Some subscribers indicated having difficulty in reading my reply to the =
above subject matter.
Hopefully the below is more uniform and can be easier to understand.
A recent compromise proposal of a 3 year freeze to Medicare DME payments =
instead of pursing a legislative proposal of competitive bidding program =
to all of DME and O&P was made in a recent e-mail posted by AOPA.
It is no wonder that VGM and AOPA ,both of whom are primary =
representatives
of the DME industry, choose to oppose and dismiss both these proposals =
when they represent
DME members whom would adamantly oppose either as an acceptable =
solution.
In my estimation that opposition to both will not advance legislative =
proposals that could raise
the standards and at the very least maintain current coverage to O&P =
members.
The focus on Medicare reform is not new and is not budget driven.
It came about as an effort to discourage and reduce the tremendous =
fraud and abuse that has occurred and is occurring in Medicare billing =
from a industry and profession that is generally unregulated.
Most of the documented reports by Attorney General on fraud and abuse =
in O&P, is DME related yet the O&P professionals are taking the rap and =
future coverage is being threatened to all requiring these specialized =
healthcare services..
In absence of this country’s national consumer organization , ACA, =
continued unwillingness to address similar advocacy issues for amputees =
nor support propose either regulation or these proposals, indulge me =
with some points that may interest you.
This is not a new battle nor is it the first assault upon providers of =
O&P services for Medicare reimbursement.
The industry is opposed to any control or regulation that maybe imposed =
on their members that include DME manufactures whom are the primary =
focus to help reduce fraud and abuse by the federal government.
AOPA and VGM (DME) also speak on behalf of the profession, since the =
Academy delegated to them the authority to negotiate on the =
profession’s behalf, all O&P legislation issues with Congress.Yet it is =
the industry whom has made repeated doomsday predictions and pleas for =
the support of O&P practitioners and “consumers” to oppose all such =
initiatives.
Whom is speaking on the behalf of patients requiring these services?
In the interest of the profession, the “patients” and recipients of
comprehensive O&P health care services, why not support a freeze on DME
payments for three years to avoid the immediate threat and likelihood of =
competitively bidding be implemented NOW and preserve
the integrity of O&P coverage from both Medicare and Medicaid ?=20
Why not support the mandatory posting of surety bonds by providers of =
DME products if this would help reduce fraud and abuse That continues to =
threaten O&P coverage for Medicare in states that have Medicaid coverage =
(Massachutes is only the first).
Why not support state by state regulation efforts of the profession as =
well
as coming to consensus on qualification language of providers for =
Medicare
reimbursements for O&P services ?
If AOPA/OPGA/VGM believe their primary reason in not supporting this
alternative is the fear the freeze would roll into O&P services, then
they should educate the lawmakers of the differences make a deal=20
instead of suggesting the qualifications and issues of protecting=20
the public from both DME manufactures and O&P providers are comparable.
If the primary issue is for AOPA to help Congress distinguish between =
O&P
and DME, how can you effectively do so when your membership includes =
both ?
Lawmaker’s confusion between distinguishing between O&P and DME is a =
matter
of design.
It is why the word “patient” was replaced by “consumer” to imply that
government regulation , both state and federal, and oversight is not =
needed
for delivery of these consumer services and durable goods !
However, the word”patient” is often resurrected to encourage increased =
coverage and reimbursement levels.
You can no longer have it both ways.
Are mandatory educational qualification for a competitive bidding =
initiative part of the equation? No=20
Is opposing a freeze on payment schedules for wheelchairs, hospital =
beds, non custom orthoses and other durable goods and services, as =
important to protect the public, as supporting educational standards to =
better prescribe, fabricate and deliver a custom prosthesis or =
scoliosis brace?
All O&P professional practitioners and “patients” of these services =
think the DME freeze proposal as an alternative to initiating =
competitive bidding for O&P which is presently on the table, than they =
should consider it.=20
After all is not DME accountable for the fraud and abuse that was done =
by their members that influenced the need of both of these proposals? =
Shouldn’t the punishment fit the crime and be directed to those that =
abused the system ?
They should also consider helping AOPA clearly define whom they =
represent
and what the differences of DME and comprehensive O&P services are to =
the
Congress , since your delegate may need a little help.
Tony Barr
—– Original Message —–
From: “Jim Andreassen”
To:
Sent: Wednesday, November 27, 2002 4:31 PM
Subject: [OANDP-L] FW: [OANDP-L]
Medicare Competitive Bidding Alternative
To List Serve Members,
Thank you to AOPA for their posting on national competitive bidding. We =
are
all very concerned about what is happening in DC and want to find some =
way
to get them to refocus on patient care and stop trying to balance the
budget on the backs of O & P practitioners. While it is true that VGM =
is the
parent company of OPGA, we have, in the past, and will continue to in =
the
future, operate as completely separate entities. We understand that DME
and O&P are different industries and should be treated accordingly.
OPGA has not or does not endorse a Medicare freeze on O&P reimbursement
levels. In fact, as you might recall from past list serve traffic, we
have been a large advocate for the O&P industry in the battle against
competitive bidding.
I did check with VGM to be sure I understood what they had surveyed =
their Members on. =20
OPGA continually responds to the needs of its Members and is not =
interested in solutions which don’t work for them. =20
However, I do not see anything in what VGM has proposed for HME which =
would prevent us from
continuing the battle to STOP competitive bidding or, that failing, keep =
it from including O&P. =20
Also understand that VGM was merely surveying it’s Members in order to =
better identify the needs of the DME/HME industry.
Beyond that, nothing has been done. First and foremost, we all =
(AOPA,OPGA, and VGM) want to stop national competitive bidding.
Jim Andreassen
President, OPGA
