20 Questions

I have a few questions.

Where will DME competitive bidding begin? (All right, if you want to be a stickler you can call it “competitive acquisition” like the government does.)

What products will be included in competitive bidding?

Who will the approved HME accreditors be? (And will they be named in time for providers to get accredited by 2007?)

What will happen to small providers — or any providers — if the effects of competitive bidding aren’t mitigated? (Read, what will happen if you and all of your relatives, friends, neighbors and customers don’t get behind the Hobson-Tanner bill?)

Why aren’t more congressional representatives signing on to the Hobson-Tanner bill? (Read this one, pick up the phone and call your rep about it.)

What documentation is acceptable to support power mobility claims? (Does anyone watch David Letterman? Maybe he could come up with a Top 10 list.)

How are mobility patients supposed to make an appointment with a physician, get an exam, be referred to a specialist, then get a prescription and get their equipment from a provider in 30 days? (Has anybody tried to make a new patient appointment in a big city lately?)

Is $21.60 enough to incent physicians to include explanatory notes in a mobility patient’s chart? (Most providers say it was hard enough getting them to sign a CMN. And who can read doctors’ handwriting anyway?)

When are legislators/regulators going to address Medicare’s “in the home” restriction for coverage of mobility equipment?

How could one congressman (Rep. Bill Thomas, R-Calif.) insert a provision (the 36-month oxygen rental cap) into the nation’s budget bill (called the Deficit Reduction Act) at the last minute — after the House and Senate had already passed versions of the bill without the provision, and without any heads-up to anyone who would be affected?

How could Congress pass such legislation?

What is the Bush administration thinking in proposing an even shorter 13-month oxygen rental cap? (Do you think the same clerk who made the error in the DRA typed up this proposal?)

How do lawmakers think elderly oxygen patients are going to handle maintenance, repair or any of the other services connected with their sophisticated equipment? (Many of the seniors I know haven’t yet mastered their microwaves.)

Will home care companies be able to provide oxygen delivery at the price CMS will pay? (In my neighborhood, it’s tough to get a pizza delivered for less than 30 bucks.)

When will someone begin answering questions about the 36-month oxygen rental cap and its ramifications? (That list is a really long one.)

What happens to service for home patients when reimbursements go so low that providers can’t give it and still stay in business?

What happens to research and development of new technologies when reimbursements go so low that manufacturers can’t afford to charge for it?

How low can reimbursements go before beneficiary access to quality goes, too?

How can providers serve their patients well if they don’t have the information to plan appropriately for their businesses?

How did our nation’s health care get into such a state?

OK, if you have been keeping close count, you know that’s actually 26 questions. And I’ve saved the hardest one for last: How do I explain all of this — and how it will affect her — to my 80-something-year-old mother?