To Enrich Lives

Posted on November 29, 2016 in HME Government Issues

President-elect Donald Trump has nominated Rep. Tom Price, M.D. (R-Ga.) as the next Health and Human Services Secretary. Price has been a long-time champion in Congress for DME providers and the beneficiaries they serve with a focus on accessibility and quality. He has been the chairman on the House Budget Committee in the 114^th Congress. Prior to his time in Congress, Dr. Price was an orthopedic surgeon, which gives him an experienced, fresh perspective on the health care system.

Price has been an open critic of the Affordable Care Act, which, following an official Senate confirmation, it is anticipated he will be leading the GOP effort to repeal and replace Obamacare. DME providers will be quick to remember the role that the ACA played for the industry as DME reimbursement cuts in non-competitively bid areas were used as a pay-for. Price has led many efforts in recent years to ensure that Medicare beneficiaries are provided with the highest quality of care with a true understanding that the best care comes from local providers. VGM looks forward to working to connect grassroots providers to the next administration as they work to implement crucial reforms across the health care sector.

From the HME News

By Tracy Orzel
Friday, October 21, 2016

WASHINGTON – Medicare payments under the competitive bidding program are below providers’ costs and therefore unsustainable, says a new study.

Medicare reimbursement rates cover, on average, only 88% of overall costs for companies providing HME services, according to the study, “Analysis of the Cost of Providing Durable Medical Equipment to the Medicare Population: Measuring the Impact of Competitive Bidding,” conducted by Dobson DaVanzo & Associates.

The study examined the cost of goods, direct and indirect costs, repair costs, administrative costs, billing costs, and licensures and accreditation fees.

“No business can sustain a 12% loss on everything they do,” said Laura Williard, senior director of payer relations for AAHomecare, which commissioned the study.

CPAP and supplies has the biggest loss, getting paid on average at nearly 69% of costs.

If CMS continues to under pay providers, there won’t be anyone left to accept Medicare contracts, she added.

“The belief has been that the larger providers can come in and take over patient care,” said Williard. “This study shows that this will not and cannot happen (because) there really is no where else to cost-shift.”

Seeing in black and white the losses incurred by the bidding program should have providers taking a hard look at whether they can accept those rates, says Tom Ryan.

“It’s a wake-up call for providers,” said Ryan, president and CEO of AAHomecare. “You cannot stay in business when you continue to lose money.”

While previous studies, like a recently released report from the Government Accountability Office, have focused on beneficiary access and utilization, the cost study shows that the current rates are unsustainable over the long term, which could help boost support for competitive bidding relief legislation.

“The people we spoke to on the Hill yesterday wanted to see the study and they were encouraged that we finally had something to show that there’s a problem here,” said Ryan. “They want to see numbers that are showing that (providers) are underwater.”

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You Can Prevent Carbon Monoxide Exposure

• Do have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.
• Do install a battery-operated or battery back-up CO detector in your home and check or replace the battery when you change the time on your clocks each spring and fall. If the detector sounds leave your home immediately and call 911.
• Do seek prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseated.
• Don’t use a generator, charcoal grill, camp stove, or other gasoline or charcoal-burning device inside your home, basement, or garage or near a window.
• Don’t run a car or truck inside a garage attached to your house, even if you leave the door open.
• Don’t burn anything in a stove or fireplace that isn’t vented.
• Don’t heat your house with a gas oven.

Frequently Asked Questions(http://www.cdc.gov/co/faqs.htm)