We all realize federal legislators and regulators seem to think
this industry is full of crooks, and that perception colors much of
how HME providers are treated by Congress and CMS. Operation
Wheeler Dealer, the Medicare Fraud Strike Force, the surety bond
requirement and, last month, an announcement by HHS Secretary
Kathleen Sebelius and U.S. Attorney General Eric Holder that the
current anti-fraud operation in South Florida and Los Angeles will
be expanded to Detroit and Houston — we get it.
Even so, it's jolting to hear directly from a former HHS-CMS
staff member that's how the industry is perceived. But that's
exactly what Thomas Barker told a room full of AAHomecare members
during the association's Washington Legislative Conference.
“There's just a perception that it's an unethical
business,” said Barker, who served as acting general counsel
and policy advisor under HHS Secretary Michael Leavitt (meaning he
was in charge of 450 attorneys who gave legal and policy advice to
Leavitt, as well as to the administrator of CMS and the
commissioner of the FDA).
CMS thinks HME providers are overpaid, dislikes
direct-to-consumer marketing and hears countless stories of
“abusive transactions,” Barker said. Those opinions
only got worse, he continued, after Leavitt personally toured one
South Florida building that supposedly housed a number of HME
companies. What he found instead were locked doors and empty
offices. Barker should know; he was along on the 2006
excursion.
Even though it was the government's own gatekeeper that gave
those sham companies supplier numbers, that field trip made an
impression that has stuck.
What can the industry do to change the bad rap? “You're
doing it,” Barker said, referring to the fact that more than
250 providers and other advocates were in the nation's capital to
talk to their legislators about HME concerns. (Of course there
should have been more, but I'll leave that for another column.)
Barker's specific advice: “Send a message that the vast
majority of HME suppliers are ethical, honest businessmen and women
who are trying to do the right thing for Medicare beneficiaries
… Stress that point over and over and over again,” he
said. “Focus on the value that HME brings to the health care
system. At the end of the day, keeping someone in a properly
functioning power wheelchair or hospital bed … produces
savings to the health care system and it can create value. Making
that point again and again cannot be overemphasized.”
Good suggestions, I agree. After all, you're the guys wearing
the white hats, and working to shed the industry's besmirched
reputation is worth pursuing. But it's definitely a frustrating
effort. When one audience member asked why the same government
contractor — the one that let in all those crooked companies
— had been given that contract again, Barker replied,
“I can't explain why or how that happened.”
Maybe we should consider this suggestion from Delaware provider
Richard Swearer. “Just a thought,” he wrote in.
“How about the HME industry launch a campaign to require all
elected officials to post a surety bond since there have been cases
in the past of elected officials committing fraud.
“Since there are isolated instances of dishonest elected
officials, that means all existing elected officials are dishonest.
Kind of the same logic CMS is using on our industry.”
