House Hearing Sheds Light on NCB Flaws
Lawmakers at Health Subcommittee hearing hit government witnesses with hard questions.
- By David Kopf
- Sep 16, 2010
CMS’s competitive bidding program for DMEPOS did not receive as warm a reception as the agency might have hoped at yesterday’s hearing held by the health subcommittee of the House Energy and Commerce Committee. While only one witness testified on behalf of the industry, lawmakers put government witnesses on the hot seat.
“CMS seems to be hiding many flaws,” was the assessment of CMS’s refusal to provide bid data by Texas Congressman Ralph Hall (R-Texas), who’s testimony was received with applause with HME industry advocates packing the hearing room. Hall provided a list of the bid program’s shortcomings during the both the original bid of Round One as well as the recent re-bid. Hall said that CMS used “abandoned rates to set the fee schedule” in the Round One re-bid.
Despite calls from Congress, CMS has refused to provide transparent bid data. (Read more.)
Besides Hall, Representatives who were notably supportive and pointed the flaws in the bidding program included Braley ( D-IA), Castor (D-FL) Shimkus (R-IL) Burgess (R-TX) and Doyle (D-PA), according to the Accredited Medical Equipment Providers of America.
Titled “Medicare’s Competitive Bidding Program for Durable Medical Equipment: Implications for Quality, Cost and Access,” the hearing aimed to “examine the conception and implementation of the competitive bidding program, the implementation of the Round One Re-Bid, and its potential effects on patients, providers, and physicians,” according to a formal notice from the subcommittee.
The industry’s central witness was Karen Lerner, RN, MSN, ATP, CWS from Allcare Medical (Sayreville, N.J.), who told the committee members the bidding program “will not achieve its desired outcomes and will in fact reduce access to care for Medicare beneficiaries, lower the quality of that care, increase costs and kill jobs.”
“I am concerned that the HME competitive bidding program will result in beneficiaries experiencing more medical complications, increased use of emergency room care, and delays in hospital discharges (increasing hospitals’ costs),” Lerner said in her testimony. “The program will compromise beneficiaries’ ability to live independently in the most cost effective setting — their homes.”
Lerner drew on Allcare’s experience serving users of wheelchairs and respiratory services in New Jersey and Pennsylvania to provide several examples about the likely negative impact on patients that would result from the bidding program. A member of the American Association for Homecare and the Jersey Association of Medical Equipment Services, Lerner worked with AAHomecare and JAMES in developing the testimony.
According to reports from AAHomecare, apart from Lerner, the other witnesses who testified at the hearing were either in favor of the bidding program or neutral. However, the association noted that while some of the members of Congress at the hearing favored the bidding program, many subcommittee members were “highly skeptical.”
Congressman Bruce Braley (D-Iowa) cited the recent University of Northern Iowa study that predicts a steep decline in HME providers in rural states due to Round One bidding. Several others, including Betty Sutton (D-Ohio), Michael Burgess (R-Texas), and Diana DeGette (D-Colo.) also raised concerns about the bidding program.
Meanwhile Energy and Commerce Committee Chair Henry Waxman (D-Calif.) defended the program and labeled concerns about access to care as “speculative threats.” Not surprisingly, similar lines were heard from government witnesses:
CMS director Laurence Wilson’s testimony focused on the standard CMS positions that the bid program will reduce Medicare beneficiaries’ out-of-pocket expenses and curtail fraud.
Dan Levinson, of the Office of the Inspector General, Department of Health and Human Services, made the claim that HME reimbursement rates encourage fraud, a statement that at least one member of Congress questioned.
“By that logic, fraud would have declined dramatically over the past 10 years, mirroring the sharp reductions in HME reimbursement rates,” a statement from AAHomecare read.
David Kopf is the Editor of HME Business.