What Are You Going to Do?

I recently sat in a hotel meeting room full of providers who were concerned about what is going to happen to their small businesses.

At this meeting, what I heard most often was, “What am I going to do? How can I become accredited by Aug. 31 and still figure out the bidding process?” Add to this the impending destruction of business by CMS — which may virtually eliminate 80 percent of the providers in each area with its mathematic formula for provider selection — and the next obvious question is, “Where am I going to get the money?”

Since I am, fortunately, not included in this process at the moment, I thought it would be easy to sit back and observe from a distance. That was not the case.

The feeling in the room was almost palpable. I had images of an innocent man on trial but facing a jury that he couldn't see or talk to, blindly trying to explain who he is and why he is innocent. Yet the jurors — CMS in this case — only turn their backs to discuss what they will be ordering for lunch, the decision made, the verdict in.

As for questions? CMS has responded to the need for answers with teleconferences. Other than sending out a form letter, I cannot think of any way more impersonal to react to the confusion and dismay providers have about the bid process.

If you have never participated in a teleconference in which you are allowed to ask questions, the process is simple. You push a designated number and wait until a disembodied voice states it is your turn, then you must state your name and your question. After several seconds of silence, another disembodied voice will give you a prepared answer from the paperwork that you have already read prior to the teleconference.

That's it. No chance for further discussion, no chance for those in that indistinct room to look at your face, to see your fear. This is the easiest way, I guess, to execute this mass destruction of so many lives.

I have been in this business for over 20 years and was involved when the demonstration projects were conducted in Polk County, Fla., and San Antonio. At that time, the usual blame for the endeavor was fraud and abuse.

I am not naïve. I know that there are people in this industry whose intentions are to grab as much money as they can and then run with it. But I also believe that the majority of providers want to catch the bad guys as much as I do. And as I observe other industries, I realize that I cannot find one that is fraud-free. There has been abuse in our churches, our Congress, among our teachers and the medical community at large.