HME News

NOV 2018

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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News HME NEWS / NOVEMBER 2018 / WWW.HMENEWS.COM 7 Download VGM's latest playbook today at! Free to VGM members and vendor partners GET READY. THE REIMBURSEMENT CLIMATE IS CHANGING. WASHINGTON – The Medicare Payment Advi- sory Commission isn't on board with all of CMS's proposed changes to the competi- tive bidding program. On CMS's proposal to implement an "any willing provider" provision on Jan. 1, 2019, while it makes changes to the pro- gram, MedPAC comments: "While we appreciate the fact that CMS is proposing some significant changes to the CBP, we believe that reforms can be implemented while the program continues to operate. If addi- tional time is needed to properly imple- ment any finalized changes, we believe the agency has better alternatives than letting the program lapse. For example, the agency could seek to extend cur- rent contracts for six months or a year." MedPAC commented on the proposed changes in an Aug. 31 letter to CMS MedPAC comments on proposed bid changes Administrator Seema Verma. MedPAC supports CMS's proposal to use lead-item pricing and maximum win- ning bids, though it worries that relying on maximum winning bids could result in "excessive payment rates if beneficia- ry demand is overestimated or supplier capacity is underestimated." It also sup- ports the agency's proposal to use bid surety bonds. MedPAC, however, does not support CMS's proposal to continue the 50/50 blended reimbursement rates for rural and non-contiguous non-bid areas, let alone all non-bid areas: "Using 50/50 blended payment rates results in large payment increases, often of 50% or more. While CMS presents data indicating that some supplier costs are higher in rural and non-contiguous areas, the agency also found that other costs are lower in those areas, and the agency doesn't present data to justify the large magnitude of the proposed adjustment." HME their marketing campaigns," wrote one respondent. For the majority of respondents, howev- er, the increasing number of manufacturers moving in this direction is hard to believe. "It goes against the dealer network," wrote one respondent. "After 40 years, in this field I never thought I would see this happen. This could spell the end of dealers." HME relationships with lawmakers and their staff. It paid off in July, when all five members of West Virginia's congres- sional delegation sent a letter to CMS Administrator Seema Verma asking her to address their concerns about the impact of the competitive bidding pro- gram in rural areas. HME NEWS: How do you manage to sus- tain strong relationships with lawmakers? Regina Gillispie: I treat them like refer- ral sources. I just thought, I've got to sell them on us. I'll send them an email every few weeks. If we get updates from AAHomecare or VGM or HME News about something, I send them copies. They can call me on my cell phone if they disaster due to challenges like increased gas prices and road closures. Guidetti is working with AAHomecare's Dobson DaVanzo study to come up with numbers specific to costs in a disaster to bolster the industry's case. "You'll have companies like Penske, who do a great job getting into the disaster area and setting up temporary gas fill-ups but the surcharge on that is three times the normal cost," he said. HME hear anything to update me. HME: Do you also work on the state level to advocate for the industry? Gillispie: We've always met with Medicaid when we've had problems. So many com- panies have closed, especially in our rural state, that Medicaid was running into access issues. When Medicare came out with rural rates for competitive bidding we said, "If you don't want to listen to us, listen to state officials." It's nice that we had that relationship and that Medicaid was willing to explain the issues from that side of it. HME: With so few providers in your state these days, how do you as a group get your voice heard? Gillispie: The providers that are left, when I ask them to help, they have been great. VGM and AAHomecare are a great help. It's a team effort. HME DISASTER C O N T I N U E D F R O M PA G E 4 NEWSPOLL C O N T I N U E D F R O M PA G E 4 GILLISPIE C O N T I N U E D F R O M PA G E 4 It does not support CMS's proposal to continue 50/50 blended reimbursement rates

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