Too Cool For Crutches

We have become very well acquainted with the four wheeled walker with seat and brakes. The walker combines the safety of the wheel locks with the convenience of a place to rest.

This new concept crutch combines the convenience of a place to rest with . . . well, a little bit of style I guess.

The design doesn't show much of a nod to ergonomics in the handle design or placement of the forearm pads, but the two crutches do stick together and lean against things.

I don't see this design gaining status as medically necessary or having a HCPC code assigned, but it is nice to see some innovation and style in the development of DME.

HME News Poll - Has Medicare been over-paying for HME?

HME News is running a poll to gauge the industry reaction to the 26% cut in Medicare reimbursement to HME.

If the winning bidders think they can survive with a 26% cut, does that mean that Medicare has been overpaying or does that mean that vendors are undervaluing their products and services thinking that the only way to increase demand is to lower prices?

If you decide to play within the Medicare box, it looks like you might just get trapped. Medicare has limited businesses to the point that they are only allowed to compete on price. If you want to compete on a different level, fire Medicare and choose the customers you want to work with.

Vote early and vote often.

Pack Up, We're Out of A Job.

Even Competitive Bidding announcements couldn't have killed off the rehab industry as entirely as this recent press release. Israeli industrial design and engineering firm Argo Medical Technologies, has announced the development of the ReWalk Exo-Skeleton.

The exo-skeleton concept is not new, UC Berkeley and Sarcos have prototypes focused on military applications. While impressive, they are bulky and not suitable for everyday living conditions.

The Argo Medical exo-skeleton brace type device is designed to attach to the body of a person with a spinal cord injury and allow that person to stand and walk. Using motors, sensors, and rechargeable batteries, attached to the brace frames and a backpack, the ReWalk is designed to allow users to walk safely with the aid of crutches. A video demo can be seen on Argo's web page.

Besides showing off the new product, Argo also dedicates some room on the website to justifying the financial impact this type of product will have. With the first two years of paraplegia estimated to cost insurance companies 285,941 dollars, the possibility to offset costs promised by the ReWalk at 120,000 dollars per year makes the device rather attractive.

This device would not only make wheelchairs obsolete, it would also kill off the standing frame industry. Argo is hoping to have this device on the market by 2009, do you see a HCPC code assigned to this product in the future? But the real question is: Will this device be included in a competitive bidding carve-out?

CMS unveils competitive bidding fee schedule for DMEPOS

CMS press release as seen on HMENews:

WASHINGTON - Providers in the first 10 competitive bidding areas submitted bids that on average will lower the fee schedule rates on many DME items by 26%, CMS officials stated during a late afternoon press conference.

"This new program means that Medicare beneficiaries will have access to some medical equipment and supplies at substantially lower prices than they are paying now," said CMS Acting Administrator Kerry Weems. "The Medicare program and taxpayers will share in these savings. This program represents yet another way to use the competitive marketplace to bring the best possible and most efficient care and services to people with Medicare. Because new accreditation and quality standard initiatives are being implemented in conjunction with the phase in of competitive bidding, this program will provide assurance to beneficiaries that they are receiving high quality medical equipment for home use."

Here's my first reactions:

1. 26% reduction in reimbursement? DMEPOS has fought every reduction in reimbursement tooth and nail, usually unsuccessfully. Given the chance to rally together and set the rates that everybody can live with has resulted in a self-imposed reduction of 26%. Not to mention the 100% reduction in reimbursement for those who did not win the bid because they wanted to keep their reimbursement higher. Ouch.
2. "The Medicare program and taxpayers will share in these savings." Sounds all warm and fuzzy to the average American who doesn't need any DMEPOS and doesn't realize how little of the total Medicare budget is actually spent on DMEPOS (1.7%).
   
3. Does anybody else cringe when you read 'use the competitive marketplace' in reference to a program that actually reduces/eliminates competition? He who controls the language, controls the debate.
   
4. When was the last time any government program was able to deliver on a promise of 'best possible and most efficient' especially when it comes to care or service?
5. Of course with the 'new accreditation and quality standard initiatives' that are being implemented, service providers have no choice but to provide the best possible equipment and service to beneficiaries.

Round 1 bid awards are expected to be announced any day now. I'm sure this announcement was a precursor to set the tone of the upcoming announcements and quell as much public debate as possible. Are you (your company) ready for this?

Round 1 Announcement Imminent

Seen on Notes from The Golden Commode:

Here’s the lastest news on round one of competitive bidding, courtesy of Don Clayback, The MED Group’s vice president of government relations. Clayback had a call with the Competitive Bidding Implementation Contractor (CBIC) earlier today. Here’s what he found out:

1.) The CBIC will send out notices to all Round 1 bidders within the next two weeks. That could mean this week or next; they would not be more specific.
2.) All letters (winners and losers) will be sent out the same day via Certified Mail. That means everyone should get their letter within a day or two of each other.
3.) Winners will receive a contract to be signed along with the new fee schedule. They will have 10 days from the mailing date to respond.
4.) The contract will be for a three year period commencing July 1, 2008.
5.) Unsuccessful bidders will also receive a letter stating they were not selected.
6.) Despite Clayback's additional inquiries, the CBIC would not share more specific information at this time.

Can Your Wheelchair Read Your Mind?

Ambient made waves a little while ago when they announced the ability to control a wheelchair by thought. They have recently expanded the application to the technology to include communication devices, access to the internet, or darn near anything else that can controlled via voice.



Controlling a wheelchair or creating an augmentative communications device may be the ultimate purpose of the technology, but these lofty ideas will not likely pay the bills. Hopefully the technology can be made available to applications with wider appeal and fund the development of the intended goal.

Competitive Bidding vs. Congressional Signatures

HME News reports that there are two letters being circulated around congress right now with the intent to put pressure on CMS about competitive biding. The letters have been signed by 100 congressmen so far. The letters don't call for an end to competitive bidding but they do ask for CMS to reexamine the impact on the small DME companies and might give enough time for congress to investigate the process as well.

The letters may just be a shot over the bow of CMS. It seems to me that if congress really wanted to stop competitive bidding there would be more aggressive moves made. However, a step is a step. Call your congressman and make sure his/her signature is on the letters.

Is this a sign that congress has decided that their local business community might be affected? Is this a sign that congress has decided that their constituency might be affected? Is the signature of 100 or more congressmen strong enough to make an impact on CMS?