Tim Hill: A CFO with a mission

Some people believe CMS's chief financial officer, Tim Hill, has an ax to grind with the HME industry. If that's the case, watch out. In the good old days before Wheeler Dealer, Medicare's senior financial management executive kept a low profile, working behind the scenes, coordinating CMS's financial management and overseeing programs that protect Medicare from fraud and abuse. In August 2003, Wheeler Dealer erupted, exposing a crooked clan of DME dealers that drove K0011 utilization in Harris County, Texas, to the Moon and back. If revelation of that scandal didn't give Hill a sour stomach, it certainly left some serious egg on his face. He acted accordingly. As CMS implemented efforts to reduce fraud and abuse and rein in power wheelchair utilization, the CFO stepped to center stage. Some say his deep embarrassment over Wheeler Dealer powered the crackdown. When CMS began to aggressively enforce its bed- or chair-confined coverage criteria, providers accustomed to a less-restrictive policy cried foul. Hill brushed them off. He categorized the K0011 industry as more about profits than patients. The industry bristled. Hill claimed a few big companies drove the industry's agenda. More bristle and counter charges of unspoken agendas. Distrust oozed from both sides. In recent months, Hill's rhetoric has cooled, but he still has a job to do. As the man who must sign off on proposed Medicare reimbursement cuts and increases before forwarding them to DHHS Secretary Tommy Thompson, Hill's influence on the typical DME's bottomline is immense. Going forward, the industry can only hope that Hill performs his duties - especially implementing competitive bidding and other components of the Medicare Modernization Act - outside the dark shadow of Wheeler Dealer. There are those who say he will, that he's not jaundiced on the industry, that he's open to input, informed and understands the DME's role. Those same people, however, say that if providers want to be treated like healthcare professionals, they need to act like them. It's Hill's job to make sure they do - whether they like it or not.