Tri-Care Home Medical

Casting yet another national spotlight on the sleep disorders of truckers, an Associated Press article highlighted the efforts of Schneider National Inc of Green Bay, Wis, to screen truckers for sleep apnea and improve safety on the nation’s highways.

Schneider screened 10,000 of its 15,000 drivers for OSA, and provided sufferers (about 10%) with CPAP masks. According to the AP report, William Rundle is one Schneider employee who benefited from his company’s efforts to treat sleep apnea. “It’s wonderful to be able to function during the day now,” he said in the article, adding that the company has helped him also to cope better with other health problems such as obesity. “You don’t see very many truck drivers that look like they’re in good shape. We’re just like anybody else.”

Approximately 5,600 people are killed annually in crashes involving commercial trucks. While not all of these fatalities can be attributed to drowsiness, research shows that commercial drivers are at high risk for OSA. The problems among truckers could lead to business opportunities for CPAP providers, a topic explored in a recent HME Today article.

Trucking companies—particularly those that are self-insured—are strong new business prospects for CPAP providers. By working directly with the company, providers can provide bundled services that include OSA screening tools, CPAP units, follow-up equipment, and compliance monitoring to large groups of employees.

Fourteen U.S. Senators have urged Medicare to extend the deadline for the competitive acquisition program for durable medical equipment (DME) until quality and patient access issues are resolved. A similar letter with more than 50 signatures is expected later from members of the U.S. House of Representatives.

In a July 13 letter to Leslie Norwalk, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), a bipartisan group of 14 Senators requested that the agency that take specific steps to ensure that implementation of the bidding program does not harm quality or beneficiary access to homecare. The bidding program is required by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

The letter states, in part, “Access to quality DME and related services can often mean the difference between a patient being able to remain in their own home or being forced into a nursing home or hospital. While Congress instructed CMS to begin competitive bidding in 2007, we strongly believe that due to its direct impact on daily patient care, it must be implemented carefully with significant attention to the effect on patients.”

The Senate letter strongly urges CMS to address several issues before implementation of the competitive bidding program. Some of those specific concerns include:

– Questions about how CMS will assess the effectiveness of the competitive bidding program with respect to clinical outcomes for certain patients such as those requiring pressure wound therapy and blood glucose self-monitoring;

– A compressed timeline for implementation of the bidding process that does not provide sufficient time for suppliers to learn about important details and obtain answers to key questions relevant to preparing bids;

– Overly broad, inconsistent, and confusing Medicare codes that raise quality and patient-access issues.

Competitive bidding for certain home medical equipment items and therapies is slated to begin this year in 10 metropolitan statistical areas: Charlotte, NC; Cincinnati, Ohio; Cleveland, Ohio; Dallas-Fort Worth, Texas; Kansas City, Mo.; Miami-Fort Lauderdale, Fla.; Riverside, Calif.; Orlando, Fla.; Pittsburgh, Pa.; and San Juan, PR. The program is scheduled to spread to 70 more areas throughout the U.S. in 2009.

The Senate letter was spearheaded by Senators Kent Conrad (D-N.D.) and Pat Roberts (R-Kan.). (See link here. or visit “advocacy” at http://www.aahomecare.org. Other signatories include:

– Sen. Lamar Alexander (R-Tenn.)
– Sen. Kit Bond (R-Mo.)
– Sen. Sherrod Brown (D-Ohio)
– Sen. Bob Casey (D-Penn.)
– Sen. Hillary Clinton (D-N.Y.)
– Sen. Norm Coleman (R-Minn.)
– Sen. Susan Collins (R-Maine)
– Sen. Russ Feingold (D-Wisc.)
– Sen. Bernie Sanders (I-Vt.)
– Sen. Arlen Specter (R-Penn.)
– Sen. George Voinovich (R-Ohio)

“We appreciate this strong, bipartisan request for resolution of key patient-access issues before the competitive bidding program is implemented,” said Tyler J. Wilson, President and CEO of the American Association for Homecare. “The American Association for Homecare has sought changes in the competitive bidding program to protect beneficiaries’ access to care and provide for greater fairness in the program.”

The American Association for Homecare represents providers and manufacturers of durable medical equipment. Association members serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other home medical equipment, therapies, services, and supplies. Membership includes providers of all sizes that operate approximately 3,000 locations in all 50 states.