Discussion Forum

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. . . .