‘Doc Fix’ Stalling Before Holidays

A failure by Congress to pass tax bill gives industry more lobbying time for MPP.

As Congress heads toward the holidays with Democrats opposed to a stand-alone bill for a “doc fix” and Republicans refusing to pass tax legislation that doesn’t incorporate language that addresses physician payments for at least 12 months, the HME industry sees an opportunity to continue lobbying for its Market Pricing Program (MPP).

The doc fix is designed to prevent a 27.4 percent cut in Medicare physician payment rates slated to begin on Jan. 1, 2012, and instead increase payment rates by 1 percent in 2012 and again in 2013 (the “doc fix”). However, as Congress is poised to go into recess, it has yet to hammer out a deal on a larger payroll tax package that would incorporate the doc fix.

The delay in a resolution regarding the doc fix means continued lobbying opportunity for the industry to drive support of the MPP.

“The Capitol Hill showdown is the latest example of 11th hour brinksmanship in the 112th Congress that underscores the difficulty of finding any type of agreement among the House, Senate, and the White House,” read a statement from the American Association for Homecare. “For the weeks ahead, including time when lawmakers are back in their home states, it’s important for HME providers to contact their Representative and Senators and strongly urge them to contact their respective leadership about the MPP.”

“The industry is still working in concert to insure that the MPP provisions are attached to whatever final legislation addressing the “doc fix” issues,” read a statement from the National Association of Independent Medical Equipment Supplies. “In order to accomplish this, we must keep up the pressure on Congress.”

Various state and national industry associations are calling on providers to contact their Representative and Senators and strongly urge them to contact their respective Democrat and Republican leadership to ask that the MPP proposal be included in the final doc fix bill that is sent to the President. Providers can reach their Representatives’ and Senators’ via the Capitol switchboard at (202) 224-3121.

Key talking points providers should keep in mind when lobbying on behalf of the MPP:

  • The current competitive bidding system has failed and needs to be replaced at the earliest legislative opportunity.
  • The MPP is a sustainable pricing system for HME.
  • The MPP includes the same HME items as the current Medicare bidding program and is implemented across the country in the same timeframe.
  • Under the MPP, two product categories are bid per geographic area. Eight additional product categories in that same area would have prices reduced based on auctions conducted simultaneously in comparable geographic areas.
  • MPP bid areas are smaller than metropolitan statistical areas (MSAs) and more homogeneous.
  • Unlike competitive bidding, bids are binding and cash deposits are required to ensure only serious bidders participate.
  • The MPP bid price is based on the clearing price, not the median price of winners.
  • The same areas that are exempted under the current Medicare bidding program will be exempted under the MPP.

About the Author

David Kopf is the Editor of HME Business.

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