Register today to attend the NCAMES Summer Meeting and Exhibit Show! The meeting will be held at the Holiday Inn Resort, Wrightsville Beach, NC from June 13-15th, 2012.
To Register Online - Move your mouse over Education and Meetings tab above and click on NCAMES Summer Meeting EXHIBITOR or PROVIDER Registration.
2012 is shaping up to be a busy year for DME suppliers with no signs of slowing down. From the implementation of a new HIPAA Version 5010, to the mandatory revalidation requirement, to the ever present threat of audits, suppliers certainly have their plates full. If you’re looking for a way to ensure compliance with the latest Medicare regulations and keep your billing staff ahead of the reimbursement curve, then you won’t want to miss this live event. NCAMES will be teaming up with DME consultant Andrea Stark to provide our members with an in-depth seminar on the major Medicare compliance and reimbursement changes that have taken place over the past several months, as well as insight on what to expect in the months to come.
(Dunn, N.C.) - Members of the North Carolina Association for Medical Equipment Services (NCAMES) and VGM gathered at an event honoring Congresswoman Renee Ellmers (R-N.C.). Stakeholders used the opportunity to discuss the DMEPOS competitive bidding program and its harmful impact on small businesses and on Medicare beneficiaries with the Congresswoman.
As a member of the Small Business Committee and Chairwoman of the Subcommittee on Healthcare and Technology, Congresswoman Ellmers examines ways to improve health care reform issues without increasing taxes and regulations for entrepreneurs. From years of experience as a small business owner and nurse, Ellmers fully understands the industry’s concerns in regards to the competitive bidding program. She is also a member of the Doctors Caucus, which helps her understand the program’s impact on the provider.
Health Reform Built to Fail
How Medicare Rigs Competitive Bidding and Hurts Patients
WSJ Article – February 7, 2012
Americans may not be familiar with the medical innovation called negative pressure wound therapy, though it has helped hundreds of thousands of patients with complex or chronic injuries like burns or diabetic ulcer complications that could never heal on their own. Now President Obama's Medicare team is about to severely damage this field, and many others too—all in the name of reforming how the entitlement pays for care.
Last week a Medicare competitive-bidding program went live in 91 metro regions—nearly all the U.S. population—for what's known as durable medical equipment. That bureaucratic jargon covers advanced devices like wound therapy, respiratory assist equipment for people who can't breathe, and feeding tube systems for people who can't eat. It also lumps in things like walkers, scooters and "support surfaces." Those would be beds. Click here for the rest of the article
Contact Your Representative Immediately About Market Pricing Program
On Friday, Representative Dave Camp, Chairman of the House Ways and Means Committee introduced H.R. 3630, The Middle Class Tax Relief & Job Creation Act. The legislation extends a number of provisions scheduled to expire at the end of the year, including extensions of the payroll tax cut, an extension of unemployment insurance program, and a provision to prevent a 27.4 percent cut in Medicare physician payment rates slated to begin on January 1, 2012 and instead increase payment rates by 1 percent in 2012 and again in 2013 (known as the “Doc Fix”).
AAHomecare has identified the “Doc Fix” bill as a possible legislative vehicle to replace the failed competitive bidding program with the sustainable market pricing program (MPP). While the Association has received positive feedback from Capitol Hill regarding MPP, the effort to stop the competitive bidding program has not been easy. The Administration opposes any changes to the current bid program and continues to tout the “success” of it. Unfortunately, the Camp bill (H.R. 3630) does not include the MPP proposal. AAHomecare has received information from Hill sources that indicate the Camp bill could be used as the basis for House and Senate negotiations for the final package to fix physician reimbursement in Medicare. Hill sources also indicate the bill could be on the House floor by week’s end.
NCAMES has already sent an email to ALL 13 Members of Congress from NC so please follow up and contact them directly as the constituent - your voice speaks loudly!
The Capitol Switchboard number is 202-224-3121. After you make your call, please email Beth@ncames.org to update NCAMES on the progress of your call!
CMS Announces Round 2 Bidding Timeline
Changes in Round 2 Competitive Bid Items
K0005s / E1030 & E0986 will not be part of this round of CBE
Thanks to many industry leaders for their hard work, and continued dedication to working together, a few delays have been announced for this new round of CB items. This is at at least some relief for complex rehab providers.
After consideration of feedback from stakeholders, CMS has removed ultra lightweight manual wheelchairs, gimbaled ventilator trays, and push activated power assist devices from the standard wheelchair product category for Round 2. CMS expects to phase in these items in a future round.
LEADERS CALL FOR UNITY IN REPLACING COMPETITIVE BIDDING WITH MARKET PRICING
The possibility that the Market Pricing Program (MPP) will replace competitive bidding depends on unity in the HME community and broad-based political support, says AAHomecare and other HME leaders.
AAHomecare recently proposed MPP as a replacement for competitive bidding. MPP is based upon principals that reduce Medicare outlays while protecting HME patients and providers.
The organization last week said that any chance of success hinges upon following:
The HME community has to be unified, coordinated in its efforts and all in favor of one solution.
The MPP alternative must achieve the same savings for the Medicare program as that produced by competitive bidding, according to the CBO, over the next 10 years
The MPP proposal must be embraced by both Republicans and Democrats as a reasonable alternative to the current bidding structure.
Mike Hamilton -- a longtime national leader in the HME community and now director of the Alabama Durable Medical Equipment Association -- said now is the time to act.
“As an industry, we are probably about as close to agreement on what to do next about Medicare as we have ever been on any major, controversial subject,” he said. “That our always unsustainable rate-setting methodology has survived this long is remarkable. A change to a real market-based system as quickly as possible seems to be the best deal we can hope to achieve. It’s time to leave the details up to the political experts, who know what we want, but also know that what we can get is certainly better than the current uncertainty.”
Hamilton said there must be a consensus in the HME community to give AAHomecare authority to negotiate with Congress for MPP. “AAHomecare directors must be allowed to provide guidance to its staff and contractors, and permit flexibility to make decisions that require compromise in the middle of a conversation with Congressional staff.”
Broad elements of MPP include:
Size of market pricing areas would be reduced and be made more homogeneous.
Capacity of providers would be limited to a provider’s historical utilization in a county.
Services required for proper use of medical equipment would be clearly defined. Thus, pricing would be based upon clear quality standards and requisite services.
Provider qualifications must be clear and transparent and known to the public before submission of a market price.
Transparency would be required in the bidding process to prevent manipulation of market pricing data.
A bid bond and a performance guarantee would be required to ensure the provider meets its obligations once it enters into a contract with Medicare.
Grandfathering would be permitted for patient protection and a smooth transition to a new payment mechanism.
The number of product categories would be limited to two categories per county.
A provider who submits a market price at or below the “clearing price” would be required to accept a contract. All suppliers whose market prices are at or below the “clearing price” would be paid at the clearing price.
Beneficiaries would have the right to purchase medical equipment privately and to file claims directly to Medicare for reimbursement.
Roll-out of the market-based pricing program would be on a similar timetable to CMS' current schedule, in order to replicate current projected savings.
Triangle Home Medical Equipment Providers Rally for Jobs During President Obama Visit
Expansion of Disastrous Medicare Bidding System Costing Jobs, Threatening Patient Care
Dozens of stakeholders from the Triangle’s home medical equipment (HME) industry grabbed homemade signs and rallied for jobs around the corner from where President Obama touted his jobs bill at a local business that outsources jobs to Costa Rica.
Organized by the North Carolina Association for Medical Equipment Services (NCAMES), the rally was designed to bring attention to Obama administration policies decimating home medical equipment providers and their employees, such as expansion of the disastrous Medicare bidding system for HME providers.
Members from the NCAMES Board were invited and did attend a specially called meeting by Medicaid yesterday regarding the incontinence program. As you know, NCAMES has been involved in this debate with the state for nearly a year and a half – offering ways to protect the benefit, protect patient access, protect the provider network and preserve fair reimbursement rates. We are still working with the Department regarding the rates they revealed yesterday which seem fair for the majority of the fee schedule but there are a few codes that need to be adjusted and the Department is open to this discussion. There is a push to begin the new pricing (including pull up codes) on October 1st. NCAMES is also working with the Department regarding this date and some adjustments that can be made to make a quick implementation more palatable.
Stay tuned for more information and Medicaid will release the fee schedule once is is approved and finalized.
CEDI Recertification by Sept 1, 2011
Please complete your CEDI Trading partner Recertification form – all trading partners must complete the recertification form to keep their ID active. The recertification form is located under EDI Enrollment....
Medicare Competitive Bidding Rules Blasted by DME Providers
Serving Medicare patients with walkers, diabetes supplies and other durable medical equipment has been a cornerstone of Bill Griffin’s Charlotte, North Carolina business for nearly 30 years....
NCAMES Members celebrate with Cong. Heath Shuler (D-NC) following his announcement to support HR 1041.
A couple dozen NCAMES members visited all 13 NC Districts to ask for support on HR 1041 - Fairness in Medicare Bidding Act - that will repeal the DMEPOS Bidding Program. Introduced by Altmire and Thompsen from PA, Heath Shuler and Larry Kissell have already jumped on the bill to support our efforts. Follow up with your Member by calling 1-202-225-3121 and ask for their support!
NC Attorney General Cooper's Opinion is up for Debate (Broadcast 02/24/11)
North Carolina's attorney general predicted on Thursday that Medicaid payments could stop if lawmakers force him to challenge the federal health care reform law. NCAMES member, Bill Griffin, commented on Cooper's opinion. As the owner of a medical supply company [Griffin Home Healthcare] in Charlotte, has been in the home health care business for 30 years. To see the rest of the story, click on the link below: http://www.wsoctv.com/news/26989856/detail.html
NCAMES Comments on WRAL's Broadcast 02/15/11
Dear NCAMES Members:
Last night, WRAL-TV in Raleigh broadcast a story on Medicare waste during its 6 p.m. newscast. The piece focused on the cost differential between a rent-to-own wheel chair paid for by Medicare vs. a wheelchair purchased by a patient.
Please click on this video link for an animated picture of the Medicare Competitive Bidding Fiasco – a short clip that can be shared with interested parties. Please share freely!
Charlotte-Area Patients, Providers Bracing for Jan. 1 Hit to Home Medical Equipment Services
NCAMES, is launching a new education program to help Charlotte-area home medical equipment patients and providers deal with negative impacts of new Medicare rules going into effect January 1, 2011
