Invoice Costs
Wil
Description
Collection
Title:
Invoice Costs
Creator:
Wil
Date:
6/22/2013
Text:
Hello Colleagues and Guests,
The issue of invoice costs related to Medicare claims is very troubling
to me. I would like to see a document that gives the federal government
authority to base the reimbursement amount for a given item based upon
actual supplier's costs. The original L-Code system was based upon usual
and customary fees (what the market will bear) and then later tweaked to
the system we have now which in no way reflects generally accepted
accounting principles. It is my understanding that all federal
contracts, by law, must allow for a reasonable profit. If a contract is
awarded that does not allow for a reasonable profit, then the contractor
will not be able to meet the requirements of the contract and thus the
intent of the contract is not fulfilled. Is this not the reason why
highway contracts require union labor rates when submitting a contract
proposal? If not, what other reason would there be? Politics? I see.
If the logic for Medicare payment is based upon item costs such as
rivets, Velcro, etc., without regard to the rest of the story, then we
need to examine the entire federal procurement system, including the
wages of all federal workers. Is there logic in how accountants,
lawyers, physicians, and politicians are paid for their services? The
answer is no, unless what the market will bear is considered logic. They
like the rest of us, rely upon a free market system that provides for a
competitive arena wherein what the market will bear is a major driving
force in what services and goods are bought and sold. It is not
necessarily based upon costs. An example of this is gasoline. Purchase
gasoline in a remote area or on the boat dock and you will likely pay
what the market will bear for the same product that sells elsewhere for
less.
I raise this issue to suggest that we need to question the legality of
Medicare's request for itemized costs. If they are legally permitted to
get our itemized costs, then the entire spectrum of our costs must be
included, including a reasonable margin for profit and the additional
administrative and professional costs that are directly related to
Medicare's requirements. In this day and age of perceived runaway greed
and corruption within and without the federal government, we need to
publicly hold those who are playing by unilateral rules accountable both
within and without.
Finally, I saw a post noting that only a few participated in the SBA
Fairness Hearing. The same has been true for many other endeavors that
may hold promise for improving our standing within the medical
profession. I'll use the recent patient survey project as an example.
Like many organization memberships, we complain about what is not being
done, but rarely find the time to get involved. I believe the
consequences of complacency will be more severe than you are willing to
accept, compared to the time and energy involved in fighting the fight.
Prior to getting my butt chewed out by the ABC Board many years ago, I
told them I felt like the country dog in the city. Stand still and you
get screwed, run and you get bit in the ass. Ever feel that way?
Wil Haines, CPO
MaxCare Bionics
Avon, IN
The issue of invoice costs related to Medicare claims is very troubling
to me. I would like to see a document that gives the federal government
authority to base the reimbursement amount for a given item based upon
actual supplier's costs. The original L-Code system was based upon usual
and customary fees (what the market will bear) and then later tweaked to
the system we have now which in no way reflects generally accepted
accounting principles. It is my understanding that all federal
contracts, by law, must allow for a reasonable profit. If a contract is
awarded that does not allow for a reasonable profit, then the contractor
will not be able to meet the requirements of the contract and thus the
intent of the contract is not fulfilled. Is this not the reason why
highway contracts require union labor rates when submitting a contract
proposal? If not, what other reason would there be? Politics? I see.
If the logic for Medicare payment is based upon item costs such as
rivets, Velcro, etc., without regard to the rest of the story, then we
need to examine the entire federal procurement system, including the
wages of all federal workers. Is there logic in how accountants,
lawyers, physicians, and politicians are paid for their services? The
answer is no, unless what the market will bear is considered logic. They
like the rest of us, rely upon a free market system that provides for a
competitive arena wherein what the market will bear is a major driving
force in what services and goods are bought and sold. It is not
necessarily based upon costs. An example of this is gasoline. Purchase
gasoline in a remote area or on the boat dock and you will likely pay
what the market will bear for the same product that sells elsewhere for
less.
I raise this issue to suggest that we need to question the legality of
Medicare's request for itemized costs. If they are legally permitted to
get our itemized costs, then the entire spectrum of our costs must be
included, including a reasonable margin for profit and the additional
administrative and professional costs that are directly related to
Medicare's requirements. In this day and age of perceived runaway greed
and corruption within and without the federal government, we need to
publicly hold those who are playing by unilateral rules accountable both
within and without.
Finally, I saw a post noting that only a few participated in the SBA
Fairness Hearing. The same has been true for many other endeavors that
may hold promise for improving our standing within the medical
profession. I'll use the recent patient survey project as an example.
Like many organization memberships, we complain about what is not being
done, but rarely find the time to get involved. I believe the
consequences of complacency will be more severe than you are willing to
accept, compared to the time and energy involved in fighting the fight.
Prior to getting my butt chewed out by the ABC Board many years ago, I
told them I felt like the country dog in the city. Stand still and you
get screwed, run and you get bit in the ass. Ever feel that way?
Wil Haines, CPO
MaxCare Bionics
Avon, IN
Citation
Wil, “Invoice Costs,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/235263.
