Washington Update on Competitive Bidding, June 8, 2009
American Association for Homecare
- AAHomecare's Gorski Raises Capacity and Other Key Issues at PAOC Meeting
- Needed: Feedback from Congressional Meetings
- Thanks to Sponsors, Exhibitors at Washington Legislative Conference
- Calendar Updates -- June 18 Mobility Seminar; June 22 Teleconference: Successful Equipment, Service Delivery
AAHomecare's Gorski Raises Capacity and Other Key Issues at PAOC Meeting
At the competitive bidding Program Advisory and Oversight Committee (PAOC) meeting in Baltimore last Thursday, June 4, the American Association for Homecare (AAHomecare) firmly presented several critical concerns to CMS staff involved in the PAOC.
Walt Gorski, AAHomecare vice president for government affairs who represents the Association on the PAOC, engaged in sometimes heated discussion with the CMS staff while pressing the industry's concerns at the full-day meeting, which attracted about 200 HME stakeholders in the audience. Gorski was joined in several of his lines of inquiry by other PAOC members who articulated similar concerns.
Discussion of Potential Flaws in Bid Program
AAHomecare is very focused on how CMS calculates the number of providers needed to serve any competitive bid area—this issue is known as the "capacity to serve a marketplace." The Association is concerned that CMS' methodology vastly underestimates the number of providers necessary to serve Medicare beneficiaries in any given area, based on historical demand for HME items and the Medicare demonstration projects. AAHomecare believes that this issue is central to the debate on bidding since it has an impact on many dimensions of the program, including patients' access to care.
The failure of a winning bidder to quickly develop capacity to serve as much as 20 percent of a competitive bidding area (CBA) would have a negative affect on access to care. Gorski indicated that the capacity calculation is a fundamental decision that CMS must not get wrong. "If a provider is denied a contract, based on a flawed capacity calculation by CMS, the provider's financial viability immediately comes into question. We will not be able to fix these types of mistakes six months or a year from now," Gorski added.
The Association pointed out that every HME provider location must be licensed in the state in which it provides services. Providers bidding in a multi-state CBA must meet licensure requirements for all states in the CBA and, if required, have at least one physical location in the state where it provides service.
Through Gorski, the Association also expressed concern about calculations for setting single payment amounts, the sustainability of prices after implementation of bidding, transparency of the bid process, financial documentation issues, the impact on diabetes patients, and the impact of the bid program generally on stability for patients and providers. The Association is deeply concerned about the ability of Medicare beneficiaries to continue to have an adequate range of choices in terms of providers, services, and products.
Next Steps
Gorski described the PAOC meeting as a productive opportunity to get patient and provider concerns in front of CMS. "AAHomecare will be working with the PAOC co-chairs to develop agenda items for future discussions," Gorski said. "We'll also be following up with CMS on the key issues that were raised during the meeting."
Tyler Wilson, AAHomecare president, commented, "At the same time, we will also need to remain dogged on Capitol Hill to make sure lawmakers join us in pushing CMS to fully address the concerns that we emphasized on June 4. In the past, the PAOC left the HME sector with more questions than answers. Our work with the PAOC will not diminish our effort to stop the program through legislative action by Congress."
Needed: Feedback from Congressional Meetings
Last week, HME stakeholders held more than 300 meetings with members of Congress and their staff. The HME messages delivered to the Hill included recommendations to ensure beneficiary access to the cost-effective HME equipment, services, and medical supplies that allow them to remain in their homes and out of more expensive, institutional settings. If you took part in one of these meetings, your feedback is vital to helping the Association track and support HME champions in Congress. Please fill out the Congressional Feedback Form located at www.aahomecare.org/legislativeconferenceand let us know how your meetings went. It's important to know which members of Congress have expressed interest in supporting legislation that would strengthen HME policy. Please return the forms to Stacey Harms at staceyh@aahomecare.org or fax them to 703-836-6730.
Thanks to Sponsors, Exhibitors at Washington Legislative Conference
AAHomecare sincerely thanks the exhibitors and sponsors listed below. Their support of the Washington Legislative Conference allowed AAHomecare to control participation costs while providing an important educational program and advocacy event that benefits the entire HME sector.
Special thanks to our exhibitors and sponsors:
Aon Affinity Insurance Services, Inc.,
Authentidate,
Authentidate,
Brightree LLC,
Brown & Fortunato,
Cailor Fleming Insurance,
Campania Management Company,
Capital Healthcare Group,
Domos HME Consulting Group,
Drive Medical,
Domos HME Consulting Group,
Drive Medical,
Fisher & Paykel Healthcare,
Invacare Corporation,
Medtrade,
Pacific Pulmonary Services,
Pacware Software Development,
Philips Respironics,
Pride Mobility Products,
QS/1 Data Systems,
ResMed,
Salter Labs,
Sunrise/DeVilbiss,
VGM, and
VGM, and
Wright & Filippis.
Industry Supporters for this event included HME News, HomeCare Monday, Mobility Management, and Respiratory Management.
Calendar Updates
AAHomecare Mobility Conference, University of Pittsburgh, June 18
Changes in Medicare policy for power and manual mobility, seating and positioning, and repair services have catapulted providers into a state of confusion and, at times, into financial loss. Participate in this seminar to better understand mobility, seating, and service policies and ways to maintain compliance while providing optimum qualifying products to beneficiaries. In the challenging healthcare environment before us, this program is necessary for all providers who continue to provide mobility, positioning, and repair services as well as for clinicians who evaluate and qualify patients for medically necessary durable medical equipment.
Speakers will include Dr. Paul Hughes, medical director for Jurisdiction A, Mark Schmeler, Ph.D., OTR/L, ATP from the Department of Rehabilitation Science & Technology at the University of Pittsburgh, and Georgie Blackburn, vice president of government relations for BLACKBURN'S. The program is jointly sponsored by the American Association for Homecare, the University of Pittsburgh Medical Center, and the Department of Rehabilitation and Technology at the University of Pittsburgh. The event is supported by an education grant from Pride Mobility Products.
CEUs will be awarded to participants attending in person or by video conference and significant time will be allotted for interactive Q&A after each presentation and at the culmination of the program. Previous audio difficulties have been fixed. The program will take place on June 18 at the University of Pittsburgh. Contact Kim Kianka at kimk@aahomecare.org for more information.
AAHomecare Teleconference: "Qualifications for Successful Equipment and Service Delivery," June 22, 2009
The AAHomecare teleconference, "Qualifications for Successful Equipment and Service Delivery," on Monday, June 22, 2009 at 2:00 p.m. EST, will feature Randy Schluter, president of DTCP/RenTrain. Schluter will provide a review of industry and CMS standards addressing quality delivery actions and documentation, as well as federal guidelines that must be followed when delivering specific types of equipment.
This session will also detail the type of individual who can be a successful delivery person and what management must do to make sure that the individual becomes an integral part of the HME business. To ensure repeat customers and referrals, quality customer delivery and service is essential for a successful HME business. This session will outline the expectations and the required regulations, policies, and procedures needed for providing excellent equipment and service delivery. For more information, visit the calendar of events section at www.aahomecare.org.
American Association for Homecare
2011 Crystal Drive, Suite 725
Arlington, VA 22202
703-836-6263
WE THANK OUR CORPORATE SPONSORS
American Association for Homecare
2011 Crystal Drive, Suite 725
Arlington, VA 22202
For more information, please call AAHomecare at (703) 836-6263.
www.aahomecare.org
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