Editor's Note

Showdown at the CMS Saloon

HMEs have secured a significant delay to PECOS, but High Noon still looms.

• By David Kopf
• Mar 01, 2010

Providers a breathing a heavy sigh of relief and then some when it comes to CMS’s troubling Provider Enrollment, Chain and Ownership System program. After one sizeable scare after another, CMS has finally agreed to delay implementation of its PECOS registration requirement until Jan. 3, 2011. (For more details, turn to “News, Trends & Analysis”)

That said, the PECOS struggle is far from over. A delay is only a delay. And in the meantime, providers will still have to contend with the onerous task of ensuring all their referral partners register in the system. Hopefully, they will have tools to help them sift through CMS’s massive list of more than 800,000 registered physicians.

But before I go into the industry’s struggle, I want to veer off into a quick tangent: my own personal struggle regarding PECOS:

Being the hack that I am, words cannot adequately convey the Herculean effort I’ve made in not using any corny Old West references in regard to PECOS. Somehow, I have resisted the temptation to pluck the low-hanging fruit and indulge in an obvious gag. That is, until now.

After getting bushwhacked by CMS last October like a bunch of ranchers stuck in a box canyon and surrounded by rustlers, the industry was able to call out CMS and get it to settle on a gun fight in the center of town on April 5. But once the industry got wind of CMS’s 13,500-plus-page PDF, providers were a-feared they’d be wearing a pine overcoat on Boot Hill by the time the town clock tower started chiming High Noon.

Spurs were jangling — and not in a good way. Then the cavalry came in the nick of time, and forced CMS to delay the duel until Jan. 3. Question is, will the industry have enough time to wrangle all the docs on the range and get them to take the PECOS brand?

Sorry About That

Sorry, but you have no idea what a relief it is to finally get that out of my system. Then again, my relief is probably nowhere near what providers are feeling at this very moment, now that PECOS has been pushed so far back. Not to mention the fact that the break in the PECOS action is much more significant in that it lets providers now focus on the task that is takes much higher priority: beating competitive bidding.

While I’m sure CMS would rather the homecare industry not have that kind of breathing room, I don’t think it had much choice given that if PECOS had been allowed to proceed per the April 5 deadline, it would have resulted in a disaster for providers, referring physicians and patients.

So far, the industry is making good progress in its efforts to beat back NCB. As I write this, providers are in the final stages of “Save our Jobs — Protect our Patients,” a massive, industrywide campaign to secure 218 co-sponsors for H.R. 3790, the bill sponsored by Rep. Kendrick Meek (D-Fla.) that calls for the repeal of CMS’s competitive bidding program. The bill began the President’s day congressional recess with 140 cosponsors, and the results of the industry’s efforts should be known as this issue is being printed. (To read more about the effort, read “News, Trends & Analysis”)

However, there is another front that providers must fight: that of continually fine-tuning their businesses to ensure that they can “surthrive” such a daunting funding and regulatory environment. That’s why we’ve dedicated this issue to the strategies that HMEs should integrate into their businesses. This issue’s features cover marketing, finding new efficiencies and cutting costs, compliance, financing, professional education and enhanced business services available to HMEs.

The special section starts on page 20 with a feature on LEAN management. Hopefully, this edition’s stories will help you keep your business stable and your aim sharp for the moment when High Noon comes calling.

This article originally appeared in the March 2010 issue of HME Business.