Influential director leaves CMS

WASHINGTON - Tom Hoyer, a longtime CMS administrator deemed by some to hold more sway over Medicare's HME program than any other, retired last month. As CMS's director of chronic care purchasing policy, Hoyer was the CMS chief who converted legislative ideas, like inherent reasonableness, into working policy, rules and regulations. Named one of the 10 most influential people in the HME industry by HME News in 1999, Hoyer's retirement caps a 31-year career at the 37-year-old Medicare program. Replacing a director with that kind of experience, say many, will be tough. “By getting in during those formative years, and being there for 30-plus years, his knowledge of the program, the beneficiaries, the trend lines within utilization and growth, the financial problems, the reasons for the policies that Medicare has - the real reasons, what was the government responding to - is vast,” said Tom Antone, a former NAMES president and a healthcare attorney who recently retired from Mintz, Levin et al in Washington. “His knowledge is encyclopedic.” Under Hoyer's watch, the industry's HME program has matured from a loosely regulated reimbursement program to a $5 billion benefit. Hoyer was an instrumental player in Medicare's development of the Six-Point Plan, the current DMERC carrier system and the fee schedule. Though sources generally lament the passing of Hoyer's institutional memory and his reasoned approach to policy challenges, some say his retirement is not likely to create noticeable changes for HME providers. “It has the potential to have a huge impact,” said one Washington source. “But we're probably not going to see much happen.” HME