Congressional Staff Gets an Earful on NCB
Industry educates Congressional staff on competitive bidding program’s pitfalls.
- By David Kopf
- Mar 03, 2011
The HME industry presented a briefing on competitive bidding to a standing-room only meeting of congressional staff organized this week by Representatives Glenn Thompson (R-Pa.) and Jason Altmire (D-Pa.).
The meeting aimed to update staff on all aspects of the bidding program from the perspectives of both the HME and homecare industry, as well as CMS. Various industry experts represented the industry at the meeting, which was so packed with House and Senate staffers that the hall reached capacity and latecomers had to be turned away.
The briefing opened with a session that was closed to the homecare representatives in which Director of CMS Chronic Care Policy Group, Laurence Wilson, told staff the bid program would stop fraud in the home medical equipment sector. This was followed by the industry’s perspective, which had been foreshadowed by A “Dear colleague” letter from Thompson and Altmire announcing the meeting last week.
“DME providers have concerns that the [bidding] program will threaten the quality of care for Medicare beneficiaries and force smaller suppliers from the market,” the letter noted.
Following that sentiment, the industry’s response was pointed:
“The program is already leading to a fast race to the bottom in terms of quality and access to healthcare,” said American Association for Homecare President Tyler Wilson. “Services related to home medical equipment are being reduced or eliminated in response to artificially low prices caused by market dysfunction.”
Wilson described the types of Medicare beneficiaries who use HME and their specific medical conditions that require home medical equipment and services. He mentioned the numerous concerns and complaints that have been logged through AAHomecare’s competitive bidding call center and website, including nearly 200 calls from Medicare patients. He concluded,
“We believe that the bidding program needs to be stopped NOW before there is irrevocable harm to Medicare beneficiaries and the well-established system of homecare providers,” Wilson urged.
Various industry experts added their concerns to the briefing:
“Business failures, layoffs, increased hospitalizations, and a lowered standard of care are but a few of the unintended consequences of the Medicare bidding scheme,” said John Shirvinsky, executive director of the Pennsylvania Association of Medical Suppliers. “One of the most serious fears that I hear from disability rights advocates is the fear of institutionalization.”
Shirvinksy noted that if rartes are slashed to the point where repairs are not readily available, the ability of a power wheelchair user to lead an independent life is placed at great risk.
“That would be a shameful outcome,” he said. “The Medicare competitive bidding program has been a flawed policy choice since its inception and it is bound to have terribly negative impacts on healthcare delivery, on our economy and on the patients who rely on DME.”
“The delivery of home medical equipment and supplies should not be auctioned off to the lowest bidder,” added Georgie Blackburn, vice president of government relations and legislative affairs for Tarentum, Pa.-based provider BLACKBURN’s. “… Our services are not commodity items. With the Medicare demographic substantially increasing, and the bidding program excluding over two thirds of current providers, we need to protect quality and access to care in the home.”
Seth Johnson, Seth Johnson, vice president of government affairs for Pride Mobility Products, added that CMS has turned away significant efforts to improve the bidding design and process.
“Congress must take action to force the agency to change course before it is too late,” he said. “As you may have heard from CMS earlier, they plan to begin the bid process to expand this program to 91 more areas for Round Two (over half the country) as early as this Spring — even though we are only two months into the flawed program and the real impact in the nine competitive bid areas remains a big question.”
Cynthia Morton of the National Association for the Support of Long Term Care (NASL) noted that her organization is concerned that there was no requirement that bidders actually needed to have experience in serving beneficiaries within a competitive bidding area or product category and many dropped out after submitting low bids which were used to calculate the final contract prices.
“The rates were unduly influenced by what I would describe as drive-by bidders who did no more than drive the rates down and then left the scene,” she explained. “Whatever can be said about the DMEPOS competitive bidding process, it cannot be said that it accurately and fairly reflects the DMEPOS market.”
David Kopf is the Editor of HME Business.