05/13/08 - Legislative Update
Posted by: Rob Brant
in News Anounces
on May 12, 2008 
Cleveland Suit to Bar Competitive Bidding Program Progresses
The lawsuit supported by Last Chance for Patient Choice which is pending in the United States District Court for the Northern District of Ohio is progressing. On Monday the Plaintiff’s in the case, Home Medical Equipment Providers and Beneficiaries, filed a Motion For Preliminary Injunction and a brief in support of that Motion. Copies can be reviewed by clicking on the links provided.
Last Chance for Patient Choice is a VGM created and VGM Member supported advocacy and educational entity that is attempting to get out the truth about the true nature of the so-called competitive acquisition scheme of the Medicare Modernization Act and calls the attention of the courts to underlying constitutional problems of the law as applied and the many, many mistakes made in the implementation of this program.
The Cleveland lawsuit is placing particular emphasis on the violation of the Administrative Procedures Act by CMS and its failure to abide by the clear mandates of the Regulatory Fairness Act. Underlying constitutional issues relating to the creation of a two-tiered medical care system (equal protection) and denial of an effective appellate review mechanism (due-process) are being addressed in other suits also.
To view a copy of the Motion for Preliminary Injunction, click here.
To view a copy of the Brief in Support, click here.
To view a copy of the Motion to Exceed, click here.
If you have suggestions or questions regarding the legal efforts you may contact Jamie Blomme at 800-642-6065 or jamie.blomme@vgm.com.
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Change Request 5978: Installment 1 of New Chapter in Medicare Internet Only Manual for DMEPOS Competitive Bidding Program
The following is important information regarding the policy on grandfathered supplies in the competitive bidding program.
The Centers for Medicare & Medicaid Services (CMS) has published the first of several installments by adding a new chapter 36 to the existing Medicare Claims Processing Manual (Pub. 100-04) which provides instructions for Medicare contractors for the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program. This first installment contains instructions regarding the overall policy of the Medicare DMEPOS Competitive Bidding Program including, but not limited to, policy on grandfathered suppliers and items, and transfer of title of capped rental DME items, oxygen and oxygen equipment. Suppliers should be aware of the notification requirement to its Medicare customers who maintain a permanent residence in competitive bidding areas (CBAs) and are furnished grandfathered items. For more information, click here.
To view a sample notification letter that suppliers may use to notify Medicare beneficiaries that they are a grandfathered supplier, click here. To view a sample notification letter that suppliers may use to notify beneficiaries that they are NOT a grandfathered supplier, click here.
Subsequent installments of this chapter on the Medicare DMEPOS Competitive Bidding Program will contain additional instructions and information about the program. In addition, the instructions within this first installment may be revised in subsequent installments in order to clarify language or add additional information on policy.
To view the first installment of Chapter 36 of the Claims Processing Manual entitled, “Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)” (Change Request 5978), please visit the CMS website here.
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Conrad Says Talks Have Yielded Deal; Conferees Up Next
From CongressDaily AM
Tue. May. 13, 2008
by Humberto Sanchez
NOTE: The compromise on the budget resolution will drive the discussion on the Doc-Fix in the next couple of weeks.
Senate and House budget writers have reached a compromise on a budget resolution that could be taken up by both bodies as soon as next week, said Senate Budget Chairman Kent Conrad.
"We reached agreement," Conrad said Monday. "We reached agreement on Friday night."
Conrad declined to give any specifics. The budget resolution is a spending blueprint that sets the discretionary spending level for the fiscal year and helps determine funding limits for the 12 annual appropriations bills.
If approved by the House and Senate, the deal will be the first budget resolution approved in an election year since the Clinton administration.
The compromise clears the way for congressional leaders to name members to a conference committee.
"So we are ready now for the House and Senate to name conferees," Conrad said. "We expect that will be done this week and we could perhaps have a conference either late this week or early next."
If the legislation is approved by a conference committee this week, the bill could possibly be considered by the House and Senate the following week, Conrad said. House Budget Chairman John Spratt and Conrad have been in unofficial negotiations on the budget to help assure its passage in both chambers.
Last week, Conrad said that among the issues that remained unresolved was an agreement on the budget's level of discretionary spending.
The budget resolution approved by the House this year would call for $1.014 trillion in discretionary funding. The Senate budget plan would provide $1.010 trillion. As of last week, negotiators cut the difference to $1.8 billion.
"It is a split as you would imagine," he said. "There is compromise throughout this agreement; both sides have given ground in areas -- both the House and the Senate have -- and that is true with the discretionary number. [But] I don't think it would be appropriate for me to put it out before we've got conferees and before we've presented it to them."
Conrad said he and Spratt will make a presentation to conferees once they are named.
The budget compromise comes after Conrad said recently that he thought that congressional action on the budget could slip until after Memorial Day, as leading lawmakers are focused on passing a supplemental spending bill for the wars in Iraq and Afghanistan.
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Mother's Day Meeting with Congresswoman Ileana Ros-Lehtinen
By Rob Brandt, President of Accredited Medical Equipment Providers of America, Inc. (AMEPA)
Congresswoman Ros-Lehtinen with VGM member Roger Ribas (AMEPA’s Director of Fund Raising)
Some people spend their Mother’s Day enjoying the company of their parents and children. When you are about to lose your livelihood and business, you spend your Mother’s Day with your brothers and sisters in the DME industry with a high-ranking Congresswoman.
Congresswoman Ileana Ros-Lehtinen, R-Fl., opened her home to a group of concerned DME providers in the Miami MSA. AMEPA’s Director of Fund Raising and VGM member, Roger Ribas of Hometown Medical was joined by AMEPA and VGM member Lee Medina of Medical Care Services and AMEPA member Liana Alvarez of Florida Health Care Services. Other local providers including Rafael and Rosaura Sosa and leading Industry Consultant, Belkis Alvarez from Advanced Consulting Concepts attended the meeting as well. They spent a casual Mother’s Day at the Congresswoman’s Pinecrest home and talked about the injustice of the current Competitive Bidding Program, rather than the joys of motherhood and family.
The group talked for nearly an hour about the gross negligence and mismanagement of the Competitive Bidding Implementation Contractor, Palmetto, GBA. They discussed how 501 Oxygen Providers in South Florida were reduced to only 44 bid winners and how unlicensed out-of-state companies were awarded bids. The Congresswoman was also very discouraged by the news that CMS changed their own rules nearly two months after most bids were accepted by the CBIC, which led to the majority of bidders being erroneously disqualified.
The group asked the congresswoman to minimally delay the program for at least 6 months so that Congress could look at CBIC’s damaging mistakes, the true economic impact of the program, and how the program will actually increase healthcare costs for patients. They also discussed how resources and costs of Medicare’s Part A, Home Health and Hospital programs would increase rather than decrease under Competitive Bidding. Since her election in 1989 to the United States Congress, Ros-Lehtinen has always been a strong advocate for the Durable Medical Equipment industry. On June 26, 2007, the congresswoman co-sponsored Hobson-Tanner Bill HR 1845. The timing was amazing, because last June, most providers in the Miami MSA were scrambling to get their bids ready by the first July 2007 deadline. Round One bidders still made time to encourage their congresswoman to support the legislation, which although stalled with only 164 co-sponsors, would have allowed “Any Willing Provider” to participate in the program in Round One.
South Florida DME providers have always been impressed by the congresswoman’s own family struggle. Forced to flee with her family from the oppressive communist regime of Fidel Castro, Representative Ros-Lehtinen became the first Hispanic woman and first Cuban-American elected to Congress. The group of DME providers greatly appreciated the opportunity to meet their U.S. Representative on a Sunday usually reserved for immediate families. The congresswoman offered her support and told the group that she would address the issue as soon as she got back to Washington.
The link below includes the facts about HR 1845 and Ros-Lehtinen’s proof of support. Her personal information came from her house.gov website.
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