Tuesday, bipartisan groups of 120 members of the U.S. House of Representatives and 17 U.S. Senators sent letters to the Centers for Medicare and Medicaid Services (CMS) raising concerns about the impact of a new Medicare competitive bidding program on small durable medical equipment (DME) providers. The letters asked CMS to release data on how the bidding program will impact thousands of small providers.

"Although CMS and the Small Business Administration raised special considerations for small suppliers during the rulemaking process, we continue to believe that these steps will not guarantee adequate participations for small businesses," the House letter stated. "This will result in a number of small medical device providers going out of business, severely impacting patient access to necessary equipment and quality care."

In addition to asking for economic data on the bidding program's impact, the House letter expressed concern about CMS's plan to initiate the second round of contract awards. The second round will take place in 70 areas across the nation in 2009, before the first round has been fully implemented and before first-round results can be properly evaluated.

The Senate letter suggested that reducing the number of small DME providers could actually increase rather than decrease Medicare costs. "Small suppliers pay close attention to local, specialized service as a commonsense means of reducing medical errors, equipment-related injuries, and returned equipment. This in turn reduces Medicare costs."

The House effort to gather support for the letter was led by U.S. Congressman Jason Altmire (D-Pa.). Co-signers included House Minority Leader John Boehner (R-Ohio). The effort behind the Senate letter was led by Senators Sherrod Brown (D-Ohio) and George Voinovich (R-Ohio). See aahomecare for the full text of the two letters.

Weeks Estimates at Least 14,575 Jobs Will Be Lost in Rounds One and Two of Bidding

The Weeks Group, a business consulting firm in Melbourne, Fla., conservatively estimates that a minimum of 14,000 full-time equivalent jobs will be lost in the durable medical equipment sector when the first two rounds of the competitive bidding program are implemented in the first 80 metropolitan areas throughout the U.S. Wallace Weeks commented, "When companies lose large portions of their revenue, there will be a significant failure rate."

Weeks estimates that at least 2,662 jobs will be lost as a result of round one of bidding, based on all of the first round areas except San Juan. His analysis of 69 round two MSAs estimates a loss of an additional 11,913 jobs, at a minimum. He excluded New Orleans from the calculation due to the lack of reliable data for that MSA.

The Weeks Group volunteered to analyze the impact of competitive bidding to help AAHomecare generate media awareness about the effects of rounds one and two. AAHomecare sent a press release to the national media today summarizing the recent congressional letters, economic studies, and Weeks Group data that all raise grave questions and concerns about the bidding program. (See Newsroom at aahomecare.)

10-Day Bid Acceptance Period for First Round Bidders

The competitive bidding implementation contractor (CBIC) confirms plans to follow the timeline posted on their website for round one of the competitive bidding program. According to the timeline, CMS will announce winning providers for the first round during this month. Therefore bidders should be receiving contracts and notices of non-winning bids within the next 12 days via certified mail. According to CBIC, winning first-round bidders will have 10 days from the date posted on the top of their letter to accept or decline the contract. At the same time, letters will be also sent to non-winning bidders with an explanation of denial. To view the CBIC timeline click here.

AAHomecare's Volunteer Committees Prepare Comments for Quality and Supplier Standards

AAHomecare's Regulatory Committee and Rehab and Assistive Technology Council (RATC) helped prepare the Associations comments on the most recent DMEPOS draft quality standards, which were open for comments until March 18, 2008. Quality standards and accreditation are requirements under the competitive bidding program. In the comments, AAHomecare focused on three core principles:

1. Improve the quality of DMEPOS items and services provided to Medicare beneficiaries,
2. Ensure that quality standards can be effectively and efficiently implemented by suppliers, and,
3. Reduce opportunities for fraud, waste and abuse.

See comments at aahomecare.

Comments on proposed supplier standards are currently under review and will be submitted to CMS by next Tuesday, March 25. If you have remarks you would like included in AAHomecare's submission, please send them to Stacey Harms, staceyhaahomecare.

Alert: OIG Is Collecting Claims Data on Power Mobility

As part of a nationwide effort by the U.S. Department of Health and Human Services Office of Inspector General (OIG), as Wednesday in Washington has reported previously, many AAHomecare members have received "Documentation Request" forms from the OIG asking for information on "complex rehab" and K0823 power mobility device codes. Please note that the deadline for returning these forms to the OIG is March 28, 2008.

Please be on the look-out for these forms and be very thorough in completing your responses. In addition, it is important to remember that providers are being given the opportunity to validate exactly what AAHomecare told the OIG at its in-person meeting in January of this year. Namely, with these forms, DME providers can explain to the OIG the service-intensive nature of providing power wheelchairs, including complex rehab, and thereby begin to quantify the service-related costs of providing the full range of power wheelchairs to Medicare beneficiaries.

AAHomecare's RATC Council, which is chaired by Tim Pederson of WestMed Rehab, through the efforts of the Council's OIG Workgroup, chaired by Doug Westerdahl of Monroe Wheelchair, is in the process of collecting data and guidance on how best to calculate the service and overhead costs of providing the full range of power wheelchairs to Medicare beneficiaries. To view the OIG form, please visit aahomecare and go to the Mobility / Rehab section in the new Action Center, which can be accessed from the front page of the website.

National Healthcare Decisions Day

On April 16, 2008, Americans across the country will be encouraged to talk about their future healthcare decisions and to complete an advance directive. AAHomecare is a participant in the National Healthcare Decisions Day campaign, which is an initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes.

The U.S. Agency for Healthcare Research and Quality (www.ahrq), in a 2003 article, "Advance Care Planning: Preferences for Care at the End of Life," found the following:

-- Fewer than 50 percent of severely or terminally ill patients had an advance directive in their medical record.

-- Only 12 percent of patients with an advance directive had received input from their physician in its development.

-- Between 65 and 76 percent of physicians whose patients had an advance directive were not aware that it existed.

Visit www.nationalhealthcaredecisionsday for more information.


Teleconference: Maximizing Profit through Patient-Receivable Management, April 1, 2008, 2:00-3:30 PM

Gain knowledge in an area that is often overlooked and misunderstood: the patient-owed receivables. This AR is often a large percentage of your revenues and many times the difference between profit or loss. This is a unique opportunity to learn techniques and skills in working these accounts, and to learn when to take appropriate steps to develop your own credit, collection, and hardship policies.

Speaker: Lisa Bargmann, President & CEO, Bargmann Management, LLC

Fees: $129 member/$189 nonmember, registration fee by Monday, March 31 to Terri Judd, terrijaahomecare, AAHomecare, 2011 Crystal Drive, #725, Arlington, VA 22202, 703-535-1884 or fax to 703-836-6730. See aahomecare for details.

Continuum of Care and Reimbursement Conferences May 6 in Long Beach, Calif.

The Continuum of Care Conference is a half-day workshop for homecare professionals offering continuing education units (CEUs and CECs) and a comprehensive look at the issues and challenges that DME, rehab and respiratory providers face. The conference takes place Thursday, May 6, 2008 from 8:00 a.m. to 12:15 p.m. at the Long Beach Convention Center in Long Beach, California. It is sponsored by Respironics, ResMed and Mobility Management.

"Maximize your reimbursement potential," the Reimbursement Conference at Medtrade Spring will be held May 6, 2008 from 8:00 a.m. to 12:00 p.m. This conference will offer tips on the best ways to maximize your reimbursement potential and will provide an in-depth look at the reimbursement strategies, coding requirements and best practices for home medical equipment. This education seminar is sponsored by RemitData, Inc.

For more information on either of these conferences call Kim Kianka at 703-535-1887 or register online at medtrade.

For a complete list of AAHomecare and industry events, visit the Calendar section at aahomecare.

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