ATLANTA – Medtrade Monday began three years ago with a mission to report industry news and spread the untold stories surrounding Medtrade and Medtrade Spring. In that endeavor, we have relied on the wisdom of industry experts, many of whom have responded late on Friday nights to offer insights on so many different issues.
“We appreciate all the input from Medtrade attendees and industry experts who continue to lend their knowledge to Medtrade Monday,” said Kevin Gaffney (pictured, top left), group show director, Medtrade. “We are fortunate as well to have a top notch editor in Greg Thompson, who brings a journalistic sensibility, and more than a decade of experience in covering the industry.” Some huge stories have materialized in Medtrade Monday’s three years. Here are the highlights from 2011-2014.
Top Story from 2011
Medicare Fraud Crackdown Back in Spotlight
WASHINGTON, DC – South Florida plunged back into the fraud spotlight in September 2011 when Attorney General Eric Holder (pictured) and HHS Secretary Kathleen Sebelius touted new Medicare fraud crackdowns totaling $295 million in false billings.
Top Quote from 2011
“Miami is ground zero for everything,” said Rob Brant, former owner of Miami-based City Medical Services, and now director of Industry Relations for AAHomecare. “It was ground zero for competitive bidding, and it was ground zero for audits. I have spoken at other state association meetings, and I have asked people whether they have been audited, and no one raised a hand.”
Top Story from 2012
Sharp Drop in Round One HME Claims
WASHINGTON, DC – Economist Peter Cramton (pictured), PhD, took a hard look at data from round one bidding areas, and essentially confirmed providers’ worst suspicions. Claims for HME bid items plummeted in all bidding categories in 2011, with complex rehab taking an 82% drop. Cramton obtained his data through a Freedom of Information Act request and reported his findings to AAHomecare officials. Advocates say the sharp drop in claims suggests a dramatic decline in access to care for Medicare beneficiaries living in round one bidding areas.
“CMS has long stated that the competitive bidding program would reduce the number of HME providers without reducing access to care or reducing claims,” wrote AAHomecare officials in a report to members. “This new data contradicts the CMS assertion.”
Top Quote from 2012
“This CMS data proves what we have suspected all along,” added Cara C. Bachenheimer (pictured), senior vice president, Government Relations, Invacare, Elyria, Ohio. “The decrease in utilization, coupled with the increased health risk for beneficiaries in the bid areas, provides compelling evidence for Congress to adopt the proposed Market Pricing Program (MPP) that would remedy the serious flaws in the current CMS program.”
Top Story from 2013
Round Two: Industry Stunned
WASHINGTON, DC – Shock and despair reverberated around the industry with the release of single payment amounts for round two of competitive bidding. The average cut across all eight product categories amounted to 45%. CMS officials projected a 72% “savings” for the for the national mail-order program for diabetic testing supplies.
Top Quote from 2013
“I am stunned and numb,” said Tom Ryan, then owner of NY-based HomeCare Concepts, and now president and CEO of AAHomecare. “I will lose up to 40% of my revenue in five months. This year , ironically is my 25th year of business, and I will be struggling to make 26 years and not be a victim of a flawed government program. The suicide bidding we feared became reality.”
Top Story from 2014
Fresh AIR for Audit Woes
WASHINGTON, DC – Introduced last week, the Audit Improvement and Reform Act (AIR Act) seeks nothing less than to fix the broken Medicare audit system. Sponsored by Reps Renee Ellmers (R-NC) and John Barrow (D-Ga), the bill is designed to increase transparency, education and outreach, and reward suppliers who have low error rates on audited claims.
Top Quote from 2014
“Medicare will only be able to pay what it can pay, and that is not much,” said Jeffrey S. Baird, JD, chairman of the Health Care Group at Brown & Fortunato, Amarillo, Tex. “The customer, then, has a choice. He can accept what Medicare pays for, or he can dig into his pocket and pay for the concierge service. Many Boomers are prepared to dig into their pockets. This is where the DME industry is going—to the cash model.”