News coverage of this week’s visit by newly sworn in SC Congressman Mark Sanford, to ABC Medical of Charleston, SC has been filtering in. Charleston’s ABC News 4 was the first to break the story as Sanford travelled across the Low Country for a series of meetings to discuss important issues going on in his district. Sanford spent 45 minutes with the stakeholders of the DME industry who attended the meeting at ABC Medical, including owner Jamie Smith, President of the South Carolina Medical Equipment Services Association (SCMESA) Dan Gooch, and our very own DME Consultant Andrea Stark. During the meeting Representative Sanford toured ABC Medical and took time to listen as Stark and other industry stakeholders educated him on the details of the currently flawed competitive bidding program. Beneficiaries were also on hand to make their voices heard as well. The final directive from the group is to request support of the Market Pricing Program alternative set forth in HR1717.
Today, the former Governor and newly sworn South Carolina Congressman, Mark Sanford, will visit ABC Medical of Charleston, SC to discuss the Competitive Bidding Program with his constituents and seniors. Andrea Stark and the leadership from the South Carolina Medical Equipment Services Association (SCMESA) will also be on site to participate in the meeting. This visit is a direct result of contact made during the AAHomecare Legislative Conference held in Washington DC last week. On May 22nd and 23rd, MiraVista, along with other industry stakeholders descended on the hill in an effort to gain support for HR1717 as well as to expose the fatal flaws of both the Competitive Bidding and National Mail Order Programs which will have a profound impact on local economies, small businesses and Medicare seniors. As a part of our visit, which was targeted to SC legislators, we dropped in to the former SC Governor’s office in hopes of securing an appointment. During our brief visit, Jamie Smith (owner of ABC Medical) extended an invitation to Congressman Sanford to discuss in detail how the currently designed competitive bidding program is negatively impacting Durable Medical Equipment providers and Medicare beneficiaries and to give him a first-hand look at our industry. Sanford, being newly sworn in just days before, had limited resources in his Washington office but acknowledged the importance of this issue and accepted the invitation.
Originally set to go into effect on May 1st, PECOS Phase 2 has been delayed…again. CMS issued word of the delay via their website citing technical issues with the claim processing side for correctly applying the PECOS edits that would have caused erroneous rejections. Specific information was not released regarding a timeframe for when the new deadline would be set. So for now, providers have an opportunity to complete their internal review process and avoid immediate claim denials.
Providers are familiar with the many delays that have affected the PECOS project. Due to repeated delays, Phase 1 has essentially been in effect for 3.5 years in one form or another; represented to providers via GEN response rejections (pre-5010) then as N544 remark codes on remittance advices (post-5010).
In March 2013, CMS announced that May 1st would be the Phase 2 implementation date. Yet five days prior to implementation, we have another delay. What does that mean to providers? At MiraVista we are advising providers “Don’t get too comfortable”. The delay is due to a technical issue and is not intended to offer providers a substantial break. We have no way to officially determine when a resolution will occur, but these types of minor issues can be fixed in as little as 30 days. As such, providers should continue to review their records and ensure accuracy to be prepared for implementation.