Summary
CMS HAS BEGUN A PROGRAM THAT MAY BE SENDING DENIAL MESSAGES TO MORE THAN JUST SPINE COVERAGE.
CMS IS LIMITING COVERAGE FOR LIFETIME OXYGEN CUSTOMERS TO 36 MONTHS AS OF JANUARY 2006.
CMS HAS PLACED THE WRITING ON THE WALL FOR ALL TYPES OF REIMBURSEMENT COVERAGES.
CMS HAS BEGUN WHAT WE CALL AS A HARD CORE STANCE THAT WILL PUT MULTIPLE MODALITIES AT RISK OF BEING CUT FROM THE PROGRAM.
CMS HAS CLEARLY ENTERED A COST CUTTING TIME PERIOD THAT IT HAS DETERMINED IS NECESSARY TO SAVE THE MEDICARE PROGRAM.
CMS HAS DETERMINED THAT NO ONE MODALITY WILL BE OVERLOOKED. THEY HAVE ALWAYS TRIED TO CONSIDER ONLY THE BARE BONES COST AND NOT THE SERVICE OR DELIVERY OF THE SERVICE.
NOTHING IS MORE CLEAR TODAY THAN THE FACT THAT CMS HAS NO INTENTION OF PAYING FOR RESEARCH. THEY WILL LEAVE THAT UP TO THE PROVIDERS TO PAY FOR THE PROOF THAT THE SERVICE OR MODALITY SUPPLIED WILL ULTIMATELY SAVE THE PROGRAM MONEY.
Analysis
TO SUPPORT MY COMMENTARY, I OFFER THE FACTS THAT HAVE BEEN PROVIDED BY THE DME INDUSTRY AND THE DECSIONS MADE IN THE 2006 BUDGET PROCESS. THE AMERICAN ASSOCIATION OF HOME CARE AND MANY OTHER ORGANIZATIONS HAVE SPENT MANY HOURS OF DISCUSSIONS WITH CONGRESSIONAL RULEMAKERS FOR YEARS, TRYING TO CONVINCE THEM THAT THE MODALITIES WE USE ARE WORTHY OF MORE THAN JUST EQUIPMENT COST. THEY HAVE BEEN SENT MULTIPLE RESEARCH STUDIES FROM OUR MEMBERSHIP AND THE RESULT WAS CUTS IN ALL AREAS OF HOMECARE AND CAPS ON ALL MODALITIES. I HAVE BEEN IN THE HEALTHCARE INDUSTRY IN MANY CAPACITIES FOR OVER 46 YEARS AND FIND THAT CMS NO LONGER WILL ABIDE BY JUST A STATEMENT THAT IT WILL SAVE MONEY. THE US HEALTHCARE INDUSTRY AS A WHOLE WILL HAVE TO RESEACH WITH OUR OWN DOLLARS AND PROVE WITHOUT A DOUBT THAT WHATEVER MODALITY WE WANT TO SAVE HAS A COST SAVINGS LONG TERM.
