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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8 WWW.HMENEWS.COM / NOVEMBER 2017 / HME NEWS WWW.HMENEWS.COM / NOVEMBER 2018 / HME NEWS Editorial PUBLISHER Rick Rector rrector@hmenews.com EDITOR Liz Beaulieu ebeaulieu@hmenews.com MANAGING EDITOR Theresa Flaherty tfl aherty@hmenews.com CONTRIBUTING EDITOR John Andrews EDITORIAL DIRECTOR Brook Taliaferro EDITORIAL & ADVERTISING OF FICE 106 Lafayette Street PO Box 998 Yarmouth, ME 04096 207-846-0600 (fax) 207-846-0657 ADVERTISING ACCOUNT MANAGER Jo-Ellen Reed jreed@hmenews.com ADVERTISING COORDINATOR Cath Daggett cdaggett@hmenews.com PRODUCTION DIRECTOR Lise Dubois ldubois@unitedpublications.com REPRINTS For custom reprints or digital reuse, please contact our reprint partner, The YGS Group, by calling 717-505-9701, ext. 100, or unitedpublications@theygsgroup.com ART CREDITS Steve Meyers: cartoon SUBSCRIPTION INFORMATION www.hmenews.com/subscribe HME News PO Box 1888 Cedar Rapids, IA 52406-1888 800-553-8878 Publishers of specialized busi ness newspapers including HME News and Security Systems News. Producers of the HME News Business Summit and the Home Health Technology Summit. CEO J.G. Taliaferro, Jr. PRESIDENT Rick Rector Bidding on the brain LETTERS & COMMENTS Where's the real change? I 'M A very small provider. I have been troubled by all of the stories and even poll questions regarding efforts to lobby for the proposed changes to competitive bidding. Here are my concerns: First, the surety bond requirement. It may limit the abil- ity of truly small providers to even bid. What are the pro- posed terms or required limits and, therefore, what would be the costs? Long ago, I wrote bid bonds for contrac- tors and they were very expensive and almost all required strong fi nancials, as well as a letter of credit. We are one- third in size of what we were prior to the changes with Medicare, and my husband and I make less than minimum wage. We were able to pass the fi nancial requirements to bid in the last auction, but I can't afford an additional bond or to have what little credit I have be tied up in the process. Has anyone considered how the truly small businesses that remain will be hurt by this? Second, lead item bidding. I have been in this industry for 29 years and the bids we submitted were based on delivering quality products that patients needed at low but fair profi ts. The only contract we were able to get was for mobility because I know wheelchairs well enough to know where I could keep the bid higher with codes that have smaller utilization rates and, therefore, smaller weights. This has allowed us to provide pretty good chairs that are actually fi t to the patients and their needs. Lead item bid- ding takes that ability away, so why do we want it? Again, I am a very small company and I'm writing this from the perspective of those that have been hanging on hoping for real change. The changes that keep coming seem to help the larger nationals and regionals. —Lori Sears, Active Home Medical Supply HURRICANE LESSON I hope the providers don't make the same mistakes that I made during Hurricane Sandy in N.J. In most cases you must bill the homeowner's insurance fi rst before Medi- care will cover replacement equipment. Lesson learned the hard way. —Rands Surgical, Toms River, N.J. THANKS CMS Until bid prices come to a reasonable level we will refuse Medicare business. I am thankful we refused the bids. There is no way you can turn a profi t with the billing, deliv- ery and upkeep on equipment with the current allowables. We have done OK without Medicare business, so until we see that we can turn a profi t, we will not accept or compete for Medicare business. We now stock high end equipment on a cash/retail platform. We have been fortunate to grow our business instead of closing our doors. Thanks CMS for forcing us to change our business model. DME is fun again! —Anonymous POUND FOOLISH As Medicare moves healthcare deeper into value-based care, excluding trained professionals and providing cheaper products is NOT the answer if payments are to be based on "outcomes." Exclusion of professionals and use of lesser quality products actually ends up in higher rates of expenditure. Penny wise, pound foolish. Look at long-term expenditures and outcomes. —Anonymous F ALL ALWAYS makes me think of the end of the year, and the end of the year always makes me wonder about the most read stories of the year. I just pulled that data for Jan. 1, 2018, through Sept. 25, 2018, which represents roughly three-quarters of the year, and the top 5 most read stories are listed below. As you can see, the list is dominated by competitive bidding news, and it has been a roller coaster year for the program. We wrote about—and you read about in ear- nest—everything from HHS's proposal to roll out a bid process for rural areas (not just bid-infl uenced pricing, but an actual bid process) to CMS's proposal later in the year to pause the program while it makes substantive changes. We knew that Seema Verma's acknowl- edgement that there are fl aws with said bid program—the fi rst time a CMS offi cial has acknowledged as much, stakeholders say— was going to attract a lot of hits. Thanks again to Theresa for staying past 5 p.m. to listen to the conference call and file this important story. In the wake of CMS's proposal to pause the program and implement an any-will- ing provider provision, a whole new set of questions cropped up and we sought answers in a number of follow-up stories, including "Any willing provider? It's not a unanimous decision" and "Expect shifts to Medicare's provider base, poll respon- dents say." Now that I've pulled this data, it makes me think of how it will change in the next few months. I can guar- antee you that one story we haven't written yet will knock one of these stories off the list: In November, stakeholders expect CMS to publish a fi nal rule with fi nal bid changes. Stay tuned. CMS UPENDS COMPETITIVE BIDDING WASHINGTON – All Medicare- enrolled HME providers are back in business starting Jan. 1, 2019. CMS'S SEEMA VERMA: CURRENT BID STRUCTURE 'NOT SUSTAINABLE' WASHINGTON – CMS Administrator Seema Verma says she wants to "modernize" the agency's long-standing competitive bidding program for DMEPOS by instituting market- oriented reforms. AMAZON WANTS TO DISRUPT HEALTH CARE, INCLUDING DME, REPORT SAYS BOSTON – DME is one of fi ve possible points of entry for Amazon to dominate the health- care market, according to a new report from global management consulting fi rm L.E.K. Consulting. PROPOSED RULE: CURRENT BID CONTRACTS WON'T BE EXTENDED WASHINGTON – A proposed rule released today seeks to make changes to the Medicare fee schedule and the competitive bidding pro- gram. EMBATTLED ARRIVA MEDICAL CLOSES CORAL SPRINGS and BOCA RATON, Fla. – Arriva Medi- cal is closing its facility in Coral Springs and laying off 142 employees, the Sun Sentinel reports. HME LIZ BEAULIEU

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