Give Me A Break

I need to rant. I suppose you could call it “offering acerbic observations about the home medical equipment industry in 2008” if that will make my words more appropriate. But after 27 years as a lawyer for the home care industry, I hope I am entitled to a rant.

I realize there are a lot of pundits out there taking potshots at us. Overrun with ne'er-do-wells and ignoramuses, selling fungible products that could always be obtained cheaper, blah, blah, blah. I do not dispute that there are many in our industry who perhaps should not be here, either because of their skewed moral compass or their poor attitude about doing things the right way.

But these types of people have been in our industry all along. I'm not even sure the number of “problem” suppliers has increased. Something has changed, however. And that is the attitude of the federal government.

The government has always been a recurring thorn in the side of HME suppliers. That is both inevitable and, I suppose, appropriate. But CMS and its agents — the National Supplier Clearinghouse, the various DME MACs and so on — have rarely been as hard to deal with, as unyielding in their attitudes nor as antagonistic toward our industry as they seem to be these days.

There are many, many hardworking, professional and skilled civil servants and contracted agents who work for CMS. This article is not about them. But the organizations themselves are very difficult and frustrating.

I don't want merely to rant; I have a point or two to make. Sometimes, we make our relationship with CMS and its agents worse by not thinking through the consequences of our words or actions. Sometimes we demand reform without realizing the extra burdens it will bring upon us. Sometimes we point fingers without remembering that old adage that three other fingers will be pointing right back at us.

Sometimes we forget that when we criticize the government, it will likely react in predictable ways. Prick an 800-lb. gorilla with a thorn and you'll get his attention. Poke him with a sharp stick and you may make him angry.

When the Feds Get Angry, the Feds Get Even

The Government Accountability Office recently stated in a report that CMS' “oversight of suppliers of durable medical equipment … is inadequate to prevent fraud and abuse.”