Medicare Patient Responds to Orlando Sentinel

Medicare Patient Responds to Orlando Sentinel By Aaron Thomas Mike Thomas' recent column on Medicare's competitive bidding program for home equipment and services was biased and laden with problems. It is based upon the flawed premise that medical equipment and related services (oxygen therapy , wheelchairs, etc.) delivered to Medicare beneficiaries in their homes should be reimbursed based on what one would pay on the Internet or at a retailer for the equipment alone. As someone who has used a wheelchair since the age of 4 due to a form of muscular dystrophy , I can tell you that a power wheelchair, specifically fitted for my disability, cannot be acquired over the Internet. Even oxygen, as a regulated prescription drug, can't just be picked up at a local Walmart. Should a user who depends on supplemental oxygen to stay alive pick it up at Walmart, adjust the flow rate, and maintain this system, plus a back-up, on their own? Will Walmart provide emergency supplies of oxygen after a hurricane when the power's out? What some don't understand is that getting the cheapest reimbursement for a medically required device for home use is not in the patient's or taxpayer's best interest. Quality home medical equipment and services help keep seniors and people with disabilities safe and independent in the most cost-effective setting for care -their own homes. Medicare currently pays under $7 per day to provide oxygen therapy in the homes of people with lung disease or heart failure. Compare that to more than $7,000 on average that Medicare pays for a short hospital stay. Bottom line: quality equipment and services provided to Medicare beneficiaries in their homes is part of the answer -not the problem -to Medicare's financial crisis. This poorly designed Medicare bidding was implemented for two weeks in 2008. The program excluded 90 percent of local area providers, excluded qualified applications, and awarded contracts to unqualified providers with no experience in this area. Had the program continued, patient choice, access to care, and quality competition would have suffered. Unfortunately , the flaws in this program remain. It's due to resume in Orlando and Miami in 2011. There is no way to predict the detrimental impact on Florida beneficiaries. A bipartisan bill to repeal Medicare bidding is supported by 255 members of Congress and designed to be budget neutral. The bill would cut payments to home medical equipment to make up for the savings the bid program would have reaped -without dismantling the existing network of home medical providers. Aaron C. Bates lives in Orlando.

Medicare Patient Responds to Orlando Sentinal

Medicare Patient Responds to Orlando Sentinel
By Aaron Thomas

Mike Thomas' recent column on Medicare's competitive bidding program for home equipment and services was biased and laden with problems.



It is based upon the flawed premise that medical equipment and related services (oxygen therapy , wheelchairs, etc.) delivered to Medicare beneficiaries in their homes should be reimbursed based on what one would pay on the Internet or at a retailer for the equipment alone.

As someone who has used a wheelchair since the age of 4 due to a form of muscular dystrophy , I can tell you that a power wheelchair, specifically fitted for my disability, cannot be acquired over the Internet.

Even oxygen, as a regulated prescription drug, can't just be picked up at a local Walmart. Should a user who depends on supplemental oxygen to stay alive pick it up at Walmart, adjust the flow rate, and maintain this system, plus a back-up, on their own? Will Walmart provide emergency supplies of oxygen after a hurricane when the power's out?

What some don't understand is that getting the cheapest reimbursement for a medically required device for home use is not in the patient's or taxpayer's best interest. Quality home medical equipment and services help keep seniors and people with disabilities safe and independent in the most cost-effective setting for care -their own homes.

Medicare currently pays under $7 per day to provide oxygen therapy in the homes of people with lung disease or heart failure. Compare that to more than $7,000 on average that Medicare pays for a short hospital stay.

Bottom line: quality equipment and services provided to Medicare beneficiaries in their homes is part of the answer -not the problem -to Medicare's financial crisis.

This poorly designed Medicare bidding was implemented for two weeks in 2008. The program excluded 90 percent of local area providers, excluded qualified applications, and awarded contracts to unqualified providers with no experience in this area. Had the program continued, patient choice, access to care, and quality competition would have suffered.

Unfortunately , the flaws in this program remain. It's due to resume in Orlando and Miami in 2011. There is no way to predict the detrimental impact on Florida beneficiaries. A bipartisan bill to repeal Medicare bidding is supported by 255 members of Congress and designed to be budget neutral.

The bill would cut payments to home medical equipment to make up for the savings the bid program would have reaped -without dismantling the existing network of home medical providers.

Aaron C. Bates lives in Orlando.

Unsteady on your feet? Unable to walk for extended periods of time? A rollator may help...

We are contacted several times a day by patients looking for "a walker with the seat and the brakes". These walkers are referred to as rollators in the medical equipment industry. Here is a bit more general information about Rollators from rollator.org

There are various reasons why a person may need a rollator to assist them with mobilizing. A rollator is a device that supports a person who is walking. The rollator is pushed by its user while they are walking. The user keeps their hands on the rollator at all times while they walk so that they do not lose their support.

A wheelchair is a device for someone who cannot use their legs, while a rollator helps someone who can use their legs but needs support. People use a rollator for various reasons. Depending on the type of comfort a user seeks, if a person can walk, a rollator serves as a great device to assist them. Some people who have had strokes or other debilitating events happen to their bodies may use a rollator to assist them when walking. Not everyone who uses a rollator needs to have a handicap that prevents them from walking.

A rollator is also built in several different variations to accommodate the different users it may need to assist. A physician or a physical therapist will be able to recommend the appropriate type of rollator a patient may need to have in order to assist them properly.

Contact HMEprovider.com at 800-951-1213 to connect to a rollator specialist in your area.

The Uplift is Uplifting

For that extra oomph getting up, the Uplift Seat Assist converts any armchair into an automatic lifting chair — without latches, switches or special installation. Safely supports seated person with a stable, horizontal surface at all elevations — it won't thrust user forward! Waterproof, washable covers available! Click here to see how this item works or connect to a local dealer at 800-951-1213 or visit us at HMEprovider.com

What You Should Know about your Home Oxygen Therapy

What You Should Know about your Home Oxygen Therapy

Medicare's New Payment Policies for Care

HMEprovider.com is an online program that works to connect the aging in place and their loved ones with a LOCAL medical equipment provider to fullfill their needs. We have received several contacts as of late from consumers either wanting to change their current oxygen provider or are looking to move and need to locate a new provider. Consumers are running into several obsticles and therefore it seemed like a good time to share some patient education. Many of the challanges patients are facing are the result of Medicare's new regulations in relationship to oxygen services. Background The Deficit Reduction Act of 2005 capped reimbursement for Medicare home oxygen after 36 months of use. In many cases, the artificial cap prevents oxygen providers from receiving reimbursement for the entire period or your medical necessity to receive oxygen, which imposes financial hardship on homecare companies. Moreover, the policy of capping payment jeopardizes your access to continued care, as well as the quality of care that you deserve. On October 30, 2008, Medicare issued a final rule outlining its payment policy for oxygen therapy that is provided after 36 months. These onerous, confusing, and poorly conceived rules established minimal and inadequate payment levels, as well as unprecedented obligations that are impeding the provision of quality care to our patients. Under the Medicare rule, the original home oxygen provider must continue to provide, without any payment, for a two-year period following the reimbursement cap:

• Unscheduled service and maintenance visits,
• 24 hour, 7 day a week emergency care,
• Equipment repairs, and
• Oxygen supplies and accessories.

The rule also establishes inadequate payment levels for scheduled maintenance and service – equal to two 30-minute visits annually. Patients and providers have begun seeing the detrimental effects of the recently implemented Medicare oxygen rule. The following examples are occurring across the country for oxygen patients who are at or nearing the 36-month rental cap:

• A patient who would like to move out of the original provider's service area, but the provider cannot find a company in the new area that is willing to provide home oxygen therapy in the new location, due to the minimal payment levels.
• A hospital that is looking to discharge a patient to a different area of the country is unable to find an oxygen provider and therefore cannot discharge the patient, forcing the Medicare program to pay for additional time spent in the hospital.
• A patient who would like to switch providers cannot find another company willing to provide home oxygen therapy, due to minimal payment levels.
• A company is going out of business and patients cannot find new home oxygen providers, again, due to minimal payment levels.

As you know, home oxygen is a critical, life-sustaining medical treatment. It is prescribed to nearly 1.5 million Medicare patients annually who suffer from respiratory illnesses such as chronic obstructive pulmonary disease (COPD). COPD is a progressive, incurable disease that causes irreversible loss of lung function. Although medications have not been shown to be beneficial in reversing lung damage, home oxygen therapy, when properly prescribed and maintained, has been shown to slow the progress of this degenerative disease. A home oxygen company provide far more than just equipment. They are also front-line caregivers. They educate you on the proper use of their equipment, answer your questions, make repairs and adjustments, and ensure that you are receiving the prescribed amount of oxygen. Additionally, they are one of the primary points of contact for many of our patients. They take calls at all hours and drive long distances to make sure that patients receive the care they need. Without reimbursements for these visits, oxygen providers will not be able to afford to provide the current level of care for many of their patients. What you can do as a Medicare beneficiary Contact your members of Congress to tell them that they must restore reimbursement for oxygen for the period of medical necessity, regardless of the time frame. Be sure to contact your representative and both of your senators. To contact them, dial the U.S. Capitol Switchboard at 202-224-3121. If you are not sure who your representative and senators are, provide the operator with your ZIP Code. The operator will use your ZIP Code to connect you to your member of Congress. (Please note that in order to reach your representative and your senators, you will need to make a total of three calls: one to your representative and one each to both of your senators.) Congress should advise CMS to modify the existing post-36 month oxygen payment policies to address serious shortcomings that are creating hardships for both oxygen patients and providers. The HME community requests that Congress consider taking additional action if CMS is unresponsive in fixing the payment rules. Without immediate changes to the Medicare oxygen policies, patient care will be compromised and Medicare costs will increase.

Caregivers: Making the transition from hospital to home easier

(ARA) - Coming home from the hospital or other care setting after an illness or surgery can be worrisome for both patients and the friends and family members who care for them. Planning ahead can make the process much easier. The Centers for Medicare & Medicaid Services (CMS) has advice that is useful to the millions of Americans who are actively involved in caregiving. Through its caregiver initiative, Ask Medicare, CMS recommends the following steps to prepare for a transition: * Plan ahead: You can - and should - start thinking about the discharge process well in advance, even as early as at the time of admission. CMS has a helpful checklist of key points in its "Planning for Your Discharge" guide, available at the "Medicare Basics" link on the home page of the Ask Medicare website at http://www.medicare.gov/caregivers/. This checklist will help you prepare for the next steps in care.
* Get ready for new responsibilities: Talk to hospital staff about what you will need to do at home, who will show you how to properly carry out any new tasks you will be taking on, such as administering medication, using medical equipment, changing bandages or giving shots. * Make needed changes to your home: You might need to rearrange your home to have room for items such as a hospital bed, walker or a wheelchair. You might need to consider installing a ramp in place of stairs - be sure to ask the hospital staff what will be needed. You should also remove area rugs and other items that may cause falls and group electrical cords together with ties or clips to keep them clear of high-traffic areas.
* Prepare for extra costs: The person you are caring for may need new medical services or medicines after coming home. Medicare may cover some of these costs, but not all. You can learn about services and care that are covered by Medicare at the "Help With Billing" and "Is It Covered?" links at the Ask Medicare home page.
* Keep a list of key contacts: Put contact information for doctors, pharmacists, home care agency staff and others involved in the care process where you can easily find them. * Don't be afraid to ask for help: If you're overwhelmed, don't hesitate to ask a friend or family member to lend a hand. If paid home health services are needed, you can learn more about home health services in the "Medicare and Home Health Care" booklet, which is also accessible at the Ask Medicare home page. It's also important to keep a file of resources on hand and to bookmark useful web sites, including Ask Medicare, the United Hospital Fund's "Next Step in Care" initiative at http://www.nextstepincare.org/ and AARP's caregiving site at www.aarp.org/caregivers. More information can be accessed through http://www.healthcare.gov/, a new web portal offered by the Department of Health and Human Services. Courtesy of ARAcontent Unsure who in your area to contact with for your home medical and home modification needs? Contact HMEprovider.com 800-951-1213 We will connect you to an expert in your area that can help with your home medical equipment, oxygen therapy, wheelchair, ramp or safety equipment needs.

Multigeneration Households Are Growing

Before there was Social Security, welfare or other social safety nets, there was family. When times got hard or life went off the rails, people went home. Multigeneration Households Increased During the Recession Since the start of the recession in 2007, people have been turning to their families again, and in record numbers, according to a Pew Research Center study. In 2008, 49 million Americans (just over 16 percent of the population, including a rising number of seniors) lived in multi-generation households-2.6 million more than in 2007. But the recession didn't start the increase in multigeneration households, it only accelerated a trend that has been building steadily since 1980, when the number of Americans living in such family units hit an all-time low of about 12 percent. In 2008, about 20 percent of adults 65 and older were living in households with at least two generations under one roof. Some had moved in with children or other relatives to make a fixed income go farther or to have a family caretaker nearby, while others were raising their grandchildren. Yet the biggest factor in creating new multigeneration households was the number of young adults in the 25 to 34 age group that moved in with their parents or older relatives. The percentage of young adults ages 25 to 34 who were living in multigeneration households in 2008 was about the same as the percentage of people who were 65 and older. But the increase in young adults living in multigeneration households was dramatic (from 11 percent in 1980 to 20 percent in 2008) while the increase among older people was more gradual (from 17 percent in 1980 to 20 percent in 2008). The Sandwich Generation is Born Many baby boomers-the so-called sandwich generation -are caught in the middle as they struggle to provide shelter and support for aging parents and adult children who are not yet able to live on their own. And the economy is making it harder for many people, young and old, to remain independent-which drives the increase in multigeneration households. The Pew Research Center reports that roughly 37 percent of younger Americans (aged 18 to 29) were either unemployed or out of the work force in 2008, the highest percentage in 40 years. And a more recent Pew Research survey found that among 22- to 29-year-olds, one in eight say that the recession caused them to boomerang back to live with their parents after being on their own for awhile. Creating a Successful Multigeneration Household For even the most loving families, a multigeneration household can put a strain on communication, lifestyles, privacy and peace of mind. It's important to keep communication open and avoid misunderstandings. Take a tip from well-run businesses and schedule a family meeting once a week-or at least once a month. Decide how household tasks will be shared, look for ways to streamline meal planning and preparation, and household chores. And don't forget to have fun together. The poet Robert Frost said: "Home is the place where, when you have to go there, they have to take you in." In today's economically troubled times, it appears that more and more people are being forced to test that theory. Artcile by Sharon O'Brien About.com Guide