GRAND PRAIRIE, TX – We are asked almost daily by our industry’s legislative groups to contact our congressmen and women about the issues that affect our industry and our businesses. I respect our legislative leaders because they are tireless, never hardened by rejection, and they are true champions for our seniors and patients with disabilities. They advocate not only for us as businessmen and women but through us to protect the most vulnerable citizens in our communities.
I am grateful for their work and have always felt compelled to heed their calls to action. It’s tough when you don’t know the political world and you feel like an alien calling Washington—what’s the protocol there? What’s the culture like? What words should I choose to make an impact?
What if I say exactly the wrong thing? Really, all I have to go on is the House of Cards marathon on Netflix I just finished. How would I possibly message this to someone like Frank Underwood [played by Kevin Spacey in House of Cards]?! It is daunting to step out of your comfort zone and put yourself in a vulnerable position where rejection is more likely than success. For that, I applaud our industry leaders in Washington. I am emboldened and resolute. I will fight beside them.
Recently, HR 5083 – The AIR Act (Audit Improvement and Reform Act) was introduced by Representatives Renee Ellmers (R-NC) and John Barrow (D-Ga) in an effort to reform the ridiculous audit avalanche that we are currently living under.
This is a piece of legislation I feel very passionate about. I want to get the message through to our government officials that we must restore clinical judgment and medical necessity when analyzing a claim’s validity. We’ve played by all the rules. We’ve participated in competitive bidding, we’ve signed contracts to care for Medicare beneficiaries, we keep up with the changing rules and regulations, we in-service our staff constantly on points of confusion in CMS regulations. We engage industry consultants to help us understand how the rules apply in our market. We avoid any activity or practice that could even appear to be in violation of a written or implied regulation.
But still, the audits come. Our Medicare Billing and AR Representative, Teresa Bush, put it this way: “Medicare has completely gotten away from documentation of ‘medical need’ as justification for coverage of DME and moved toward ‘documentation of documentation’ as justification for coverage of DME.”
This is unacceptable and I believe The AIR Act to be a promising solution because it directly addresses the need to restore clinical inference in the bill. Another reason I support this legislation is because it would also give reprieve to companies who consistently have low error rates.
This bill makes the MACs responsible through education efforts to reduce the overall error rates in their jurisdiction through education and outreach. The reward for achieving lowered error rates is fewer audits.
After reading through AAHomecare’s briefs and bill text I am prepared to contact my congressman and confidently ask his support for HR 5083 – The AIR Act. In deciding how to engage my congressmen, I have turned to past actions and built on that.
Last year, I traveled to Washington, DC, with AAHomecare and our Respiratory Therapist, Rhonda Merritt, to lobby our congressional leaders to stop round two of competitive bidding. Even though our company was a round one bid winner, we felt we had a unique perspective to offer.
We were not lobbying as a potential losing supplier, but explaining to our government officials how even winners are losers in this flawed bidding program. None of my day-to-day activities prepared me to walk on to Capitol Hill and into the congressman who helped construct the competitive bidding program’s office and tell him what a disaster it is.
I dreaded this visit—of all the congressmen on the Hill, how did we get the one who was most invested in the continuation of Competitive Bidding? However, we had a seasoned group whose message was on point, the Congressman and his aide were very gracious, and we walked out feeling gratified (although he did not end up supporting the legislation). This was my first visit to our Congressman. If a novice like me can get this man’s ear and make him hear the issue, I can talk to anyone about it.
During our visit to DC, we provided a blow-by-blow account of our activities on Capitol Hill through Twitter and Facebook. We included the congressmen and women we spoke to in our tweets, publicly thanking them for the meetings and urging them to sign on to the Thompson-Braley letter asking CMS to stop round two of competitive bidding.
The congressman who represents our retail store location actually signed! We thanked Rep Marc Veasey publicly for his support on social media. Congressman Barton had read our tweets before we even walked into his office. His social media coordinator greeted us by name. This was a big lesson for me in how to harness social media for political gain—what a brilliant tool.
Now I have a roadmap for making sure our congressmen know about HR 5083. Yesterday, I recalled the email communications I had with both of our congressmen’s offices last year. I forwarded those emails back to the aides I had met and began to tell them about The AIR Act.
I asked for a meeting with each of them while they are in district this August. I invited them both to our facilities to see first-hand how increasing audits impact our ability to focus on patient care. I’ve tweeted them and asked for their support.
I made it known that this article would be published in Medtrade Monday, a nationally distributed industry newsletter on Aug 4, and that I would like to tell my industry colleagues if we will be meeting. At press time, I had not yet received a response.
It is my hope that we will get our meetings in August scheduled with Congressmen Barton and Veasey. I’ve plotted my course, made my contacts, and now I wait to update you on how this story will end.
Laurie Bachorek is chief operating officer at MetroCare Home Medical Equipment Inc, Grand Prairie, Tex.