Congressman Mike Ross Revs Up AAHomecare Audience on Advocacy, Competitive Bidding

Main Category: Caregivers / Homecare
Article Date: 11 Jun 2005 - 7:00 PDT

email to a friend   printer friendly   opinions  

"It's time to restore some common sense to CMS," Rep. Mike Ross (D-AR) told the American Association for Homecare conference yesterday. "And a good place to start is getting rid of competitive bidding."

Ross, who serves on the House Energy and Commerce Committee, which influences healthcare laws, delivered a call to homecare providers to stand up and deliver a strong message to Congress about the value of homecare. In return, the hundreds of providers in the audience stood up and gave Ross a standing ovation.

Ross, who owns a 12-person HME and pharmacy business in Arkansas with his wife, is the only homecare owner in Congress. He delivered the keynote address at the AAHomecare Washington Leadership Conference this week where members gathered to lobby Congress and strengthen homecare policy.

The Congressman predicted that there may be an opportunity to influence Medicare law in early to mid 2006, after the new prescription drug benefit in the Medicare Modernization Act (MMA) has taken effect. Sen. Chuck Grassley (R-IA), Chair of the Finance Committee, has indicated that he will not "open up" the MMA for changes this year.

He told the group that the most important message is that, "Without the services and equipment we provide, thousands of seniors would be forced into nursing homes."

Noting that "most Members of Congress don't understand what you do," he stressed the importance of explaining the value of homecare and homecare providers. Specifically, he recommended that providers speak with the scheduler for their Members of Congress to set up an appointment for the Member to ride along on a homecare visit or site tour to illustrate homecare firsthand.

DMERCs Explain Transition for Coverage of Mobility Equipment

Today the Durable Medical Equipment Regional Carriers (DMERCs) released the anticipated transition article for the new National Coverage Determination (NCD) for Mobility Assistance Equipment (MAE). The article explains the new NCD and how it applies to the current Certificates of Medical Necessity (CMN) and their Local Coverage Determinations (LCD).

The article provides an overview of the new NCD as well as a chart, which explains how the current CMNs for motorized wheelchairs, scooters, and manual wheelchairs must now be completed under the new NCD. Specific questions on the motorized wheelchair, scooter, and manual wheelchair CMN now no longer apply.

The DMERCs state that the new coverage criteria outlined in the new NCD applies on or after May 5, 2005. Regarding documentation requirements, the DMERCs said, "It is expected that the patient's 'medical records' will reflect the need for the care provided. The patient's medical records include the physician's office records, hospital records, nursing home records, home health agency records, records from other healthcare professionals, and test reports."

Also, suppliers may be asked to provide information that corroborates the medical need for the MAE provided in the event of an audit or review. They encourage providers to work with referral sources to ensure the necessary information is documented in the patient's medical record. More on documentation will be included in the Power Mobility LCD, which is expected to be released for comment sometime this summer.

AAHomecare's Rehab and Assistive Technology Council will continue to communicate to CMS the need to release the additional companion regulations to the NCD (face-to-face exam requirements, revised CMN, revised POV policy).

Seth Johnson, director of government relations at Pride Mobility and new RATC Chair, met with CMS officials this week in Washington D.C. CMS indicated the publication of these regulations is a top priority for Administrator Mark McClellan and they will be released very soon. These additional regulations will offer additional guidance for suppliers regarding documentation and coverage.

To read the article, see "Transitioning to the Mobility Assistive Equipment National Coverage Determination" under "What's New" at
palmettogba.com/palmetto/providers.nsf

Michael Reinemer, VP, Communications
American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171 703-535-1881
http://www.aahomecare.org

• Additional
• References
• Citations