Re: EMERGENCY MEETING! DATE CHANGE TO BE ANNOUNCED!
Lou Haberman CPO
Description
Collection
Title:
Re: EMERGENCY MEETING! DATE CHANGE TO BE ANNOUNCED!
Creator:
Lou Haberman CPO
Date:
7/12/2013
Text:
To All:
I am pleased by your responses. Thank you, all, for your many insightful
comments, commitments and contributions to understanding the magnitude of the
CMS issue. I expect to reply to each of you in the days ahead. I still do
not see a collective response from independent practitioners. An
alternative strategy must be employed without much more delay. An effective strategy
and response will require many more of you to enlist.
We have a wonderful story to tell. We must tell it! Every one of you will
be taken to the 'gallows' in the months ahead. The purpose of this meeting
is to share experiences and knowledge, suggest strategies and form a
coalition. There is much more, but I do not wish to discuss such things here. I
believe that every state must be represented so as to reach out to their
peers (thank you Wyoming, Florida and Illinois). How can anyone ignore this
challenge? And, if you don't already know it, we should all be best of
friends!
In this battle, some of our peers have demonstrated remarkable strength and
endurance while amassing a wealth of information unknown to the rest of
us. Kudos to them.Yet, individually, we will continue to reinvent the wheel
as we battle the behemoth. None of us have the resources to perpetually
fight these abuses and, simultaneously, operate a patient-care facility
without a cash flow or an assurance of payment.
I have been advised, by participants of this group, that many of our fellow
practitioners are not users, or regular users of this List Serve and
remain unaware of this Call To Act More time is needed for the notification
of our peers for participating in this critically important discussion. You
should all call your new best friends about this gathering. Another meeting
announcement will be made shortly. It should be mailed to every
practitioner in your state. Acquire your state's Facilities mailing list. You all
must help us in this effort. The meeting must occur in August. If you are too
busy, or on vacation, and will not participate, then you do not yet realize
the power and scope of HHS/CMS.
This meeting is limited to Certified and Licensed O & P practitioners and
entrepreneurs (facility owners) . I regret that there can be no Webinar or
call-ins. I will require your commitment to determine a final location to
accommodate this gathering, and more.
Additionally, by this note, I wanted to advise those of you that have
committed to the July 20th meeting to plan for a later date. There are several
practitioners now assisting in putting this meeting together. We are, like
you, very busy and working hard to produce even less revenue. Your actions,
or inactions, will determine this profession's continuity.
There are some measures that should be instituted, without delay, within
your offices and this information will, also, be provided to you soon. I
cannot assure you that we can win, but we will be seen, heard and we will make
an impact! Simply, there are few, if any other, options left to you. Your
support of this initiative cannot be overstated.
Lou Haberman, CPO/LPO
In a message dated 7/8/2013 9:25:09 P.M. Eastern Daylight Time,
<Email Address Redacted> writes:
To All:
If you provide Medicare services, you will be audited! You cannot hide by
being silent. New prosthetic work delivered will be subject to Pre-Audits
and old claims are being audited by Regulations, issued retroactively.
Your cash-flow will vanish, if this has not already happened. In time, I am
certain, this process will be withdrawn and CMS will say ... Ooops, sorry,
but you will be selling life insurance or used cars, by that time. It will
take years to repopulate this profession by caring and educated
practitioners like yourself. I am astonished by the lack of commentary by my peers
regarding the most dire issue faced by our profession! Let it, also,be known
that your professional credibility, via CMS/HSS Regulation, has now been
reduced to that of a home health aid! Your education/training/clinical
experience no longer has any credibility! What do you need to 'wake you up!!!' You
will be out-of-business within 1 year. This current business model could
not be survived by AT&T! CMS does not listen and does not care. Our pleas to
them have been ignored for over a decade. The AOPA lawsuit will take years
for a decision/result and a positive outcome is uncertain. CMS is a
juggernaut and is unchecked in their prosecution of the prosthetic industry
(Orthotics, en masse, soon to come).
It is time to come together and discuss this issue and take action. It is
time to make the media and the public aware of this debacle. I believe,
that a political remedy is this profession's only remaining course of action.
Politicians measure/gauge the seriousness of any situation by a ruler
against a stack of paper complaints. We will need feet to accomplish a remedy.
I am planning a meeting/chat on Saturday, July 20, 2013 in New Jersey.
Actionable approaches will be discussed and consumer handouts will be
provided. I've noticed only a few voices on this List-Serve that are willing to
fight these injustices. Years ago, I spent much time to enlighten
practitioners that it was important, critically important, to move the profession
forward, via State recognition ... licensure. This fight is even greater. If you
do not respond, I will engage no more with this community. Your RSVP is
required ASAP. There is little time remaining for a meaningful response. The
entire country is invited. Get involved now ... you can be part of the
solution. Let me know.
RSVP to <Email Address Redacted> (mailto:<Email Address Redacted>)
Lou Haberman, CPO/LPO
In a message dated 7/8/2013 4:49:00 P.M. Eastern Daylight Time,
<Email Address Redacted> writes:
Please find the link below for our video on this subject matter. Also, see
our written update.
Death by a thousand cuts. Video Webcast
( <URL Redacted>)
Death by a Thousand Cuts
A little dramatic perhaps, but the title of this month's update seems to
describe the Medicare auditing situation and the growing pressure on
orthotic and prosthetic providers and suppliers. This month alone, CMS has
proposed a new regulation that would permit CMS to disenroll a Medicare
supplier if they have a pattern of high error rates in Medicare audits,
even
if the denied claims are being appealed. The HHS Office of Inspector
General
issued a report on surety bonds that has already prompted some contractors
to begin collecting on surety bonds even in instances where Medicare
regulations prohibit this from occurring. And CMS issued a Transmittal
allowing CMS to deny enrollment applications of O&P and other providers and
suppliers when an overpayment exists, even though that overpayment is in
the
administrative appeals process.
NAAOP, in conjunction with the O&P Alliance, is responding to each of these
new developments and actively pushing back, but given CMS's lack of
response
on the physician documentation problems to date, the outcome of our
advocacy
is difficult to predict. Protecting the Medicare program from fraud and
abuse is good politics, but the fact that these efforts are ensnaring
legitimate providers in all settings, including O&P, is beginning to take
hold.
But hope is on the horizon. The Senate Finance Committee recently held a
hearing on Recovery Audit Contractors and, to the surprise of many
observers, all but one Senator expressed concern that perhaps the RACs
financial incentives are so lucrative that RACs are ultimately denying
legitimate claims in order to make a profit. A recent OIG report found that
60% of RAC denials are overturned at the ALJ level of review, a figure that
many Senators on the Finance Committee found very alarming.
In fact, Senator Hatch, the ranking Republican on the Finance Committee,
stated, Such a high rate of reversal raises questions as to whether RACs
are being too aggressive or do not understand current medical practice.
Raising awareness of overzealous Medicare contractors is a necessary
ingredient to getting Congress to act to reign them in.
NAAOP will continue to track these developments and advocate for
protections
for O&P professionals, providers, and suppliers. Thank you for your
support.
Please visit our website at: www.naaop.org
NAAOP
1501 M Street, NW
7th Floor
Washington, DC 20005-1700
e-mail: <Email Address Redacted>
(800) 622-6740
(202) 624-0064 Phone
(202) 785-1756 Fax
www.naaop.org
I am pleased by your responses. Thank you, all, for your many insightful
comments, commitments and contributions to understanding the magnitude of the
CMS issue. I expect to reply to each of you in the days ahead. I still do
not see a collective response from independent practitioners. An
alternative strategy must be employed without much more delay. An effective strategy
and response will require many more of you to enlist.
We have a wonderful story to tell. We must tell it! Every one of you will
be taken to the 'gallows' in the months ahead. The purpose of this meeting
is to share experiences and knowledge, suggest strategies and form a
coalition. There is much more, but I do not wish to discuss such things here. I
believe that every state must be represented so as to reach out to their
peers (thank you Wyoming, Florida and Illinois). How can anyone ignore this
challenge? And, if you don't already know it, we should all be best of
friends!
In this battle, some of our peers have demonstrated remarkable strength and
endurance while amassing a wealth of information unknown to the rest of
us. Kudos to them.Yet, individually, we will continue to reinvent the wheel
as we battle the behemoth. None of us have the resources to perpetually
fight these abuses and, simultaneously, operate a patient-care facility
without a cash flow or an assurance of payment.
I have been advised, by participants of this group, that many of our fellow
practitioners are not users, or regular users of this List Serve and
remain unaware of this Call To Act More time is needed for the notification
of our peers for participating in this critically important discussion. You
should all call your new best friends about this gathering. Another meeting
announcement will be made shortly. It should be mailed to every
practitioner in your state. Acquire your state's Facilities mailing list. You all
must help us in this effort. The meeting must occur in August. If you are too
busy, or on vacation, and will not participate, then you do not yet realize
the power and scope of HHS/CMS.
This meeting is limited to Certified and Licensed O & P practitioners and
entrepreneurs (facility owners) . I regret that there can be no Webinar or
call-ins. I will require your commitment to determine a final location to
accommodate this gathering, and more.
Additionally, by this note, I wanted to advise those of you that have
committed to the July 20th meeting to plan for a later date. There are several
practitioners now assisting in putting this meeting together. We are, like
you, very busy and working hard to produce even less revenue. Your actions,
or inactions, will determine this profession's continuity.
There are some measures that should be instituted, without delay, within
your offices and this information will, also, be provided to you soon. I
cannot assure you that we can win, but we will be seen, heard and we will make
an impact! Simply, there are few, if any other, options left to you. Your
support of this initiative cannot be overstated.
Lou Haberman, CPO/LPO
In a message dated 7/8/2013 9:25:09 P.M. Eastern Daylight Time,
<Email Address Redacted> writes:
To All:
If you provide Medicare services, you will be audited! You cannot hide by
being silent. New prosthetic work delivered will be subject to Pre-Audits
and old claims are being audited by Regulations, issued retroactively.
Your cash-flow will vanish, if this has not already happened. In time, I am
certain, this process will be withdrawn and CMS will say ... Ooops, sorry,
but you will be selling life insurance or used cars, by that time. It will
take years to repopulate this profession by caring and educated
practitioners like yourself. I am astonished by the lack of commentary by my peers
regarding the most dire issue faced by our profession! Let it, also,be known
that your professional credibility, via CMS/HSS Regulation, has now been
reduced to that of a home health aid! Your education/training/clinical
experience no longer has any credibility! What do you need to 'wake you up!!!' You
will be out-of-business within 1 year. This current business model could
not be survived by AT&T! CMS does not listen and does not care. Our pleas to
them have been ignored for over a decade. The AOPA lawsuit will take years
for a decision/result and a positive outcome is uncertain. CMS is a
juggernaut and is unchecked in their prosecution of the prosthetic industry
(Orthotics, en masse, soon to come).
It is time to come together and discuss this issue and take action. It is
time to make the media and the public aware of this debacle. I believe,
that a political remedy is this profession's only remaining course of action.
Politicians measure/gauge the seriousness of any situation by a ruler
against a stack of paper complaints. We will need feet to accomplish a remedy.
I am planning a meeting/chat on Saturday, July 20, 2013 in New Jersey.
Actionable approaches will be discussed and consumer handouts will be
provided. I've noticed only a few voices on this List-Serve that are willing to
fight these injustices. Years ago, I spent much time to enlighten
practitioners that it was important, critically important, to move the profession
forward, via State recognition ... licensure. This fight is even greater. If you
do not respond, I will engage no more with this community. Your RSVP is
required ASAP. There is little time remaining for a meaningful response. The
entire country is invited. Get involved now ... you can be part of the
solution. Let me know.
RSVP to <Email Address Redacted> (mailto:<Email Address Redacted>)
Lou Haberman, CPO/LPO
In a message dated 7/8/2013 4:49:00 P.M. Eastern Daylight Time,
<Email Address Redacted> writes:
Please find the link below for our video on this subject matter. Also, see
our written update.
Death by a thousand cuts. Video Webcast
( <URL Redacted>)
Death by a Thousand Cuts
A little dramatic perhaps, but the title of this month's update seems to
describe the Medicare auditing situation and the growing pressure on
orthotic and prosthetic providers and suppliers. This month alone, CMS has
proposed a new regulation that would permit CMS to disenroll a Medicare
supplier if they have a pattern of high error rates in Medicare audits,
even
if the denied claims are being appealed. The HHS Office of Inspector
General
issued a report on surety bonds that has already prompted some contractors
to begin collecting on surety bonds even in instances where Medicare
regulations prohibit this from occurring. And CMS issued a Transmittal
allowing CMS to deny enrollment applications of O&P and other providers and
suppliers when an overpayment exists, even though that overpayment is in
the
administrative appeals process.
NAAOP, in conjunction with the O&P Alliance, is responding to each of these
new developments and actively pushing back, but given CMS's lack of
response
on the physician documentation problems to date, the outcome of our
advocacy
is difficult to predict. Protecting the Medicare program from fraud and
abuse is good politics, but the fact that these efforts are ensnaring
legitimate providers in all settings, including O&P, is beginning to take
hold.
But hope is on the horizon. The Senate Finance Committee recently held a
hearing on Recovery Audit Contractors and, to the surprise of many
observers, all but one Senator expressed concern that perhaps the RACs
financial incentives are so lucrative that RACs are ultimately denying
legitimate claims in order to make a profit. A recent OIG report found that
60% of RAC denials are overturned at the ALJ level of review, a figure that
many Senators on the Finance Committee found very alarming.
In fact, Senator Hatch, the ranking Republican on the Finance Committee,
stated, Such a high rate of reversal raises questions as to whether RACs
are being too aggressive or do not understand current medical practice.
Raising awareness of overzealous Medicare contractors is a necessary
ingredient to getting Congress to act to reign them in.
NAAOP will continue to track these developments and advocate for
protections
for O&P professionals, providers, and suppliers. Thank you for your
support.
Please visit our website at: www.naaop.org
NAAOP
1501 M Street, NW
7th Floor
Washington, DC 20005-1700
e-mail: <Email Address Redacted>
(800) 622-6740
(202) 624-0064 Phone
(202) 785-1756 Fax
www.naaop.org
Citation
Lou Haberman CPO, “Re: EMERGENCY MEETING! DATE CHANGE TO BE ANNOUNCED!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/235354.
