Packer Perspective: The Will to Win

Posted on in HME Government Issues

By Greg Packer, U.S. Rehab

The will to win, the desire to succeed, the urge to reach your full potential…these are the keys that will unlock the door to personal excellence. – Confucius

This is a perfect example of where we are today in the complex rehab arena. We have the will to win and the desire to succeed. We are starting to reach our full potential at this time as we have the ear of Congress. We have unlocked the door, now we need to step through it.

As an industry, we were able to achieve the delay of the application of competitive bid pricing to complex rehab power wheelchair accessories through hard work and perseverance. We have gone further than we have in this fight, and we are not finished. It is time to push the ball down the field further than we have ever gone before.

CMS has used alarming methods of trying to divide us as a group to make sure their agenda is pushed. This has worked temporarily. They know that this shortsighted mentality will not prevail in the end. This is why we will succeed as they have pushed the wrong message to Congress too long with misrepresented information.

Let me explain. In December 2015, CMS pushed Congress at the 11th hour to not include manual chairs in the delay of complex rehab accessories. Why would they do that? They are the same accessories for the same type of patients and with the same therapeutic value. Why would anyone in their right mind do this to patients?

The one logical reason is that CMS knows something about the therapeutic value that we do not. We know that this cannot be the case. It seems like CMS is trying to save money anywhere they can, and cost of delivering equipment to patients is not a concern to them. Based on the current deceptive methods and statements CMS makes to Congress, it seems that the protection of patients’ financial well-being is not a concern to them either. CMS deceptively told Congress that the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) did not have manual chairs in it, so why would the industry overreach by trying to include it in the current legislation?

This tactic is so deceptive that it is hard to stomach because the industry knows the real story. We know that MIPPA was passed when only power equipment was being bid. CMS knows this as well. Congress does not understand this unless an individual congressman or congresswoman was present in 2008, was directly involved in the issue and is still there. This is how CMS is playing the game and how deceptive communications are passed to your legislators. 

CMS has recently deceived us again. They announced that the one-year delay of applying competitive bid pricing to group 3 power wheelchair accessories will not be implemented until July 1, 2016.  Instead of holding onto claims until the system was updated to pay these claims appropriately, providers will have to submit these claims and request a reopening to anything that was paid incorrectly at the competitive bid rate. This process causes a tremendous burden on you because you will have to track incorrect payments and request they be paid correctly.

The deceptions perpetuated by CMS makes me fighting mad. We need to be ready to push back with all our might. We are pushing for changes to the Medicare policy for the right reasons and for the right people: those with disabilities who are not able to function without medically necessary equipment. We understand the issue, but Congress does not understand it at our level. However, they understand it now more than they ever have, and it is time to strike. The old saying, “strike while the iron is hot so you can make the change” is in play. Congressional leaders and key committee members understand what we are about now; they know complex rehab is not DME. The goal is to get them to understand even more so CMS cannot deceive them in the future.  

We will be in the fight of our lives again very soon for complex rehab accessories and need to have our agenda accomplished before the next recess and all political campaigns go into full swing this year. This urgency is why it is so critical when the industry reaches out to you. We will be coordinating the efforts with NCART and AAHomecare. Please understand that when we have a call to action, we are serious about it. Please take the call and move on it.

Thank you to all who have helped get us to where we are today. It has not been easy, and you are the reason we are here. The efforts that were done at the end of last year were monumental and because of that, we are still in this fight. Thank you so much from the whole industry and especially from VGM/US Rehab.