CMS Admits New Surety Bond and Accreditation Requirement for Home Medical Equipment Suppliers Creating Patient Access Issues

CMS Admits New Surety Bond and Accreditation Requirement for Home Medical
Equipment Suppliers Creating Patient Access Issues

Medicare Beneficiaries in Eight Montana Counties May Be Forced to Pay Full
Costs for Supplies if They Have No Access to a Medicare Approved Supplier

WASHINGTON, Nov. 3 /PRNewswire-USNewswire/ -- In an email sent to Montana home
equipment suppliers on October 30th, a Center for Medicare and Medicaid
Services (CMS) official admitted there are "areas within Montana, a Medicare
beneficiary may experience supplier access issues in obtaining certain"
durable medical equipment and supplies. CMS official Lucretia James further
notes patient access problems are due to a shortage of suppliers meeting the
agency's new surety bond and accreditation requirements. She added, "some
have chosen not to stay enrolled."

The email states Medicare patients may have experienced problems accessing
oxygen, enteral nutrition (tube feeding), parenteral (intravenous nutrition),
and power wheelchairs in eight Montana counties, Daniels, Sheridan, Roosevelt,
Phillips, Musselshell, Fergus, Stillwater, and Carbon. In addition to this
burgeoning access problem, Medicare patients will be penalized financially if
they use a supplier they've being going to for years, which doesn't meet the
new requirements, but may be the only supplier in their area. James warns, "If
a beneficiary continues to get supplies from a supplier who has not met these
requirements, Medicare won't pay and the beneficiary may have to pay the full
cost for the supplies."

"While CMS claims these requirements were aimed at preventing fraud and
increasing patient quality standards, it's clear the $50,000 surety bond
mandate per store combined with up to a $25,000 accreditation cost is a
financial burden too great for many small independent suppliers to shoulder.
These well-intended, but misguided policies are clearly reducing the number of
qualified suppliers to serve patients, thereby restricting patient access to
services and equipment in Montana and who knows how many other states," said
Wayne Stanfield, president, National Association of Medical Equipment
Suppliers (NAIMES).

"Durable medical equipment (DME) is a small player in Medicare, comprising
less than 1.7% of CMS' estimated $460 billion Medicare costs each year. If
home medical equipment was such a wildly profitable industry, suppliers could
afford to meet these costly albeit misguided requirements," noted Bob Sherman,
outgoing President of the Big Sky Association of Medical Equipment Suppliers
representing Montana and Idaho suppliers.

Mandated by the 1997 Balanced Budget Act, the surety bond requirement, which
became effective October 2, 2009 requires durable medical equipment suppliers
to maintain a surety bond of $50,000. If a supplier has multiple locations, he
must have a surety bond for each store. CMS alleges this new rule was designed
to combat fraudulent Medicare payments to phony supplier companies.

The new accreditation requirement, which was part of the 2003 Medicare
Modernization Act, requires home medical equipment suppliers to become
accredited to meet the Medicare's quality and business standards.
Accreditation is granted by independent organizations and initially costs
suppliers about $25,000 and thereafter thousands of dollars in renewal costs
every three years. Instead of helping Medicare beneficiaries continue to get
high-quality products and services and prevent fraud, as CMS alleged, the
accreditation/surety bond requirement is causing interruption in patient care.

"Attacking the home medical equipment industry through onerous policies and
blaming suppliers for the fraud and abuse in the system only harms patients
and makes CMS look like it's not doing its job. More than 55,000 independent
home medical equipment suppliers in this country make up over 95% of the
industry's suppliers. The DME industry is already highly regulated by FDA,
DOT, and State Pharmacy Boards," added Stanfield. "We abhor any fraud and
abuse, however these two programs and the pending competitive bidding program
will do little to stop it. CMS must act to stop fraud and abuse by preventing
criminal elements from entering the DME industry, not by harming patients with
programs which limit access to care."

It is quite probable more small independent suppliers won't be able to afford
this double whammy of costly new requirements and be driven out of business.
This will leave patients with limited or no access to life sustaining home
medical equipment and supplies, resulting in increased emergency room visits
and soaring Medicare costs. NAIMES urges members of Congress to closely
examine this harmful patient access issue erupting because of the new
accreditation/surety bond requirement and support HR3790, sponsored by
Congressman Kendrick Meek (D-FL), to repeal the competitive bidding program,
which would further limit patient access to services and suppliers.

About NAIMES
NAIMES is a national association representing independent durable medical
equipment suppliers and a grassroots advocate for the DME industry. Leveraging
its grassroots network of small independent suppliers, the association has a
committed, aggressive, proactive approach to changing political minds, one
member of Congress at a Time! NAIMES was founded on the belief that
influencing the political process begins with harnessing local relationships
at home to create a powerful national organization driven by the strength of
its members.

SOURCE National Association of Independent Medical Equipment Suppliers
(NAIMES)

Crystal Wright, +1-202-829-0848, for the National Association of Independent
Medical Equipment Suppliers (NAIMES)