WASHINGTON – The Home Medical Equipment industry is not afraid of competitive bidding—as long as it’s done right, stakeholders told lawmakers at a hearing last week in which they touted the market pricing program.

“We have an alternative; we have a solution to the problem,” said Joel Marx, AAHomecare chairman and chairman of Medical Service Company in Cleveland. “We believe it saves the same amount of money, makes it fair to providers, and doesn’t threaten beneficiary access.”

Marx was one of several speakers at Wednesday’s hearing before the Subcommittee on Health of the House Ways and Means Committee. Also testifying: Laurence Wilson, director of CMS’s Chronic Care Policy Group; Kathleen King from the Government Accountability Office; Wayne Sale, NAIMES chairman; Dino Martis, president of Ablecare Medical in Cincinnati, a contract supplier; and Alfred J. Chiplin, Jr., from the Center for Medicare Advocacy.

While the industry has talked up MPP for the last several months, last week’s hearing marked the first time the industry was able to give MPP a “public airing,” said Seth Johnson.

“In the past, we didn’t have the alternative locked down like we do today,” said Johnson, vice president of government affairs for Pride Mobility. “My hope is that the public airing of the issues surrounding the current program and review of MPP that took place will lead to a CBO score in the near term and put the industry in a much better position to advance it later this year.”

When asked by lawmakers about MPP as an alternative to competitive bidding, Wilson said, “We believe it will result in universal failure,” but didn’t elaborate why.

“I think that shows that we need to make sure that CMS understands key issues related to MPP,” said Walt Gorski, vice president of government affairs for AAHomecare. “I just don’t think they are that interested in doing that. When you shut off to others’ perspectives, I think that’s when mistakes get made.”

Other key points made during the 2.5 hours of testimony included competitive bidding’s impact on the market and the difficulties of preparing a bid in March 2012 for what you will be paid in 2016.

“I think we showed them some things they had not seen before and opened their eyes wider to the danger of CMS’s version of competitive bidding,” said Sale.

While the industry scored some points, last week’s hearing was just a step forward in a long march, said Cara Bachenheimer.

“We’ve been told all along that this needs to go through the regular (process),” said Bachenheimer, senior vice president of government relations for Invacare. “We expect a second hearing, on the Energy and Commerce side, in a month or so. It’s never going to be a slam dunk but we need to go through this.”

Call to action

WASHINGTON – Industry stakeholders are asking providers to contact them with the names of any companies that they believe may have closed as a result of competitive bidding. The move is in response to a request made by Rep. Pat Tiberi, R-Ohio, during Wednesday’s hearing, who asked AAHomecare for such a list. Please contact AAHomecare: jayw@aahomecare, or The VGM Group: jamie.blomme@vgm.com or Brittany Terrell brittany.terrell@vgm.com at 800-642-6065.

According to the HME News
By Laurie Watanabe May 02, 2012

It’s official: The bill to finally and formally define complex rehab technology (CRT) – and to establish a separate Medicare benefit category for it – has been introduced in the U.S. House of Representatives.

The bill – H.R. 4378 – was introduced April 16 by Rep. Joe Crowley (D-N.Y.), a member of the House Ways & Means committee. The bill is named “Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012.”

Don Clayback, executive director of NCART, called the bill’s introduction “a major milestone,” and added in a news statement, “With legislation now introduced, we will begin a much broader effort to secure additional sponsors and work to get the bill attached to a larger piece of legislation and passed. The Separate Benefit Category Steering Committee will continue to provide direction on the legislative activities and decisions as the bill moves ahead.”

The steering committee comprises the American Association for Homecare, the Clinician Task Force, NCART, NRRTS, RESNA and United Spinal Association. The bill’s introduction coincided with the complex rehab technology industry’s annual Continuing Education & Legislative Advocacy (CELA) event, during which industry members and consumers met with legislators and their staffers on Capitol Hill.

Among this year’s action points during CELA, Clayback said, was generating interest in a companion bill for the Senate.

A Definition, An Explanation, A Need

H.R. 4378 begins by defining CRT and the people who benefit from it.

The bill acknowledges that people “with disabilities and significant medical conditions…experience physical, functional and cognitive challenges every day.” Examples of those conditions are listed: cerebral palsy, muscular dystrophy, multiple sclerosis, spinal cord injury, ALS and spina bifida.

The bill also lists examples of CRT: “complex rehabilitation power wheelchairs, highly configurable manual wheelchairs, adaptive seating and positioning systems, and other specialized equipment, such as standing frames and gait trainers.” These kinds of products, the bill explains, “enable individuals to maximize their function and minimize the extent and costs of their medical care.”

PHILADELPHIA, Pa. – Recent changes in Medicare reimbursement policy, including competitive bidding, may be contributing to a sharp increase in the number of wheelchair breakdowns, according to a study released this week.

About 53% of wheelchair users reported one or more breakdowns that required repairs per six-month period from 2006-11, up from 45% from 2004-06, according to the study, which will be published in the American Journal of Physical Medicine & Rehabilitation in June.

“This paper should serve as a call to re-evaluate and revise current policies and standards testing for wheelchair prescription in the United States,” stated Dr. Michael Boninger of the VA Pittsburgh Healthcare System, who led the study.

Boninger and colleagues analyzed data from an ongoing survey study of more than 700 wheelchair-dependent SCI patients, all of who used their wheelchairs at least 40 hours per week.

According to the study, the average number of repairs per person also increased: 1.42 in 2006-11 vs. 1.03 in 2004-06. The rate of adverse consequences of breakdowns, such as being stranded, increased as well: 30.5% in 2006-11 vs. 22% in 2004-06.

Other findings of the study: Power wheelchairs, especially those with power seat functions, had more problems than manual wheelchairs; and users whose wheelchairs were funded by Medicare or Medicaid had higher rates of breakdowns and consequences compared to those covered by private insurance or other sources, such as the Department of Veteran Affairs or workers’ compensation.

In addition to re-evaluating policies and standards testing, researchers recommend educating wheelchair users on the importance of routine maintenance, such as replacing cushions, caster wheels and batteries at recommended times.

Read the report here: http://journals.lww.com/ajpmr/Documents/Increases_in_Wheelchair_Breakdow…

For the past five-years NRRTS, in partnership with NCART, has presented CELA – the Continuing Education and Legislative Advocacy conference bringing hundreds of people to Capitol Hill for over a thousand appointments with Members of Congress. Because of these events and tireless efforts by NRRTS and NCART staff and volunteer leadership, we have legislation in the House of Representatives – H.R. 4378 – “Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012″ to establish a Separate Benefit Category for Complex Rehab Technology.

The term Complex Rehab Technology – CRT – has become the accepted terminology to describe our industry and profession. In order to better reflect this new terminology the NRRTS Board of Directors has decided to modify the CRTS and RRTS credential.

Effective May 7, 2012 the CRTS© acronym will remain the same but the corresponding designation will be Certified Complex Rehab Technology Specialist. Similarly the RRTS© acronym will remain but the corresponding description will be Registered Complex Rehab Technology Specialist.

Changing from “Supplier” to “Specialist” more accurately reflects your role in the service delivery process. According to CMS and other funding organizations, “supplier” indicates the company providing the equipment not the individual.

This change does not require you do anything. There are no additional Registrant requirements.

We ask only that, when you re-print business cards and other promotional material, you add the new designation. We also ask that when the situation arises you explain the designation change to your colleagues, consumers and referral sources.

CELA 2012, presented by NRRTS and NCART in association with New Mobility magazine, is the centerpiece of our industry and profession’s strategy to realize a separate benefit category under Medicare for Complex Rehab Technology products and associated services. The impact of the separate benefit would extend to Medicaid and other payers sources as they historically have followed Medicare’s lead.

They been building toward this advocacy effort on Capitol Hill for well over three years. CELA 2011 brought 250 industry professionals and 40 Consumer Advocates to meetings with Members of Congress and their staff. These meetings built awareness of the Complex Rehab issue and garnered promises of support from dozens of Members.

CELA 2012 will build on the success of the 2011 efforts. They have legislative language, and if all goes as planned, they will have a bill already introduced in Congress. They will be armed with a specific ask-for – support the legislation to create a Separate Benefit Category for Complex Rehab Technology.

The Centers for Disease Control and Prevention (CDC) is fighting fire with fire to help reduce smoking rates across the country. On March 15^th, the CDC launched a new, hard-hitting media campaign to combat the tobacco industry’s $1 million an hour marketing budget. These new ads hope to convince people to quit smoking, or better yet, never start.

“Tips from Former Smokers” profiles real people who are living with smoking-related diseases, including amputations from Buerger’s disease, throat cancer, stroke, heart attack and asthma. 

“We want to thank these individuals for publicly sharing how smoking has shattered their lives so that others may learn from their tragic experiences,” said Harold Wimmer, President & CEO of the American Lung Association of the Upper Midwest. “This media campaign is long overdue, is powerful and will have a significant impact on reducing tobacco use.”

Ad campaigns like this are proven to be effective at encouraging current smokers to quit and prevent America’s youth from starting, a fact highlighted in the report, Preventing Tobacco Use Among Youth and Young Adults, recently released by the U.S. Surgeon General.  

Every hour of every day, the tobacco industry spends $1 million on marketing.  Meanwhile, states’ failure to invest in proven policies and programs has resulted in 3 million new youth and young adult smokers, a third of whom will ultimately die from their addiction. 

Like most states, Minnesota has failed to do enough to reduce tobacco use. According to our 2012 State of Tobacco Control Report, Minnesota received an “F”, a “D”, an “A” and a “C” for Tobacco Prevention, Cessation, Smokefree Air and Cigarette Taxes respectively. Check out Minnesota’s grades here.

To reverse this trend, the CDC’s ads will air nationwide, across a wide variety of media, including television, radio, print and online, with the heaviest concentration in areas with the highest smoking rates. Minnesota likely won’t see additional ads as we maintain the 9^th lowest smoking rate in the country at 14.9%.

Smoking’s terrible toll on America’s health makes the need for such an aggressive campaign clear. Tobacco-related diseases are the leading cause of preventable death in the United States, killing over 443,000 people each year.  Smoking alone costs the U.S. economy $193 billion dollars every year, $96 billion in direct health care costs and $97 billion in lost productivity.  In Minnesota, smoking killed more than 5,500 people last year and cost our economy $3.2 billion.

The Lung Association has been successfully helping smokers quit for more than 30 years with our Freedom From Smoking program. In addition, our Not-On-Tobacco® (N-O-T) program is designed for smokers aged 14 to 19 who want to quit and is America’s most popular smoking cessation program for teens. If you need assistance with quitting smoking or have additional questions about lung health, please call the American Lung Association’s Lung HelpLine at 1-800-548-8252.