The respiratory care community well knows that all politics
eventually affect businesses in their own backyard, according to
Marcia Nusgart, executive director of the Coalition of Respiratory
Care Manufacturers (CRCM), and Ron Billingsley, director of
government relations for Murrysville, Pa.-based Respironics.
In their conference session, “Update on Respiratory Issues
Facing Manufacturers and Providers,” Nusgart and Billingsley
explained how CRCM was addressing several regulatory topics —
competitive bidding, inherent reasonableness, the Health Insurance
Portability and Accountability Act (HIPAA) Uniform Code Set issues
and HCPCS coding process issues — then urged the audience to
be advocates for the industry as well.
Inherent reasonableness is an important issue to watch and speak
to congressmen about, Nusgart said. IR has always been a regulatory
mechanism that can be used to adjust Medicare reimbursement rates,
but the process was redefined, allowing DMERCs to make changes of
50 percent without the formal rule-writing process, she said,
adding that the first products to undergo IR may be power
wheelchairs due to the recent federal crackdown on fraud in that
sector of the industry.
HIPAA Uniform Code Set issues are also a concern because there
might be a gap if there were no national HCPCS code that described
the local code, Nusgart said. Consequently, over the past two
years, CRMC has worked with state Medicaids to review
“crosswalking” of Medicaid to national HCPCS codes and
apply for new codes if gaps existed.
Manufacturers and providers also need to speak out about issues
such as non-invasive positive pressure ventilation (NPPV), oxygen
local medical review (OLMR) policy, new respiratory HCPCS codes for
2004 and pending local medical review policies, Nusgart said.
While the Coalition represents the industry, “it's still
important for respiratory manufacturers and providers to speak
intelligently about issues that affect them and not to be
intimidated by the Washington process,” Billingsley noted.
“Your congressman wants to hear what [these issues] really
mean to you and to the economy. Plus, you vote for them and pick
Winners of Medtrade's New Product Pavilion awards, based on
attendee votes, were:
The Ergonomic Shower Chair with Built-in Bidet by Mobility Inc.,
The DeVilbiss FlexAire Mask from Sunrise Medical, Longmont,
The Weighted Exercise Vest by Walkvest, Beverly Hills,