NCB: It’s Baaack

After a short break, competitive bidding rears its ugly head once again.

With just a weekend between the end of the Bush administration and the beginning of the Obama administration, CMS decided it was the perfect time to announce that it was readying to re-bid round one of its national competitive bidding program.

Was this a parting shot at the HME industry in the waning days of the Bush administration? It’s tough to tell, but no matter the explanation for the timing, the news wasn’t all that surprising. We all knew that the delay to implementing competitive bidding was just that, a delay.

The truly galling part of the announcement is that it makes it crystal clear that CMS has never grasped the value of homecare. I know that the argument has been made many times over, but it bears repeating: while HME makes up less than 2 percent of the Medicare budget, homecare rings in several times cheaper than any hospital stay.

So if CMS wants to save taxpayers money, then why would it implement a bidding program that would devastate the one segment of the healthcare industry that can help it dramatically reduce Medicare costs? I keep trying to come up with a logical answer to that question, but just can’t. (Then again, neither has CMS, so maybe logic doesn’t factor into the process.)

And, of course, let’s not forget the Americans currently benefitting from HME who will be negatively impacted by competitive bidding. As we all know, competitive bidding will result in an situation that will almost foster a degradation in the quality of care for homecare patients. Clearly, no aspect of NCB?is in the taxpayer’s best interest.

Fighting on Two Fronts

However, the industry has a solid opportunity to stop competitive bidding. It’s clear that healthcare reform is a key agenda item for the Obama administration. (The formation of the White House office of Healthcare Reform makes that plain.) If President Obama and incoming HHS Secretary Daschle want to cement solid healthcare gains for taxpayers, then homecare and HME have to be part of the solution.

Fighting competitive bidding is going to be just one regulatory battle providers must fight this year. Another key front for homecare is oxygen policy. The 36-month rental cap still remains, which puts a significant pinch on oxygen providers.

Fortunately, a new oxygen benefits reform package has surfaced that aims to eliminate the 36-month rental cap, and would change the Medicare status of oxygen suppliers to providers. It would also exempt oxygen services from the competitive bidding program.

The lobbying efforts to support this package have already begun. The American Association for Homecare has made communicating the reform plan’s specifics to Congress a key agenda item for the Homecare on Capitol Hill Day, the association’s Feb. 11 Washington, D.C. fly-in.

Back to Reality

But in the meantime, oxygen providers must deal with the unsavory aspects of the current, crushing regulatory reality. Read this month’s feature on oxygen survival strategies (“Is the Oxygen Business Up in the Air?” page 20) to see which cost-cutting and efficiency solutions providers are putting in place to give their businesses a firmer foothold in a shaky marketplace.

Of course, funding pressures are affecting the entire industry, and providers of all kinds and sizes are trying to find every resource they can to stay in the black. One source of those resources are the expanding support services available from manufacturers, who are realizing that their success depends on providers’ success. Turn to this month’s cover story, “At Your Service” (page 16) to learn more about the types of expanded resources that are available from manufacturers.

This article originally appeared in the February 2009 issue of HME Business.

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