The oxygen community “needs to lock arms” and show a unified front, he said.

“Ultimately, this plan is going to be a plan that helps the industry survive and provides for stability within the benefit over the long term,” Gorski said. “We can’t be in this environment where we don’t know how to project revenues for the next year or have the prospect of not being able to provide a service because Medicare says you didn’t win a bid.”

VGM Tackles Scooter Store Tactics
WATERLOO, Iowa--The actions of a “prominent national provider” are endangering the future of the HME industry, the CEO and founder of buying group giant VGM Group said in a statement distributed at Medtrade Spring in Las Vegas.

“We are endangered by misguided and hostile government policies, and it is getting worse,” wrote Van G. Miller in an open letter to VGM group members. “We are also endangered by one prominent national provider, which has engaged in practices and followed policies that have brought this government backlash onto all the rest of us.”

In his letter, Miller asked independent providers to consider the business practices of New Braunfels, Texas-based The Scooter Store. The national provider routinely runs television ads that have proven controversial in the industry and also was a winning bidder in several markets in last year’s delayed competitive bidding project. In 2007, the company paid the federal government $4 million and agreed to waive another $13 million in Medicare payments to settle Medicare fraud charges.

“Consider the additional costs we all have had to bear lately due to these aggressive marketing practices and regulatory backlash in an environment where our net reimbursement received decreases regularly,” Miller wrote. “Think … added documentation costs, audit risks, surety bonds, mandatory accreditation, lobbying time and expense, etc., etc. Most of this could have been avoided if just a few companies had heeded common sense and refrained from figuratively ‘poking the tiger with a sharp stick.’”

Mark B. Leita, senior director of government relations for The Scooter Store, responded to Miller’s letter: “In light of his accusations, The Scooter Store recognizes there are larger issues plaguing the home care community that require our complete attention, such as rescinding the [interim final rule for competitive bidding]. Our multiple manufacturing partners, as well as the state and national organizations we work closely with, all recognize that if we do not pull together and rescind this government-mandated consolidation program now, quality of care for our seniors will suffer.”

Miller also took issue with Pride Mobility Products in Exeter, Pa., saying it continues to supply the bulk of The Scooter Store’s inventory. He questioned whether The Scooter Store was getting better support from the manufacturer in service, terms, loaners and trial equipment than other providers.

“Is the provider that insists on using advertising and sales tactics that anger the regulators getting better support and service from a manufacturer than you are?” Miller asked. “Ask … and make them prove to your satisfaction that you are not inadvertently using a vendor who is fighting for the other side.”

He noted that other manufacturers--specifically Invacare Corp. in Elyria, Ohio, and Permobil in Lebanon, Tenn.--“have decided not to make these sales at our expense and are thereby not supporting a vendor that is harming the industry and bringing down the wrath of the regulators on us.”

Pride is not the only manufacturer servicing The Scooter Store. A visit to the provider’s new mobility arm, Alliance Seating & Mobility, for example, shows a healthy list of nationally known manufacturers that supply products to the company.

For its part, Pride refused to be drawn into the fray. “We are very focused on moving the industry forward. Our focus is going to remain on moving the industry forward,” said Kirsten DeLay, senior vice president, sales management and operational planning, for Pride.

She pointed to the company’s government affairs initiative of working to rescind the competitive bidding IFR and getting the project eliminated altogether, as well as to the company’s philosophy of “patient first.”

“That’s really all around our effort to make superior products at an economic price point, always keeping the needs of the patients … foremost in mind,” she said. “Those help all of our providers survive and thrive. In addition to that, we have Pride providers’ standards and Quantum [Rehab] standards. And we adhere strictly to those standards. Anyone we do business with has to meet those standards. We feel that’s a very important part of helping the industry to move forward in having those standards and making sure we abide by them.”

Open Door Addresses Surety Bond Questions
BALTIMORE--At an Open Door Forum on Wednesday, CMS officials ticked through a raft of important dates for DMEPOS providers on accreditation, the interim final rule on competitive bidding, the Recovery Audit Contractor program and use of the revised 855S enrollment form. But it was clarification on several points about the agency’s new surety bond requirement that garnered the most attention from teleconference listeners.

In reviewing the $50,000 bond requirement, CMS’ Jim Bossenmeyer emphasized the May 4 deadline for providers applying for Medicare enrollment. If providers have an application pending with the National Supplier Clearinghouse on that date, he said, it is subject to the bonding requirement unless the provider is exempt. Existing providers must have a bond in place by Oct. 2.

Bossenmeyer said while the agency is still working with the surety industry to come up with a bond “template,” he assured providers “the market exists” and that they could find issuers. Providers must, however, use a surety approved by the U.S. Department of the Treasury and listed on its Web site.

Once providers have settled on a surety, Bossenmeyer said, that company may request any information needed to obtain a bond, such as corporate and/or personal financial statements, tax returns, NPI applications or billing policies and procedures.

When the surety has received all the materials and can begin processing the bond request, Bossenmeyer said, “what we are told is that this process should take approximately 15 days.”

Bossenmeyer added that once a surety bond has been obtained, it is the provider’s responsibility to send proof of that bond to the NSC.

Responding to a question on the bond deadlines, Bossenmeyer said if a provider is changing ownership, a bond must be posted by May 4, but if an existing provider is simply submitting updated information to the NSC, a bond is not required until Oct. 2. As to how many bonds providers need, he stated, “You will need a surety bond per practice location. If you are a corporation and you have four locations, you need a bond for each one with a separate NPI.”

One caller asked if a Medicare surety bond would be required if providers were already holding a state-required Medicaid bond. "It will need to meet federal requirements. It will need to be from a company on the Treasury list. If you have obtained a bond from a surety that is not recognized by Treasury, you will definitely need a separate bond," Bossenmeyer responded.

He said CMS would release additional FAQs addressing that issue and others within the next weeks.

Also on the Open Door call (which drew 526 listeners):

--CMS’ Sandra Bastinelli reminded listeners of the Oct. 1 accreditation deadline to retain billing privileges under Medicare. If providers have not complied by that date, she said, the NSC will begin the revocation process and providers will start receiving letters to that effect “on or after Oct. 2.”

--The agency will roll out its Recovery Audit Contractor program to all 50 states in 2010. To explain the program and give information to providers in “first-wave” states, CMS will hold two special RAC Open Door Forums, one for Part A providers on April 8 and a second for Part B providers on April 14.

To participate in the April 14 teleconference, which will be held from 2 to 3:30 p.m. ET, dial 800/837-1935 and reference Conference ID 92489480. (For more on RACs, see “RACs Ready to Rack Up Improper Payments,” Nov. 17, 2008.)

--Officials encouraged providers to begin using the revised CMS-855S enrollment form now, but said it must be used on and after June 1. Access the form at www.cms.hhs.gov/cmsforms/downloads/cms855s.pdf.

--CMS’ Joel Kaiser said the competitive bidding interim final rule will become effective April 18. “The law requires us to conduct a competition in 2009,” he said, although he noted there is no new information about the program. “We are still evaluating a timeline to determine how to proceed in order to be in compliance with this requirement,” he said.

Tobacco Regulation Bill Passes House
WASHINGTON--FDA regulation of tobacco moved closer on Tuesday with passage of the Family Smoking Prevention and Tobacco Control Act in the House. Co-sponsored by Reps. Henry Waxman, D-Calif., and Todd Platts, R-Pa., the bill would give the FDA authority to oversee and regulate tobacco marketing and sales in the U.S.

Under the bipartisan legislation, the FDA would have specific authority to:

--Restrict tobacco advertising, especially to children.
--Ban candy-flavored cigarettes.
--Require tobacco companies to disclose the contents of tobacco products, changes to their products and research about the health effects of their products.
--Require changes in tobacco products, such as the removal or reduction of harmful ingredients.
--Prohibit health claims about so-called "reduced risk" products that are not scientifically proven or that would discourage current tobacco users from quitting or encourage new users to start.
--Require larger health warnings on tobacco products.
--Prohibit advertising or terms that imply health claims such as "low-tar," "light" and "mild."

President Obama has indicated he would sign the legislation, but the bill faces opposition in the Senate from North Carolina Sens. Richard Burr (R) and Kay Hagen (D), who have introduced an alternative bill that would create a new department altogether to oversee tobacco regulation.

"We stand together with our public health allies in urging the U.S. Senate to make swift passage of [the Waxman-Platts] bill a top priority," said Charles D. Connor, president and CEO of the American Lung Association. "Swift passage of this urgently needed legislation will save countless lives, not to mention the $193 billion spent annually on tobacco-related health care costs and in lost productivity."

And after "millions of tobacco-related deaths," according to the American Thoracic Society, its members want to see the Waxman-Platts bill passed immediately. "The Waxman-Platts bill needs to pass and it needs to pass now," said ATS President-elect J. Randall Curtis, M.D., M.P.H., a professor of medicine and public health at the department of Pulmonary and Critical Care Medicine at Harborview Medical Center and the University of Washington. "It is simply unconscionable that we go forward without this bill and thereby allow the tobacco industry to continue to addict our children and to enslave another generation to their deadly product."

While there are more than 400,000 tobacco-related deaths annually, 12 million people--and another 12 million to 16 million who are unaware--have chronic obstructive pulmonary disease, according to the COPD Foundation. And according to the Department of Health and Human Services, smoking accounts for as many as nine out of 10 COPD-related deaths.

Oxygen therapy is currently the best treatment for COPD, increasing the amount of oxygen that flows into the lungs and into the bloodstream, improving shortness of breath. Several studies show that long-term treatment with oxygen at home increases quality of life and can prolong survival for people with severe COPD who have low blood levels of oxygen.

The Waxman-Platts bill has been placed on the Senate Legislative Calendar for an upcoming vote.

In Brief
Sebelius Vote Postponed; HME Advocates Stand Up for Homecare
Kansas Gov. Kathleen Sebelius (D), President Obama's nominee to head HHS, sailed through a Thursday confirmation hearing before the Senate Finance Committee. According to press reports, during the hearing Sebelius addressed the prickly issue of universal health coverage by saying, "There may be variations about how best to reach the goal most effectively, most cost effectively, most efficiently, with the best health outcomes of insuring every American. I know the president is totally committed to that proposal, that every American should have health insurance."

Despite a revelation earlier in the week that Sebelius and her husband had filed amended tax returns to repay more than $7,000--the latest in a string of Obama nominees with tax problems--the issue did not come up at the hearing. Some Republican senators objected to voting on Sebelius' confirmation the same day as her hearing, however, so the vote will be held after Congress returns from its current two-week recess.

HME Advocates Stand Up for Homecare
AAHomecare's "Stand Up for Homecare" reception last month drew 200 attendees and raised $35,000, officials said. Held March 24 during Medtrade Spring, proceeds from the event will be used for support of the association's public awareness campaign promoting the mission of home care.

NCAMES Attends White House Reform Forum
The North Carolina Association for Medical Equipment Services’ Beth Bowen, executive director, and Joey Tart, past president, attended the fourth regional White House forum on health reform, held March 31 in Greensboro, N.C. Hosted by Gov. Beverly Perdue and Nancy-Ann DeParle, director of the White House Office for Health Reform, the event drew an estimated 700-800 people, with clinicnans about 40 percent of the invited participants, according to Bowen.

Despite efforts to be recognized for a turn at the mike--including Tart, president of Family Medical Supply in Dunn, waving his portfolio in the air--"we weren't called upon to make our case for the home medical industry," Bowen said, although a letter from NCAMES was given to Gov. Perdue. In a release about the meeting, Bowen urged, "Our fragmented health care system is a huge problem--integration and a primary care network is critical. Let's stop this 'hamster health care,' running around with no progress, like it is now and reform the health care delivery system as it is today. Home care and the DME industry is part of the solution!"

The fifth and final in the series of regional health reform summits, called for by President Obama, will be held today in Los Angeles.

Medtrade Spring Organizers Pleased with Turnout
Medtrade Spring organizers said last week attendance at the Las Vegas expo revealed "home medical equipment providers across the country are dedicated to finding creative solutions that enhance the lives of their patients and the success of their businesses." Some 4,600 HME stakeholders--3,000 of them providers--gathered for the mid-year event, held March 24-26. "Medtrade Spring 2009 attendance was up 12 percent from last year," said Kevin Gaffney, show director. "Despite industry and economic conditions, both attendees and exhibitors continue to see the value in face-to-face client interaction and education."

Gaffney said as the producer of the Medtrade shows, Nielsen Business Media "is significantly committed to the industry. With the legislative and regulatory issues and the economy and all of the things that could fracture the industry, it's more important now than ever to bring the industry together in a central location."

Nielsen and AAHomecare recently agreed to a 15-year contract under which Nielsen will provide increased financial support to the association. "We want the industry to succeed and be healthy," said Gaffney. "We will do everything that we can to make that happen."

MED Group Reschedules Rehab Conference
Lubbock, Texas-based The MED Group has changed the dates for its National Rehab Network Summit to May 19-20 in Denver. The date change was made so members could take advantage of better travel and hotel rates, the group said. This year's annual educational and networking event will focus on using best business practices and improving operational efficiencies. For information, visit www.medgroup.com.

ICD-10 Call Transcript Available
The audio transcript of a Nov. 12, 2008, conference call for Part A and B providers explaining the new ICD-10 codes and how they differ from ICD-9 is now available from CMS. Access the transcript in the Downloads Section at www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp.

Are You Certain about CERT?
NHIC, the Jurisdiction A DME MAC, is offering a "Test Your Knowledge" quiz on Comprehensive Error Rate Testing. After completing the quiz, users will be directed to the correct answers along with where to locate more information on CERT. The results will also be used to detect educational needs among the supplier community, the DME MAC said. Find the quiz on the NHIC Web site.

Jurisdiction B Offers Medicare 201 Seminars
The Jurisdiction B DME MAC will be conducting Medicare 201 “Straight Talk with Medicare” half-day seminars throughout the month of May in each of the region's seven states. To be held May 12-21, the sessions will cover advanced billing, modifiers, reopenings and appeals, documentation requirements, proper use of the ABN and billing of oxygen. For exact dates and locations, check the NGS Web site.

Jurisdiction C Presents Wheelchair Ed Week
Jurisdiction C has designed an entire week of manual and power wheelchair Webinars ranging from basic billing education to addressing accessories and policy requirements. The sessions will be held April 13-17. Find more information on the Cigna Web site.

To revisit this news any time during the week, go to www.homecaremonday.com.

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