EMERGENCY MEETING! WAKE UP ... YOU CANNOT HIDE FROM THE CMS!!!
Lou Haberman CPO
Description
Collection
Title:
EMERGENCY MEETING! WAKE UP ... YOU CANNOT HIDE FROM THE CMS!!!
Creator:
Lou Haberman CPO
Date:
7/8/2013
Text:
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certain, this process will be withdrawn and CMS will say ...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
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, “EMERGENCY MEETING! WAKE UP ... YOU CANNOT HIDE FROM THE CMS!!!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/235356.
