The Big Fix

Jim Greatorex thinks something is broken in the mobility marketplace, and it is past time for it to be fixed.

“In a three-week span, we received four calls from Medicare recipients who had received equipment that had been dropped off by a national company and was sitting in their basements because it was unusable,” says the president of Black Bear Medical, Portland, Maine, who is also vice president of the New England Medical Equipment Dealers Association. “Whatever would put a stop to this needs to happen … You can't tell me that [companies that do this] have the client's best interest at heart.”

Like so many other home medical equipment providers, Greatorex, a 23-year veteran of the industry, is hopeful that both recent and impending actions by the Centers for Medicare and Medicaid Services will put an end to such abuses and remove the shadow of fraud that hangs heavy over the industry.

In early February, CMS proposed new coverage criteria for wheelchairs and scooters, expanded the number of billing codes from five to 49 and is preparing a rule requiring beneficiaries to have a face-to-face exam with a physician in order to receive equipment. The agency is also considering revision of the accompanying Certificate of Medical Necessity (CMN) and, as required by the Medicare Modernization Act, adding supplier quality standards that are expected to be finalized by the fall.

It is the first time Greatorex and others say they have had hope of positive change in the industry. “In the last two years, our industry had been better represented in Washington, and [government officials] understand us better than they ever have,” Greatorex says. “I am hopeful that a new policy, instead of being 100 percent detrimental, will be somewhat helpful.”

Dan Meuser, president of Pride USA in Exeter, Pa., also is optimistic. “I like our industry's position,” says Meuser, noting that HME's relationship with legislators and policymakers has changed in the last year. “Actions are not taken behind closed doors, things are being done in an open manner with industry input, and, therefore, anything that is going to affect [the HME] business [HME providers and manufacturers] are going to know in advance.”