More Providers Voice Rural Bid Frustrations

Additional HME businesses share impact of cuts with AAHomecare as advocates work to reverse bid expansion to rural, non-bid areas.

In a follow up to earlier reports about providers in rural areas sharing their concerns regarding how the full, July 1 national bid expansion cuts are impacting their businesses and patients, more providers are voicing their concerns and frustrations.

As part of its work with lawmakers to reform the bid expansion program, the American Association for Homecare reported that the industry’s congressional champions and their staff asked the association to collect as many provider statements and examples of the cuts’ real world impact. Those stories will be used during the summer recess and when Congress reconvenes in September to help build a strong case for reforming the bid expansion.

The association shared several examples of direct provider feedback it had collected so far from providers around the nation:

California — “So here we are after 27 years in the DME business and with this second set of cuts I will have to close my doors within a 45-60-day timeframe. It will not be pretty. I've had as many as 30 employees and now I have three; two of them are part time … When all this comes down I will also lose my home. Talk about having my world turned upside down.”
Texas — “2016 marks my 20th year serving the needs of HME and supply customers. Due to the competitive bidding debacle, I’ll pack up 20 years’ worth of memories into a box and see what is next. The 20 people that hold full time jobs with me will have to be terminated. They won’t be alone, as all private HME companies serving rural areas will go out of business and lay off their employees. There will be thousands of them across Texas … Like I’ve said a thousand times, we could set up a hospital in the home for a fraction of what it costs to be hospitalized. We can provide years’ worth of oxygen therapy for what it costs for a couple days of being in the hospital. Not anymore. After July 1, rural patients will have to beg someone for these products.”
Kentucky — “No one thinks about the cost of our equipment along with the cost to deliver and educate the patient and family that is depending on us to help a mom or dad or a loved one. We also deal with insurance guidelines, deal with insurances two to three times on a claim, and have overhead that never stops … No business can keep its doors open when you are losing money to take care of someone.”

New York — “There is a much bigger picture that seems to be overlooked by government. It’s about preserving services and equipment to individuals and the elderly with severe disabilities and the livelihood of local and county businesses and residents … We are giving up any hope. The light at the end of the tunnel is about to go out.”

Alaska — “The only reason we are still in business is because we are family owned and operated. Many times we do not get a paycheck. We started this business twenty years ago because of the need for DME. We now have over 200 clients we serve. If I close the doors, they have no place to go except the hospital, which is at capacity most of the time, and the cost to Medicare will increase by 2,000 percent. The other option is to move South.”

AAHomecare underscored the need for providers impacted by bid expansion to send the association their stories to further buttress the industry’s case.

“Your stories need not be as dramatic or heartbreaking as these examples are; anything that demonstrates how the July 1 cuts are affecting your policies, your ability to compete, or your patients’ access to HME is helpful,” a statement from AAHomecare read. “We appreciate getting stories that we can share publicly, and with the media, but we are also willing to use your story anonymously, in a summary we are creating for use on Capitol Hill.

“Please help us make the strongest case possible as we prepare to advocate for relief for rural and non-bid area providers in September,” the association added.

Providers can share their stories or ask questions about the effort by emailing Tilly Gambill at

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on LinkedIn at and on Twitter at @postacutenews.

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