HME News

FEB 2019

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 / February 2019 / hme news e ditorial Publisher Rick Rector rrector@hmenews.com e ditor Liz Beaulieu ebeaulieu@hmenews.com managing e ditor Theresa Flaherty tflaherty@hmenews.com contributing editor John Andrews e ditorial d irector Brook Taliaferro e ditorial & a dvertising oFF ice 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 re P rints 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 a rt c redits Steve Meyers: cartoon s ubscri P tion i n F ormation www.hmenews.com/subscribe HME News PO Box 1888 Cedar Rapids, IA 52406-1888 800-553-8878 Publishers of specialized business 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 25 big ones, and still crazy for cartoons provider perspective s The CMS business model J uly 1, 2016, (when competitive bidding pricing was applied to non-bid areas) was one of the worst days of my life. I woke up with half my revenue gone. I was immediately put in a position where my expenses were more than my income. The disruption was immediate and damaging to patient care and our business. Medicare patients were unable to get their much-needed supplies because I could not justify pro- viding product and service at a loss to the company. Payroll was immediately halted. It took me six months to find "cheaper," less expensive products for my CPAP patients. Compliance and adherence to CPAP was drastically affected. However, this was the business model CMS presented to me at the time. I have made some progress providing expensive products on a penny budget, though I have leaps and bounds to go before I can afford a paycheck and newer delivery equipment. This hostile environment of dramatic cuts has crippled my industry to the point of sheer survival. I live in a truly rural area of 50,000 people within a 35-mile radius. I can't afford to deliver a hospital bed for $60 per month, when that bed and delivering it cost me at least $750. I have voiced my concerns politically and locally. I have no reason to believe CMS will begin to respond rationally to my industry. However, I will always remain optimistic. —Bill Malloy, Allpaps Medical Equipment & Supplies, Lake Havasu City, Ariz. a mazon shamazon I am a business development manager for a DME retail store that does bill insurance. The article about Jeff Bezos and Ama- zon would not work. They do not have the customer service that goes along with what ever insurance requires you to do state and federally. They deliver you products in boxes by u .S. postal or third-party postal delivery. The economics on something like that would wipe out how everyone gets their mail. It takes time to deliver, sign paper work and give clear instructions about how to use the equipment. Please stop writ- ing articles that you do not know anything about. t ricare troubles DME provider in Michigan here. Since the transition to Tri- care East, a majority of our claims are being underpaid and processing is slow. We are forced to send our claim paper because they require CMN with the claim rather than just on file, which slows down the process already. Then when they finally process months later, we are being paid around 30% less than our contracted amount. Numerous calls have been placed requesting adjustments, all of which were canceled because they claim no additional payment is due. It has taken almost a month to get a response from our provider rep, and she, as well as others I have spoken to, has absolutely no sense of urgency about claims that are 10 months old and still not paid correctly. Absolutely ridiculous! c P a P sel F -audits? c ue goose bum P s Pulling a statistically valid random sample and extrapolat- ing the results is relatively easy. I'm just curious how many samples would be deemed acceptable. Extrapolation—the word gives me goose bumps. 47 claims turned into a three-year nightmare ending in relatively nothing for CMS. Reading this article just scares me; I do not want to deal with this again, ever! at P credibility at stake This is a sad scenario. I for one, a 35-year old experienced ATP, was pushed out of the ATP profession by the industry forcing ATPs to be salesman, rather than allowing me to continue advancing my education in the field and truly being an expert, while doing what is best for the patient. Very unfortunate. I T o C C u R R E D t o m e a n d Managing Editor Theresa Flaherty, as we were pasting up the January issue (yes, in addition to writing 98% of all the stories that appear in the issue, we also lay it out using InDesign!), that 2019 is the 25th year that HME News has been in print. 25 big ones. Check out the new 25th Anniversary seal on the front page! Theresa and I have been work- ing at HME News since 2005 and 2004, respectively, so in other words, about half of the publication's life. l ooking at the front page of HME News way back in 1995 is quite a trip. Remember when HME manufacturers had high-profile spokesmen, includ- ing Don Shula for "Pridehealth" in the issue? I also remember Arnold Palmer for Invacare. Most of the other news and companies on this front page predate me—except for Sunrise, of course—but there are a number of themes that remain relevant today: mergers and acquisitions, man- aged care, licensure, etc. I started down this memory lane because I wanted to know if we have published cartoons in our Edit Spread section from the beginning and, as it turns out, we have. And cartoons by the same cartoonist no less: Steve Meyers, based right here in Maine. The cartoon for that first issue in 1995 concerned audits. No one has to "remember" those; they're still very much a problem. I wanted to know if we've published cartoons all this time because one way Theresa and I would like to mark our 25th year of publishing is re-printing five of our favorite cartoons over the years. We already know one of them will be the cartoon of HME providers at a Christmas party, all wearing ugly sweaters, one of which reads: shrinking reim- bursement. The little doc in that cartoon says, "Don we now our not-so-gay apparel." It still cracks me up. hme

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