Packer Perspective

Packer Perspective 


I hope all of you had a good Thanksgiving.   I read a volume of information in there classification report of routinely purchased to capped rental that I really despised. If you would like to drive a stake through your own heart, try reading this in detail (CMS1526-F).   This gives me a new respect for our reimbursement and government relations teams because they read items like this all the time.  


CMS is, in my opinion, a rogue agency that has no knowledge about or consideration for patient access or outcomes.   It’s making sweeping decisions based on God knows what.   It appears they are moving us back to a system of institutionalizing all people with any type of disability, and pulling away from the home-based care. 


We all know this is a very stupid move because home-based care is a cost-saver.   CMS does not give a flying power chair about whether it is a cost-saver. This agency views it as a cost, period.  It took CMS years to close down a fraud-laden company, and days to audit a good provider out of business. It has grown to a behemoth conglomerate that is unable to get out of its own way. 


The Big Website has failed (different discussion) and they’ve continued with a project (competitive bidding) that a group of Nobel Laureate economists say will not work.  Looking at 27-year-old rules and data to make decisions today is completely irresponsible.   CMS has a building full of bureaucrats who push paper and don’t listen to any of the people doing the actual work. They are apparently accountable to no one.


As providers, we understand that if you cap rent certain items, it will simply ration them to the patients that need them.  This limits access, and puts perfectly capable people who can be taken care of at school and home in an institution.   The current institution would be a nursing home where the equipment they need to stay healthy and mobile is not provided because of inadequate reimbursement .  


Where do we go from here?


To quote John Gallagher, “We need your help.   We, along with NCART, NRRTS, CRMC and AAHomecare,are compiling talking points that you can present to our legislators. The message needs to be carried to the key people on select committees who make the decisions to actually rain on the evil empire.   We need the force you can give us to push the legislative members to make a decision and not pontificate.   Competitive bidding is not working, and more than 170 economists said it would not work as written.


The one light of hope in the industry is the demonstration project. It is working. Why? Because there were conference calls and group stalking about how to implement and work through the process . Is it working to the best of its ability — yes and no — but are we starting to get a message on how to handle the paperwork and what is required to get approval and who will qualify and who will not?     


We need to stand united in the fight to give patients access to high-quality products that are needed to age at home.   We need to fight for high-quality service and delivery so that people understand their medical equipment and required therapy.


Reducing read missions and having better outcomes is a cost-saver. We know this, but Congress doesn’t. The message we need to carry is stop the multifaceted attacks on the DMEPOS section of Medicare and Medicaid:  

·Work with the providers who have saved you large volumes of dollars over the years.  Let them help work out solutions to the issues that are in front of us. 

·Listen to the people who provide the service and delivery to the patients that CMS is responsible to help. 

·Remember the true meaning of partnering to make a better system.  

We and the other organizations are working on the message.   When it comes out in the next few weeks and months, please carry the torch and help make our industry strong in the future.  We are not just fighting for our industry; we are fighting for the patients and their well-being.  


Would you rather have a child at home with their family or in an institution being cared for by someone else?   Would you rather have Mom and Dad aging at home?I know what I want for my parents and I’m willing to continue the fight.   Please make sure you watch our website and continue to read our Legislative Updates and follow our patient advocacy groups.  The message needs to reach Congress and the news media.