Home Health & Hospice Week

Stakeholder presentations dominate meeting.

With competitive bidding looming on the horizon, suppliers' anxiety levels remain high.

Durable medical equipment stakeholders got plenty of time to voice their worries about the impending changes at the Centers for Medicare & Medicaid Services' Program Advisory & Oversight Committee's two-day meeting held recently in Pikeville, MD.

The PAOC was supposed to discuss the proposed rule on national competitive bidding at the September meeting, but that rule is still wending its way through the White House Office of Management & Budget's clearance process. As a result, the roughly 200 people attending the meeting heard presentations on competitive bidding by various industry sub-sectors, from providers of diabetic testing supplies to oxygen equipment to high-end wheelchairs.

Most of the meeting was devoted to discussing the supplier standards CMS unveiled three days before the meeting began (see HCW, Vol. XIV, No. 35).

"This was the first PAOC meeting where I felt we got down into the real meat of the matter," Dr. Don Vliegenthart, PAOC member and medical director for the Sarasota, FL-based Hoveround Corp., tells Eli. "CMS listened intently and made it clear they want to do the right thing."

Avoid DME Suicide--Get Accredited

At the meeting, CMS contractor Research Triangle Institute reported the findings of the small-provider focus groups it held earlier this year. Not surprisingly, smaller DME providers are worried about the costs and administrative burdens associated with the requirement that all DME suppliers be accredited.

Many small suppliers said they would delay accreditation until they have more information about which accrediting bodies CMS will recognize and whether the agency would grandfather in suppliers that are already accredited. Only about one in five of the 98 providers participating in the focus groups said they were already accredited--a finding that frustrates Vliegenthart.

"If you've been standing on the sidelines and doing nothing about accrediting, then you're committing suicide in the DME business," he declares. "The handwriting's on the wall."

Meeting attendee Eric Sokol of the Power Mobility Coalition wishes there had been more consideration of how smaller suppliers would afford not only accreditation per se but the things necessary to earn accreditation, such as a compliance plan, he says.

Carve-Out for High-End Chairs Wins Support

The PAOC was generally unimpressed by appeals from suppliers of diabetic testing equipment, off-the-shelf orthotics and enteral nutrition to be excused from competitive bidding, Vliegenthart reports. However, high-end power wheelchair providers made a strong case for an exemption, he says.

"That's a niche industry that involves a lot of small clinics and a lifelong relationship between the therapist and the client," Vliegenthart observes. "By competitively bidding that, you'd be basically taking a severely disabled person and separating them from their lifelong companion."

Respiratory providers also made a solid argument for giving special status to more intensive services such as in-home ventilators and granting recognition for the level of intensity of services and monitoring.

Once CMS releases the competitive bidding proposed rule, the PAOC will meet during the comment period. Meanwhile, CMS is accepting comments on the proposed supplier standards through Nov. 28. 

Note: For more PAOC information, visit www.cms.hhs.gov/suppliers/dmepos/compbid/paoc.asp.