CMS’ Open Door Mantra: ‘Send an E-Mail’

BALTIMORE–Industry stakeholders seeking answers to questions
about accreditation, compensation for competitive bid winners and
other home medical equipment issues for the most part came away
empty-handed from CMS’ Open Door phone call last week.

Agency officials apologized repeatedly during Wednesday’s
question-and-answer session for home health, hospice and HME,
noting that, because of vacations, “we don’t have the whole
staff here.” Callers were asked to e-mail their questions so
they could be routed to the appropriate person at CMS.

Officials did have information on last weekend’s transition from
the Statistical Analysis DME Regional Carrier–Palmetto GBA–to the
new Pricing, Data Analysis and Coding Contractor, Noridian
Administrative Services.

Effective today, they said, the Web site at www.dmepac.com would be fully operational.
Also, the PDAC help center can be contacted from 8:30 a.m. to 4
p.m. CT at 877/735-1326.

CMS’ Nancy Sullivan clarified for one caller that claims should
continue to be sent to providers’ current carrier.

Other questions from the 394 callers on the line went mostly
unanswered, however.

Two callers requested substantiation of a Dec. 2 deadline by
which, under a provision of the “Conditions of Payment”
final rule for hospices, all HME providers who supply equipment to
Medicare hospices must be accredited (see
HomeCare Monday, Aug. 11).

“We, like many other DMEs in the country, were under the
impression that mandatory accreditation [for DMEs] wasn’t needed
until Sept. 30, 2009,” the first caller said. The Dec. 2
deadline, he added, was “a very unreasonable deadline to
meet.”

“I think we do not have the right folks to answer
this,” responded Lori Anderson of CMS. “We think that
information is clearly defined in the regs. But if you can send the
question to me, we can get you an explicit answer.”

Moments later, Bruce Rodman of the National Home Infusion
Association said he had read the regulations and it was still
unclear to him whether the Dec. 2 deadline stood for those HME and
infusion providers supplying hospices.

“I think DME providers and home infusion providers need a
clarification–and a quick one,” he said.

Again, Anderson directed Rodman to send her an e-mail.

Several callers also inquired whether CMS would be addressing
the issue of compensation for providers who were awarded
competitive bidding contracts in round one but subsequently lost
those contracts when the bidding project was delayed under H.R.
6331.

“Will there be any guidance written concerning damages or
potential damages under competitive bidding as a result of the
withdrawal of those contracts?” asked Eric Sokol of the Power
Mobility Coalition. Sokol elaborated, saying he was concerned that
suppliers might have entered into other contracts that they might
now be liable for.

“Joel Kaiser (deputy director of DMEPOS policy for CMS) is
not in the room with us,” Anderson said. Again, she requested
an e-mail to be forwarded to Kaiser.

Because CMS dropped its accreditation deadlines for HME
providers in round two of bidding, Sokol also questioned whether
CMS had considered rolling out additional deadlines instead of the
Sept. 30, 2009, universal accreditation deadline for all
suppliers.

“I wish I had an answer for you today, although we are
working with our general counsel,” answered CMS’ Sandra
Bastinelli, adding that she hoped to have guidance on that issue
during the next Open Door call.

Rob Brandt of the Accredited Medical Equipment Providers of
America asked whether CMS had a timeframe for when the oxygen title
transfer rules would be released and whether there would be a
comment period. He was told to send an e-mail.

So was a caller who said National Government Services, which
holds the Common Electronic Data Interchange contract, had been
unresponsive to phone calls and messages.

Mary Ellen Conway, president of Capital Healthcare Group,
Bethesda, Md., reaped a bit more information in response to her
request for clarification on whether physicians dispensing HME were
exempt from accreditation “at this place and time until
further guidelines are issued.”

“We do not have any guidance to send out to the
public,” Bastinelli said, adding: “If you read the law,
it does appear that it does have a different deadline for
physicians and professional groups.”

Because of the dearth of qualified CMS personnel to answer his
questions, Walt Gorski, vice president of government affairs for
the American Asosciation for Homecare, sidelined his queries about
the local coverage determinations that have emerged from the DME
MACs on CPAPs.

“These are significant changes from the current policy and
I think people need to have some guidance from CMS,” he said.
“Can we have people there who can answer a full range of
questions next month?”

CMS officials said that would be possible. The next Open Door call
is scheduled Sept. 17.