US Politics: RE-Post : Accepting a Congresstional Freeze in lieu of Competitive Bidding
Anthony T. Barr
Description
Collection
Title:
US Politics: RE-Post : Accepting a Congresstional Freeze in lieu of Competitive Bidding
Creator:
Anthony T. Barr
Date:
12/2/2002
Text:
Some subscribers indicated having difficulty in reading my reply to the above subject matter.
Hopefully the below is more uniform and can be easier to understand.
A recent compromise proposal of a 3 year freeze to Medicare DME payments instead of pursing a legislative proposal of competitive bidding program to all of DME and O&P was made in a recent e-mail posted by AOPA.
It is no wonder that VGM and AOPA ,both of whom are primary representatives
of the DME industry, choose to oppose and dismiss both these proposals when they represent
DME members whom would adamantly oppose either as an acceptable solution.
In my estimation that opposition to both will not advance legislative proposals that could raise
the standards and at the very least maintain current coverage to O&P members.
The focus on Medicare reform is not new and is not budget driven.
It came about as an effort to discourage and reduce the tremendous fraud and abuse that has occurred and is occurring in Medicare billing from a industry and profession that is generally unregulated.
Most of the documented reports by Attorney General on fraud and abuse in O&P, is DME related yet the O&P professionals are taking the rap and future coverage is being threatened to all requiring these specialized healthcare services..
In absence of this country's national consumer organization , ACA, continued unwillingness to address similar advocacy issues for amputees nor support propose 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 services for Medicare reimbursement.
The industry is opposed to any control or regulation that maybe imposed on their members that include DME manufactures whom are the primary focus to help reduce fraud and abuse by the federal government.
AOPA and VGM (DME) also speak on behalf of the profession, since the Academy delegated to them the authority to negotiate on the profession's 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, 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 and likelihood of competitively bidding be implemented NOW and preserve
the integrity of O&P coverage from both Medicare and Medicaid ?
Why not support the mandatory posting of surety bonds by providers of DME products if this would help reduce fraud and abuse That continues to threaten O&P coverage for Medicare in states that have Medicaid coverage (Massachutes is only the first).
Why not support 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 ?
If AOPA/OPGA/VGM believe their primary reason in not supporting this
alternative is the fear the freeze would roll into O&P services, then
they should educate the lawmakers of the differences make a deal
instead of suggesting the qualifications and issues of protecting
the public from both DME manufactures and O&P providers are comparable.
If the primary issue is for AOPA to help Congress distinguish between O&P
and DME, how can you effectively do so when your membership includes both ?
Lawmaker's confusion between distinguishing between O&P and DME is a matter
of design.
It is why the word patient was replaced by consumer to imply that
government regulation , both state and federal, and oversight is not needed
for delivery of these consumer services and durable goods !
However, the wordpatient is often resurrected to encourage increased coverage and reimbursement levels.
You can no longer have it both ways.
Are mandatory educational qualification for a competitive bidding initiative part of the equation? No
Is opposing a freeze on payment schedules for wheelchairs, hospital beds, non custom orthoses and other durable goods and services, as important to protect the public, as supporting educational standards to better prescribe, fabricate and deliver a custom prosthesis or scoliosis brace?
All O&P professional practitioners and patients of these services think the DME freeze proposal as an alternative to initiating competitive bidding for O&P which is presently on the table, than they should consider it.
After all is not DME accountable for the fraud and abuse that was done by their members that influenced the need of both of these proposals? Shouldn't the punishment fit the crime and be directed to those that abused the system ?
They should also consider helping AOPA clearly define whom they represent
and what the differences of DME and comprehensive O&P services are to the
Congress , since your delegate may need a little help.
Tony Barr
----- Original Message -----
From: Jim Andreassen < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Wednesday, November 27, 2002 4:31 PM
Subject: [OANDP-L] FW: [OANDP-L] <US Politics> O&P Urged to Oppose VGM
Medicare Competitive Bidding Alternative
To List Serve Members,
Thank you to AOPA for their posting on national competitive bidding. We are
all very concerned about what is happening in DC and want to find some way
to get them to refocus on patient care and stop trying to balance the
budget on the backs of O & P practitioners. While it is true that VGM is the
parent company of OPGA, we have, in the past, and will continue to in the
future, operate as completely separate entities. We understand that DME
and O&P are different industries and should be treated accordingly.
OPGA has not or does not endorse a Medicare freeze on O&P reimbursement
levels. In fact, as you might recall from past list serve traffic, we
have been a large advocate for the O&P industry in the battle against
competitive bidding.
I did check with VGM to be sure I understood what they had surveyed their Members on.
OPGA continually responds to the needs of its Members and is not interested in solutions which don't work for them.
However, I do not see anything in what VGM has proposed for HME which would prevent us from
continuing the battle to STOP competitive bidding or, that failing, keep it from including O&P.
Also understand that VGM was merely surveying it's Members in order to better identify the needs of the DME/HME industry.
Beyond that, nothing has been done. First and foremost, we all (AOPA,OPGA, and VGM) want to stop national competitive bidding.
Jim Andreassen
President, OPGA
Hopefully the below is more uniform and can be easier to understand.
A recent compromise proposal of a 3 year freeze to Medicare DME payments instead of pursing a legislative proposal of competitive bidding program to all of DME and O&P was made in a recent e-mail posted by AOPA.
It is no wonder that VGM and AOPA ,both of whom are primary representatives
of the DME industry, choose to oppose and dismiss both these proposals when they represent
DME members whom would adamantly oppose either as an acceptable solution.
In my estimation that opposition to both will not advance legislative proposals that could raise
the standards and at the very least maintain current coverage to O&P members.
The focus on Medicare reform is not new and is not budget driven.
It came about as an effort to discourage and reduce the tremendous fraud and abuse that has occurred and is occurring in Medicare billing from a industry and profession that is generally unregulated.
Most of the documented reports by Attorney General on fraud and abuse in O&P, is DME related yet the O&P professionals are taking the rap and future coverage is being threatened to all requiring these specialized healthcare services..
In absence of this country's national consumer organization , ACA, continued unwillingness to address similar advocacy issues for amputees nor support propose 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 services for Medicare reimbursement.
The industry is opposed to any control or regulation that maybe imposed on their members that include DME manufactures whom are the primary focus to help reduce fraud and abuse by the federal government.
AOPA and VGM (DME) also speak on behalf of the profession, since the Academy delegated to them the authority to negotiate on the profession's 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, 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 and likelihood of competitively bidding be implemented NOW and preserve
the integrity of O&P coverage from both Medicare and Medicaid ?
Why not support the mandatory posting of surety bonds by providers of DME products if this would help reduce fraud and abuse That continues to threaten O&P coverage for Medicare in states that have Medicaid coverage (Massachutes is only the first).
Why not support 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 ?
If AOPA/OPGA/VGM believe their primary reason in not supporting this
alternative is the fear the freeze would roll into O&P services, then
they should educate the lawmakers of the differences make a deal
instead of suggesting the qualifications and issues of protecting
the public from both DME manufactures and O&P providers are comparable.
If the primary issue is for AOPA to help Congress distinguish between O&P
and DME, how can you effectively do so when your membership includes both ?
Lawmaker's confusion between distinguishing between O&P and DME is a matter
of design.
It is why the word patient was replaced by consumer to imply that
government regulation , both state and federal, and oversight is not needed
for delivery of these consumer services and durable goods !
However, the wordpatient is often resurrected to encourage increased coverage and reimbursement levels.
You can no longer have it both ways.
Are mandatory educational qualification for a competitive bidding initiative part of the equation? No
Is opposing a freeze on payment schedules for wheelchairs, hospital beds, non custom orthoses and other durable goods and services, as important to protect the public, as supporting educational standards to better prescribe, fabricate and deliver a custom prosthesis or scoliosis brace?
All O&P professional practitioners and patients of these services think the DME freeze proposal as an alternative to initiating competitive bidding for O&P which is presently on the table, than they should consider it.
After all is not DME accountable for the fraud and abuse that was done by their members that influenced the need of both of these proposals? Shouldn't the punishment fit the crime and be directed to those that abused the system ?
They should also consider helping AOPA clearly define whom they represent
and what the differences of DME and comprehensive O&P services are to the
Congress , since your delegate may need a little help.
Tony Barr
----- Original Message -----
From: Jim Andreassen < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Wednesday, November 27, 2002 4:31 PM
Subject: [OANDP-L] FW: [OANDP-L] <US Politics> O&P Urged to Oppose VGM
Medicare Competitive Bidding Alternative
To List Serve Members,
Thank you to AOPA for their posting on national competitive bidding. We are
all very concerned about what is happening in DC and want to find some way
to get them to refocus on patient care and stop trying to balance the
budget on the backs of O & P practitioners. While it is true that VGM is the
parent company of OPGA, we have, in the past, and will continue to in the
future, operate as completely separate entities. We understand that DME
and O&P are different industries and should be treated accordingly.
OPGA has not or does not endorse a Medicare freeze on O&P reimbursement
levels. In fact, as you might recall from past list serve traffic, we
have been a large advocate for the O&P industry in the battle against
competitive bidding.
I did check with VGM to be sure I understood what they had surveyed their Members on.
OPGA continually responds to the needs of its Members and is not interested in solutions which don't work for them.
However, I do not see anything in what VGM has proposed for HME which would prevent us from
continuing the battle to STOP competitive bidding or, that failing, keep it from including O&P.
Also understand that VGM was merely surveying it's Members in order to better identify the needs of the DME/HME industry.
Beyond that, nothing has been done. First and foremost, we all (AOPA,OPGA, and VGM) want to stop national competitive bidding.
Jim Andreassen
President, OPGA
Citation
Anthony T. Barr, “US Politics: RE-Post : Accepting a Congresstional Freeze in lieu of Competitive Bidding,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/220230.
