CMS Removing Barriers, DMEPOS Providers Remain Vigilant, and FEAT

Published in Member Communities on April 07, 2020

CMS announced last week that it would be removing Local and National Coverage Determination requirements for oxygen and other respiratory equipment such as PAP, RAD and ventilators, in addition to infusion products. By doing this, it opens up the ability to bill and receive payment for these products in instances that would not have warranted coverage before. It will allow acute patients in the hospital with pneumonia to be discharged home with oxygen on a temporary basis in order to free up the much-needed hospital bed. It will also allow for the application of an oxygen concentrator or a ventilator for COVID-19 patients.

We are being given an enormous opportunity by CMS at this moment. An opportunity to shine, provide tremendous value, and help save lives during this pandemic, which could forever change the image of our industry with policymakers for the future. This also means we must remain vigilant. We as an industry have worked hard to have a unified message and improve what was a less than stellar image—let’s not undo all the work we’ve done. We have a responsibility to do the right thing.

Lifting restrictions also comes with the potential for abuse. CMS has also opened up the enrollment process to allow for entities to enroll and receive temporary billing privileges without being accredited while waiving application fees and background checks. This certainly makes Medicare and our industry vulnerable to unscrupulous outsiders taking advantage of the situation.

Our efforts to maintain an ethical society within the DMEPOS industry led to the formation of the Fraud Eradication Advisory Team, or FEAT. VGM, in conjunction with a group of industry stakeholders and an advisory council of consultants, is taking a collaborative approach to combating HME fraud and abuse. FEAT operates as a sounding board for all (including state associations, advocacy groups, manufacturers, providers and beneficiaries) to assist CMS in its task of rooting out the criminals that are robbing our government of precious healthcare benefit dollars.

We created a website and electronic reporting tool for use in conveying information about suspected fraud or abuse of the Medicare program. Medicare is a federally funded program created for your healthcare benefit. Fraudulent activities not only steal from the government, but from you as a taxpaying citizen. If you suspect a supplier, physician, clinician, manufacturer or other entity is committing an act of fraud against Medicare, we ask that you act and report them now. All submissions remain confidential.

Click here to view a letter from Clint Geffert, President of VGM & Associates

Click here to view a letter from Wayne van Halem, President of The van Halem Group, a subsidiary of VGM

Click here to see AAHomecare’s message.