Re: US Politics: Accepting a Congressional DME Freeze OR Competitive Bidding
Gingras, Ron
Description
Collection
Title:
Re: US Politics: Accepting a Congressional DME Freeze OR Competitive Bidding
Creator:
Gingras, Ron
Date:
12/2/2002
Text:
Tony
Once again you hit the nail on the head. It is time for the Academy to step
up to the plate and represent high standards of consumer care and the O&P
professionals that they claim to represent. Leaving the lobbying and policy
making to AOPA regarding issues of O & P care is absurd. AOPA has too many
other interests that come before the consumer and professional , its like
leaving the fox in charge of the hen house. Clearly , the responsiblily to
represent consumers and professionals falls squarely on the shoulders of the
Academy. However, until its members insist on it , it will be doubtful that
any change will take place.
The Academy is best suited to educate congress through its mission of
patient care advocacy and high standards of care for professionals .A good
example of the success the Academy has achieved legislatively is project
Quantem Leap. Through the legislative efforts of the Academy regarding
Quantem Leap they were able to get over 1 million dollars from congress for
education and reseach. Think of the possibilities.We the consumers and
professionals need legislative representation on an ongoing basis not just
for ad hoc programs such as Quantum Leap.
Remember , it was the AOPA's legislation that has led to the erosion of
educational qualification's nationally regarding qualified providers. Now,
we, the professionals are paying thousands of dollars out of our pockets for
the negotiated rule making to try to keep standards of care high enough to
protect consumers.
While the Academy is to be commended for their participation in the
negotiated rulemaking sessions, if they had provided legislative
representation initially this dilema could possibly have been avoided by
blocking the legislation that AOPA pushed through.Until there is a strong
voice for the consumer and professional AOPA will do as it wishes. It is
time for the profession to move beyond Big Brother.
Ron
> -----Original Message-----
> From: Anthony T. Barr [SMTP: <Email Address Redacted> ]
> Sent: Friday, November 29, 2002 4:55 PM
> To: <Email Address Redacted>
> Subject: [OANDP-L] US Politics: Accepting a Congressional DME Freeze
> OR Competitive Bidding
>
> > As pointed out by VGM and AOPA, a compromise proposal has been
> > developed to place a three
> > year freeze to Medicare DME payments instead of imposing a legislative
> > proposal of competitive bidding program to all of DME and O&P.
> >
> > Inspite the recent claims by OPGA and AOPA, these legislative proposals
> are
> > not budget driven.
> > They are driven by multiple documented fraud and abuse cases,
> unqualified
> > providers seekin reimbursement and lack of regulation of the industry.
> >
> > It is no wonder that VGM and AOPA , both of whom are primary
> > representatives
> > of the DME industry, choose to dismiss both proposals.
> >
> > Since you stated you would like possible solutions here they are.
> >
> > Due to the obvious, conflict in representations and cross breeding
> > representation of DME and O&P interests, it is my estimation neither
> > organization, AOPA nor OPGA will advance legislative proposals that
> could
> > raise the current standards nor the very least maintain current coverage
> to
> > O&P members.
> >
> > AOPA leadership must separate their representation of both or the
> Academy
> > should negotiate their own legislative policy without consideration of
> > looking after the interests of DME manufacturers.
> >
> > This focus on Medicare reform initially came about as an effort to
> > discourage and
> > reduce the tremendous fraud and abuse that has occurred and continues
> in
> > Medicare billing, from a industry and profession that is generally
> > unregulated. Most of this fraud and abuse in Medicare billing is DME
> > related.
> > However,it is the O&P professionals that are taking the rap!
> >
> > Now Congress asks the industry and profession to reach a compromise.
> >
> > In absence of the this country's national consumer organization , ACA,
> > and their unwillingness to address similar advocacy issues for amputees
> nor
> > support or
> > oppose either regulation or these proposals, indulge me with some points
> > that may interest you.
> >
> > This is not a new battle nor is it the first assault upon providers of
> O&P
> > goods and services for Medicare reimbursement.
> > I remember the same issues in the late 1970's occurring.
> > That threat was derailed primarily as the result of a amputee Senators
> > input to Congress and the industry's and the Academy's promise to
> support
> > regulation .. That did not occur and they issues are baaaack!!
> >
> > The industry is opposed to any control or regulation that maybe imposed
> on
> > their members that include DME manufactures whom were the primary
> culpurts
> > and focus to
> > reduce fraud and abuse by the federal government.
> >
> > AOPA and VGM also speak on behalf of the profession, since the
> professional
> > association ,the Academy
> > delegated to them the authority to negotiate on their behalf all O&P
> > legislation issues with Congress.Yet it is the industry whom has made
> > repeated doomsday predictions and pleas for the support of O&P
> practitioners
> > and consumers to oppose all such initiatives.
> >
> > Whom is speaking on the behalf of patients requiring these services?
> >
> > In the interest of the profession and the patients and recipients of
> > comprehensive O&P health care services,why not support a freeze on DME
> > payments for three years to avoid the immediate threat of CB and
> preserve
> > the integrity of O&P coverage from both Medicare and Medicaid ?
> >
> > While the solution remains in limbo and contention, several state
> > governments are considering eliminating O& P coverage.
> > What would be best for the patient to help stop this threat ?
> >
> > Why not support the mandatory posting of surety bonds by providers of
> DME
> > products to help curb fraud and abuse?
> >
> > Why not support and help enact state by state regulation efforts of the
> > profession as well
> > as coming to consensus on qualification language of providers for
> Medicare
> > reimbursements for O&P services ?
> >
> > Most O&P professionals that I have met, want to be regulated in their
> > perspective states and deserve the recognition and reimbursements of
> > becoming licensed health care professionals. They don't wont to be
> labeled
> > as DME providers.
> >
> > If AOPA's position in not supporting the freeze to the competitive
> bidding
> > alternative, is their fear the freeze would roll into all O&P services,
> > then
> > they should educate the lawmakers of the differences instead of
> suggesting
> > that the qualifications and issues of protecting the public of both DME
> > manufactures and O&P providers are comparable.
> >
> > If the primary goal is for AOPA to help Congress distinguish between O&P
> > and DME, how can you effectively do so when you represent both
> interests.
> >
> > Lawmaker's confusion between distinguishing between O&P and DME is a
> matter
> > of design.It is why the word patient was often replaced by consumer
> to
> > imply that
> > government regulation , both state and federal, and oversight is not
> needed
> > for delivery of these services and durable goods !
> >
> > However, the recipient of these services the word patient and
> protection
> > of the patient are often
> > resurrected to encourage increased coverage and proper reimbursement
> > levels.
> > You can not continue to have it both ways.
> >
> > Is educational qualification or a competitive bidding initiative for
> > wheelchairs, hospital beds and off the shelve orthoses as important to
> > protect
> > the public, to correctly prescribe, fabricate and deliver a custom
> > prosthesis or scoliosis brace?
> >
> > All O&P practitioners and patients of these services should be comforted
> > to know that this DME freeze proposal could be an acceptable alternative
> to
> > competitive bidding
> > and support it.
> >
> > They should also consider helping AOPA and OPGA/VGM clearly define to
> > congressional leaders, whom they represent
> > and what the differences are of DME and comprehensive O&P services ,
> since
> > it appears they could use the help!
> > Now, to go work off some more turkey.
> > Have a nice weekend!
> >
> > Tony Barr
>
>
Once again you hit the nail on the head. It is time for the Academy to step
up to the plate and represent high standards of consumer care and the O&P
professionals that they claim to represent. Leaving the lobbying and policy
making to AOPA regarding issues of O & P care is absurd. AOPA has too many
other interests that come before the consumer and professional , its like
leaving the fox in charge of the hen house. Clearly , the responsiblily to
represent consumers and professionals falls squarely on the shoulders of the
Academy. However, until its members insist on it , it will be doubtful that
any change will take place.
The Academy is best suited to educate congress through its mission of
patient care advocacy and high standards of care for professionals .A good
example of the success the Academy has achieved legislatively is project
Quantem Leap. Through the legislative efforts of the Academy regarding
Quantem Leap they were able to get over 1 million dollars from congress for
education and reseach. Think of the possibilities.We the consumers and
professionals need legislative representation on an ongoing basis not just
for ad hoc programs such as Quantum Leap.
Remember , it was the AOPA's legislation that has led to the erosion of
educational qualification's nationally regarding qualified providers. Now,
we, the professionals are paying thousands of dollars out of our pockets for
the negotiated rule making to try to keep standards of care high enough to
protect consumers.
While the Academy is to be commended for their participation in the
negotiated rulemaking sessions, if they had provided legislative
representation initially this dilema could possibly have been avoided by
blocking the legislation that AOPA pushed through.Until there is a strong
voice for the consumer and professional AOPA will do as it wishes. It is
time for the profession to move beyond Big Brother.
Ron
> -----Original Message-----
> From: Anthony T. Barr [SMTP: <Email Address Redacted> ]
> Sent: Friday, November 29, 2002 4:55 PM
> To: <Email Address Redacted>
> Subject: [OANDP-L] US Politics: Accepting a Congressional DME Freeze
> OR Competitive Bidding
>
> > As pointed out by VGM and AOPA, a compromise proposal has been
> > developed to place a three
> > year freeze to Medicare DME payments instead of imposing a legislative
> > proposal of competitive bidding program to all of DME and O&P.
> >
> > Inspite the recent claims by OPGA and AOPA, these legislative proposals
> are
> > not budget driven.
> > They are driven by multiple documented fraud and abuse cases,
> unqualified
> > providers seekin reimbursement and lack of regulation of the industry.
> >
> > It is no wonder that VGM and AOPA , both of whom are primary
> > representatives
> > of the DME industry, choose to dismiss both proposals.
> >
> > Since you stated you would like possible solutions here they are.
> >
> > Due to the obvious, conflict in representations and cross breeding
> > representation of DME and O&P interests, it is my estimation neither
> > organization, AOPA nor OPGA will advance legislative proposals that
> could
> > raise the current standards nor the very least maintain current coverage
> to
> > O&P members.
> >
> > AOPA leadership must separate their representation of both or the
> Academy
> > should negotiate their own legislative policy without consideration of
> > looking after the interests of DME manufacturers.
> >
> > This focus on Medicare reform initially came about as an effort to
> > discourage and
> > reduce the tremendous fraud and abuse that has occurred and continues
> in
> > Medicare billing, from a industry and profession that is generally
> > unregulated. Most of this fraud and abuse in Medicare billing is DME
> > related.
> > However,it is the O&P professionals that are taking the rap!
> >
> > Now Congress asks the industry and profession to reach a compromise.
> >
> > In absence of the this country's national consumer organization , ACA,
> > and their unwillingness to address similar advocacy issues for amputees
> nor
> > support or
> > oppose either regulation or these proposals, indulge me with some points
> > that may interest you.
> >
> > This is not a new battle nor is it the first assault upon providers of
> O&P
> > goods and services for Medicare reimbursement.
> > I remember the same issues in the late 1970's occurring.
> > That threat was derailed primarily as the result of a amputee Senators
> > input to Congress and the industry's and the Academy's promise to
> support
> > regulation .. That did not occur and they issues are baaaack!!
> >
> > The industry is opposed to any control or regulation that maybe imposed
> on
> > their members that include DME manufactures whom were the primary
> culpurts
> > and focus to
> > reduce fraud and abuse by the federal government.
> >
> > AOPA and VGM also speak on behalf of the profession, since the
> professional
> > association ,the Academy
> > delegated to them the authority to negotiate on their behalf all O&P
> > legislation issues with Congress.Yet it is the industry whom has made
> > repeated doomsday predictions and pleas for the support of O&P
> practitioners
> > and consumers to oppose all such initiatives.
> >
> > Whom is speaking on the behalf of patients requiring these services?
> >
> > In the interest of the profession and the patients and recipients of
> > comprehensive O&P health care services,why not support a freeze on DME
> > payments for three years to avoid the immediate threat of CB and
> preserve
> > the integrity of O&P coverage from both Medicare and Medicaid ?
> >
> > While the solution remains in limbo and contention, several state
> > governments are considering eliminating O& P coverage.
> > What would be best for the patient to help stop this threat ?
> >
> > Why not support the mandatory posting of surety bonds by providers of
> DME
> > products to help curb fraud and abuse?
> >
> > Why not support and help enact state by state regulation efforts of the
> > profession as well
> > as coming to consensus on qualification language of providers for
> Medicare
> > reimbursements for O&P services ?
> >
> > Most O&P professionals that I have met, want to be regulated in their
> > perspective states and deserve the recognition and reimbursements of
> > becoming licensed health care professionals. They don't wont to be
> labeled
> > as DME providers.
> >
> > If AOPA's position in not supporting the freeze to the competitive
> bidding
> > alternative, is their fear the freeze would roll into all O&P services,
> > then
> > they should educate the lawmakers of the differences instead of
> suggesting
> > that the qualifications and issues of protecting the public of both DME
> > manufactures and O&P providers are comparable.
> >
> > If the primary goal is for AOPA to help Congress distinguish between O&P
> > and DME, how can you effectively do so when you represent both
> interests.
> >
> > Lawmaker's confusion between distinguishing between O&P and DME is a
> matter
> > of design.It is why the word patient was often replaced by consumer
> to
> > imply that
> > government regulation , both state and federal, and oversight is not
> needed
> > for delivery of these services and durable goods !
> >
> > However, the recipient of these services the word patient and
> protection
> > of the patient are often
> > resurrected to encourage increased coverage and proper reimbursement
> > levels.
> > You can not continue to have it both ways.
> >
> > Is educational qualification or a competitive bidding initiative for
> > wheelchairs, hospital beds and off the shelve orthoses as important to
> > protect
> > the public, to correctly prescribe, fabricate and deliver a custom
> > prosthesis or scoliosis brace?
> >
> > All O&P practitioners and patients of these services should be comforted
> > to know that this DME freeze proposal could be an acceptable alternative
> to
> > competitive bidding
> > and support it.
> >
> > They should also consider helping AOPA and OPGA/VGM clearly define to
> > congressional leaders, whom they represent
> > and what the differences are of DME and comprehensive O&P services ,
> since
> > it appears they could use the help!
> > Now, to go work off some more turkey.
> > Have a nice weekend!
> >
> > Tony Barr
>
>
Citation
Gingras, Ron, “Re: US Politics: Accepting a Congressional DME Freeze OR Competitive Bidding,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/220228.
