Author

Cara C. Bachenheimer, Esq.

  • CMS/Medicare

    CMS Moves in the Right Direction

    The Centers for Medicare and Medicaid Services (CMS) announced its three-pronged initiative to address power wheelchair issues at the Senate Finance Committee’s April 28 hearing on Medicare coverage and payment for power wheelchairs. Overall, CMS’ initiative is a significant step in the right direction to address perceived and real issues in this area. There are, however, several recommendations to improve and refine CMS’ initiatives that will yield improved results. RAMP’s 10-Point Plan Consistent with CMS’ initiative, the industry coalition RAMP, the Restore Access to Mobility Partnership, has recommended a 10-point plan to help CMS fight fraud without harming the people who require power wheelchairs to increase their mobility. The coalition has developed this plan and is actively lobbying CMS and members of Congress for CMS...

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  • Legislation & Regulation

    Getting Rid of the FEHBP-Based Cuts

    The quintessential Washington wisdom this year is that of all election years — it will not be an active legislative season. So the HME industry must use this time to enlist political support for the objectives we have, both short-term and long-term. Although it appears all attention is focused on the presidential election, Congress is still charged with a number of must-do actions this year. As an industry, we simply have too many issues on our plate to be politically complacent. Think of the sheer number of issues imposed on our industry by the Medicare Modernization Act (MMA). We cannot afford to sit on the sidelines. In the short term, we are faced with reimbursement cuts for five categories of DME slated for January 2005...

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  • CMS/Medicare

    Many Rivers to Cross

    The Centers for Medicare and Medicaid Services’ retraction of the DMERCs’ December Web bulletins on restrictive Medicare coverage for motorized wheelchairs and power-operated vehicles (POVs) was a great victory for the entire power wheelchair community, consumers and the HME industry. It is, however, only the first milestone that the industry, in partnership with consumers, needs to attain. Our overall objective related to powered and manual mobility is to ensure that consumers with real medical need continue to have access to mobility devices, enabling them to engage in activities of daily life within their homes. Achieving the following five goals, in conjunction with the consumers we serve, should be an industry priority at the national level. A specialist in health care legislation, regulations and government relations,...

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  • Legislation & Regulation

    Grassroots Lobbying It’s Our Business

    With the many Medicare changes (and when do we not have to deal with various legislative, regulatory and other policy changes?), every provider in our industry must first take the time to understand how important it is to get to know his or her legislators, and second, to spend time educating these legislators about our businesses, the products and services we provide and the consumers we serve. For those of you who have resisted over the years, now is the time to act. No one can do a better job than you. The following step-by-step primer focuses on how to lobby federal legislators, but the same rules apply to state representatives and senators. A specialist in health care legislation, regulations and government relations, Cara C....

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  • CMS/Medicare

    Spread the Word

    In early December, the durable medical equipment regional carriers posted Web bulletins clarifying existing Medicare coverage policy for motorized wheelchairs and power-operated vehicles (POVs). Part of the Centers for Medicare and Medicare Services’ Operation Wheeler Dealer initiative, the so-called clarifications actually provide a more restrictive definition of the circumstances under which Medicare will provide coverage for a motorized wheelchair. The bulletins state that these medical review guidelines will be applied not only to new reviews but also to any provider-specific reviews the DMERCs are currently conducting. The attempt to apply these medical review guidelines retroactively is unfair and contrary to Medicare law and regulation. While the industry must fully support CMS and DMERC activities to eliminate fraud from Medicare, these policy changes will have absolutely...

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  • Legislation & Regulation

    Prescription for Change

    It’s been a few weeks since Dec. 8, when President Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 into law. With regard to its impact on the home medical equipment industry, this is, without a doubt, the most devastating package of legislation ever passed by Congress. The following summary details some of the many HME-related provisions in the new law and explains the potential impact of those provisions on individual providers and the industry as a whole. Mandatory Accreditation The U.S. Dept. of Health and Human Services will establish and implement “quality standards” to be applied by independent accreditation organizations. Durable medical equipment suppliers must comply with these standards in order to furnish DME to Medicare beneficiaries and to receive and...

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  • Legislation & Regulation

    Lessons Learned

    As the dust settles on Medicare-reform legislation, it is not too early to examine what we, the home care industry, accomplished this year and where we fell short of the mark. This year’s experience provides us with valuable lessons for 2004. This year we were more successful than ever in turning members of Congress into not just supporters, but advocates for home care issues. Rep. Dave Hobson, R-Ohio, led the charge in the House of Representatives, boldly declaring to Rep. Bill Thomas, R-Calif., and chairman of the Medicare Conference Committee, that he would vote against the Medicare drug package if it included competitive bidding (In a twist, Hobson eventually voted for the bill). We were also successful in garnering significant support on the Senate side....

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  • CMS/Medicare

    Sound the Alarm

    The Centers for Medicare and Medicaid Services’ “Operation Wheeler Dealer” hit the trade press and even the mainstream press in early September. If there is any good news hidden in this massive motorized wheelchair scandal, it is that this represents a needed wake-up call for both the home medical equipment industry and the federal government. Both parties need to do a better job to ensure that scam artists cannot so easily rip off the Medicare rogram and pollute our industry. While we can and should fault the regulators who failed to notice the dramatic increase in new supplier numbers coming out of Harris County, Texas, and the unbelievable rise in claims for motorized wheelchairs coming out of the same area in a year, that is...

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  • The Next Step

    The Medicare Prescription Drug Conference Committee's first accomplishment this summer was agreeing on a package of Medicare regulatory and contracting

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  • On Notice

    When Centers for Medicare and Medicaid Services (CMS) Administrator Tom Scully announced his concern about the increased use of motorized wheelchairs

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