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by: Mike Moran - Thursday, October 11, 2007

Here is my response to an email I received this morning from an outraged HME provider:

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Dear Brett,

Thanks for writing but I totally disagree with you. There is nothing irresponsible about the headline “Fraud called ‘easy to get away with’ that appeared on the front page of our October issue. It’s the truth.

Father and Scout movie DME fraud is way too easy to get away with, as the providers in the story point out, and it is not the industry’s fault. It is CMS’s fault. CMS has the tools to keep maybe not all but a great many fraudulent providers from participating in the Medicare program. Instead, CMS continues to crack down on the industry in the name of fraud and abuse, inflicting a ton pain on innocent HMEs, when the real culprit is CMS itself. This is a travesty.

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The headline refers to the fact that providers believe DME fraud is too easy to get away with and that CMS is at fault for letting this happen.

CMS has done the industry a terrible injustice and has never been held accountable. What’s worse: this is an ugly pattern of behavior. For example, no heads rolled after Wheeler Dealer; CMS simply deflected the blame from itself and imposed all kinds of new regulations on providers of power wheelchairs. They are doing the same thing with fraud and abuse. There are numerous other examples.

You have a right to be sickened, but not by the headline: by CMS.

If I haven’t changed your mind, I hope we can agree to disagree on this issue. Everything we do here at HME News is an effort to keep providers informed and, where possible, serve as an industry advocate.

Sincerely,

Mike

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by: Mike Moran - Wednesday, October 10, 2007

I’m not holding my breath, but it would be nice if the industry gets some straight answers tomorrow, Oct. 11, when CMS meets with the Program Advisory and Oversight Committee (PAOC) for national competitive bidding. For instance:

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Given the problems that occurred this summer in the first 10 metropolitan statistical areas (delays, registration snafus, incomplete utilization data, etc.), do CMS officials feel confident that things will go more smoothly when they roll out the program in an additional 70 MSAs next year?

What did CMS learn from the first round that will help them improve the process going forward?

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How many providers submitted bids in the first 10 MSAs? Is this more or less than CMS expected?

How many suppliers submitted bids as part of a network?

Home Movie on dvd On what date will CMS require all HME providers to become accredited?

These are pretty simple questions, but as one provider said, when it comes to dancing around questions, CMS is a real star.

by: Mike Moran - Wednesday, October 10, 2007

Clubbed dvd Okay, so not only does the GSA have a bribery problem, it has a not-doing-its-job problem, too.

The Washington Times (America's newspaper, dontcha know) reports Paris hd that USProtect, the company that bribed its way to government contracts back when it was known as Holiday International, wasn't even on the up-and-up when it put in its application for GSA scheduling.

Richard Hudec, 44, was charged in federal court in Maryland last week with tax evasion and concealing information about his background, which included four felony fraud convictions, in connection with his role as chairman and chief operating officer for USProtect Corp., a private security company.

Oops.

But, of course, Hudec isn't the story here. I include items like this for your perusal not because this is somewhat related to the practice of installing security systems, but because many of you have to work with the GSA, and there is now more than a little reason to doubt the GSA's competence.

Some details of Mr. Hudec's incarceration can be obtained over the Internet. For example, the federal Bureau of Prison's free public inmate locator database — www.bop.gov — shows that Mr. Hudec was released from prison on Feb. 21, 2001.

According to charging documents, Mr. Hudec "assisted in the preparation and submission" of the security company's application to the General Services Administration in 2002, which once approved placed the company on the federal supply schedule, a clearinghouse of government-approved contractors.

The Same House movie The application listed Mr. Hudec as chief operating officer and improperly certified that no principals of the company had any fraud judgment within the past three years, authorities said.

Okay, so that may be some crappy writing on the part of the venerable Times, but it essentially makes the point that you could have Googled this guy and discovered he was a felon. I'm all for giving people a second chance, but something in my gut says people who've been convicted of multiple fraud counts maybe shouldn't be working with the federal government.

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USProtect is competing with a number of well respected companies for this government work. Is the GSA keeping appropriate tabs on your competitors as you vie for contracts?

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by: Mike Moran - Tuesday, October 9, 2007
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Medtrade seemed oddly quiet this year—subdued, you might say. No blockbuster acquisitions. No major movement on the legislative and regulatory front. No exhibitors trading insults—at least that we heard. It was, you might say, a nice quiet show with lots of neat products, people networking and buying. A few days removed from the show, I now think that the lack of any big news is the news, and, I should add, not all that surprising. Medicare has created an environment of extreme uncertainty —through competitive bidding and other reimbursement and regulatory changes. As a result, many in the industry (certainly not all) have hunkered down and are waiting for the dust to settle. Unfortunately, with Medicare set to expand competitive bidding to 70 additional communities next year, I think the dust is going to remain in the air for a while. That is of course, unless the industry and its champions somehow derail the inevitable. That’s all the more reason, I would think, for you to take part, if you aren’t already, in these industry efforts.

In case you didn’t get to Medtrade, here’s some of the news we covered as part of our show reporting (you’ll find more in our November issue):

Canadians dominate new Product Pavilion
Providers cast votes for best in show
NEW PRODUCT PAVILION — Providers spoke with their votes last week, selecting their favorite products in this year’s Product Pavilion,
The Innovation award went to Ottawa, Ontario-based Healthcraft Products for its Dependa-Bar, a weight-bearing bath-safety device that lets users safely enter and exit the bathtub. Featuring a dual rail with five locking positions, it fits most standard bathtub widths and is rust resistant.
PDG Product Design Group, from Vancouver, B.C., picked up the Provider's Choice award for the Fuze Power Tilt, an add-on option for its Fuze T50 Manual Tilt Wheelchair. Wheelchair users or their caregivers can control the Fuze Power Tilt, making it easy to maneuver the chair.
The Comfort Zone by Elizabethtown, Ky.-based Life Gear garnered the Merit award for its portable blanket warming system. The lightweight system allows providers the ability to offer patients the comfort of a warmed blanket. It uses 5 amps, runs on 110 volts and warms a blanket to 115 degrees.

'Get it right the first time'
ORLANDO, Fla. - HME billing expert Jane Bunch gave attendees a sage piece of advice: Get your billing right the first time, rather than getting denials and carrying huge accounts receivables.
"I don't want to hear the mentality, 'Let's just get the bill out the door,'" said Bunch, vice president of HME consulting for CareCentric, during the seminar, "Common Billing Mistakes: How Do I Prevent Them?"
Starting with the intake process, make sure you have the beneficiary's name and HIC number correct, along with their correct address and ICD 9 code diagnosis, she said.
As if billing Medicare isn't complicated enough, providers must learn to use various modifiers correctly. One of the biggest confusion points these days is the KX modifier, said Bunch. Learn to use it correctly or risk audits.

Providers needn't go it alone
ORLANDO, Fla. - Echoing the sentiments of many HME providers, AAHomecare’s Walt Gorski told attendees that he believes "the deck is stacked against us."
"Why do they single us out?" asked Gorski, the association’s vice president of government affairs. "They just think that they can."
Gorski made his comments during a seminar entitled: AAHomecare's Top 10 Series on Critical Issues Facing the Industry.
With the HME industry staring down the barrel of national competitive bidding and several other cost-cutting measures, Gorski reminded attendees that they must band together if the industry is to have a chance at modifying cuts or repealing measures altogether.

Theft reminds exhibitors to take security seriously
ORLANDO, Fla. – Someone apparently stole two 65-inch flat screen TVs (valued at $2,500 each) from Dedicated Distribution’s booth, reminding exhibitors and attendees that show security should not be taken for granted.
Medtrade officials caution exhibitors to treat the show the same way they would a hotel room: Do not leave your valuables alone. Medtrade provides security, but mainly that involves making sure only registered attendees and exhibitors walk the show floor.
Exhibitors must take their own security precautions, which mostly involve commonsense, said a number of vendors and show officials.
Lock up or take home laptop computers and other popular consumer items. When it comes to shipping in TVs an other large merchandise (something that may catch a person’s eye), use black shrink wrap—not clear—so the items don’t call attention to themselves. Take expensive goods out of their boxes and pack them in non-descript or unlabeled boxes. Some exhibitors said they lock up show valuables in cabinets that double during the day as display tables. Others, like Invacare, hire additional security guards to patrol booths during non-show hours.

by: Mike Moran - Tuesday, September 18, 2007

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Now this is more like it—let’s just hope AAHomecare, state associations and other HME powers-that-be take note.
Instead of mainstream media stories on HME that focus on fraud and abuse, two recent newspaper articles lend strong support to industry lobbying and advocacy efforts.
On Sept. 21, the Kansas City Star

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ran a long story under the following headline: “Small medical equipment suppliers worry about new Medicare bidding process.”
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A few days earlier on Sept. 16, the Sacramento Bee ran an in-depth story that called into question the actions of Medicare-contract auditors (“Medicare auditing program could end up costing U.S. taxpayers”).
Fly-ins and site visits are fine, but I think we can all agree that they’ve met with limited widespread success. If the industry wants more success, it must build up public support, and the only way to do that is with an aggressive PR campaign that targets the mainstream media—that includes everything from the Wall Street Journal down to your little local newspaper, TV and radio station. Politicians monitor the media obsessively, and unless they detect a groundswell of public support for something (something that could help determine if they are re-elected), they are unlikely to lend their support. Mainestream media stories also turn up the heat on regulators, like those at CMS and state Medicaid offices. It’s high time the industry woke up to this in a very big way. Your future depends on it.

by: Mike Moran - Wednesday, September 12, 2007
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Alone in the Dark II dvd Just about 200 providers attended the HME Business Summit Sept. 10 & 11--our annual educational event--and one thing became crystal clear: when it comes to building your business, there's no magic bullet. I thought there might be but there is not; short of, possibly, acquiring a company or opening up a new branch, there doesn't seem to be anything that will boost your annual revenue by 15% or more. You can implement a GPS system, scanning technology, innovative sales compensation, join AAHomecare and your state association, boost retail sales, switch to hybrid delivery vehicles, seek out high-deductible health insurance policies for your staff--but none of these revenue building and expense reduction actions (and these are just some that attendees discussed) produce the "eureka moment" (as speaker Dexter Braff called it), the moment when someone reveals a strategy that if pursued correctly will produce a significant jump in revenue. The closest thing to a magic bullet might be expanding into CPAP and bilevel (as most Summit attendees indicated they had), a market that holds tremendous growth protential. The bottomline here is this: While there's no obvious magic bullet, there's plenty you can do to boost revenue and decrease expenses incrementally, turning your company, in the process, into, as they say, a leaner, meaner machine. That's a key takeaway from this year's Summit—if you plan to remain a viable business well into the future.

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