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Responding to concerns regarding the National Supplier Clearinghouse provider-number moratorium, Centers for Medicare and Medicaid Services Administrator Tom Scully said the agency will process some provider numbers this month.
During an Oct. 7 CMS Open Door Forum covering home health, hospice and DME, Scully said CMS staff and its regional offices would look at new supplier numbers on a case-by-case basis starting Nov. 1. He said whether a company is issued a number or not will depend on, among other factors, how far along a provider is in the application process. Scully warned, however, that applications from providers entering the program for the first time are not likely to see an outcome until January 2004.
Although he apologized for any hardship providers face because of this delay, Scully said CMS' chief concern is its beneficiaries. “I have not heard one beneficiary say they are having access problems [finding a DME dealer],” Scully said. “I haven't seen a supply and demand problem. No one is complaining, ‘I can't get a free wheelchair at 1 o'clock in the morning.’”
Scully emphasized that CMS' goal is to improve the Medicare program, which he believes is “in the interest of all DME suppliers.”
Said Scully, “We want to make it clear: You can't open up a mailbox and get a supplier number. There is a perception … that this is free money.” However, the CMS administrator added that if a beneficiary access problem does arise, the agency could possibly ease the moratorium.
“This is one of those periodic loops you have to go through so you can be sure we're not asleep at the switch,” Scully said.
On Sept. 9, responding to a surge in Medicare claims for power wheelchairs, and in the wake of a massive alleged fraud scheme in Houston revolving around the expensive equipment, CMS issued a 10-point initiative dubbed “Operation Wheeler Dealer” aimed at curbing fraud and abuse of the Medicare power wheelchair benefit. The federal campaign includes aggressive scrutiny of all new supplier-number applications and collaboration between CMS, DMERCs and law enforcement agencies to process fraud cases.
While industry response to the CMS action has generally been favorable, representatives from the Alexandria, Va.-based American Association for Homecare hand-delivered a letter to Scully outlining concerns in implementation of the initiative “without carving out existing suppliers who are acquiring new companies or opening branch locations,” the association said.
For details on the Houston fraud case, see “Houston Power Wheelchair Indictment Unsealed,” page 12.
60% percent of respondents to a HomeCare Web poll said they were ready for the Oct. 16 HIPAA deadline. Twenty (20) percent of respondents said they were ready, but that their trading partners were not prepared. Another 20 percent said they felt their business associates, DMERCs and CMS were ready, but that their companies were not ready.
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