DMEs across the country are preparing for some quality face time this week with their congressional representatives who will be home for the Memorial Day break. The providers will be talking about the two bills that have now been introduced that may spare the industry a devastating shakeout and threaten access to medical equipment by the elderly and people with disabilities.
The DME community received some much-needed good news last week when Kent Conrad (D-ND) and Orrin Hatch (R-Utah) introduced a Senate companion bill to the Tanner-Hobson legislation in the House in late March. While unlikely to keep accreditation or competitive bidding from going forward, the bills presence now in both houses of Congress gives DMEs the only hope they have that the independent sector of their industry may yet avoid irreversible damage.
Similar in effect to Tanner-Hobson, Conrad-Hatch tries to shelter smaller, independent providers from the marketplace inequalities that would give an advantage to the largest providers with the deepest pockets. Even if they don’t win a bid, smaller DMEs would be able to keep serving Medicare clients so long as their charges don’t exceed the competitive bid rate. The Senate bill would also exempt from competitive bidding rural areas with fewer than a half-million people and remove from competitive bidding those products whose winning-bid prices don’t represent at least a 10 percent savings.
The new Senate bill differs from Tanner-Hobson in relatively minor respects. It lacks, for example the any willing provider provision that would allow any provider to participate in competitive bidding if they agree to submit a bid below the Medicare fee schedule amount and meet other requirements. Also absent is a provision that would require Medicare to study and report to Congress on the affect of competitive bidding on beneficiaries and providers.
Were the House and Senate bills to pass, they would have to be reconciled, and the reconciled version would have to clear both houses before going to the president. But, that’s academic because no one expects this to legislation to go through the pipeline solo. It would have to be hung on a larger bill with substantial momentum, and it remains far from clear what that vehicle would be.
Meanwhile, DMEs plan to educate lawmakers about competitive bidding and the legislative fix that may take the edge off. If they miss each other this week of Memorial Day, they’ll have another chance during the July 4th and August congressional breaks.
