HME News

AUG 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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Page 8 of 32

8 WWW.HMENEWS.COM / AUGUST 2019 / HME NEWS Editorial What's your bid style? PROVIDER PERSPECTIVE One last signature needed I N TODAY'S world, navigating the insurance industry can be difficult. It can be especially hard for those with complex disabilities. This group of people depends on complex rehab technology (CRT) to live an independent life. CRT is used by people with complex medical needs and includes equipment like individually confi gured wheel- chairs, custom seating systems, adaptive bathing equip- ment and gait trainers. Currently, Medicaid does not have concrete guide- lines to protect CRT in New York State. There is no guarantee that individuals with complex disabilities will have appropriate access to the items and services that they require. The governor has a chance to do what is needed by signing the A7492/S5741 bill into law to preserve the independence, improve the quality of life, and reduce the health care costs of New Yorkers across the state who depend on it. I am the owner of Monroe Wheelchair, a complex rehab technology supplier based out of Rochester with branches in Albany and Syracuse. I've been in this busi- ness for 40 years and am proud to say we have grown to a company of 92 employees providing equipment and supporting services to more than 15,000 people with disabilities across the state. A large portion of what our company provides is CRT. The process to provide CRT is meticulous and labor intensive. A specially trained and credentialled assis- tive technology professional (ATP), is needed to work with each of our CRT customers. Their role is to ensure that medically appropriate equipment is built from the ground up to support each individual's unique physical and functional needs. The process begins with collecting medical docu- mentation to be reviewed to determine necessity, and all functional mobility evaluations must be conducted by clinicians. Demo equipment must be tested, autho- rizations obtained, and each component must be coded, ordered, pieced together, delivered and billed correctly. The entire process can take anywhere from 60-120 days and is a far cry from providing standard durable medi- cal equipment where someone could walk into the store with a prescription from their doctor and leave 30 min- utes later with their new equipment. Insurance coverage for CRT has changed over the years, making it increasingly challenging to continue offering this service to our commu- nity. Reduced reimbursements, budget cuts, changes in policy or coverage, and archaic coding systems are additional hurdles that threaten how and what my company is able to provide, while still offering excellent service and keeping our doors open. I want to see this specialized equipment protected and defended because I understand its importance. This bill has been passed by the New York State Legislature and it would protect individuals with complex needs without adding additional cost to the state or its tax- payers. All that is needed now is the signature of the governor. To me, my employees, the clinicians we work with, and the people with disabilities that we serve, signing this bill into law is a no-brainer. Our collective hope is that Gov. Andrew Cuomo feels the same way. You can help us fight for this needed bill. Tell Gov. Cuomo why it matters to you by visiting —Doug Westerdahl is the president and CEO of Monroe Wheelchair in Rochester, N.Y. PRESIDENT & PUBLISHER Rick Rector EDITOR Liz Beaulieu MANAGING EDITOR Theresa Flaherty tfl CONTRIBUTING EDITOR John Andrews EDITORIAL & ADVERTISING OF FICE 106 Lafayette Street PO Box 995 Yarmouth, ME 04096 207-846-0600; (fax) 207-846-0657 ADVERTISING ACCOUNT MANAGER Jo-Ellen Reed ADVERTISING COORDINATOR Cath Daggett PRODUCTION DIRECTOR Lise Dubois ART CREDITS Steve Meyers: cartoon REPRINTS For custom reprints or digital reuse, please contact our reprint partner, The YGS Group, by calling 717-505-9701, ext. 100, or SUBSCRIPTION INFORMATION AUDIENCE DATA MANAGER Adam Knatz, HME News PO Box 1888 Cedar Rapids, IA 52406-1888 800-553-8878 Audience analysis and verifi cation is provided by Stamats Data Management. VGM Group, d/b/a United Publications, publishers of specialized busi ness newspapers including HME News and Security Systems News, producers of the HME News Business Summit. T HERESA AND I met in July to talk about the stories we were working on for this August issue. Except for a quick update on bid calcu- lators (see story page 2), we didn't have much in the way of competitive bidding related news. Which is, well, unusual. Much of the focus by stake- holders lately has been on sign-on letters in the House of Repre- sentatives (180 signers!) and the Senate (38 signers!) asking CMS to drop non- invasive ventilators from the bid program (see story page 2). Which is technically bid news, but we were talking more about overarching bid news, like is there any movement in getting reimbursement relief for non-bid, non-rural areas? The bill in the House that would do just that, H.R. 2771, has 31 co-sponsors right now, by the way. This got Theresa and I talking about possible angles on bid stories and staring us right in the face: the bid window open- ing on July 16. Which got us to talking about how providers are strategizing their bids (see story page 12). No one's going to talk to us about what they're bidding (nor should they), but we're curious about: ✔How did providers decide what prod- uct categories to bid on, and what not to bid on? ✔How did they educate themselves on the changes to the program? Did they attend the industry's "Bid Smart Summit" in June? Did they listen to any of the vari- ous webcasts offered? ✔When are they more like- ly to submit their bids? At the beginning, middle or end of the bid window? Is there an advantage to one or the other? I'm especially curious about this one: What's their bid style? To be proactive? To procrastinate? ✔How did they go about formulating their bids? Did they use the bid calcula- tors? Did they develop their own spread- sheets? Of course, the timing of the bid window is less than stellar—from July 16 to Sept. 28. So what's the scoop providers, other than that you'd like to be doing something else with your summer? Email us (, tfl, DM us on twit- ter (@hmeliz, @hmetheresa), call us (207- 846-0600, ext. 230 and 226, respectively). Oh, and fear not, Theresa did write an update on H.R. 2771 (see page 1). HME LIZ BEAULIEU D. Westerdahl

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