Watch Out for Rubber Duckies
After reading your article (“Florida Mandatory Accreditation Bill Introduced,” HomeCare Monday, Jan. 24), I felt compelled to reply [even though I am] from Alabama. Gainfully employed by a rather large accredited regional HME, I don't have a “dog in this fight.”
First, I need to tell you that I am at odds with those in this industry who think mandatory accreditation will resolve the majority of the ills inherent with HME companies. Secondly and more specifically, I think Mr. Talamo is wrong in his belief that mandatory accreditation will snuff out fraud. If a company/company owner is determined to commit unlawful acts, accreditation will not deter him/her. As a matter of fact, I can see the possibility of those types of operations using accreditation to hide behind.
I can visualize the scenario now. An investigation is begun on a company suspected of committing fraud, and the owner simply says, “It can't be me! I'm accredited!”
Let's face it — crooks can be accredited, too! We should also keep in mind that HME accrediting bodies … are not fraud police. The reason for accreditation is for companies [to] engage in a process that will hopefully improve their company [operations and efficiency], and for the betterment of the patient.
Regardless of accreditation, remember the duck theory always
applies: If it looks like a duck, quacks like a duck, walks like a
duck, it's probably a DUCK. The same analogy applies to
crooks.
— Stewart Pace, senior vice president, Med-South Inc.,
Birmingham, Ala.
Make Me a Match
My name is David Jayne. I am a 17-year survivor of ALS, Lou Gehrig's disease. I am totally paralyzed, ventilator-dependent and communicate with an augmentative communication system. I am the founder of The National Coalition to Amend the Medicare Homebound Restriction (NCAHB). Bob Dole is honorary chairman.
I am the CEO of Homebound Solutions LLC [dba RespiteMatch],
which was born from a personal need to take advantage of the power
of the Internet for a disabled individual to find a caregiver. It
is truly my desire for RespiteMatch to be a service that will
[help] other disabled and senior individuals avoid the home health
pitfalls I have endured.
— David Jayne, CEO, Homebound Solutions LLC, Rex,
Ga.
Note: NCAHB is a coalition working to amend Medicare policy that requires beneficiaries with significant illness to remain homebound. An Internet petition posted by the organization in January of 2001 garnered more than 14,000 signatures and, in 2003, resulted in the addition of a demonstration project to the Medicare Modernization Act to clarify the definition of homebound. A two-year study, the Home Health Independence Demonstration will run in Colorado, Massachusetts and Missouri to assess the benefits and costs of allowing beneficiaries with severe, chronic conditions to be deemed homebound in order to remain eligible for Medicare home health services, even though they leave home more than would be allowed under the usual rules. For more on the demonstration, visit www.cms.hhs.gov/researchers/demos. More information about Mr. Jayne's newly launched online patient-caregiver match service, for which there is a charge, is available at www.respitematch.com.
More Info, Please
Can you [tell me more] about the dispensing fees mentioned in
your story (“Medicare Finalizes Dispensing Fees for
Respiratory Meds,” December 2004)?
— Brenda Fulton, accounts receivable supervisor, AnMed,
Anderson, S.C.
Note: As part of the 2005 Physician Fee Schedule, Medicare announced $57 monthly and $80 quarterly dispensing fees for Part B respiratory medications, including albuterol and iptratropium, to offset the costs associated with providing the drugs. More information on the fees can be found at the DMERC Web sites: Region A, www.umd.nycpic.com; Region B, www.adminastar.com; Region C, www.palmettogba.com; and Region D, www.cignamedicare.com. Information is also available on the CMS Web site at www.cms.gov. For additional clarification, you may want to contact your DMERC directly.
