No Tears Here
We in the industry do not cry crocodile tears over The Scooter Store's lamentations (“Scooter Store Lays Off 200,” February 2003). I am sure that the store's ads have been in no small part responsible for Medicare's increased scrutiny of power wheelchair claims.
The Scooter Store has predicated its business model on the fact that Medicare has not been aggressively auditing providers of power mobility products. Many of us in the industry have been well aware of both Medicare's regulations regarding the ambulatory status issue and the fact that, quite frankly, many claims for these items have been improperly paid due to “holes” in the DMERCs' edit/audit systems.
When you use phrases such as “we guarantee Medicare coverage, or you pay nothing,” you are waving a red flag. Unfortunately, the rest of us are penalized, in increased labor/overhead costs to deal with increased paperwork, etc., whenever such high-profile problems arise.
— Jerry Waller, COO, Option One Home Medical Equipment, Irvine, Calif.
Why Do You Rob Banks, Mr. Sutton?
I can only wonder why we DMEs allow the HMOs and some insurance carriers to think that we can provide products and services below the already reduced Medicare/Medicaid allowables. We were told by Blue Cross, when we complained that their reimbursement was below our costs, that to remain a provider, we had to “take it or leave it.” We are no longer a provider to the Blues.
Other insurance carriers are requesting copies of our purchase invoices and are telling us that they will only pay 20 percent over invoice. I can only speak for my company, but this does not pay for our overhead, and we are strongly resisting this intrusion on our business practices.
I submit that DME prices have not gone up in more than 10 years. DME is less than 5 percent of the medical budget, and we are being hammered. To address the increasing cost of medical care, I can only look at the hospital and physician fees. The cost-cutters should use the Willie Sutton approach and go where the money is.
— Dale W. Richardson, R&R Discount Medical, Kalamazoo, Mich.
Note: “Slick” Willie Sutton, the gentleman robber, was known for his disguises and his ability to evade the law, carrying off many heists in broad daylight. Popular lore has it that Willie told a reporter he robbed banks “because that's where the money is.”
Be a Player
One of the main goals of the lobbying effort is to educate legislators about the legitimacy of our industry, but we may be missing a great opportunity.
If each of us asked some of our patients and their families to write their congressmen and senators to let them know of the impact and value of service that our companies have provided, then we could make a difference.
We have been through a lot of changes, but the legislation facing us is a whole different beast. It is time for us all to get off the sidelines and jump in the game.
— David Mills, president, First Choice In-Home Care, Chesapeake, Va.
E-mail your letters to Editor-in-Chief Gail Walker at gwalker@primediabusiness.com
