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EMERGENCY MEETING! WAKE UP ... YOU CANNOT HIDE FROM THE CMS!!!
Posted By: Lou Haberman CPO on July 8, 2013
To All: If you provide Medicare services, you will be audited! You cannot hide by being silent. New prosthetic work delivered will be subject to "Pre-Audits" and old claims are being audited by Regulations, issued retroactively. Your cash-flow will vanish, if this has not already happened. In time, I am certain, this process will be withdrawn and CMS will say ... "Ooops, sorry," but you will be selling life insurance or used cars, by that time. It will take years to repopulate this profession by caring and educated practitioners like yourself. I am astonished by the lack of commentary by my peers regarding the most dire issue faced by our profession! Let it, also,be known that your professional credibility, via CMS/HSS Regulation, has now been reduced to that of a home health aid! Your education/training/clinical experience no longer has any credibility! What do you need to 'wake you up!!!' You will be out-of-business within 1 year. This current business model could not be survived by AT&T! CMS does not listen and does not care. Our pleas to them have been ignored for over a decade. The AOPA lawsuit will take years for a decision/result and a positive outcome is uncertain. CMS is a juggernaut and is unchecked in their prosecution of the prosthetic industry (Orthotics, en masse, soon to come). It is time to come together and discuss this issue and take action. It is time to make the media and the public aware of this debacle. I believe, that a political remedy is this profession's only remaining course of action. Politicians measure/gauge the seriousness of any situation by a ruler against a stack of paper complaints. We will need feet to accomplish a remedy. I am planning a meeting/chat on Saturday, July 20, 2013 in New Jersey. Actionable approaches will be discussed and consumer handouts will be provided. I've noticed only a few voices on this List-Serve that are willing to fight these injustices. Years ago, I spent much time to enlighten practitioners that it was important, critically important, to move the profession forward, via State recognition ... licensure. This fight is even greater. If you do not respond, I will engage no more with this community. Your RSVP is required ASAP. There is little time remaining for a meaningful response. The entire country is invited. Get involved now ... you can be part of the solution. Let me know. RSVP to [E-mail Address Removed] (mailto:[E-mail Address Removed]) Lou Haberman, CPO/LPO In a message dated 7/8/2013 4:49:00 P.M. Eastern Daylight Time, [E-mail Address Removed] writes: Please find the link below for our video on this subject matter. Also, see our written update. "Death by a thousand cuts." Video Webcast (http://www.naaop.org/vid.asp?name=bcast_july-2013.mp4) Death by a Thousand Cuts A little dramatic perhaps, but the title of this month's update seems to describe the Medicare auditing situation and the growing pressure on orthotic and prosthetic providers and suppliers. This month alone, CMS has proposed a new regulation that would permit CMS to disenroll a Medicare supplier if they have a pattern of high error rates in Medicare audits, even if the denied claims are being appealed. The HHS Office of Inspector General issued a report on surety bonds that has already prompted some contractors to begin collecting on surety bonds even in instances where Medicare regulations prohibit this from occurring. And CMS issued a Transmittal allowing CMS to deny enrollment applications of O&P and other providers and suppliers when an overpayment exists, even though that overpayment is in the administrative appeals process. NAAOP, in conjunction with the O&P Alliance, is responding to each of these new developments and actively pushing back, but given CMS's lack of response on the physician documentation problems to date, the outcome of our advocacy is difficult to predict. Protecting the Medicare program from fraud and abuse is good politics, but the fact that these efforts are ensnaring legitimate providers in all settings, including O&P, is beginning to take hold. But hope is on the horizon. The Senate Finance Committee recently held a hearing on Recovery Audit Contractors and, to the surprise of many observers, all but one Senator expressed concern that perhaps the RACs financial incentives are so lucrative that RACs are ultimately denying legitimate claims in order to make a profit. A recent OIG report found that 60% of RAC denials are overturned at the ALJ level of review, a figure that many Senators on the Finance Committee found very alarming. In fact, Senator Hatch, the ranking Republican on the Finance Committee, stated, "Such a high rate of reversal raises questions as to whether RACs are being too aggressive or do not understand current medical practice." Raising awareness of overzealous Medicare contractors is a necessary ingredient to getting Congress to act to reign them in. NAAOP will continue to track these developments and advocate for protections for O&P professionals, providers, and suppliers. Thank you for your support. Please visit our website at: www.naaop.org NAAOP 1501 M Street, NW 7th Floor Washington, DC 20005-1700 e-mail: [E-mail Address Removed] (800) 622-6740 (202) 624-0064 Phone (202) 785-1756 Fax www.naaop.org ******************** To unsubscribe, send a message to: [E-mail Address Removed] with the words UNSUB OANDP-L in the body of the message. If you have a problem unsubscribing,or have other questions, send e-mail to the moderator Paul E. Prusakowski,CPO at [E-mail Address Removed] OANDP-L is a forum for the discussion of topics related to Orthotics and Prosthetics. Public commercial postings are forbidden. Responses to inquiries should not be sent to the entire oandp-l list. Professional credentials or affiliations should be used in all communications. |
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