington is littered with Executive Orders that never got off the ground.”  Unfortunately, the plan components are top down, not … Continue Reading

From: Home Care Magazine

CORDOVA, Ala. — Almost a month after a string of storms devastated wide swaths of the southern United States, Ken Glover, RPH, quietly opened the doors of a large trailer and filled prescriptions for grateful patients. The sturdy 100-year-old building that once housed Glover Drug in Cordova, Ala., was no more, heavily damaged by two tornadoes on April 27.

In addition to the operation in Cordova (population 2,400), Glover has two other pharmacy/home care locations in Jasper, Ala., and one in Dora. All four sites had power knocked out after the first storm hit at the … Continue Reading

From: Home Care Magazine

WASHINGTON — CMS took an airbrushed picture of Round 1 competitive bidding to Capitol Hill last week, but the distorted image could end up working in the HME sector’s favor, some stakeholders believe.

At a congressional staff briefing on the five-month-old program May 10, CMS representatives said it was moving along more smoothly than anticipated with “virtually no complaints.” Repeating numbers relayed at a Program Advisory and Oversight Committee meeting in early April, agency officials said of 54,000 “inquiries” to the Medicare hotline, only 43 were complaints about bidding.

It was a case of “more … Continue Reading

“I live in California. I have received information about Medcare not allowing seniors to have certain durable medical equipment. I want to say I am not in favor of this at all. I would hope I have a chance to [???] something that is really beneficial to me and affordable also. Thank you.”… Continue Reading

From: Home Care Magazine

WASHINGTON—A radical Republican plan that would slice $6 trillion off federal spending over the next decade got a thumbs up on Friday—but only by House Republicans. Every Democrat voted “no.”

By a vote of 235-193, the Republican-run House managed to push the $3.5 trillion, 2012 blueprint for government spending from Rep. Paul Ryan, R-Wis., onto the Senate floor, though by some accounts there it is DOA.

The Democrat-run Senate is expected instead to go along with President Obama’s 2012 budget and companion cost-cutting measures, which, announced last week, would generate $340 billion in savings by 2021 and at least … Continue Reading

From: Home Care Magazine

LAS VEGAS—“Life was pretty good on Dec. 21, 2010,” said John Geller, vice president of 61-year-old Medical Service Co. in Cleveland. “I put my head down on the pillow that evening and when I woke up on Jan. 1, no question it was a new day.”

Geller, whose company was awarded multiple contracts in three competitive bidding areas in the Round 1 rebid, said management thought it was prepared for the start of the program. But he called what it has encountered since the bid’s Jan. 1 implementation the “triple witching hour,” citing a 33.5 percent … Continue Reading

From: Inside Health Reform

A top Congressional Budget Office official said the Medicare competitive bidding program for durable medical equipment is seriously flawed, and although CMS has privately set up the first round bid in a way that makes it appear the program works, the agency is setting a precedent that will make it impossible to find the competitive market price for products in the future, which will lead to the program failing. CMS Medicare chief Jonathan Blum countered that effort is a reasonable success, but also said the agency is in “listening mode” for potential changes and will discuss … Continue Reading

“Yes this is a call. I am calling regarding what has happened with being a witness to watching what my mother’s had to go through just to get a piece of equipment for her sleep apnea monitor/machine and we have been to 3 different [Some help} companies trying to find out who could service here at this point. This actually, I’ll just cut this short. I am totally against this action. I think you can’t Wal-Mart … Continue Reading

“I would like to say that I do not think I should have to be made to go somewhere else to get my CPAP equipment because I’m happy with getting it at Home Infusion at Mecklenberg Medical Group in Charlotte, North Carolina. I’m there, I’m elderly, I don’t like to drive all over Charlotte. I can get it right there where my doctors are.  I do not think I should be made to go somewhere else … Continue Reading

“I am a regular user of home care oxygen equipment and being able to have a company that will come to me quickly and do good work like the one I have is very important.”

Listen to complete call

From: Home Care Magazine

ELYRIA, Ohio — If you’re looking for a bit of good news in the home medical equipment sector, here it is: Congress is finally interested in what is going on in this industry, particularly in competitive bidding.

“There is huge interest on the Hill,” said Cara Bachenheimer, senior vice president of government relations for Elyria, Ohio-based Invacare Corp. “That is encouraging. So we need to be doing more. Everybody needs to be doing more.”

In an interview Friday on key challenges confronting the industry, Bachenheimer emphasized that stakeholder involvement could perhaps prevent some negative legislative … Continue Reading

From: Home Care Mag

It’s not working for patients and businesses are going down, Florida providers tell agency’s deputy administrator

ORLANDO, Fla. — Apparently hoping to better understand the effects of Round 1 competitive bidding, CMS’ Jonathan Blum heard from Florida providers last week in a quick meeting that nevertheless pointed up the severe cracks in the program, according to attendees.

“It seems as though he was there to collect information and see how they could improve Round 2,” said Sean Schwinghammer, executive director of the Florida Alliance for Home Care Services. “But there are fundamental … Continue Reading

“I deal with Genesis for all my medical equipment. I’m on Medicare, I’m 73 years old, and I would just like to say I’d like to keep the people I buy from or deal with through Medicare. All the equipment that I need, they’re very nice they help me, I’d appreciate if Congress would just leave things alone and let us elderly have the nice things that we have already without stripping us. I don’t appreciate … Continue Reading

“Hi I’m on CPAP machine at night along with oxygen and I’m on oxygen 24 hours a day. So if they take it away from me, I don’t know what I’ll do. …  I hope you don’t have to lose it because I’m very dependent upon it thank you.”

Listen to complete … Continue Reading

KANSAS CITY, Mo., Feb. 8, 2011 /PRNewswire-USNewswire/ — Medicare beneficiaries are reporting problems receiving medically required home medical equipment and services following the January 1, 2011 implementation of Medicare’s “competitive” bidding program in Kansas City and nine other regions across the U.S.  The bidding program will affect many of the more than 250,000 seniors and people living with disabilities in the Kansas City area who are enrolled in Medicare.

The bidding program applies to oxygen therapy, enteral nutrients (tube feeding), continuous positive air pressure (CPAP) and … Continue Reading

From: HME News

Beneficiaries are quiet on bidding issues 

By Theresa Flaherty Managing Editor

BALTIMORE – While reports of problems associated with Round 1 of competitive bidding are trickling in, one group has remained quiet: beneficiaries.

“We are not hearing anywhere near enough (from beneficiaries),” said Wayne Stanfield, executive director of NAIMES. “There are obviously problems, but not enough that would make Congress take notice.”

Reported problems so far range from delayed hospital discharges to trouble finding the right equipment or provider, but most of these problems are being reported by providers themselves.

“I am a 70 year old retired nurse. I live in Ames, Iowa. I am very concerned that I will be able to continue to get my medical equipment from my business of choice. My pharmacy is also concerned about what’s going to happen to them. Both of these businesses think they are going to be driven out of business with the changes that are coming. … Continue Reading

Yes, I’m calling from Texas. I wanted you to understand that the Attends that my sister wears because she had a muscle disease called [Giambaray?], and the Attends is the only brand of pull ups that we found that will fit her body. And if you try to put a cheaper brand on her she just cannot wear them. Now we are satisfied with what we are getting otherwise. But the Attends is the main thing that we just can’t figure out any other way for her to wear. Alright. Thank … Continue Reading

December 21, 2010 marks the tenth anniversary of the Data Quality Act (DQA), also known as the Information Quality Act, 44 U.S.C § 3516, note.

The DQA has deep roots developed over nearly a half-century as the result of a seed planted during the Johnson Administration which germinated in the Nixon Administration, was watered by the Carter Administration and whose product was harvested by the Reagan Administration, made available to the public in the Bush I Administration and subsequently enhanced by the Clinton Administration and promoted by the Bush II and Obama Administrations. See: http://thecre.com/ombpapers/SystemsAnalysisGroup.htm and http://thecre.com/quality/20010924_fedinfotriangle.html

“My name is Donna…. And I had been on a oxygen machine in the evenings for about 9 months now. And I get my service from Remke Medical here in my location. I’m very pleased with the people. They come and check my equipment on a regular basis to see that everything is operating the way it should be. And the representative they send is always extremely helpful. And courteous. And I really like this service … Continue Reading

Hello…for the last year I have been using the Remke Medical oxygen and home care equipment here in Erlanger, Kentucky. I am very pleased with these people and I am able to afford their services. They are very good about coming and keeping up with my equipment and I understand that you’re going to be taking bids on competitive companies and I would just like to say I want to keep Remke Medical  because I enjoy their … Continue Reading

Hi. I wanted to let  you know that I am very happy with the way I received my oxygen now. I don’t want it to change. I have no way of getting out to pick it up. They way they deliver it, they right here on time. Everything works for me and I am just appalled that you would even go so far as to do this to older people that just can’t do … Continue Reading

Good afternoon. …I recently had my right big toe amputated and I’ve been receiving medical treatment at home and the person that’s doing my treatment forewarned me that there’s a possibility that starting the 1st of the year, that he would no longer be able to come to the house and give me the kind of treatment that I have been getting in the past and I would like to just make my opinion known that … Continue Reading

“Hello. …  I am a resident of Boynton Beach, Florida. I go home for maybe two months, to Connecticut to visit my family in summer and maybe for the holidays, but I am a resident of Florida. I am not too happy with this competitive bidding, because I have a CPAP Machine that I get from Connecticut, when I go there I see them and they mail me all my supplies that go to it. And … Continue Reading

“Hi. … I wanted to call and let you know how disappointed I am that the new law for Medicare patients is not helping them have access to their medical equipment supplier due to competitive bidding which Congress has set is very disheartening. I went into this local store and they said ‘well, I’m sorry but we are in the process to change and we are not able to acknowledge patients that have Medicare and you have to pay the regular price.’ And he said that you are more than welcome … Continue Reading

Next year I will be entering Medicare at this time. I am very angry, very upset with the way Medicare competitive bidding is taking place with medical equipment. I need a sleep machine. I have good access with a local provider, and to think I will have to go to a big box operation just is outrageous to me. Because I get older, I am sacrificed. I think it’s a terrible shame for my government to … Continue Reading

CMS is about to implement an unprecedented program dealing with the provision of medical products and services to senior citizens on Medicare. The program is the CMS Competitive Bidding program for durable medical equipment, oxygen tanks, beds, and related medical supplies.Attached Files:

Members of the academic community who specialize in these “bidding” programs have advised the federal government that the program if implemented as presently designed will result in an increase in prices and decrease in services.

… Continue Reading

“I have had very very good experience with the current vendor for the home respiratory equipment and I think that was made possible because my doctor was able to refer me to the best equipment available. I didn’t care about the price at this point in time, I wanted the best equipment and my doctor was able to do that. If my doctor was only able to use whatever is the least expensive because that’s what the … Continue Reading

Describe complaint: On October 7, 2010 I called…to place my mother’s monthly order for COLONOSPY BAGS. Since June 2010, my mother has been received quantity of 50. The colonospy bags are a two piece items. Before June 2010, my mother was receiving a quantity of 30 bags and has both a prescription for the 30 a month and for the 50 a moth as well as a letter of MEDICAL NECESSITY.

… Continue Reading

“Hi…I’m calling on behalf of my mother….  She’s a 92 year old widow lady and I’m having a problem with…. It seems that A, she’s already turned over to their collection agency, which is Alliance One. B, I changed the billing address for my mom to my address….. The problem that I have, they never send out statements. I’ve called 5 or 6 different offices and no one can tell me why I’m not getting statements. … Continue Reading

“I just received notice that there’ll be limits on my health care provider as far as my oxygen goes. I’m handicapped, I need someone to keep an eye on my machine to see if it’s working properly, my oxygen machine.  I think it’s ridiculous to attack handicapped people and older people at this stage of their life and panic them with these changes.  I don’t know where to go, I’m unable to travel very far.  I think it’s totally, totally ridiculous and I wish you would just do something different … Continue Reading

I was up the other night thinking how my country could condone

something so damaging to our health care and to the citizens

of the United States of America as the competitive bid.  I am

in awe that my government would try to save money at the

… Continue Reading

“I was just reading about the competitive bidding law that was passed by Congress and I’m not in favor of it at all.  Many businesses will lose their incentive for innovation and everything else. The low bidders will be a monopoly, so I don’t like it at all, you can forward that on.”… Continue Reading

“I’m on Medicare. I get my sleep apnea equipment from Medicare Supply here in West Allis and I found out that they’re doing this competitive bidding and I think that’s totally wrong and not good for us people who want to get around and pick this stuff up and I think somebody should do something about it because you know. They to want save money but you want to make it harder for us and … Continue Reading

“I received my CPAC at home, all the necessities that go with it every three months, and it’s very helpful for me and I don’t believe in this competitive bidding.  I would wish that they would just stop it and let me go ahead and get what I am getting where I am getting it. Thank you. Bye bye.”… Continue Reading

“Hello. … I deal with North West Ohio Medical Equipment here in Bowling Green and I wish to be able to deal with them in the future. I am very unhappy with the Medicare bill that has just been passed, so if you can pass that on please.  … Thank you very much.”… Continue Reading

“I’m calling about this new law that they passed for medical equipment use. It’s doesn’t make any sense. I want my local, I don’t want… I’m sorry I just can’t put into words what I’m trying to say. But it’s a bad law.”

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“Yes I am calling to express my concern about this competitive bidding because I use an oxygen concentrator and its attendant supplies. Right now I am able to call the company that I work with, if anything is wrong they will come out immediately. I can also go to the office to the door, purchase equipment that I need right then and there, no waiting. They know who I am. I am identifiable very easily to them and they care about me. I am just worried about the fact that the company that I work with … Continue Reading

Does the National Competitive Bidding Provision Violate “Separation of Powers” in the Constitution?

Background

 “Separation of Powers” is one of the most profound political principles of the Constitution and … Continue Reading

“I have a very definite reason for calling. My medical equipment is being supplied by Northwest Ohio Medical Equipment and they are doing a fantastic job. There is no way in the world that I ever would want them to change or have anyone come in and take their place. They have done a spectacular job of keeping everything right where I need it, when I need it. They have gone out of their way entirely … Continue Reading

“I prefer to go to a store, like for example Brownings where I go, so that you get a person to help you with a walker to fit exactly the way it is supposed to. I for one had to go get one today and Medicare would not even help me pay for the damn thing because I had a metal walker that I thought I had forever but I had gotten in 3 years ago. … Continue Reading

“What are they doing now? Trying to change the whole system? It seemed to be working very well. In other words we have a wheel that isn’t broken, so what are you trying to change it for?  Thank you.”

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I am not happy with the passing of the new Competitive Bidding Law.

I am very satisfied with the medical supply I have chosen and do not want to be told who I have to use for my medical supplies.

… Continue Reading

“Hello. I am calling concerning the competitive bidding and what it means. I would like you to know that I would not be happy with this law. I think I should be able to decide who gives me my medical equipment and who takes care of it. I think it’s very very important. I had a husband who was very, very ill for many years and I was happy to be able to choose who I … Continue Reading

“Hi, I just wanted to voice my concern on competitive bidding. I do receive equipment at home and feel that this would be terrible if I could not get someone in my local area to provide these services. Just please pass this message on. Thank you.”

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“I am calling from South Windsor, Connecticut. I am a 41 year old woman who is caring for her 73 year old mother who has dementia, who is bed ridden, has a trache in her throat, a catheter for urine, and a feeding tube for her food, water and medicine. She currently is on Medicare and has home health care service. She has two durable medical supply companies and a company that provides the jevity that … Continue Reading

“This is Ella … and my husband Edmund …. We are Medicare patients. We are against Congress calling the bill they passed that might force different home medical equipment suppliers chosen by the government because of a low bid and they call that competitive bidding. We are against that. We want our small businesses to stay in the American economy and we want to be able to have that one- on-one relationship with them. I thank … Continue Reading

“Hello, I am calling to let you know that I have nebulizers that I use every 4 hours with breathing medication delivered to the house. I have someone who comes out to check the nebulizers.  I have portable oxygen with home fill and I also have, of course, emergency oxygen and in addition have had multiple admissions to the hospital and am involved with the Harold Leaver Cancer Center. I have access to using, of course, a … Continue Reading

“I am a Medicare beneficiary and I also have sleep apnea and I’m using respiratory equipment, a CPAP machine. I’m very unhappy with Rule of Congressman, it’s really  quite frightening to think that they would do this to us and I have some relatives also that I believe would be effected by this too and we’re all Medicare Beneficiaries and we all have sleep apnea, we use sleep apnea machines and I’m very concerned about them … Continue Reading

“I wonder if this country is going Communist or crazy. This is competitive bidding is all wrong. We old people are going to suffer also is our good medical pharmacy and a lot of other businesses. Please go back to where we are today.  We’re in good shape today and we will soon be in hell  and will blame all politicians. Now, lets get this straight we are doing well now but will be … Continue Reading

“I received something in the mail saying that Congress has passed a law that I’m forced to use a different home medical equipment. I don’t want it. What happened to free choice? I want to continue using the company that I have. They’re extremely efficient and very reliable. I certainly doesn’t mean that I’m going to be forced to get somebody that YOU want. OK. Thank you.”

“I just recently was diagnosed with needing oxygen at home. I went out and bought my own hospital bed but if I had to start paying for oxygen that I’m getting, that going to really run up an expense. I’m sure it’s not going to stop at that. I just had a PET scan for my lungs because they think other problems there and I really wish you’d leave the Medicaid alone. We have enough problems … Continue Reading

“I do not want to see my provider of medical equipment, in my case oxygen equipment, I don’t want to see Obama the one who decides what company I can use. The one I’ve been using has been very good. And I just want Obama out of it. Thank you.”

Listen to … Continue Reading

“I so far have not had any difficulty because I have  been able to pick the company for my medical equipment and I would like to keep it that way.”

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[From Inside Washington Publishing]

Posted: May 10, 2010

A Texas trade association and a Dallas oxygen company have taken CMS to court over its durable medical equipment competitive bidding program, alleging the agency violated Medicare law by neither specifying nor allowing public comment on the financial standards companies must meet to participate.

The lawsuit complains that bidders for the program, including plaintiff Dallas Oxygen Corp., “had to formulate their bids while being in the dark about the financial standards that would … Continue Reading

“Hello, I live in Naples, FL. I have been treated for the last past year for sleep apnea so I have a CPAP-type machine and serviced by a local equipment provider with supplies and whatnot.  My wife has been supplied with a wheelchair on a monthly basis with another supplier.  So, I just appreciate the service they provide and hope it can continue without a lot of red-tape. Thank you very much.”

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“I do not use oxygen service, but my father in law who lives next door does. He just received a letter stating that the company that supplies him his oxygen maybe cut from being able to do the service that they provide for him because of quote unquote competitive bidding.  Sometimes competitive bidding means less quality and less service, which is going to happen with him. He’s been very pleased with what he’s been getting, and … Continue Reading

“I am calling on behalf of my step-mother Betty who needs oxygen 24 hours a day, 7 days a week.  And the bill would affect the person’s freedom and their freedom to choose their provider for their home medical equipment. Also the levels of service and quality would be affected and having a 24 hour on-call service is vital to these patients having a lung disease and having to rely on a machine to breath can … Continue Reading

“My husband has bone cancer. He can’t walk and he can’t stand and someone was nice enough to give us a wheelchair to borrow for his use and because he can’t walk or stand he’s getting sores on his butt and I asked the visiting nurse if he could get a pillow from Medicare and they told me that Medicare would not pay for a pillow unless they gave him a wheelchair. I thought saving the … Continue Reading

“I am calling to say that we are very very sorry to hear about this competitive bidding. We are very happy with the service we are getting and I don’t know why they have to do this. So please think it over very carefully because they have been very good to us, Okay? Thank you.”… Continue Reading

“I’m just calling to make a comment on the Center for the Regulatory Effectiveness on the home medical  competitive bidding for oxygen and so forth. We’re very satisfied, we couldn’t be happier with our Alert Medical of Michigan and we would like to keep them rather than having to go with the lowest bidder, with the new government rules. It means an awful lot to us to have the personal care that this company … Continue Reading

“Hi. I’m calling about the competitive bidding on medical equipment. I don’t think it’s a good idea, I mean there is an old saying that says you get what you pay for. If you going to accept the lowest bid I sure you’re not going to get the quality that you would with some other competitor. The one I go to has been there for as many years as I can remember. Maybe 50 years and … Continue Reading

“I am on the CPAP and husband is on a VPAP. It s very important equipment to us because otherwise our oxygen levels go too low at night time and my husband has a pacemaker. I do not want Obama or anybody else  in Congress dictating to me where I should buy my medical equipment. I think it is wrong. If I wanted something like that, I’d move to England. I prefer, I think … Continue Reading

“Yes, I received the brochure on Medicare Competitive Bidding.  I am satisfied with my home care people. I don’t want anybody choosing what I refer to as a good company.  I have had bad trouble with some of these places that service the oxygen concentrator, etcetera.  I am happy with mine. I don’t need any more help from the Federal government wanting to cut everything.  I need more help not less help than they are giving me.”… Continue Reading

“According to a new law passed by Congress, we could be forced to use a different home medical equipment supplier that was chosen by the US Government because if a low bid rather than the one that we currently are using. We are very pleased, we do not want to have a change. And so as a result, I’m calling to ask you to please forward this message on to whoever it needs to go to, … Continue Reading

“I didn’t finish my recording a while ago.  You know it’s strange that the President and the ones involved, they can have wars in other countries and they fund the wars and they can cost them billions or trillions of dollars defending foreign countries and send American dollars to foreign countries everywhere, and it’s not wanting to help their own people, the elderly here in America. I don’t understand that at all. They can spend a … Continue Reading

“I called to tell you that I’m very displeased with the new law and it looks like they’re just avoiding or leaving behind all the elderly the way they’ve done.  Medicare, you know, has cut, Medicare out on the elderly.  I’m 79 years old my husband is 81 and I’m telling you it’s terrible, the law that they’re coming across with.  I wouldn’t do that to the elderly … Continue Reading

“I’m calling from Waterbury, Connecticut. My [???] and I just want to say that, for last couple of years, they’ve been top notch as far as I’m concerned. It’s bad enough now that they’re giving me generic drugs, now they probably to pass generic supplies onto me. And I think it is highly unfair, very unfair that what we got today, when we’re taking a back seat to something else now. Putting back [???] to being put back on the back burners again. So, when you get our age, I hope to G-d that you don’t … Continue Reading

“This is…at Cambridge Nebraska and I just wanted to voice my opposition to the competitive bidding law. So count me as being against it. Thank you.”

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“I live in Charlotte, North Carolina. I got a notification that I am using a durable medical equipment, I am using oxygen tanks. I have COPD and I use a company here in Charlotte called Hometown Oxygen. They have been just great. Every time I have needed something or something went wrong with the equipment, I had no problem at all. They helped me on the telephone to be able to fix it if it was … Continue Reading

“Good evening, good day. … I have an air machine and I have another machine. I am a diabetic patient. I have been trying to do everything that I possibly can to live a little longer because my health was really bad. I’ve been just to do everything I can to go on a little bit further. The people that bring me my [???] are very good people and they are nice people. And so I’m trying … Continue Reading

“I really don’t know what to tell you about this except that I’m on oxygen.  I depend on it.  I mean you really panic when you can’t get your breath.  These people are so good and so considerate, they immediately respond if you have a problem with anything, they there for any kind of advice or question.  You feel like you can call them with anything and there … Continue Reading

“I’m on Oxygen and my provider is a small company called Bethesda and I have been with them since 2004 and they have been very good and they supply and take care of my equipment at minimal charge because I’m Medicare, Medicaid and now I’m being told that I might lose them and I really do not want to. I still want to have the choice of who I have because I tried … Continue Reading

“I am calling to let you know that I am totally against the competitive bidding, [passes?] and law that’s been enacted. And I recent it because I will loose my freedom to chose my own medical equipment, my quality of service will be affected and I just wanted you to know that I would like to see this law abolished. Thank you very much, bye.”… Continue Reading

“I understand that a new law has been passed by Congress passed has been forcing people to use different home medical equipment suppliers and that the contract was given to low bidding suppliers, so the small businesses in the community that are providing the extra services at no charge for customers are not getting contacts. So we not going to be able to use them anymore. I have a breathing machine and the company that … Continue Reading

“Both my husband and I are wheelchair bound with many medical issues, his being terminal lung cancer. I’m not happy with this new ruling that may be passed called Competitive Bidding.  We experienced that once before where they made us change providers for all of our BiPAP equipment and the one that we were allowed to use or assigned to, or however you want to express it, was not good.  So fortunately that changed and … Continue Reading

“I would just like to let the Congressmen know that I am not happy with the new law that they have passed about…Congress was saying that they’re going in competitive bidding in my area of medical and medicine and I am not very happy about it because I’m happy with my Medicare people that are handling my stuff right now, such as J &L Medical Services for my CPAP.  I do not want to … Continue Reading

“My husband’s oxygen equipment and everything and I just want to say that we’re not very happy hearing about this competitive bidding. Okay. We don’t like the idea of that at all. So thank you.”

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[Editor’s Note:  The following call, although lengthy, provides a sense of the value beneficiaries can place on their supplier and how strongly they are concerned about competitive bidding.]

“I’m from East Chatham, Connecticut. I deal with J&L Medical Equipment in Middlebury, Connecticut for respiratory. I was on machines that kept me alive in the hospital and sent home and I’m still alive because this company… even when I’m… and when an emergency happens and something is wrong with the machine. This is a small company that has built itself up. It’s not a big major company and … Continue Reading

“…this competitive bidding on medical supply company is for the birds.  I’ve chose this company  to take care of me, my oxygen, all of my equipment that I have to have my nebulizers and they check on me regularly that the oxygen machine is running perfectly.  And I don’t want to change. I know the people, I like the people, they’re very, very helpful and considerate and I do not … Continue Reading

“I live in Norwalk Connecticut and I use J &L Medical Services out of Middlebury, Connecticut. I am very disappointed with what is going on in Washington in regards to our medical care. Having worked in a medical office for 33 years, it’s not what they telling us, it’s what they not telling us. They make it sound like it’s one big great birthday present to all of us. Well it is not. It’s disastrous. … Continue Reading

“I just received my CPAP mask, headgear and tubing and a little brochure telling me about competitive bidding. I am horrified that this is going to go out to bidding because I have had an experience where I was with one durable company and I wasn’t quite satisfied with them so I changed to the new one that I really, really like and I want to be able to go where I feel I get the … Continue Reading

“I’m just calling to say that my husband’s on oxygen and he’s very happy with the company he has and I don’t know why they want to make any changes at all.  I’m just very unhappy about hearing this.  We’re very sorry to hear it and we hope it does not change at all. Thank you.”… Continue Reading

“I have a brochure in front of me that tells me that Medicare patients will no longer be able to, will be forced to use a different home medical equipment supplier that was chosen by the US government because of a low bid. I happen to have a CPAP machine and I’m in Florida 7 months of the year and maybe 4-5 months of the year in Connecticut and I do get my CPAP from Connecticut … Continue Reading

“Good morning. I’m calling to protest the competitive bidding measure that is going to be passed by Congress for the different home medical equipment supplier. I’m very happy with the present supplier that I have. They provide me with good quality equipment. They’re very prompt and they are available at all times. I feel that a competitive bidder will go for cheaper, less effective equipment. Thank you.”… Continue Reading

“I use a wheelchair to get around,I use medical equipment in my house for lifting me out of the wheelchair and get me into bed and I don’t want cheaper medical equipment and I want to depend on the suppliers that I have now that carry quality medical equipment. So this competitive bidding is a bad idea. I need good quality medical equipment and I don’t think going cheaper is going to make any good sense… Thank you.”

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“I want to object to a new law that’s being passed by Congress that forces me to use a particular home medical supplier and that the government chooses that supplier they want me to use. I do not want the government controlling small business. This eliminates competition and our government and our society and way of government thrives on competition. So I am definitely not for Congress passing any new law to this effect of enforcing … Continue Reading

“I’m a senior citizen but my husband and I still pay income tax and I would like it to be recorded that we are against this competitive bidding I had a pamphlet on it explaining it and we get good service from a smaller durable medical equipment company and I, listening to the President, I noticed he said the small business man is the answer to these problems that we’ve got, we need to shore them … Continue Reading

“I am calling about the call the Congress has for competitive bidding on the Medicare beneficiaries. I have been on a CPAP for over 15 years and the first company I was with was absolutely terrible. One time my hose got a hole in it and they didn’t replace things regularly, the hose was at least two years old, and the company would not replace it without a doctor’s orders. We had to tape the hose … Continue Reading

“I would like to be able to keep my local company.  It was very good in case of a storm when our facility, I’m the only one in the facility with oxygen and they asked me to leave because they had no lighting and without electricity of course.  And my provider came right away, brought me my oxygen tank that I would need for overnight at my daughter’s house and they’ve always … Continue Reading

“Hi. I would just like to be sure that we can maintain the durable equipment that we have. My husband is ill and we have to have those things at home and I just want to make sure that they are still available to us and that nobody is telling us from whom we can get them. So if there is something I can do to be of help, in that regard, I would certainly be … Continue Reading

“I received a brochure from my medical suppliers for services regarding the competitive bidding and I want to put on notice that I’m very dissatisfied with that because in this brochure that I received it says Congress calls this competitive bidding, it is not used in any other area of medicine and it is new to all of us and will lead to many companies like ours being barred from serving Medicare benificiaries. I don’t like the idea of being forced to choose another bidder, and a low bidder at that, after I’ve had JNL for … Continue Reading

“I have been with Professional Respiratory Service for several years and I would like to keep them as my professional respiratory because they always been good the time if something happens they’re out here in a short while.  And they always take good care of my machine and they take care of me and my oxygen and I would gladly appreciate it if you would keep them as my services. Thank you.”… Continue Reading

“Hi. I am an 85 year old Senior Citizen and I want to let you know how unhappy I am with this new law. It will affect my physical and mental health very much. I have oxygen tanks and other machines and I need a close provider to help me when I need them. My provider now is Community Medical Equipment in Bloomsdale, Missouri. Thanks for listening, have a good day.”… Continue Reading

Crackdown on home health fraud causes ripple effect

Home health nurse Henrietta Jacobson used to visit a disabled diabetic in Fort Lauderdale twice a day to give him insulin shots, enough help so he could keep living on his own.

No more. The man, about 70, moved to a nursing home because of a … Continue Reading

“Hello. I’d like to tell you that I’ve had very, very good experience with the company that I’m with since 2005 for the oxygen supplies.  I can always call on of them.  Their equipment has been very, very good quality, and their service has been just outstanding, and I really appreciate it where such an important thing, if something goes wrong you really need, just about immediate attention to it.  The company I am with is … Continue Reading

“Hello this I am very disappointed in this new law and it will effect my physical and mental health. It is closer for me to get to get to go down to [???] and get what I need as I live by myself and it is very inconvenient any other way. Please see that this law [don’t go?] through. Thank you.”… Continue Reading

“I want you to know, and to let all the people know, how unhappy I am with this new law.  I have COPD, I am on oxygen 24/7 and my local health care provides it to me, they bring to me.  I do not want anyone else helping me with this, so please, please do not let this new law be passed.  Thank you.”… Continue Reading

“I’m disabled handicapped. I’m on oxygen and I’ve been paying into this Medicare system since its conception. And I want to know why they’re thinking about putting us on this one company. Why are they taking away the company that we were used to, that have been my medical provider for quite a while now and they’re excellent in their work. And I don’t worry about whether I’m going to be able to breathe tomorrow or … Continue Reading

“I have oxygen and I am only on it at night but the people that take care of me is a small company and they come every 10 days and check my, make sure everything is ok and give me my supplies and I am very satisfied.  I live in a small town. We have no place to get oxygen so I have to go to the town next down and if they don’t … Continue Reading

“I am calling about competitive law bidding.  I live in a small town of 7,000 and we have only one equipment provider.  And when we need somebody, he always comes when we call. He is on call 24 hours a day.  And we have got used to him and if it was somebody else, they would have to come 20 miles to where I live.  And a lot … Continue Reading

I’m concerned that small, local DME companies, who are already operating at the barely surviving level, will be forced out due to the bidding process, particularly in rural areas. CMS claims that this concern has been taken care of, but it seemed in the first flawed bidding process the large city areas like Los Angeles, etc. were so large that they overlapped into what are really rural areas of California which are actually hours removed from any DME supplier who might have been awarded contracts under the bidding process. Small, local DME companies with quick delivery to patients are the … Continue Reading

“Yes, good afternoon. The reason I’m calling for is I read this flyer about what they call competitive bidding for the Medicare patients. Thecre.com who says that there’s a good possibility that I would have to, what did they say, go to another provider for oxygen. I’ve had these people for a long time and there is no way that you’re going to change that. I don’t care. Tell Dr. Obama, President Obama whatever he is, … Continue Reading

“I live in Cooper County in Missouri and I have been on Medicare for quite a while and I’ve got breathing problems and other stuff that my medical provider gives me. I have been so well taken care of by these people I should would hate to have to start all over again with somebody new. I’d appreciate you voting no for this problem and so we can stay we are at cause I’m well pleased … Continue Reading

“I would just like to say that I’m disbled, I’m on a walker, I have sleep apnea, I’m on oxygen at night, I live in a small town and I’m serviced by another small town that’s about 15 miles away that gives excellent service.  I’m just concerned about the new law and how it would affect me and everything.  I know I don’t know really, what all to say, just know that it sounds … Continue Reading

“I just wan to tell you that I am very much against this competitive bidding. I don’t want to lose our local agencies because them I can depend on, otherwise I could not depend on anything. So I don’t want this competitive bidding. Thank you.”

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“A couple of years ago I had pnemonia four times. I never could seem to get over it and the local home medical company came in and they set me up with an oxygen machine which had been an almost life saver at that time.  I enjoy having the local people because they come and they service it, they check to see if it’s running properly and they do this about every 6 weeks … Continue Reading

“I’m calling to complain about this Medicare competitive bidding. I’m working with a small company.  I have sleep apnea and they are wonderful, courteous, timely and effective and I really, really don’t want to lose that to a competitive bidding. Please please do something about it. Thank you.”

Listen … Continue Reading

“Yes, I’m calling in regards to the oxygen that I receive from my caregiver.  I like the company, they’re there when you need them 24/7.  In the middle of the night 3:00, 4:00 in the morning, if you need something, they ride out to your door.  Bigger companies aren’t like that.  I was with one company that let you run completely out of oxygen.  I couldn’t … Continue Reading

“This is…again I am really upset about what this government is trying to do. This small business is in my area and if I have any problems I can call them and they’ll be right out her. Now I don’t want somebody from Kansas City, I live in New Franklin about 100 miles from ’em. I don’t want someone in Kansas City have to drive throughout here and maybe have to wait two or three days … Continue Reading

“This is…in New Franklin, Missouri and I have a small business that I love and they are very good. I use oxygen at home and I use portable oxygen. They come by. They check all my equipment every month. And I don’t want these people to be, I don’t want to lose these people. Now, somebody do something, this is bull. These guys are good at what they do. They are very reasonable. And they have … Continue Reading

“Yes, I’m calling about the changes that they’re trying to make with providers on durable medical equipment. Changing providers for senior citizens is not good. We have a hard enough time trying to make ends meet with fixed incomes and then have to find out where the new providers are located if y’all change us and build up trust in the new providers. I just don’t think this is a good idea. We’re set with our … Continue Reading

“Yes, I understand the new law passed by Congress, you could be forced to use a different home medical equipment supplier that was chosen by the US government because of a low bid.  I enjoy using my local home care.  A very competent supplier.  I use it for myself.  My husband uses it, and I used it for my very aged mother.  They are … Continue Reading

“Hello, we got this flyer from our oxygen provider telling about this competitive bidding and I really don’t like that. It seems like we might be forced to have another bidder. One that we don’t know, maybe one that’s not in our town, these people are here and we get very, very good service from them and we’re on Medicare so we wouldn’t want to be forced to change. I don’t think that’s a, an ethical … Continue Reading

“Hi.  I live in San Angelo, Texas and I have a wonderful medical equipment provider and I would hate to lose them. They are there, they support our community and they are very dependable and I don’t think the government should tell me how and what people to use for my medical treatment and stuff. I am very concerned about this law being passed and I hope the powers that be can stop this and cancel … Continue Reading

“I would like to express my disappointment in this competitive bidding option, not an option, but competitive bidding for the oxygen equipment for Medicare patients. It means that we no longer have a choice and it’s very bad for us and for our country.  Thank you.”

Listen to complete … Continue Reading

“I am a Medicare patient and I am concerned about what Congress does.  At this point I am concerned about quality of service and accessibilty to being able to access, be able to go for fittings. I use a CPAP equipment and I am worried about the quality, you usually get what you pay for and I don’t believe we need to ruin a lot of small businesses for monopolies. I just think that if Congress … Continue Reading

“I’m a Medicare patient and I don’t like the new law, the competitive bidding, for my oxygen supply and medical equipment. At one point I was on hospice, where it’s the very cheapest of whatever because they provide it, and the oxygen machine was so loud and it was old and decrepit. All the equipment they brought me was just worn out. When hospice dropped me, I had to get my own medical company, and so … Continue Reading

“Yes our oxygen advocate that came over to check on my husband’s oxygen and stuff is telling us that with this new law it’s gonna affect my husband’s oxygen and within 3 years and I’m to let you know I am unhappy about this law. Thank you.”

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I’m an oxygen purchaser from the Lincare Company in Prescott, Arizona. I received your folder telling about the new competitive bidding which has lowered the — not lowered our prices, but restricted our purchasing to certain companies that will only be approved by you people. Not by you, but whoever the government is handling this. And I’m not thrilled with the idea to having to take a forced company rather than one which is handy and … Continue Reading

“Hi, this is regarding…. She’s 97, oxygen, and has CPAP and all the equipment that the Antelope Valley Pulmonary in Lancaster, California. They’re very personal and they give her things that the big companies do not give her, that they actually charge to themselves. And this would be taken away if this … Continue Reading

“Yes. I live in Jacksonville, Arkansas and I have to have my diapers from Advocate Medical Supply Mobility. I’m not just a human being with real needs and the company they’re like as [?] provide medical care, not just a delivery service. And they’re very nice and they’re very professional and because of the Medicare and the Congress passing this stupid legislation, we may be forced to use another company. I don’t want another company. … Continue Reading

“With this law, a lot of people will die, they are like me.  They will be unable to handle the oxygen preparations, taking care of the tubing, or how to regulate the amount, the numbers.  As I’m half blind, I would not be able to handle any of this without the help of the man and his company that I have now.  Please, please do something about it.  … Continue Reading

“Yes. I receive a nebulizer to keep me breathing freely with the condition that I have. And, I’m not happy with the new law and its effect on my physical and mental health. And, I feel like that I’d be losing most of my freedom to choose my medical equipment at home and I feel like I’m just being used and I’m going be given what you want me to have and not necessarily what I … Continue Reading

“I live in Washington State.  I am highly against this competitive bidding and the no choice of medical durable equipment because small businesses are much kinder, and they better serve you, and they are more personal.  The big giant medical services are awful to people,  they just are absolute horrible,  they don’t bring what you want,  you don’t get what you need…. Continue Reading

“I’m very unhappy with the way that Congress and Senate are handling Medicare and I don’t like it at all.  They think they are burning us and we are suppose to be running them. ”

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“I do not approve of the government taking away my right to choose,  where I get my supplies.  I prefer to do my own shopping for the best price for my equipment, and for the best service.  You are putting the small companies out of business.  We are suppose to be supporting small business.  My suppliers are providing me with the best service I can … Continue Reading

“I was calling in regards to the so-called competitive bidding on my medical supplies. I have a very competent supplier, Professional Medical, out of San Angelo, Texas. I have a oxygen concentrator. They come by every month. Next week, check out the machine to be sure that it’s running properly. I have a telephone member that I can call in in case anything is not working. They will come immediately. I have oxygen tanks so that … Continue Reading

“Hi, I’ve got a brochure here that talks about the competitive bidding, this new law. I don’t like it at all because it take away our freedom and we have a [???] my husband and I both.  We were not satisfied with one company and so we switched to another. And we like MedSource. It’s a very good company. They’re very diligent about our calls, and I don’t like this whole business. It just seems so wrong … Continue Reading

“Yes, I deal with Monroe Wheelchair in Rochester, New York, and I would like to keep it that way, so competitive bidding, I don’t like that.  I don’t want to lose my freedom of choosing my home medical equipment.”

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“I just called in a few minutes ago but nobody ever said anything so I’m not sure they got my message, so I’d like to repeat it to be sure that somebody knows that I called in. I’m very unhappy with the new law passed by Congress that force my home medical equipment supplier to go out of business. That’s not right, I don’t know who thought it up, but whoever it was evidently has never … Continue Reading

“I just wanted to let you know how unhappy I am with this new law that may force my medical place to go out of business. I have used Hi-Tech for many years now. Not only for the oxygen – I’m on oxygen 24 hours a day – but also a nebulizer. I have been very satisfied with their providing my care, and I’m very unhappy to know that they may be forced out of business. … Continue Reading

“Yeah, Hello. I just got this letter today. They brought my husband some medical equipment out here. And, this letter said that we may be in of losing our service through our Genesis Oxygen Home Medical Equipment. This is very important for my husband because of his condition. They always bring out the medicine that he needs. The bandages, the gauze and things like that, as much as he use of the stuff. I don’t want … Continue Reading

“I just got this notice. The man who delivers my pads and things. He works with Genesis and they’ve been very good to me. And I don’t understand what this is, this new act. Competitive Bidding Act I guess is what they call it. I don’t understand it. And I wish someone would let me know what there, you know, what this is all about. …  And I just would like to know what this is … Continue Reading

“Yes I just wanted to voice my opinion on this competitive bidding. I think it really stinks, especially for people like myself who get their oxygen through the company that’s right here in my area and people that can work on my equipment. It’s just ridiculous to think that I would have to go all the way somewhere else to get something like that and I think you should think about the older people that cannot … Continue Reading

“Yes I’m calling to register my angst regarding this Competitive bidding for Durable Medical Conditions. …  Currently we have a wheelchair that Medicare is providing through a medical equipment provider in New York for my father as well a bed and other medical equipment for the pad of the bed to keep the circulation going. They have provided good service, reliable good service and to be able to, you know to continue with … Continue Reading

“Yes, we have had a terrific experience with our health care provider, which is in Tampa, Texas. And anytime that we have called him they have responded immediately and I would hate to see this go. I can call and ask them, it’s my husband’s breathing equipment, and they are there immediately. And I would hate for this heath care program to go to where we could not get good health care service. Thank you. Bye.”… Continue Reading

“I am very concerned about this change of going to a competitive bidding where I will not have a free choice of providers for my oxygen equipment.  And one of the things they really wonder about is why is it that for Medicare Part D it’s against the law to have competitive bidding, but all of a sudden we have competitive bidding starting in a place where we hadn’t had it before. That’s about it, but I … Continue Reading

“I am 73 years old. I’m on oxygen and a provider told me that there’s gonna be these caps on the Medicare. Well, I guess we’re just gonna have to die. The old people are gonna have to die because if we most of us are on social security and I have very little savings. There’s no way that I can pay for all my medications and the oxygen.”… Continue Reading

I live in Winder, Georgia. I received a brochure from my provider for my medical equipment, my nebulizer and breathing medicine and it says that Congress is gonna cut a lot of this out. We’re gonna go to other companies, it calls it competitive bidding. I am so against this. I, like so many other Americans, need this to keep us alive and I would like to keep using my provider. … … Continue Reading

“…we’re both on Medicare, and she is a person with COPD and other problems that require her to be on oxygen 24 hours a day, 7 days a week. She is presently on liquid oxygen and uses a hand tank the name of which I can’t think of right now, but when we go out , its a very convenient way to carry her oxygen. It’s frozen oxygen to start with and it’s very easy, very … Continue Reading

“I live in Winder, Georgia. I have had a bout with lymphoma and I think as a result of this I have lymphedema in my legs. I require the hose during the day and the night time garments, at night. Plus, I have a mild case of  COPD and I use the CPAP during the night to help me sleep. I think this is a necessity for my health and I just really don’t … Continue Reading

“I think as a Medicare patient and the equipment, I can’t believe that AARP has sold us out. I can’t believe the senators in Congress have sold us out. They’re not even under the same plan that they’re telling everybody else to be under. I think the whole program stinks. Thank you.”… Continue Reading

“I’m from Lexington, Georgia. I’ve had lung cancer and a section of my lung removed. I’m 72 years old, retired and I’m on oxygen therapy. According to this competitive business thing that this flier is mentioning, I might lose the oxygen company that I’m with now.

I’m a fisherman. That’s the one … Continue Reading

“I just received a notice that the medical, my oxygen and medical…is gonna be done on a competitive business and it’s gonna like do away with small people. Well I don’t appreciate this at all. I depend on this oxygen and I don’t want you to missing around with it. Because it’s a federal government gets in on it, it’s toast. So, can you please keep this out of the hands of the competitive biding which means … Continue Reading

“I’m totally against this new competitive bidding for oxygen supplies. All it does is confuse us older people that are on it and as it is we pay enough money for our services.  We paid and dues and paid in to Medicare and I think that Senators and those that vote on this stuff should take him consideration that we are old and we have to live on a limited amount of income like social security. It’s very, very hard … Continue Reading

“I’m a home care salesman for the last 40 years and seen a lot things happen over the years and what I have seen right now, I don’t like.  It is jeopardizing my livelihood but not only that, it’s hindering the patients that need the care and big GovCo is not going to be the answer to this problem.  What needs to happen is the fat cats need to be getting taken out of the picture and … Continue Reading

“I am very upset that there’s a  possibility for me to get equipment that I need for the rest of my life that I may have to go out of our town or maybe state to receive this equipment. It’s very unhealthy for older people to have to go further out of their city to get their medical equipment that they possibly will need and I live in Cabot, Arkansas. We have a equipment … Continue Reading

“I am calling on behalf of my husband who will eventually, in about a year, be a Medicare recipient. Right now he is on oxygen, and on top of it he has a refillable tank so that he can still go back and forth to work at the moment. That he does have a huge amount of breathing problems, does depend on this oxygen, and I understand that this new law that’s been in acted by … Continue Reading

“Hi, good afternoon. I just received a notice about this so-called competitive bidding about home care equipment – home medical care. And I can say that I am very, very disappointed in this. I expect our congressman to do better by those of us who are aging and who are on Medicare. I get my equipment from Monroe Wheelchair company who have been very, very kind and very helpful and everything they’ve done for us. … Continue Reading

“We have been using Professional Medical to supply oxygen for my husband.  I have discovered that there is a new law which is going to make you use some of the cheapest bid, bidder for such.  I do not agree with this.  I think, that I would prefer to use a small business, that’s local, and that I would have be better  be able to communicate with them, communicate my … Continue Reading

“Now that the legislation has been passed for Medicare and you have decided to take my benefits away and I’m retired, it’s gonna be very hard to vote for anybody in the senate or the presidency or that supported this Medicare change and hopefully it will be rescinded. I was told that I no longer will get my CPAC replacements because they have changed that law and they went to the lowest bidder and the provider … Continue Reading

“I’m a licensed social worker and I do discharge planning at a nursing home… in Piketown, Ohio. I’m concerned about the competitive bidding process, that law that’s being considered or actually passed, I’m not sure. I’m very strongly advocate of consumer choice and patient directive planning. Right now, I use 2 or … Continue Reading

competitive bidding will put many suppliers out of business, including us. we’ve been in business for 12 years, have been accreditated for 4 years, passed the CMS on-site visits with out the bat of an eye. What will happen is the suppliers that win the bid will not let the beneficiary decide on what equiptment thay want and will be forced to take the equiptment that is least expensive to that supplier. It is a lose lose program

My business is also awaiting for the accreditation company to come give us our site survey. We registered for the accreditation in June of 2008 and they tell me that they may not be able to get to our store in time. We have been servicing patients for 12 years and it will be devastating to our business if we do not receive our survey in time from the accreditation agency. I don’t believe this was the intention of the law to financially destroy our business or put us in this situation where we can not service our patients. Our … Continue Reading

“I have oxygen in my home. And I don’t want to change because it’s hard for me to get to know how to work everything because I can’t walk a lot or I get out of breath. And when I do call the service I’ve got, they’re here right away. And that I really don’t want to change and I don’t know why you have to change. When I’ve got the service that I’ve got that … Continue Reading

“I recently had this, get onto using oxygen in the house and also in transportation. And I just received a statement from my oxygen company, oxygen supplier today, stating that, it’s gonna be put on competitive bidding, and I may or may not have the same company, or I may or may not have 24 hour service in case something goes wrong with the machines or upkeep on the machines, or whatever, whatever the situation is, that these folks up … Continue Reading

“The patient is…my wife. We have very good service from the medical home health equipment people. It’s like the service that we get our hospital bed that we have for her in the house. It is necessary to be able to keep it operating properly and the oxygen machine and the two types of nebulizers that she needs, one for water and one for medicine has to be taken care once in a while and the CRE … Continue Reading

“This competitive bidding, especially on oxygen, is totally wrong. This is something that we do not need to pass. Once you have someone that has to be on oxygen as a lifesaving measure and you have to go with the company that only wants to give you the service that only government would allow, that just gives them a total monopoly, they can treat you however they want, they cannot be there for the accident, they … Continue Reading

“Hi, I have gone right now through a wheelchair and a walker and thank God I am down to a cane. But I have been able to talk these people they check to make sure to see if I am using the right size equipment and everything. I never go for low bids. Low bidding meens you’re getting crap. I mean I got when I examined what I am getting for my money. I dont want anybody telling me I cant go where I am going to get good personal service, just because they cheaper. Good … Continue Reading

Homecare Magazine
Dec 10, 2009 11:27 AM

WASHINGTON — More than a year after Congress delayed Round 1 of competitive bidding in July 2008, the Government Accountability Office has officially confirmed what industry stakeholders have been saying all along: The first round of DMEPOS bidding had major problems.

In a report released Dec. 7, the GAO found Round 1 suffered from poor communication by the Medicare program and an “inadequate” bid submission system, among other things.

According to the 65-page report, the bidding program “has the potential to produce considerable benefits including reducing overall Medicare spending for DME and limiting potential fraud through increased … Continue Reading

“I just got a notice today from our, the carrier that furnishes oxygen to my wife, and that company is called Medox.  They’ve been very, very good to us and I just hate to think that this competitive bidding thing is going to make them go out of business if you will.  I’m just so unhappy with this business, this thing that the government is fooling around, people in Congress is fooling around with.  … Continue Reading

“Yes I’d like to be as sure that I’m going to get the best oxygen equipment possible rather than getting some second class or something that’s on the blink all the time. My life depends on my oxygen and I would prefer to have the best. Thank you. Bye.”

Listen to complete call

I’ld like to keep the medical supply place that I have. Because I’ve been with them for years and I know how they operate and I just don’t want to change.”

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“I take care of my mother…. She is 83 years old and totally dependent. She’s on a feeding tube, in diapers, can’t walk, can’t swallow. End stages of dementia. I take care of her at home and I depend on small companies to assist me with their duro medical  equipment and the service. So I am very much against the competitive bidding that has been allowed. I just want to let you know … Continue Reading

“I’m very unhappy with the new law that and its effects on physical and mental health, the one with competitive bidding. I think that I ought to be able to choose the home health service, the Medicare place that I want to. Thank you.”

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“I live in Portsmouth, Ohio and I really am dead set against this bill. Right now I have a company that I enjoy, they’ve always been there for me midnight, 2:00 in the morning, if the power goes out. They’re bringing me down extra oxygen when I need it and I’ve grown to depend on. I’ve had them for the last 12 years and I don’t want somebody coming in and telling me that I have … Continue Reading

“Yes, I’m from Birmingham Alabama and we have received home health benefits from the small companies in our area and I do not think the government needs to play into this and take control of it. I think it needs to be left to the freedom of the people and to the small businessman to where they can compete with one another, and we will not be paying a high price and I’d like to see … Continue Reading

“Yes, I use Cornerstone Medical Services in Columbus, Georgia. I’ve been using them for 4 years and I’m very happy with their services. I do hope Congress leaves this alone and let us take care of our own medical needs. We don’t need their help in doing it. I wish to continue using Cornerstone Medical. Thank you.”

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-I am on oxygen 24/7. My supplier is always available if there were an emergency. I have been given the latest up to date concentrators as they become available and they use good equipment with equipment checks and all that sort of stuff. I don’t know if this letter is to late to help.

Keep up the good work watching out for the little guys, patients & suppliers.

HME News

WASHINGTON – The VGM Group last week encouraged providers and their patients to submit formal complaints about national competitive bidding with CMS. The Center for Regulatory Effectiveness (CRE) has identified three ways to do this: submit complaints by suppliers or individuals to the CMS competitive acquisition ombudsman; submit complaints by beneficiaries to the CMS Medicare beneficiary ombudsman; or submit complaints by beneficiaries to Medicare quality improvement organizations. Providers and their patients should provide a copy of their complaints to CRE, along with their permission to use them in discussions with CMS. “Do what is right for the industry and … Continue Reading

“…We have already been through problems where we did not get our diabetic supplies… and if you go to this then we might go back to that and we may not have any choice. You may not give us a choice as to who can provide them and if that’s the case then we have to start paying for them again and he hasn’t, he doesn’t have the money for that. He is on SSI and … Continue Reading

“Yes, I would just like to express my opinion on the competitive bidding. I am against it and I would like to have my free will to chose to buy where I need to buy my medical supplies. Thank you.”

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“My husband and I both receive at home care for CPAP. He has one. I have one. We happen to have 2 different companies who supply us but they are small companies. They service us very well. The reason we have two different companies is we got them at two different times and that’s the way it worked out. But we very happy with the companies that we are using and I don’t want the … Continue Reading

“Yes, I am very well satisfied with the medical personnel that I got my breathing machines and equipment through and I prefer to stay with them instead of going to a smaller unpreferred company.  I’d like to stay with the company I’m with which is James Medical Equipment in  Danville, Kentucky and I’m very well pleased with them.  Thank you and have a good day.”… Continue Reading

“I’m calling in regards to the competitive bidding that Congress has put in effect. I get my Medicare from a locally owned home medical equipment company here in Columbus Ohio and if a larger company takes over then I may have to wait a week or so before I can get my medication. This way this locally owned medical equipment company provides me with my Medicare assistance in a day or 2 days, at least.  I just want you to know that I’m for the small company.  Large companies shouldn’t be taking … Continue Reading

From Watchdog Watch

A senior HHS official told the Senate that provision of durable medical equipment “is an industry that has historically high risk for fraud.” The Department’s leadership also testified that “continuous positive airway pressure (CPAP) devices, oxygen equipment, glucose monitors and test strips, and power wheelchairs…are the most lucrative items for suppliers and thus, at the greatest risk of fraud.”

HHS leadership emphasized to the Senate the importance of CMS’ advanced data analysis techniques in assisting law enforcement authorities in combating fraud.

The official testified that “CMS is currently in the final stages of building an integrated data repository … Continue Reading

I have a very rare neurological disorder. I’m in a wheelchair, and get Willington Medical Supply catheters every month, and they supply my urological needs, and they tell me that I may loose them because of competitive bidding which means, well you know what competitive bidding is. I’m very unhappy with that, they’ve been very good to me over the years, and very kind and good, and when you find a company that’s kind and good … Continue Reading

“Mid Carolina Home Care Specialist is bringing me my oxygen and I don’t want them to be changed. I want them as my provider. They’re very nice, they courteous, they come when I needed something and this is very upsetting. I’d like to stay with them. I don’t know why they starting to go against seniors, you know, we did work all our lives and we are the backbone of America you know. It’s ridiculous. What … Continue Reading

“I called before….  I get my oxygen from Advance Home care in Lawrence, Kansas.  I really would hate to see, I would hate to leave them, as my contact for oxygen.  I don’t know really, if there’s something else I need to do to help keep it.  I know other people that’s on oxygen and it’s rough, it’s really rough. …  It would make it … Continue Reading

“Yeah, I’m on oxygen, in my home and the new law that takes effect, has really got me bothered. I don’t know what I would do if I lose the oxygen, cause I don’t think my survival rate would be very good without my home medical equipment. Because I have severe sleep apnea and I’ve got COPD and I really don’t want to lose the oxygen and I just wanted to know what I can do?”… Continue Reading

“Hello. I’m calling, but you keep Crest Care and smaller businesses that attend personally to my Medicare needs as far as breathing machines and respiratory and CPAP machines, and even wheelchairs and whatever might come under different things and because even, you know, maybe supports or back things. I have a lot of pain, extreme pain every single day in my back, behind my hips, legs, my feet. But as far as the respiratory things and equipment supplies … Continue Reading

“Hi, I am calling because a new law pass by Congress that would force me to use a different home medical equipment supplier. I  would like the law to remain as it has been so that we have free choices. Thank you.”

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“Yes, I’m a senior and on Medicare and I do not like government gettin’ in to Medicare because they can’t even take care of Social Security. So if they try to take care medical equipment and everything, then the seniors and anyone that needs medical equipment are gonna be at loss because they will get the lowest bidder. Unlike when they bid for something they get somebody that will give them a kick back.”

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“I am disabled, I’ve been disabled since I was I 40 years old. I’m 49 now. And I’m in a power wheelchair. And have been in a wheelchair completely for 8 years. 4 years in a manual chair and now 4 years in a power chair. I get my wheelchair and all the service from Advanced Medical, Advanced Medical Concepts in Owings Mill and from what I understand about this new law that passed by Congress, … Continue Reading

“I’m calling on behalf of my mother…. She receives home oxygen from Cornerstone Medical in Ohio. She has been receiving her equipment from them for several years, has been totally happy and we have received a letter that she may not be able to because of your competitive bidding law. This is very upsetting to someone in their eighties who has been given good service by the company that she’s with. That’s just to let … Continue Reading

“I’m calling about this new law that was passed by Congress. I don’t want to have to use a different medical equipment supplier than the one I’ve been using. They’re local, if I have a problem, they take care of my problems. I don’t appreciate having to go to some big conglomerate, that they have everything to say and we have nothing to say. I think that this should be changed, and we should keep these … Continue Reading

“Yes, I am very happy with the Clay Home Medical that we have here in Petersburg, Virginia. I don’t like the new law whatsoever, because I buy my dad’s colostomy supplies up there and you know it’s not fair for the government to regulate this or to try to push  small business owners out. I’m not gonna try to go all the way to Richmond to give his colostomy supplies. If they change it and like … Continue Reading

“I don’t want the government in being involved in what I can use to make my last few years on earth complimentary easy to care for. My oxygen people are great. They call me when I call or come to me when I need them or what ever. So let’s leave things as they are and let the government stay out of the health care business. I think there are things they should do and not … Continue Reading

CRE filed a petition with CMS demanding they disclose the Secretary’s “Financial Standards” for DME suppliers.

As CRE exlains, unless the financial qualification standards are disclosed, “bidders are potentially subject to various forms of discrimination, bias, favoritism, cronyism, and other abuse of agency discretion – all of which will go undetected since there are no publicly available standards against which the agency’s financial qualification decisions can be measured.”

The petition requests that CMS “suspend initiation of the DMEPOS Competitive Bidding program until after the agency publishes their specific financial qualification policy.”

“I’m required to be on oxygen 24 hours a day. I have very good service with Med-Ox, and there’s no other convenient or equal of supplier nearby, and when 3 years are over, I’m sunk, because I won’t have any place to go. The new legislation to make things more competitive is a disaster, and I hope you will do something to correct the situation for those of us that are dependant on our oxygen suppliers.”… Continue Reading

“I’m really very disappointed that we will be changed, might be changes in the Medicare. I get home equipment and I really appreciate the 24 hour service calls that we get. I’ve several times had problems with my equipment and was able to call somebody and get help, and either had somebody come out or help me over the phone, and somebody to check the machines and stuff is very important, and people updating you and being able to pass … Continue Reading

“I am a lady of 76 years old. I have worked 40 some years. I wanted to work till I was 70 because of having better insurance and better, higher income and I had to retire before I reached that age. I have since had numerous medical bills. I fell, I broke my neck. I had to go through all kinds of physical therapy to try to learn to walk and the doctors are doing their best so that I … Continue Reading

Due to technical problems, postings on the Forum have been wrongly rejected as spam. CRE apologizes to the commenters and all of our readers for these mistaken rejections. CRE will NOT reject any topical post unless it contains obscenities or other grossly inappropriate statements.

CRE strongly encourages all readers to post any rejected comments or to send them to us for anonymous posting. Please send your comments to cmscomments@thecre.com

I am the owner of a DME billing and consulting company. I have worked with multiple Suppliers and Accrediting bodies over the past two years in particular. Our company made sure our Suppliers were well trained and prepared for Accreditation. And, for the most part, I had no problems with Suppliers or the Accrediting bodies. However, I cannot understand the fiasco we have seen taking place.

A part of me blames Suppliers who have known for over two years about mandatory accreditation and did nothing to prepare, thinking they could “throw something together” at … Continue Reading

“Well my problem is I just got the information now that there’s  liable to be some changes and I’m not so sure that I  an crazy about them. And I have been having emphysema and I’ve been taking oxygen for the since the beginning of last year and I will like more information of what’s going on on your part. So please give me some information.”… Continue Reading

“I just wanna pass along that I am not for the competitive bidding process. I feel this will gravely impact the service that we currently receive in regard to oxygen here at our home and I think with these new means that you’re looking at implementing in regard to the level of service, not being able to have the opportunity to choose our own providers is a very poor aspect and I thought this was a … Continue Reading

“I live in Groveport, Ohio which is kind of in the country. And I have had such good service from Cornerstone for my medical equipement. They have been friendly, they have been helpful, they have have met my emergencies, and they have quality equipment. I don’t know what criteria to the government is using to decide who’s gonna supply my medical equipment. However, I would like to say that if the equipment isn’t top notch then … Continue Reading

“I’m calling about the competitive bidding and it’s not going to serve me very well for us to be changed because we lose our freedom to choose our own medical equipment providers and I’m satisfied with the service that I get now. So how will this new change help us? How will it help us? I would like to know that.  And I’m not happy with the change, with the law that has been changed. and … Continue Reading

“I’m only calling because I receive my medical equipment in the mail through a medical company and I have had a very successful rate with the medical company that is prescribing my medicine. I have sleep apnea and they supply to me. I have…I’m sure you know what that is.Its when I … Continue Reading

“I am against competitive bidding.  I feel that this makes a monopoly to certain companies and the smaller companies are left out in the cold, and I like the oxygen company I have right now and I do not want to be switched. So I’m totally against competitive bidding. It’s … Continue Reading

Feds ignored Medicare scam warnings for years
By KELLI KENNEDY The Associated Press
Friday, November 13, 2009; 8:57 PM

MIAMI — For three years, the federal agency in charge of preventing Medicare fraud repeatedly ignored internal watchdog warnings about swindlers stealing millions of dollars by scamming several programs, documents show.
The Centers for Medicare and Medicaid Services received roughly 30 warnings from inspectors over three years – mostly under the Bush administration – but didn’t respond to half of them, even after repeated letters, according to records provided to The Associated Press by U.S. Sen. Charles Grassley’s office.
A July 2008 … Continue Reading

“As a home bound senior citizen, the equipments that I have in my home that’s been provided with different people here in the community that I live in and since I can’t get out of my house, it is imperative that I have somebody that can come in and be with me and be my therapist and show me how to use different things to help me get around my house so that I am not … Continue Reading

“I’m calling on behalf of my husband…who has to live on oxygen. The respiratory consultant here on Springs Street in Newton, New Jersey, informs my husband that because of a bidding that you had in Washington there, they will no longer be able to give him his oxygen. Now I wanna know why y’all passed it through already? What is the problem? I didn’t think we were gonna put the health insurance through, I didn’t think it went through. Now, he’s on Medicare. We can’t afford to pay any more on this, and why are y’all … Continue Reading

“I’m a registered voter and I am totally against them changing the medical supplier for our equipment at home. I think it’s a crime to change the Medicare. They’ve already cut us to the hilt. Things that we’ve got to Medicare and made prescription drugs now, which are senior citizen and they’re disabled, can’t afford to get it. I’m totally against you dictating to us whose supplier that we should have. Thank you, and have a good … Continue Reading

“I am utterly dismayed to find that my use of Oxygen One of Waukesha may be forcefully taken from me and I feel like I’m being dumped in a middle of a lake and I don’t know how to swim. Anyone on oxygen knows how scary it can be when your supplier is not reliable cause without him you cannot breath. It’s reassuring to know he sees you as a person and not just a customer. I’ve now been on oxygen for about 4 years and when I began I had regular visits from a  respiratory … Continue Reading

“I just got a booklet from where I get my oxygen from, Cornerstone.  I’m very pleased with it and they tell me that the Congress passing the latest law that I may not be able to get my supplies from Cornerstone.  I think that is terrible.  This isn’t Russia, this isn’t no communist place, we have a right to choose our own place where we get our own medical supplies, … Continue Reading

“I would prefer to have my strips for my diabetic testing provided by a local and not a large national business where I won’t get personal service and I do not like this Health Care Reform bill that’s going through Congress now and will affect most of us in a negative way and the bill that’s to pay for this is to large for us to absorb.”… Continue Reading

“I received my diabetic supplies right on time as usual along with the letter stating that according to the new law we would be forced to use different home medical equipment supplier and I was wondering if this means that they already now that we will not be able to use Personal Care Products or if we would be notified who else will be delivering them or just what we are supposed to do.  … Continue Reading

November 11, 2009

by Astrid Fiano, DOTmed News Writer

The Senate Judiciary Committee held a recent hearing on the problems of health care fraud. According Chairman Patrick Leahy (D-VT), the scale of health care fraud in America today is “staggering.” “According to conservative estimates,” the Senator said in his opening statement, “about three percent of the funds spent on health care are lost to fraud — more than $60 billion dollars a year. In the Medicare program alone, the Government Accountability Office estimates that more than $10 billion dollars was lost to fraud just last year.”

“My name is Jean and I’ve been getting breast prosthesis in bras and Medicare has paid for 80% of them and they tell me know that maybe we will be, won’t be able to go to the places we have been, that we have to go some other place that bids the lowest for everything and I really would hate to see that happen. The provider that we have now is Nipple Health Care and they do such a great job of fitting bras and prosthesis and helping you out when you feel kind of low … Continue Reading

“I’m calling about this competitive bidding and I really don’t understand why they are doing this. They’re going to eliminate the smaller oxygen companies and this country was founded on small businesses, not just your big giants, like you take General Motors and Chrysler who have to have bail outs. You don’t see the small owners coming with their hands out and I’m happy with my oxygen provider and I really don’t think they’re being fair … Continue Reading

“Yes, I enjoy getting all my oxygen things from Liberty and I don’t think anyone should have the right to tell me where I can get it from.  I think that should be be my choice.  I’ve been a taxpayer for my whole life but now that I need help I would like to have my own expression of where I do get it from.  I don’t think anyone should … Continue Reading

“This is Mary…calling from Wisconsin. I have oxygen and I’m not very happy about the new law that Congress passed about competitive bidding. I am been with the same company for going on 4 years and I’m very happy with them. I’m familiar with all the people that work there. Very happy. It would be terrible if I had to switch. Be really hard. So, I hope something happen on this. Thank you. Goodbye. “… Continue Reading

“I’m a taxpayer. I’m very concerned about cutting out small businesses and patient services by this lowest bid for oxygen and other support systems for the elderly. My dad is 92 and my step mom is 85. We use these resources and having them close an accessible with the local businesses, we feel really care and are helpful. This is not the place cut out fraud. This isn’t where the fraud is.  You need to be … Continue Reading

“I’ve been on Oxygen for several years now.  When originally went on it my private insurance is paying for it and they require I go with a certain company.  The company was horrible, it did not provide services.  When my doctor ordered me to go on, the first time was at night when my doctor wanted me to go on the tanks during the day too, they never got around … Continue Reading

One of my customers brought us a letter they had received from CMS stating that their records show that she purchased/rented medical equipment and/or supplies through Medicare but because her supplier hasn’t met the new requirements to become Medicare approved,  starting 10-1-09, the supplier can no longer bill Medicare for equipment/supplies.  It then goes on to say that the beneficiary can call 1800MEDICARE and their representative will help them find a new supplier.  I have talked to NSC: my supplier number is … Continue Reading

“I’m calling because my husband…is on oxygen, and if Congress do something to not keep this out and not have the advantage that we have now, it’s gonna be a critical time for him. I think it’s a disgrace that Congress is trying to keep down the use of oxygen in the homes when it’s needed. They better put the money, they take it out of their big pockets, and put it towards Medicare instead of … Continue Reading

“…I’m on Medicare and I’m also on liquid oxygen which is delivered here to my home company called [Gooles?] which is a local company and I had pamphlet, been told some information that when you’re on oxygen, you know, Medicare will only pay for so much or you’re limit what you can do. And I know a lot of people that are on oxygen where some of the companies will not provide full service for them. I’m lucky, mine does … Continue Reading

“My adopted mom is disabled she has a wheelchair a walker and a hospital bed and is on oxygen due to multiple health  problems.  I don’t appreciate Medicare cutting her off or trying to cut her off or going to the lowest bid. I think thats terrible, its horrible. Patients should have the right to go to whom she wants and the lowest bidder and it will probably be a lousy person with … Continue Reading

“Yes I was calling, I’m concerned with competitive bidding law that congress has put into effect that we won’t be able to use the manufactures that we want to use for Medicare benefits. I’m apposed to it . I want to be able to use my own Boardman medical supply company because of their service they’ve always given us and I don’t wanna be told who we can and cannot use.  So if you can please take … Continue Reading

“…I  don’t idea of you giving out to the lowest bidder. I like USA Drug. They treat us very good and help you very much and especially that’s a great help and we depend on that  for your life line  and they have always been real good and I don’t think we should have to fight for what  we deserve.”… Continue Reading

“I’m calling in response to the competitive bidding law that was passed by Congress.  My mother is 96 years old and she has to have oxygen, at least in the evening, at night. And I think as a result of this new law, the company that she deals with is not going to be able to continue to service her perhaps.  She will lose the fact that she has 24 hour on … Continue Reading

“I’m very disappointed in you people passing  competitive bidding means for medicare beneficiaries.  I have oxygen delivered to me.  I’m on oxygen 24 hours a day.  I had 2 other lower price companies serve me for quite a while.  I’m very disappointed, could not get service, when I needed.  I’m with Bayonet Point Oxygen Service right now and they are beautiful people, they’re there when I … Continue Reading

“Yes, I’m calling to report that I’m very very unhappy with this new law and it’s affect on me. And what it’s going to do to me physically and spiritually and mentally with this competitive bidding. I’m in a hospital bed in my own home trying to learn how to walk again. I have a bariatric wheel chair. I have an oxygenater in my home for COPD. I’m on constant oxygen and now I’m receiving information … Continue Reading

“My mother is 97 years old she’s on oxygen and a CPAP and found out information and even for a long time that the company that she uses may not be contracted with because of the Government, some kind of regulation and this company is absolutely amazing.  None of the other companies do for her what this company Antelope Valley Pulmonary does.  So please give it to the Government officials, we are … Continue Reading

“I am a heart patient. I have CHF, heart failure. I am very careful about what I eat so that I can keep the food down in my body. I get as much low sodium, what some people say is salt-free, which is impossible, but a low sodium product, you know, to take care of. Well anyway, I don’t know how I got this CRE pamphlet and I was amazed to know about this new law … Continue Reading

“I’m a spinal cord T – eleven, T- twelve who just recently broke her femur almost up to my hip joint. I have been dealing with Wilmington Medical Supply for my wheelchair tires. Also more importantly my urological supplies. I have a longstanding relationship with them even though they there are in North Carolina. They are exquisitely good… They keep up their paperwork for Medicare. I have to use not just any urological bag. I have to use specialized one I have been in this chair for 25 years. …

I do not want Competitive Bidding because I just don’t want … Continue Reading

“I purchase and had medical supplies given to me by T B Medical Supplies, a small family owned business in Linken Park and because of what is going on with health care, they could lose their right to supply medical supplies. They are very important to someone like me who for a while was bedridden and they brought the supplies to my house in the evening and they were able to transfer supplies that came from … Continue Reading

“I am calling to let you know that I oppose the new law in competitive bidding. My son is severely disabled and we have a company in Columbus Ohio that is, just been fantastic and I’m very concerned about that this new law is going to put good service out of business. So please note my opposition to competitive bidding. Thank you. Bye.”… Continue Reading

I am a 65 year old women and I am against Obama’s health care because I have one leg and I depend on a prosthetic. I have been an amputee for forty years. When I lost my leg they did not have the technology they have today. My first prosthetic weighed about 9 lb. and I weighed about 90 lb. and I couldn’t walk on my leg without crutches because my prosthetic was to heavy for me, that caused me a lot of problems and I went through several surgeries because of it. The point I am trying to make … Continue Reading

“I live in Kinderhook, New York, and I’m disabled, and I rely on a motorized wheel chair.  I receive service for my wheel chair through Monroe wheel chair and sometimes my wheel chair breaks down, I can be just completely stranded at home, and I can’t, you know get the chair to move, and it’s really important, that I have a service provider, who can come to my home, when I’m unable to drive … Continue Reading

“I have Greene Respiratory in Milford Ohio as my oxygen people and I don’t want the government people messing with that.  I am doing just fine with Greene’s Respiratory, they have been very kind to me, very good to me.  They gave me oxygen when I couldn’t afford it, when I wasn’t even on MediCare, or Medicaid or anything and I needed it and I couldn’t afford it and these people have … Continue Reading

“I am calling to protest the new law passed by Congress to force to use a different home medical equipment supplier, instead of one chosen by the government.  I have very good service from my home medical supplier and I am very happy with that, and I would be very unhappy if I have to let the government decide who I may or may not choose to service my medical equipment at home…. Continue Reading

It has come to my attention that the United States Government is attempting to require all medical home equipment providers engage in a competitive bidding process in order to provide medical equipment to patients.

I AM AGAINST THIS TYPE OF ACTIVITY. As a Medicare recipient I have been paying into the system for a number of years and do not appreciate the idea of our government interfering with a program that is successful now and has been successful for a number of years. When will BIG BROTHER stop trying to interfere with successful programs and start paying attention … Continue Reading

“I am currently utilizing a concentrator for oxygen. I use oxygen 24 hours a day, 7 days a week because I have a rare lung disease know as PAH Pulmonary Arterial Hypertension. Without the use of this oxygen equipment I would not be able to survive on a daily basis. I understand that Government is trying to take over home medical equipment suppliers by requesting that they submit a bid which means I will be getting … Continue Reading

“I am calling in reference to the competitive bidding on Home Care Supplies. I am not in favour of just competitive bidding and not taking quality into consideration. If you go for the lowest bidder, most of the time you do not get quality products or quality service. I am 67 years old, I have worked for the Federal Government. I know how unproductive competitive bidding can be unless you have some guidelines for quality supplies … Continue Reading

“Yes I’m very upset over this letter I got from Personal Care talking about Congress had passed a new law saying that we might have to go to wherever they decide we go for serving MediCare beneficiaries. This is wrong. This is free America and I’ve lived in a free country for 77 years. I am now disabled and need the benefits that we receive from every place we get them ’cause even to the point … Continue Reading

“Well, I am on constant tube feeding. I have to have it, and the place that gives it to me is OK with me, and I cannot understand why supposedly Congress, or whoever’s trying to change all of this. I suppose they’ve got all they need, so the heck with us. Thank you. “… Continue Reading

“I have been diagnosed with cancer. I’m also a diabetic. I have hypertension. I am 68 years old and I have neuropathapy in my hands and my feet. I have been blessed with getting a lift chair that I can keep my feet elevated and I’ve also been blessed to have hand rails placed in my home so I can go up and down the stairs without any complications of falling. They have placed in my … Continue Reading

“It seems that everything we have and have had for a long time and is a wonderful working plan is now being dumped somewhere. Anyway. I don’t want to change my plan that I have for monitoring me in my home and I  have been with this company many years now and I’m an old lady. I’m 89 years old. I don’t like all these changes. Please leave things alone.”… Continue Reading

“I’m calling in regards to Congress’ proposed bill of competitive bidding for Medicare beneficiaries and I would definitely be against that simply because you end up with a monopoly or a congressman’s buddy gets the bid and you end up with lousy care because once you become a monopoly you could care less what happens to the consumer because you answer to nobody. Just like AIG and the banks and everybody else and I would definitely … Continue Reading

“Okay, I’m glad to have this opportunity to register my concerns about the creation of another federal bureaucracy to do bidding on something that we don’t want bidding done.  I am on oxygen, I have been for 4, 5 years now, and my local company, Boardman Medical Supply, has done everything right and does everything well and it’s a local company, owned by local people and I really don’t want to try to deal … Continue Reading

I am writing to voice my displeasure at this new law.
I am very satisfied with my medical equipment supply
Company, Boardman Medical Supply, Girard, Ohio.
I do not wish to be told who I can have. My family has
Used this facility for over 20 years and they do an
Excellent job. I have no complaints about them.
Their service is superior and I do not want a big box
Operation serving my family’s needs.
Thank you.

I’m an LPN.  I was just calling to let you know that it’s very vital that these patients receive their oxygen.  I have patients that live on Bon Air Mountain, it’s part of Tennessee, who receive oxygen from Pro Air Respiratory Services.  We’ve had patients on Hospice.  I even have a mother who personally needed oxygen at home, that couldn’t function without her oxygen at home.  This is … Continue Reading

“I’m a Vietnam veteran. I fought for freedom. Why am I losing my freedom to choose where I want my medical supplies and how to use it. I need my supplier at Medox in hometown because just close for me and I am in a wheelchair. Please, help me and help all the other people and veterans. Thank you.”… Continue Reading

“I’m calling to say we are very unhappy with this new law and it’s effect on my husband’s physical and mental health.  He is on a Concentrator every day, and when he’s not on it, when we go somewhere, he’s on Liquid Oxygen.  I think it’s terrible what the Government is doing, trying to control our whole life, and this new health care is full of balony and so is the President, and I wish to … Continue Reading

“To whom it may concern. I am an 82-year old woman who is been  in oxygen since 1994. I have lung cancer and presently being treated at a cancer institute because the cancer has spread to the last viable lobe in my lungs. Oxygen is what’s keeping me alive and for  you to cut me off and put  me in a position to where I can’t afford it. I mean,  you are … Continue Reading

“To whom this may concern, which is probably somebody in the government, they’ve probably never made a buck in her life, except working for the government. We’re just Medicare recipients of oxygen, for a situation where my wife’s lungs are totally deteriorated. I spent 4 years in the service, in the Korean War, and now the shift has taken place, it’s worse, and it’s unbelievable. You know as well as I do, if you go on a bid basis for … Continue Reading

From Watchdog Watch

At least three different serious concerns have been raised regarding the Centers for Medicare and Medicaid Services’ (CMS’) competitive bidding program for home medical equipment.

First, the Center for Regulatory Effectiveness (CRE) has received allegations against the third-party organizations that accredit medical equipment suppliers. Among the charges are that one of the accrediting organizations is cutting corners on the accreditation process, possibly with CMS’ knowledge and consent. CRE is undertaking their own investigation of the allegations.

Second, about 90% of home medical equipment supply companies are small businesses. Many firms have expressed concern that the competitive bidding program … Continue Reading

“I’m 84 years old and I’ve been getting diabetic shoes and other diabetic things to help me, like walkers and that.  And I can’t see.  Another thing that the government has to stick their nose in.  We have our own special people that we go to.  We know what they do.  We know how they can help us.  Why did they have to come … Continue Reading

“I’m calling today because I’m very, very upset. I have been on home oxygen for a couple years and the first year was a nightmare experience, they never brought me new canulas. They never came and serviced the concentrator and about 6 months ago I finally got connected to a good company that supplies me with liquid oxygen, a small tank that I can carry with me, so I can continue to live my life like … Continue Reading

“Yeah, I’d been receiving your durable medical quotes for a few years now, and this new change that they’re on about, the competitive bidding, easily winds up with the big companies out bidding little companies, because they’re much bigger, and they got bigger resources, and soon the little companies go out of business….”

Listen to complete call

As the president of a Boston based respiratory company I would quickly
like to share a few issues in regards to the completely irrational
decisions that CMS has made:

1. We had a capped patient at MGH who wanted to spend her last months
living with her daughter in Virginia. We couldn’t find a provider in that
section of Virginia wiling to service her. She spent 3 extra nights at
MGH and ultimately we had to UPS her concentrator to her daughters house
in Virginia.

2. A small DME company in Mass is deciding not to continue in … Continue Reading

yesterday i recieved a call from an elderly oxygen patient who is on high
flow oxygen to his trach. his patient owned suction machine was not
working properly and he called me for help. i was at his house in 15
minuets and quickly fixed the problem with no charge to him or medicare.
he was my oxygen patient and asked for my help because he choose our
company based on our reputation and proximity to him, in case he would
need exactly the type of assistance that he needed yesterday. When this
law goes into effect he may or … Continue Reading

Is it true that our DME can be accredited while we wait on our site survey? Was it not mandated by CMS to have a site survey, before we could become accredited?

Thank you,

Editor’s Note: CRE encourages readers to respond to questions.

Per MIPAA legislation, CMS had to remove Group 3 Complex Power Wheelchairs from Competitive Bidding. Standard Power Mobility, including scooters (POVs) and all Group 1 and 2 Power WCs are still included. But rather than bidding this Power Mobility Group as one category, CMS has created 2 separate bid categories.

Look closely at the Power Wheelchairs in the new ‘Complex Group 2’ category: the total utilization for the wheelchair base codes in the CBAs, as reported by CMS, was 173 chairs. AND this includes a highly suspect reporting of ‘1’ chair per code per CBA or most of the codes; causing … Continue Reading

Our arguments demonstrating the shortcomings in the CMS competitive bidding program will be more forceful if our DME argments are supplemented by the negative impact on providing diabetic supplies.

Please send additional arguments along the line of the comment submitted below.

CRE

This must pass the senate or 1000’s of pharmacies and many more 1000’s of seniors will suffer. A pharmacist can dispense the most regulated items in the world like schedule 2 narcotics but can’t sell a box of diabetic test strips that sits out on the counter with no restrictions.While psychologist’s, speech pathologist’s,
dietitians, social workers and physical therapist’s are exempt. Pharmacists are still the most trusted and available heath care professionals there are. The seniors who suffer should know the congress controlled democrats truly failed them if Pharmacies are’nt given an extension and then exempted. Mike Williams P.D.
Webster City, Iowa

“this competitive bidding, I think it stinks myself.  This is terrible.  All you got to do, is knock this little guys, right out of business, and they’re the ones who give us the service, and they’re the ones who’s save or keep our lives going.”

Listen to complete … Continue Reading

HomeCare Magazine
Oct 1, 2009 10:28 AM
Susanne Hopkins

WASHINGTON — Just hours before the implementation of mandatory DMEPOS accreditation, the already chaotic situation exploded Wednesday with actions on the part of CMS, the Center for Regulatory Effectiveness and even Congress itself that threw into question the deadline, onsite surveys and indeed, the whole program.

Based on “an avalanche” of posts on its Web site that took issue with the accreditation program and said it would force thousands of providers to close, the CRE announced it was launching an investigation of the program.

“I’m one of the people who gets home care oxygen. I’m 90 years old, and my man brings the oxygen tanks, the oxygen, and helps me watch my breathing and my oxygen content. And if that law passes, I will die because I will be unable to handle the tubing and the oxygen….”

Listen to Complete Call

September 30, 2009

Active bill in Congress

H.R. 3663: To amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies.

I guess pharmacies are a special group. What about the rest of us?

Where are the lobbyist for the locally owned and operated DME suppliers?

www.govtrack.us

Those of you who are in a position to furnish information to assist CRE in its investigation of the CMS accreditation for DME suppliers should post relevant  information on this Forum.

The allegations we will be investigating are set forth in this thread http://www.thecre.com/Forum/?p=1420

CRE

I read in the CMS’s own documents that the site visits MUST BE UNANNOUNCED. I spoke with a few companies that accredit and they were not even aloud to give a hint when they were coming to visit.
So the two questions out there are how did the customers of ABCOPP get accredited without a site visit .
If ABCOPP had a special deal with CMS to avoid the site visits so they could take on many more customers and guarantee them they would not miss the deadline, how caould these be unannounced.
Did CMS post this unique special option for all and … Continue Reading

I am in a rural community and need another 30 days to complete accreditation. I am am strapped due to my small size and few employees, not to mention financial obligations. THe flu virus cut my staff in half this month which has put us off schedule. I will have to close if there is any cash flow decrease. I have a 13 year old buisness and over 2000 customers. They will have no local provider and will suffer the most!

We are in pre-survey status.Our service area is about 11,000 square miles with a considerable portion of it rural where no other providers operate. Beneficiaries in many areas will suffer loss of all service and will suffer irreparable harm. Suppier-beneficiary relationships will suffer as well as we will be “blamed” for this lack of service. Immediate reconsideration of deadline extension needs to take place with the immediate petition for reconsideration for dealers like us mandatory.
I ask “how could CMS make such a decisiion that will hurt so many beneficiaries, hurt so many providers and their employees”

I’m an industry consultant, and we have helped hundreds of DMEs through the accreditation process. We know what we are doing and all of our clients pass, and we also don’t gouge people. We didn’t raise our prices when accreditation became mandatory. We have worked with every accredting body on CMS approved list.

I’m not going to use my name here, because I don’t want anyone mad at me. But here is the real deal as I see it, from both sides — the DME provider side, and the CMS side.

1. The industry as a whole has known this requirement was … Continue Reading

CRE has had extensive discussions with CMS regarding accreditation. CMS has decided not to grant an extension to DME providers. In arriving at this decision, CMS has given serious consideration to several Congressional mandates, including patient access and Congressionally mandated deadlines.

CRE is not in a position to provide its readers with business advice; however we are in a position to inform you of your options regarding accreditation.

If you are likely not to be accredited you should give consideration to voluntarily terminating your enrollment in the Medicare program–please see page 4 of the CMS 855S. If you fail to voluntarily terminate … Continue Reading

I own a small retail medical supply store in Seminole, FL. Medicare/CMS has mandated that we as providers have to become accredited by September 30, 2009. This is an incredibly expensive process for a small business like mine. With policy and procedure manuals, consulting, and the fee for accreditation this will cost us about $10,000, not including all the time I have involved. That is about 20% of what we will bill Medicare for this year. We are currently being told by our accreditation company that it may be 6 months before they can inspect us, … Continue Reading

CRE met with CMS officials regarding the DMPOS accreditation deadline. Agency staff and leadership have a highly detailed, in-depth and up-to-date knowledge of all pertinent information. Officials are keenly aware of the twin goals of ensuring regulatory compliance and maintaining beneficiary access.

: Medicare has set a deadline of all medical equipment providers to be accredited by Oct 1st. Almost 30,000 providers and pharmacies are still in the process. Inspectors are overloaded and unable to inspect everyone. Medicare is droping provider numbers of everyone who does not make it by Oct 1st. Thousands of jobs and small businesses are at stake. Not to mention the Medicare patients being cared for. Please help us if you can. A 3 month deadline extension could save thousands of jobs.

I know I am in the same situation as many Durable Medical Equipment Suppliers. I have acquired the Bond for our company and I have completed all of the work room information for accreditation. The only thing we are waiting on is the survey. Due to the back log I do not know if will have our accreditation complete by the October 1st deadline. We have worked very hard to complete everything we have been required to do. We really need CMS to give an extension for the accreditation deadline. Due the oxyen cap … Continue Reading

We as a business have done everything in our power to stay in guidlines and to also help our customers at the same time. We have contacted the source that is suppose to come and inspect our facility but we have yet to hear from them since the end of July. We are now just in the waiting game to see if they show up before Oct. 1. We were told to contact them by the end of July to make sure we would be done in time but now are told that it could be up … Continue Reading

All providers have been aware of this requirement for some time. Now here we are once again at the deadline and some in our industry are crying foul. When we start behaving proavtively this industy will be better off. If you are on the cry foul side are you politically involved, are you a member of a trade association etc. We must be proactive or we will all be watching a slow and painful death to an incredibly important industry. WAKE UP!

should have started proecss at least two years ago as we did. Everyone knew that there was going to be a mad rush at the end to get accrediation. don’t forget surety bonds

I’m a Medicare beneficiary. I get exceptional care from my small service provider. I hope for my sake and other’s that someone is listening to small busineses.They need consensus on this. Has anyone considerd a huge LAWSUIT!!!?

Hello,

I have been an active participator in your discussion boards and I just read the letter to Ms. Frizzera.

I see you mention the rural areas in the letter, this extension if granted….will it be only applicable to rural areas?!

Also in your letter I read that you mentioned only 200 providershaving to close their doors? What about the 81,000 providers still not accredited I have read about? Is there any way to put more emphasis on the accrediting organizations responsibilities to survey in time?

It is truly disheartening, so we (a 6 employee working … Continue Reading

WHAT NOW? WE ARE IN THE SURVEY “QUE” WHICH MEANS ACTUALLY NOTHING TO ME, EXCEPT THAT THERE IS NO WAY WE WILL BE SURVEYED IN TIME. PURE SADNESS. NOTHING TO DO WITH CMS OR CONGRESSIONAL MANDATES…BUT ACCREDITING AGENCY INTERNAL DEADLINES…..EVERYONE DEADLOCKED, SHUT OUT AND POTENTIALLY DEVASTATING MY SMALL COMPANY NOT TO MENTION OUR INDUSTRY! WHO ARE SUPPOSED TO CARE FOR THESE PEOPLE IN NEED?!

MY QUESTION….WHAT NOW?

I AM INCREDIBLY TORN BY WHAT TO DO NEXT….HANGING BY A THREAD ISN’T THE MOST SOUND BUSINESS DECISION BUT THE ALTERNATIVES AREN’T PARTICULARLY SOUND EITHER.

SURRENDER MY NUMBER = LOSS OF REVENUE, DOWN … Continue Reading

We too are just finishing up our paper work. We will not be accredited on time. We have always gone above and beyond for our customers . I know from personal experience many companies refuse to. Our company has relationships with a large base of medicare recipients. Our specialties do not exsist in our area. Our business exsist with very limited resources and man power. The big companies with thier selfish intercept have no concern about the well being of medicare recipients like our beloved customers.Money is their bottom line.Their motto should be, “WE WILL TAKE ALL … Continue Reading

Perhaps if Medicare set a date that companies had to have applied for Accreditation by and used that. There has to be some way to not punish the ones that are prepared and ready for Accreditation and at the mercy of the Accrediting bodies. If you applied for survey this month then you should not be so naive to believe that it would be done that quickly. The ones I’m concerned about at the ones that have applied for survey and have done little or nothing to be prepared for adhering to the standards. They should … Continue Reading

My name is rita jeane I am the owner of home care medical supplies. My address is 8030 hwy 6 hitchcock tx 77563. I have applied for accreditation in January and havn’t had my final decision yet. We will not have it in time to bill medicare this next month. We have lots of capped oxygen customers who no one will take because they will not get paid. What are these people to do without their oxygen? We desperately need and extension so we can continue serve our patients. Please take this in consideration we need to do … Continue Reading

As an employee of a small family owned HME company ( they have had this family business for 73 years in their family) I find it quite appalling that a Medicare patient will be forced to only use a HME/DME company that has been deemed by Medicare as a Medicare provider. Our company offers our customers so much more than just equipment. They are part of our family and are treated as such. With competitive bidding everything will be based solely on low pricing and low ball bidding. Bigger companies will be okay, but a smaller company such as ours … Continue Reading

HME Sales & Service, Inc. dba HME Medical has been tied up in the accreditation process for 7 months. We have been ready for inspection, and were just informed by the accreditation company (ACHC) that there may not be enough time for them to inspect, review, and process our accreditation in time for the deadline.

HME medical feels that it would be very unfair for us to loose our Medicare billing privileges through no fault of ours. Business is bad enough and for us to lose Medicare billing privileges would put us totally “out of business”.

realy admire your action into requesting an extension for the accrediattion process, hundreds of DME providers are in the middle of the process, most of them would not be accredited ready by the end of the month, jeopardizing their medicare billing priviledges, but the most affected part is for those who may have to reduce/downsize operations, which equals to more unemployement, increasing the nation’s unemployemnt records, putting a financial load in the system. Such extension would help providers to stay in bussines, we hope that MEDICARE oficials would help with this issue.

Thanks for your action on this looming deadline. It makes no sense that CMS did not stagger the deadline in the first place.

Why on earth would you make every single HME/DME in the country have the same deadline date? There were suggestions made to CMS by several credible groups and individuals that having a single deadline would result in huge congestion and disruption that was totally unnecessary. States do not have all Drivers Licenses expire on the same date do they? Only CMS would wonder why….or maybe they hoped that the crush would eliminate lots of pesky … Continue Reading

Delayed Implementation of Change Request 6528 Affecting Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (“DMEPOS”)

As described in our August 2009 Client Alert, the Centers for Medicare and Medicaid Services (“CMS”) issued Change Request (“CR”) 6528 revising the Medicare Program Integrity Manual in a way that will severely limit physician and non-physician practitioner DMEPOS consignment closet and stock and bill arrangements. These changes will impact a vast number of arrangements between DMEPOS suppliers and physicians and non-physician practitioners and was to become effective September 8, 2009. However, on September 1, 2009, CMS delayed the implementation of CR 6528 until … Continue Reading

August 31, 2009 at 10:48 am

Michael Reinemer, American Association for Homecare
With respect to oxygen and durable medical equipment, it’s worth noting that Congress has already cut Medicare reimbursement rates for home oxygen therapy numerous times over the past 10 years — in 1997 (BBA), 2003 (MMA), 2005 (DRA), and 2008 (MIPPA). Reimbursement rates have been cut by nearly 50 percent over the past decade, so those savings from the bid program have been realized already through congressional action. Today, Medicare pays about $6 per day to provide a senior with home oxygen therapy, which about one million Medicare beneficiaries depend … Continue Reading

Medicare Reimbursement Information I
August 31, 2009 in Medicaid/Medicare

This week, I will be discussing Medicare Reimbursement in detail. The Medicare Payment Advisory Commission (MedPAC) has a high-quality series of reports analyzing Medicare’s reimbursement system. Findings from these reports includes:

Physician Services

In 2006, about 569,000 physicians billed Medicare.
In 2007, Medicare paid $60 billion for physician services.
All physician services are reported to CMS according to the Healthcare Common Procedure Coding System (HCPCS), which contains codes for about 6,700 distinct services. Payment rates are based on RVUs.
Under the Medicare incentive payment program, physicians receive bonus payments when they provide services in … Continue Reading

New Economic Study Exposes Faults in Controversial Medicare Competitive Bidding Program Scheduled to Start this Fall

Study Shows that Competitive Bidding Benefits Insurance Companies and Forces Many Seniors to Use Out-of-State Providers

ARLINGTON, VA, August 10, 2009 – The American Association for Homecare hosted a media conference call this afternoon, unveiling a new economic study that exposes severe flaws in the Medicare competitive bidding program for durable medical equipment and services. The bidding program is set to re-start this October. The study, released today by Brian O’Roark, PhD, of Robert Morris University, found that the federal Centers for Medicare and Medicaid Services … Continue Reading

Not only are you going forward with competitive bidding, but you are telling these companies tha tthey ahve to provide free service from the 36th month through the 60th month. Who else has to provide free service even if the patient decides to move out of their area? And if you go out of business you have to continue to service these people? How well is that going to work. Not only are the people going to get bad service, the companies aren’t going to be able to make it. This just makes no sense for anyone involved except CMS>

Medicare continues to not factor the true costs of oxygen therapy and the cost of the regulations that Medicare imposes on providers.

For a provider to deliver oxygen the cost are concentrator $575.00, oxygen tanks( avg 6 per week, but higher liter flows may use up to 20) $35.95 ea.,tank fills 3.95 ea tank, nasal cannulas 4 per month2 $1.00 ea, tubing 2 per month at $1.00 ea, connector $1.25 per month, delivery drivers time and paperwork for setup 1hr at 13.00 to 15.00 per hr, 15 pages of perwork for setup to meet criteria and regulations, gas,mileage and wear/tear on … Continue Reading

Since the 36 month cap has been implemented, our company has had to turn away several patients wanting to switch providers. Their provider isn’t willing to provide the latest technology in portable oxygen, but we do offer that to our patients. The patient is the one who loses, because this becomes a quality of life issue for many oxygen patients who would be able to get out more if they had the technology that allowed them this freedom.

The congress people need to realize that the services and equipment that DMEs provide are life sustaining equipment; with the continuous cuts in reimbursement and now competitive bidding, lives will be at stake. Many DMEs are closing doors which means national chains are more prominent. This also means unemployment. Utilizing national chains are vary dangerous, they lack customer service, don’t respond to emergency call outs, and so much more. If the congress is looking at saving dollars, maybe we need to keep the non-U.S. citizens out of our country whom are spending our hard worked money. The congress needs to … Continue Reading

Patients attempting to move to a new location are finding it to be
next to impossible to find a new supplier. Patients approaching their
cap, and some with as many as 18 rental months remaining are finding
that suppliers are unwilling to take them on as new patients.

CMS has no clue the impact of Competitive Bidding will do to the healthcare in our country. They were mandated to implement a program and that is what they intend to complete. With little or no understanding the program they have proposed has been stopped once already and will crash and burn if they implement it again. Who looses? The Medicare Beneficiaries but no one is being honest enough to tell them what is going to happen. As I refer to it the “unintended victim”

If CMS had any desire to be a credible agency they would stand up and tell … Continue Reading

Medical equipment suppliers loose again. The 1st round of the CMS competitive bidding program was a disaster as once again the lowest bidding contractor who was responsible for the bid on CMS’ behalf did not do a fair nor complete job. The same faulty program (with no recourse for those that have to complete bids) is about to go to round #2. In the So. Florida area the 1st bid reduced the number of oxygen providers allowed to deliver these services to about 11% of the existing providers at that time. It would have increased the patient load on these … Continue Reading

I am a registered respiratory therapist and have been in the field since 1979. For the past 8 years I have co-owned a Durable Medical Equipment (DME)company. We never anticipated to become wealthy but wanted to at least make a salary comparable to what we earned working on staff at the local hospital. Since the changes made by Medicare that went into effect 1-1-2009 especially on oxygen payment it has become very difficult for the small independent provider to remain open for business. The patient is the one who ultimately suffers the most. The 36 month cap on oxygen and … Continue Reading

Our DME company was recently contacted by a patient who had moved into our service area from Florida in order to be closer to his cheildren. We were asked to take over his stationary and portable oxygen needs. Unfortunately, his provider in Florida had been paid for 35 months of O2 rental. We had to turn down his request, because after receiving 1 month of reimbursement we would have been responsible for the next 24 months of service for practically no money. There is now a patient using a concentrator that he brought with him from Florida, with no portable … Continue Reading

I have worked in the HME industry providing home oxygen for over two decades. The one driving force that insured that the patient received quality and timely service has been that the patient was always free to choose another oxygen provider. Under the new reimbursement system for oxygen, the longer the patient uses the oxygen, the more limited their choices become. In fact, beyond 18 months of service, they will be hard pressed to find any other provider who would be willing to accept them. As they get nearer and nearer the 36 month cap, they simply have no options. … Continue Reading

Patients wanting to change from their current oxygen supplier for no or poor service. I ask them how long have you been on oxygen and if it is near 36 months or over. That I can not help them because you have cap out on your oxygen. I also give them the names in congress, the phone numbers and ask them to call.

Charles H. Wadick.

Has CMS already forgotten that DME took a 9.5% reduction in fees for the 10 categories that were up for bid in Round One of the competitive bid project last summer? And has CMS forgottent that the cut was taken simply to allow a DELAY in the program? The simple fact that our industry was willing to take a nearly 10% cut to delay a program does not indicate that we as an industry are overpaid…it indicates that we as an industry were trying to buy time to figure out how to survive.
I know that our small company in west … Continue Reading

“Competitive Bidding” What we are really doing is auctioning off health care services to the lowest bidder. Is this really what we want health care services to become in the USA? Competitive bidding might work in other industries where the variables of the service elements can be tied to a cost, in home medical equipment this can’t be done because of the uniqueness of our business, we care for people, we do not just deliver supplies or commodities, those of us who have been successful realize the service side of our business is important. Unfortunately Competitive bidding will force most … Continue Reading

“Competitive Bidding” this is not bidding at all, this is “competitive discounting” at best. The laws read, the bid must be LOWER than the current amount paid. How can this be a bid? If the cost is higher, if process changes, if costs increase how can prices drop. Not long ago gas was $4.50 or more in many areas, could a DME adjust for costs? Of course not, but it was demanded that they drop fee’s charged by 9.5%. Oxygen was CAPPED, with an additional 24 months of responsibility and liability added on to the DME in the 34th month … Continue Reading

Congress needs to clean house at CMS and hire competent administrators. The competitive bidding for DME as it stands will force numerous legitimate providers out of business, increase unemployment, increase bankrupties and possibly home foreclosures. Limiting providers will only decrease accessability, service and quality to Medicare patients. DME is actually a part of the solution to reduce health care costs by keeping patient’s out of hospitals and SNF’s. DME is approx. 2% of the whole health care budget. Nobody can get good, high quality healthcare for free!

Competitive bidding without the “any willing provider” component is just an avenue to grant access to the unethical providers. “AWP” will help keep the ethical companies in the game. But the real issue is that Competitive Bidding (the way it is structured) is a waste of the tax payers money. It is all ridiculous when CMS sets the price anyway. So just set the price and let the chips fall where they may. This whole thing is a waste of time, money and definitely energy.

This company has been in the DME business for twenty five years. Over the last fifteen years ,the industry has been on a self distruction track. The addition of unethical suppliers to the mix has only increased the need for increased GAO unenounced inspections. With the mandated order of accreditation and bonding, you would think that the process would weedout the bad apples. The competative process that is in place right now will probably put this company out of business

Competitive bidding will do nothing to save Medicare money. The companies that are the unethical companies that are over marketing the benefits are the same ones that will win the contracts and all the bidding process will do is take away the ethical competition that gives Medicare clients an option. CMS already sets the allowable and by taking away number of providers, they offer less CHOICE for elderly and much worse service. The Scooter Store already bills about 1/3 of Medicare powerchairs, won I beleive 6 of first 10 areas and they won’t make that mistake again, they will win … Continue Reading

I am part owner of a small HME near Pittsburgh, so we are in Round 1a. Competitive bidding is a jobs killer and a service killer and will do nothing to reduce fraud as has been suggested. We have already agreed to the 13 point fraud reduction program, Surety bonds, and are subject to RAC audits. What else can be expected of our industry? Competitive bidding is designed to eliminate 70-80% of the DME companies which will reduce competition and reduce quality of product and service provided to keep the costs low.
The Medicare population is expected to … Continue Reading

The Competitive bidding program addresses the wrong problem. Total Medicare expenditures will not decrease if Medicare contracts only with the provider who gives the least services (lowest labor cost)and only the cheapest hardware.

Where significant service is required, and outcomes are clearly defined, Medicare should switch to paying only for successful treatment of a disease, not just for delivery of a gizmo.

1. Home health care is the low cost alertnative to institutional care. We are the solution, not the problem. The whole DME industry developed in response to a need to shorten the lenght of hospital stays. I hope the Obama administration researches the comparative effectiveness of home medical equipment and supplies versus institutional care. Maybe then the administration would protect the industry from CMS’s and the Republicans’ constant attacks.
2. Medicare policy is so complex and mercurial that it takes constant monitoring of the changing policies, rules, billing and documentation requirements in order to be a COMPLIANT … Continue Reading

I have been medical biller for two DME Medical providers for the last 20 years in Michigan. I have seen alot of changes; however, Competitive Bidding does not make any sense to this business. I have always been very proud to be a part a business that helps people. That has always been our main objective-to help people and provide quality equipment/service. Service is a large component of what a DME business does. The original allowables were created by “averaging” what suppliers billed in certain regions; which resulted in inflated billings in order to keep reimbursement rates reasonable–which I never … Continue Reading

I don’t understand why Medicare can’t set reimbursement prices then let DME’s decide if they can or want to provide services for Medicare recipients. It is now required that you must be accredited and bonded in order to become a DME in the Medicare program. I’m asking this to determine why we must bid to set the prices when Medicare already sets them.

The attached document was the second of two attachments provided to the IPD along with the letter beginning, “Having been in the Home Medical Equipment business for the best part of 40 years….”

Lincare sole survivor-From HME Business.doc (27 KB)

The attached document was one of two attachments provided to the IPD along with the letter beginning, “Having been in the Home Medical Equipment business for the best part of 40 years….”

Flaws in Bid Implementation July 2008 2-page summary 070808.doc (113 KB)

[The complete text of the following letter with proper formating of the table is posted in the attachment “IPD Letter.doc”   The next two posts contain the two attachments to the letter that were provided by the letter’s author, “Flaws in Bid Implementation July 2008 2-page summary 070808.doc” and “Lincare sole survivor-From HME Business.doc” — CRE]

Having been in the Home Medical Equipment business for the best part of 40 years, I have seen many changes in the industry, some good, and some bad. None of which would have the negative effect on the quality of care that the National Competitive Bidding … Continue Reading

Just like what was stated above so eloquently by Shannon whom I couldn’t agree with more. You lawmakers seem to have no knowledge of what it’s like to run a small business much less a DME business. Sorry if that seems harsh but reality is far from you policy. In your attempt to cut Medicare costs you are only pushing for increased Part A costs by limiting the suppliers payment for services on Oxygen. You are also really wasting taxpayer money by spending so much time on this competitive bidding issue. It seems that it would be more productive to … Continue Reading

If you think it is bad now, just give it a little time and you will see how bad it can really get. Congress passed a law and handed it down to CMS to enforce and they have made it clear that there are no exceptions to the law. I fully understand the intent but I also think I might have a clearer picture of what is coming than you do in regards to this specific legislation.

On January 1, 2009 Medicare stopped paying the monthly rental fee for every Oxygen patient that has been on service since on or … Continue Reading

Competitive Bidding is the wrong term for the program that CMS has and still is proposing. It is more of an auction for the lowest bidder, who may not be a qualified provider of the equipment they are bidding on. This does not save money, nor does it give the patient the freedom of choice that Medicare has always demanded. CMS has not proven that they have eliminated the issues that Congress demanded and are going ahead with a program that that is inadequate.

I was involved in a focus study group a number of years ago which was a … Continue Reading

I am a sole proprietor and have been in the DME business and a Medicare Provider for over
24 years. I am a small business owner (8 employees) in the Sierra Nevada mountain range in California. Yosemite National Park is part of my service area. I have Medicare Customers scattered all through these mountains. It’s normal for my drivers to put 200 to 300 miles a day of mountain driving to service Medicare Patients with their medical equipment needs. Like the Post Office we deliver / service thru “rain, hail, sleet and snow,” but ours is 24 hours a day 7 … Continue Reading

It appears to me that we should save the money of going through the bidding process. If you are in this business you already know if you are not a National company you are already out of business, so save the money of the process.

July 17th, 2009 at 11:27

Competative Bidding & Medicare Advantage plans are a dis-advantage to beneficiaries needing DME equipment. My company just this mornign told a sweet couple looking for a wheelchair that our company was not a provider for the Medicare Advantage Plan they had. Truly a SAD situation because I do not know how this couple is going to get what the wife is needing. They just pulled out of our parking lot more lost than when they came in.

Now how is Competative Bidding going to fix this? No way it can. Limiting providers will be a … Continue Reading

July 17th, 2009 at 10:53

The DMEPOS competitive bidding program will be harmful to both small business and to Medicare beneficiaries. Due to the fact that the program will exclude all but a handful of DMEPOS suppliers, and Medicare provides nearly 50% of industry revenues, literally thousands of small businesses will be thrown out of business by the program. In addition, beneficiaries will be left having to go to multiple DMEPOS suppliers for their product needs. For example, a beneficiary who needs oxygen, power mobility, orthotics, and aids to daily living will be forced to do business with 4 or … Continue Reading

July 17th, 2009 at 08:44

While I believe that the results of round 1 prove that a gross amount of flaws exist in the competitive bid program I am further perplexed that CMS has decided to proceed without the corrective action plans in place to proceed.I listened to everthing CMS had to offer at the PAOC meeting in Baltimore and the 8 hour day did not scratch the surface to address the flaws and yet here we go full speed ahead. If the current administration has success in providing a national healthcare program the insured ranks would grow by … Continue Reading

July 17th, 2009 at 08:26

Medicare spokesmen have repeatedly stated that it is there specific intention to drastically reduce the number of DME suppliers. Rather than do their job and properly screen those to whom they issue provider numbers they are resorting to a ’scorched earth’ policy in an attempt to reduce cost and get rid of providers that should have never been allowed into the system in the first place.
There are sufficient regulations on the books now that would permit them to shut down any DME provider in the country that they deemed to be abusive or fraudlent.
Right … Continue Reading

July 17th, 2009 at 07:32

It appears to me after reading this it is the plan and hope of the government to use competitive bidding as the tool to put solid, ethical, small mom and pop DME’s out of business at the expense of the locate residences that use them. So, set the prices and let the small business serve their communities and neighbors. Where is the free enterprise, boundries of forming monoploy

It appears to me that we should save the money of going through the bidding process. If you are in this business you already know if you are not a National company you are already out of business, so save the money of the process.

My company was a winner in the first round of competitive bid in the
Dallas/Ft Worth area. We won all the areas that we bid including high
end rehab power chairs. We are a RESNA certified ATP company.

However, we would have been a big loser had competitive bid been fully
implemented. Let me explain.

We bid a very low price base on the fact that we would have a quasi
monopoly. Some 75% to 85% of my competitors were supposed to be
eliminated from the market that I had won. However, that was not the
reality!!!

I’m a Resna certified ATP servicing the Great City of Houston, Texas. The Medicare bidding program is fundamentally flawed and stifles competition. It does not account for “Low-Ball” out of state bidders that never develop any meaningful relationship with their patients. These same “out of sight & state” providers will also be nowhere to be found when emergency and repair services are needed. This program will only drive out of business a large portion of high-quality, local homecare providers who have served their communities for many years. Problems with the design and operation of the bidding program will seriously … Continue Reading

In today’s financial environment it is unthinkable that CMS is proceeding with implementation of a bidding system that will put so many small DME businesses out of business. Not only will these companies be forced to close, but all their employees will be out of jobs at a time when jobs are difficult to come by. In addition it will make it very difficult for those needing equipment to find it in a timely manner. Will hospitals release patients to go home when they need equipment that is supplied by competitive bid of a company 200 miles away?

DME competitive bidding will without a dobt put several small companies out of business as they cannot compete with the pricing of large compnaies. The process itself if very flawed. DME accounts for 2 % of Medicare expenses yet has been subjected to the most scrutiny of price cuts already not including competitive bidding. Why not start with the hospitals having to submit bids for Medicare and take a 30% pay cut like DME has done over the last few years. Or the doctors who have had raises or a freeze every year for the last 5 years when DME … Continue Reading

July 16th, 2009 at 17:31

While I am a firm believer in free enterprise, competative bidding simply isn’t competative. If it were, there would not be a cap.

Think for a moment about one of your dearest family members. Imagine if you will that the were the unfortunately suddenly in grave neeed for a wheelchair. They would be unable to be independent without this equipment. Due to lack of sensation your loved one develops pressure uclers where the bones in their tailbone break through the skin. They are in depserate need of a custom molded seating system and pressure mapping. (Lets … Continue Reading

July 16th, 2009 at 17:02

I am very concerned about this plan. It seems it will limit the number of suppliers that my parents can use. And I can tell you that they are not all the same. The quality of care suffers tremendously when you limit suppliers. It seems the larger the more impersonal and the longer the wait. Please don’t limit my choice. Thank you for consideration of this matter

Since CMS has done such a lousy job of identifying fraudulent providers, here’s a low-tech way that should keep a sizable percentage of the bad guys from getting provider numbers.

First, CMS makes a bunch of postcards that have questions to be answered regarding the physical facility: Is this address a) a residence b)a strip mall c)an office buildingan d) other? (this is where you would put “airport runway” or “Wrigley Field”). Then you ask questions to determine whether or not a viable business exists there.

Then, you send the postcard to the USPS letter carrier for that address … Continue Reading

● CMS (Medicare) seems to do a “poor job” of administering their policies.
Yet, they cry out “fraud and abuse” of the durable medical equipment industry (DME). CMS actually issues the “provider numbers”. CMS supposedly investigates and checks the validity of each durable medical equipment provider before they issue a provider number. So, why are they issuing numbers to crooks? If CMS investigated them, why does CMS allow fraudulent provider numbers to be issued in the first place.
… Continue Reading

So I made 3 trips yesterday to a ALS patient who was becoming more and more anxious as she became more and more short of breath. Mind you respiratory therapy visits are non reibursed and provided as part of the service we offer. Had she capped (which will happen in 6 months) she would have been sent to the ER admitted, intubated and sent to ICU. So which plan is more cost effective?? Keeping her home or capping her and causing an addmission.

The National Competitive Bidding program was created to “control” the increasing costs to the Medicare program. Contrary to it’s purpose, it will eliminate competition, put 1000’s of small business and their employees out of business and eliminate the freedom of choice to the Medicare recipient. As we move forward with Health Care Reform, the Competitive Biidding program needs to be eliminated as an outdated and ill conceived method to control Medicare costs.

CMS can not initiate the competitive bidding program until OMB approves its information collection request ( ICR) pursuant to the Paperwork Reduction Act. CRE has identified a number of deficiencies which demonstrate that the CMS ICR is not PRA compliant.

CRE also recommends a solution to the problem: allow all qualified small suppliers to provide equipment at the single payment amount if the suppliers meet the SBA definiton of a small business.

CRE comments are appended hereto.

CMS Competitive Bidding ICR Comments.pdf (146 KB)

The goal of CMS must be to put DME companies out of business. After the recent cut in reimbursement for oxygen services, many DME companies are already struggling to survive. If CMS again reduces reimbursement and reduces the caps on payment, it will put many DME providers out of business. The other factor that has compounded the reimbursement issue, is the increased requirements, i.e. CMS standards, accreditation, surity bond, etc., all which have increased the cost to provide oxygen services.
I’m a firm believer that we need standards and such to insure quality, but ther has to be … Continue Reading

competitive bidding is acctualy the complete oposite. it turns a life saving service into a walmart type of homecare. the service that has long defined the care provided will be gone. no provider will be able to send a thereapist out to see grandma at no charge to re-instruct her or check her sat because she seems less able and more short of breath. patients will head to the ER rather than calling their provider because their provider is now more interested in selling scooters than oxygen.

That would surely cut alot of providers out. They would be closing there doors and telling employees ” I’m sorry…..the Government has put us out of business” You think unemployment rates are high now, wait til that happens. I am sure there would be no way for small DME’s to get a bailout package. People who don’t pay ourselves million dollar bonuses and then ask Congress for a BAILOUT. If we make bad decisions then we must live with the outcome. DME makes up about 4% of the medicare budget but gets the most cuts. My favorite quote, ” If … Continue Reading

why after decades of saving CMS untold amounts of money by assisting in timely disharges from the hospital while demonstrating that good service prevents readmission, are we the DME idustry being made out to be the evil step child. Our costs are a tiny portion of the CMS budget yet we save them millions. Our industry thrives because competition forces service to be the driving factor for the care we provide. Remove the competition from the mix by forcing a bidding program will remove the service that the medicaly fragile needs.

the only approach to reforming our healthcare system that has any chance of making a difference is this: Find out what is inefficient and fix it and find out what is working well and structure the healthcare system around it. Home Medical Equipment certainly falls into the latter category, particularly home oxygen therapy. Since reimbursements have, for the most part, been the same for all providers, we have been competing with each other on the basis of service. Prior to the 36-month cap, we would do whatever it took to keep our patients satisfied (and maybe even … Continue Reading

Today we compete for every referral based on quality service. I have been in the industry for 34 years and that basic standard has NEVER changed. With this illconcived consept called Competitive Bidding will terminate compition in the market place and erode quality service. An example of what I am talking about. Round 1 CMS awards a contract to the SCOOTER STORE to provide Home Oxygen. Are you kidding me? Someone with ANY knowledge of Oxygen Therapy should have raised the Red, White and Blue flag and asked the question. Does the SCOOTER STORE has a record of billing us … Continue Reading

Recent news reports are stating that the Cleveland MSA has lost more than 10% of it’s population since the last census. The population is now less than 433,000. We are now 46th in poulation size. Far less than the mandated number of 500,000 or more to be included in round one. Why then is CMS including Cleveland in round one if it does not meet their own citeria.

We are a mom and pop DME company which specializes in ostomy care. As you know ostomy care falls unders the consolidated billing. When we give patients ostomy supplies we always call to get an eligibility. Many times the Home Health episode does not show up as soon as they go under the Home Health episode. Later on we get recouped and when we approach Home Health agencies their respond is they did not order these supplies from us therfore will not pay for them. Home Health agencies do not report to Medicare as soon … Continue Reading

We got a referral from a local hospital for home Oxygen last Wednesday. The patient came to Los Angeles on vacation from Ohio, without bring oxygen with them. Once in LA the patient was hospitalized for Shortness of Breath, and upon discharge the attending phyician order O2. After learning that the patient was capped we declined the order and the discharge planner started calling other Oxygen vendors with NO takers. The results was that the patient was unable to be discharged until Friday at 4PM, after we worked out a creditcard payment for 1 month rental and a $2000.00 deposit … Continue Reading

We are a provider in Texas. We had a patient move another state up north. The patient was capped out and in our attempt to find a new provider, no one would accept this patient. That said Medicare requires us to provide and maintain the equipment.We are only have a license to dispense oxygen in the State of Texas. Medicare reuires us to follow all State laws. Since we cannot dispense oxygen out of state ,how is this patient to be taken care of if we cannot provide for them by law and no other provider will take them onto … Continue Reading

The competitive bidding program is a race to the bottom for the healthcare industry. It is based on the mistaken impression that the DME companies are ripping Medicare off! I have yet to meet a patient who WANTS to carry an oxygen vessel around in order to breath! Patients use medical equipment because they HAVE TO!! Currently DME companies compete based on service. The prices are fixed by Medicare and allow only a modest 20% profit which we finance interest free over 13 months for rental items. Oxygen reimbursement is causing all the uproar … Continue Reading

nursing homes thus, enhancing their quality of life and cutting medical costs. Competitive bidding and oxygen reduction will cut costs but it will also force whatever companies survive to cut costs by providing less services, inferior equipment and less control of the patient outcomes. I don’t care what kind of standards and regulations CMS puts in place, no one is going to be able to provide the same level of care with cuts of this nature. Eliminate competitive bidding and stop the oxygen cuts now.

DME suppliers are about more than just equipment!! I work for a small family owned DME that really cares about the patient. We provide service to the patient. Many Medicare patients have a hard time comprehending and dealing with new things in their lives. Oxygen can be very intimidating to these patients. We are the ones who provide the time and compassion to make that adjustment easier to handle. Aside from the adjustment period when the Oxygen is first brought in-we spend a lot of time trying to keep the patient compliant throughout the … Continue Reading

The President of the American Association for Homecare testified before Congress on the CMS competitive bidding rule.

Statements included:

The bid program as currently constituted:
• Eliminates approximately 90 percent of homecare providers in a marketplace;
• Lowers quality and access to care for seniors and people with disabilities;
• Reduces competition and limits choice by shutting out the majority of qualified providers;
• Ignores the fact that the home medical sector is the slowest-growing portion of Medicare;
• Fails to understand the reality of how home medical equipment and services are provided.

Complete Testimony is in the attachment hereto.

As a small independent supplier I am seriously concerned regarding continued changes, NCB, timeliness of payment, restrictions on cushions every two years even w/ documentation of discomfort and changes to client/patient needs, also restrictions regarding changes in mobility/wheelchairs prior to 5 years.  Many clients/patients have disabilities that create need for change in their equipment.  When a DME responds to the medical teams (Therapists, and Physician) recommendations with extensive medical documentation and excellent team evaluation and we still do not get paid, this is unacceptable.  Either we should get paid (timely – we now have over $150,000 … Continue Reading

Deutsche Bank predicts the Senate’s proposed cuts for oxygen suppliers will vitrallly eliminate ‘Mom and Pop” firms.

What would the Deutsche Bank predict if the cometitive bidding system, as originally designed, were implemened naionally?

“Because Medicare comprises the majority of the sector’s revenues, we don’t believe the remaining public companies would be able to
withstand a 30%+ cut without extreme duress; smaller mom/pop entities (45% ofmarket share) would likely fare even worse – thus leaving LNCR to “sop up” a tremendous amount of market share given its 1000-branch national network”

CRE

I run a small DME business and I can assure you that the “Competitive Bidding” process is anything but competitive. The only companies that can survice are the ones that have other business that make money when DME does not. It this flawed progam is allowed to proceed thousands of people with loose their jobs and be forced to look to the government for support. Competition belongs at the dealer level, not at the government level. Also, what about the rights of the benificiary? Should they not be allowed to choose the company THEY wish … Continue Reading

The documentation collection associated with the final rule entitled
Medicare Program; Conditions for Payment of Power Mobility Devices,
Including Power Wheelchairs and Power-Operated Vehicles, CMS is seeking
re-approval of the collection of information requirements associated
with the final rule, CMS-3017-F (71 Fed. Reg. 17021), published on April
5, 2006.

The final rule eliminated the Certificate of Medical Necessity (CMN), a
form used by physicians to certify the medical necessity of power
mobility equipment and replaced it with a prescription and undefined set
of patient medical records. In addition, CMS contractors also require
an additional two-page detailed product description to be developed by
the supplier and completed by the … Continue Reading

Michigan USA
Small Business is all we have left in the USA. When will the Politicians get it that we are not all theives,
and that this will put us out of business. This will also hurt the end user YOUR GRANDMOTHER Let Not Forsack Them. Sincerley Bob

I work for a small DME company in Cleveland, Ohio. After witnessing all of the confusion and anxiety felt by the elderly and and sick in the first round, and the new rules and regulations of the second round proves that competitive bidding must be eliminated. It would also creat job loss for small DME businesses in an already difficult economy. Please eliminate competitive bidding.

Please eliminate competative bidding. I’m employed by a small medical equipment company in Cleveland Ohio. We spent a great deal of time on the first round of bids & nothing happened. This does a great injustice to patients and equipment companies. Medicare patients will suffer the greatest due to changes in regulations. Many small companies will have layoffs as we already have done. The second round of bidding looks just as confusing. Please consider a more effiecent & less complicated way for changes in the medical equipment business. Thanks for your consideration.

Best Regards,
Terry Minadeo

When the decision to postpone competitive bidding was made, I had hoped the idea would be shelved altogether. I work for a small DME company in Cleveland, Ohio where we concentrate on giving affordable but quality care to our patients. One of the things that really bother me is that the patients will be the ones who suffer the most when they are forced to deal with companies that are not qualified to give them the care they need, and they won’t even realize it until it is too late! Please eliminate competitive bidding. I’m sure we can come up … Continue Reading

I work for a small medical equipment company and I believe that competitive bidding will hurt many people, especially patients who use oxygen. Competitive bidding will greatly limit what DME companies can do to service the patient and many companies nationwide will be forced to go out of business in the process. I am begging you to please eliminate competitive bidding! Please!!!

I work for a locally owned medical equipment company in Cleveland, Ohio and I am deeply concerned over the Medicare Competitive Bidding program. I worked with my company on the first round of creating a bid and found the system confused and flawed. I have followed closely to the progress that has been going on with establishing new rules for the next round of bidding. This next round of bidding is shapping up to be more of the same. This competitive bidding process is not based on any medical evidence that states that it will help any of … Continue Reading

Those most unjustly affected by competitve bidding practices will be the elderly beneficiaries of Medicare. These people are often very ill and changing regulations are confusing and frightening to them. They will be forced to change providers and if they are unhappy with the provider, they will be unable to choose to go to another provider therefore forcing them to accept sub-par care. I work for a small DME company in Cleveland and we strive to provide the best possible care to our clients. The implementation of a new competitive bidding round will compromise our ability … Continue Reading

The people most impacted by another confusing and costly attempt at competitive bidding will be patients and small businees employees. The elederly and sick customers will struggle with finding and switching supplers. Small business employees will worry over possible job loss in an already horrible economy. This program already targets some of the most economically depressed cities in the country and now they will sustain more job losses and lower revenue.

I am extremely concerned with competitive bidding for medical equipment. This will greatly affect the accessibility patients will have to the medical equipment they need. I have been certified as an assistive technology provider (ATP) for the past 4 years. I currently work for a DME company in Cleveland, OH. We have positively impacted hundreds of thousands families and individuals with the knowledge and services we provide. We have over 40 years of combined experience in this field, and I am very concerned that the patients will not have access to the knowledge and experience … Continue Reading

When competitive bidding came into our system around 10/08 it was totally devistating to our customers. It was so confusing and totally very stressful to all the people. I believe it also could be very dangerous for people that are confused and wait til the last moment to receive their equipment only to find they have to scrable around to be helped by the correct dme company.

I work for a Durable medical equipment company in Cleveland Oh. The amount of time and money spent on the last round of competitive bidding was outrageous. The time that vendors had to put in to get qualified for them to not go through only cause confusion to the beneficiaries. People with equipment we confused with all of this and it panicked people who already had items in their homes thinking that someone would be knocking on the door to pick it up. Or worse yet that it would not be covered it you did not have the right item … Continue Reading

I believe competitive bidding is ridiculous. Let the companies who know what they are doing handle suppling these products.

I write to express my concern over Medicare DMEPOS Competitive Bidding Program both as an employee of a locally owned durable medical equipment company in Cleveland, Ohio and as an incoming medical student at one of the nation’s elite medical schools. Having worked with my company during Medicare’s first attempt at creating a bidding process and having followed the progress that has been made in establishing new rules and procedures for the second round, I must admit that I am profoundly disappointed. The second round of bidding is shaping up to be just as confusing and have as little transparency … Continue Reading

I work for a locally owned company that is supplying Oxygen to many Medicare customers and with the competitive bidding coming up soon it is going to hurt my company along with many many others nationwide. The Customers are going to get hurt most of all. There are going to be companies that will not be able to supply them any longer or refuse to supply them because of their insurance. The whole concept is confusing and needs a specialist to figure out the wording if that can even be done. Please help us to help others who really need … Continue Reading

I work for a local medical equipment company in Cleveland, Ohio. Much time and effort was put into the previous attempt at competive bidding and I feel starting over again is not in anyone’s best interest; especially the patient. It will most likely put many DME companies out of business and cause a great deal of confusion. I strongly believe that competitive bidding should be eliminated.

I work for a locally owned DME Company in Cleveland, Ohio and went through competitive bidding the first time. It was a very confusing process and made the Medicare beneficiaries upset about having to go with unfamiliar and unqualified companies. Competitive bidding is very expensive, time consuming and should be eliminated..

I work for a locally owned medical equipment company in Cleveland, Ohio. I saw the confusion and flaws that were part of the orignal round of competitive bidding. Medicare beneficiaries will suffer as they will not get the equipment that meets their needs and they will not get the quality of equipment that is needed. Competitive bidding will put 90% of small DME companies out of business. Competitive bidding MUST BE ELIMINATED.

I work for a small dme company in Cleveland, OH. Competitive bidding will make our company and other small dme companys, close their doors. We are taking a cut on medicare fee schedule allowables that are set, and we’re turning clients away. forcing them to go to another company who is not experienced and may cause more damage than good. Our citizens deserve better. the should receive the homecare services, help, support and equipment they need, but which company they choose. competitive Bidding will make everything worse!!!!

I work for a local DME/Rehab dealer in the Cleveland Area. Competitive Bidding needs to be stopped. Farming out business for the lowest bidder has never worked before, I am not sure why anyone would think it would work for healthcare. The failed attempts to start this process should be proof enough. They awarded providers with no experience in rehab to be providers as well as awarding respiratory to vendors who have never provided that type of service.
It seems to me that no one is taking the patients care into consideration. Our administration come up … Continue Reading

I WORK FOR A DME COMPANY IN CLEVELAND, OHIO. FIRST AND FOREMOST, LET ME JUST SAY, WE HAVE ALOT OF EXCELLENT PATIENTS….AND DUE TO THIS COMPETITVE BIDDING, WE CHANCE OF NOT JUST CLOSING OUR DOORS AND BECOME JOBLESS, BUT SENDING OUR PATIENTS TO ANOTHER DME COMPANY WHO MAY NOT HAVE THE EXPERIENCE WHICH MAY FIT THIS PATICULAR PATIENT. THATS LIKE SAYING, WELL YOU HAVE A HEART ISSUE, BUT HERE IS A BRAIN SURGEON. AND WITH THE WAY THE ECONOMY IS, WOULDNT IT MAKE SENSE TO SET A MONTHLY FEE SCHEDULE AND GIVE THAT MONEY TO NEEDED EQUIPMENT FOR PATIENTS AND … Continue Reading

I work for a family owned DME company that spent alot of time and money for the first round of competive bidding only to have all our efforts be thrown away. The entire competive bidding concept only causes confustion with the consumer. The consumer will not get the service they deserve. This will force many companies out of business. Medicare already has an existing fee schedule. They can set the reimbursment and the companies should be able to decide wether or not to accept the business.

I work for a locally owned DME in Cleveland, Ohio and competitive bidding is ridiculous. The last round of this was so confusing and none of our patients understood any of this and of course, once we got them to understand, we had to go back and change everything again. Now the solution is to go and do this again? How does that make any sense. Also, how does it make sense to put small businesses out of business. What happened to change? This is more of the same bureaucracy we’re used to. … Continue Reading

i work in cleveland, ohio for a small dme company. competitive bidding caused a lot of confusion and i believe it would not benefit medicare beneficiaries. our company may go out of business if competitive bidding is implemented. i say it should be eliminated.

I work for a locally owned DME company in Cleveland, OH. Competitive Bidding is NOT what our patients need, nor the DME suppliers. How can the government expect other DME companies to take care of patients in areas that they have no experience in? It is going to be the smaller companies and our patients who end up hurting in the end.

Competitive Bidding Program. Why is Medicare spending an excessive amount of money on competitive bidding when Medicare could use that money to pay for medical equipment? Competitive Bidding Program will put some Oxygen Supply Companies out of business that does not receive a contract that will result in job losses. Why can’t Medicare just set a fee schedule for monthly rental for oxygen and any Oxygen Supplier that is willing to accept that fee schedule can provide oxygen to beneficiaries? This would be so much more cost effective and would save more jobs than the Competitive Bidding Program. The beginning … Continue Reading

I work for a small, family owned DME company in a rural part of Ohio. One of the many services we offer is home oxygen. We have been accredited for years (long before it was mandatory) and also have state liscensure. The services that we provide to an ever increasing aging and chronically ill population is extremely important. The oxygen payment cap rule and (not-so) competitive bidding is making it harder and harder to offer quality equipment with a high level of service. The constant cuts the government are enforcing, with the goal of lowering … Continue Reading

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Thx!

I am requesting that CRE investigate the oxygen cuts and the DME competitive bidding that CMS has placed. The 36 month oxygen cut is ridiculous. CMS has not considered ANY of the servicing that takes place for oxygen patients. Medicare oxygen patients are generally not healthy individuals who can maintain equipment. These patien’s require many home service calls in which are no longer reimbursed after 36 months. I don’t see CMS or congress working for free!! I work for a small independently owned DME company that has been receiving many calls from Medicare recipients that want to change their oxygen … Continue Reading

Please reference the “Selective Contracting” comments just submitted. Specific to this cap I will just say that there is a false assumption that we have been paid well enough in three years that we can write blank checks in the final two years. Providers have been paring back services to some extent while doing everything we can to protect beneficiaries since the BBA cuts in 1993. To compare the acquisition cost of a concentrator on the internet to what a provider potentially could be reimbursed for stationary oxygen over a five year period is an apple to … Continue Reading

Though compelling in their most conservative estimates I’ll leave out the supporting statistics so as not to distract the message with questions on the accuracy of the numbers. Let’s just consider common sense. Lots of people are getting older. Healthcare needs can therefore be expected to increase. The cost of providing care to so many people is a major concern especially considering the current status of America’s debt and ongoing budget deficits. Admittedly, home medical equipment services is a very small sliver of the Medicare spending pie but one that should be examined. … Continue Reading

We bid and lost, missing paperwork was the reason and our bid was below the average discount in DFW area. There were 286 providers which bid and only 34 selected, of which 2 were from out of state NO presence in the STATE. I was informed that the majority who did win had been in business less then 4 years with a average staff of 5 and one delivery truck. Discharge planners had a much to juggle to get items delivered at a time requested.
Our Industry is less the 1.6% of total CMS expenses and the slowest growing 0.9 … Continue Reading

Our company was not located in the Dallas/Fort Worth competitive bidding area, but we are well know as a provider of complex rehab systems in that area. After the bid awards were announced we received several calls from providers who had been awarded the bid for complex rehab in this area, but had never provided that service. They were looking for some hints as to how to get started. Is this what we really want — inexperienced providers building complex seating and mobility systems for people with multiple sclerosis and other serious neuro disorders? This is NOT … Continue Reading

As a Respiratory Therapist working for a DME company it is essential for all patients to be provided with superior care. This rule on paying for oxygen vexes patients will compromise patient care by limiting the patients ability to find a new supplier if moving to a new address. The suppliers are comprehensive about taking on a patient that is approaching their cap. This is forcing patients to pay out-of-pocket for oxygen services because of inability to find a willing supplier at the new location. Please consider all oxygen patients and reverse this ruling.

If people think the economy is bad now, wait until Competitive Bidding drives thousands more small suppliers out of business. A desire to curb rising medical prices should begin with the culprits, which are NOT DME providers; we are barely hanging on as it is, with the constant barrage of Medicare cuts and additional regulations. When the cost of supplying a patient with oxygen in their home is a tiny fraction of the cost of supplying it in the hospital, why is the governmnet targeting DME? All we need to do is look at the bloated bureaucracy that … Continue Reading

(AIShealth.com)

Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and analysis on the Medicare (and Medicaid) managed care programs.

By Judy Packer-Tursman (tursman@comcast.net)

To illustrate what he calls the “tough times” that Medicare Advantage (MA) plans face in 2010, consultant William MacBain told a recent audioconference to look at what will happen to MA payment rates in Montgomery County, Md., an affluent suburb of Washington, D.C. The county’s 2009 MA benchmark payment rate of $818.77 will plummet to $755.46 for 2010 after the first-ever coding-intensity adjustment and other technical adjustments are factored in (assuming the plan has identical risk scores from one year … Continue Reading

John Reed, EVP and COO, PRO2 Respiratory Services

The mandate to create the Competitive Bidding Program for DMEPOS was based on a false premise.

That premise is that Medicare overpays for durable medical equipment, and there are a number of public records that show CMS officials, White House staffers and others with access to factual information, grossly overstated the real Medicare expenditures for durable medical equipment.

REGARDING PRICE:

From data from the CMS Office of the Actuary for the top 20 providers providing certain types of medical equipment to Medicare beneficiaries, the following facts contradict (gently speaking) those statements:
– E0260 Hospital Bed. The … Continue Reading

John Reed, EVP and COO, PRO2 Respiratory Services.

The 36 Month Oxygen Cap rules have introduced a number of issues and operational barriers to home oxygen providers, physicians and patients.

At some point, CMS needs to recognize that mandated service requirements contained in CMS’s own Supplier Quality Standards add significant costs to equipment providers well above the direct cost of equipment.

Reimbursement for CONTENT BASED OXYGEN SYSTEMS is less than the provider’s direct costs. The direct cost for a stationary liquid oxygen vessel and portable is approximately $1700 before considering the additional equipment costs (oxygen transfill vessel, box truck or a second … Continue Reading

CMS is trying to dismantle the home medical equipment services industry. The rules concerning Home Oxygen Therapy reimbursement are short-sighted and arbitrary. Home Oxygen Therapy (HOT) is an ongoing service that guarantees 24/7 availability of Medical grade Oxygen to patients in the cost-effective environment of their own homes. To stop payment after an arbitrary time period puts patients at risk for finding providers to support their therapy needs, dis-insentivizes providers from givning good service after a period of months because they know that a patient is now locked in because of the cap, prevents patients from finding … Continue Reading

Amy Merrick, Wall Street Journal, 6/16/09

More than one million people rely on Medicare to pay for home-oxygen therapy. Now some patients are running into problems switching their suppliers because of complex new rules the federal insurer uses to pay for the services.

Under the new rules, which began to affect patients on Jan. 1, Medicare will pay suppliers at its prevailing rate for the first three years after a patient begins coverage. Suppliers are then required to continue providing oxygen services to patients for another two years, but at a sharply reduced payment rate. After that, patients are … Continue Reading

CMS’s competitive bidding process placed an extraordinary burden on suppliers in terms of providing financial information and, to make matter worse, CMS was vague and ambiguous in defining how it would use this financial information.

In the initial round of bid submissions, I worked with many suppliers in helping them to interpret what financial information was required, in advising how they could develop this information in the format demanded and counseling them on how CMS might or could utilize the information. I can assure you that the amount of time and expense consumed by requiring this information was … Continue Reading

I am writing this letter in response to your request for information regarding the economic impact of H.R. 3559, Medicare Durable Medical Equipment Access Act of 2005.

In particular, I would like to comment on the impact of the provision that would allow

. . . suppliers that are classified as small businesses under the Small Business Act to continue to participate as suppliers at the selected award price so long as they submit bids at less than the fee schedule amount otherwise applicable to the items. . . .

It is essential that members of the regulated community supplement information presently before CMS.

The following post is on the home page of the IPD. We encourage our readers to address this issue.

CRE’s Data Quality Alert emphasized the need for reliable data on a number of specific issues including “supplier capacity.” This term refers to CMS’ estimates of the ability of bidders to meet projected demand for DMEPOS items within a Competitive Bidding Area (CBA). CMS’ planned methodology for estimating supplier capacity includes looking “at trend data for new suppliers in that area, and examine the capacity of other … Continue Reading

After the end of the public comment period up through the publication of a final rule, the government has a monopoly over the regulatory process. In essence the public, including the regulated community, is shut out of the process.

The same problem occurs after a rule is promulgated and the agency goes into program implementation; in this instance the agency makes numerous decisions which could not have been envisioned at the time of the NPRM.

In our wired society, the generation of information on a regulatory issue does not cease at the end of a public comment period. In essence, the sixty … Continue Reading

On June 19, 2008, GW’s Department of Health Policy stated:

“This analysis shows how the competitive bidding program makes an already vulnerable population even more vulnerable. Medicare must immediately take steps to help seniors with diabetes avoid confusion and ensure that their treatments are not interrupted,” said Sara Rosenbaum, JD, Hirsh Professor of Health Law and Policy and chair, Department of Health Policy, and lead author of the study.

The conclusions of this study are counter to the thrust of the CMS rule; readers are encouraged to review the attached study and submit their commments hereto. (Please note that in submitting comments,  authors … Continue Reading