- BMS News
- HME News
- BMS - Accepts Medicare HMO, PPO, Advantage Plans
- BMS - Help Protect Access To Complex Rehab Technology - Get H.R. 4378 Passed
- More News Coming Soon
BMS - Accepts Medicare HMO, PPO, Advantage Plans! (return to top)
BMS is accepting almost all private insurances. If you have a Medicare HMO, Medicare PPO or Medicare Advantage plan that replaces a RED-WHITE-BLUE Medicare card, chances are BMS can help you. Call 800-443-3390 and let us check to make sure you are covered. For more information click here.
BMS - Help BMS Get H.R. 4378 Passed (return to top)
Legislation has been introduced in Congress (H.R. 4378) to protect access to Complex Rehab Technology (specialized wheelchairs, seating systems, and other adaptive equipment). We need everyone’s help to get it passed! Please visit www.access2crt.org to send emails to your members of Congress and sign the national petition. With your help we can improve and protect access to CRT for people with disabilities. Download this "Call To Action" to help.
More News...coming soon (return to top)
- Contact your members of Congress to support HR 6490.
- What is competitive bidding and what does it means to the consumer?
- DMEPOS Competitive Bidding Product List for Round 2
- Competitive Bid Areas for Round 1 (Current) & Round 2 (Scheduled for 2013)
- A look at competitive bidding after 4 months.
- Competitive bidding's $20 million dollar question.
- Oxygen update: Policy simplifies billing, audits complicate documentation.
- Electric Mobility's days are numbered.
- Game is changing for home oxygen.
- In brief: OIG lobbies for 13-month oxygen cap, Philips sponsors sleep day.
- Power wheelchair documentation: 'CMS is going to go berserk over this'.
- Medicare policies are changing the way PWC providers do business.
- Competitive bidding: Who's on the hook for wheelchair repairs?
Contact your members of Congress and urge them to support and co-sponsor HR 6490.(return to top)
Contact your members of Congress and urge them to support and co-sponsor HR 6490.
Experts have spent more than a year developing changes to the current bidding program and strongly urge Congress to support MPP. AAHomecare urges Congress to pass legislation that would change the current, flawed bidding system to a sustainable market pricing program at the earliest legislative opportunity.
This legislation would replace the current Medicare DMEPOS competitive bidding program with a sustainable market pricing program (MPP) that is based upon sound economic principles that are embraced universally by auction experts across the country. The market pricing program would be implemented on the same timetable and apply to the same DMEPOS product categories as the current program, and it will reduce government spending for DMEPOS items nationwide. It is intended to be at least budget‐neutral.
What is competitive bidding and what does it means to the consumer?(return to top)
The Centers for Medicare and Medicaid Services (CMS), are trying to control who you, the patient or caregiver, can buy products from based on a lowest bidder agreement. In theory, a DME (Durable Medical Equipment) company, like BMS, submits a bid to CMS. CMS then selects who they want to do business with – primarily the lowest bidder.
Patients and/or caregivers are compromised by, 1) the quality of products offered, and 2) length of service limitations. For instance, someone on oxygen therapy may be with one supplier until the CMS bid expires, then the patient is required to accept the new supplier or they pay out of pocket. And, that new supplier does not have to be local, they can be out of state – or just the lowest bidder.
Exerts from the HME News – the business newspaper for Home Medical Equipment providers, indicated the product category on the list that’s particularly worrisome to industry stakeholders are ventilators. “I don’t know how you would competitively bid vents, because it’s such a clinically and service intensive product,” said Wayne Grau, vice president of supplier relations and government affairs for The MED Group.
Earlier this month, the Centers for Medicare and Medicaid Services (CMS) officials shared with members of the Program Advisory and Oversight Committee (PAOC) a list of the 20 product categories under consideration for Round 2. The list contains the nine product categories in Round 1 plus infusion pumps and related drugs; manual wheelchairs; off-the-shelf orthotics; negative pressure wound therapy devices; nebulizers; ventilators, TENS devices; commode chairs; patient lifts and seat lifts; blood glucose monitors; and lymphedema pumps. A product category that industry stakeholders are fairly certain CMS will try to slip into Round 2: manual wheelchairs.
“CMS plans to improve coding for manual wheelchairs, but they put that on hold, so that’s a pretty good indication that they’ll be in,” Bachenheimer said. “The question is whether they will exclude some of the higher-end chairs. The expenditures there aren’t significant, so CMS may be receptive to excluding those.”
Industry stakeholders were able to get complex power wheelchairs (Group 3) excluded from Round 1, but it took an act of Congress. A product category that raised eyebrows: patient lifts and seat lifts. Providers often consider these products cash items. Unfortunately, at the end of the day, money, not quality of care, will drive CMS’s decision, industry stakeholders say. “CMS is charged with targeting the product categories with the highest price tag or those where the beneficiary co-pay is the most,” said Walt Gorski, vice president of government affairs for AAHomecare.
There is a perception that HME providers cannot influence policymakers in Washington, said Walt Gorski, vice president of government affairs for AAHomecare, but that's not the case. "Steady pressure over time will crack any rock, and, frankly, steady pressure over time makes diamonds," he said. Providers need to be vocal about competitive bidding issues, Gorski said. Regarding bill H.R. 1041, the bill to repeal competitive bidding. According to Tom Milam, an industry consultant and PAOC member, “We’ve got to have many, many more sponsors and a Senate companion bill if we expect to make an impact on Congress,” he said. “That’s going to require grassroots efforts at the state and district levels to make this happen.”
Help BMS reform H.R. 1041 to repeal competitive bidding.