There is no time like today to take your company's — and
our industry's — future into your own hands.
At press time, the Tanner-Hobson bill (H.R. 1845), which would
make substantive improvements to the competitive bidding program,
was approaching 100 cosponsors in the House; the Hatch-Conrad
version in the Senate (S. 1428) had a dozen cosponsors; and H.R.
2231, the rehab carve-out bill, had about a dozen cosponsors.
It's time again to focus on contacting your legislators to ask
them to sign on to these important bills. If competitive bidding is
implemented in its current form, it's not difficult to imagine a
host of scenarios in which consumers end up with a raw deal that
could range from substandard equipment to limited service
availability — or even worse.
Use the following talking points:
Medicare Durable Medical Equipment Access Act of 2007 (H.R.
1845, S. 1428)
These bills are critical in protecting beneficiaries and
preserving the nation's home care infrastructure, which is an
important part of the answer to the looming Medicare and Medicaid
crisis.
They would protect Medicare beneficiaries and small businesses
that provide home care by amending several of the competitive
bidding requirements for home care that were included in the
Medicare Modernization Act of 2003. Some contracting provisions in
the MMA could have the effect of restricting competition, reducing
access to home care and hurting small providers.
The bills would:
Exempt smaller, rural MSAs (populations under 500,000).
Allow qualified providers that are small businesses and that
submitted a bid below the current allowable to participate at the
selected award price (S. 1428 limits this provision to providers
whose annual revenues are $6 million or less).
Restore the right of providers participating in the competitive
bidding program to administrative and judicial review.
Exempt items and services unless savings of at least 10 percent
can be demonstrated, compared to the fee schedule in effect Jan. 1,
2006.
Require CMS to conduct a comparability analysis for areas that
are not competitively bid to ensure the rate is appropriate to
costs and does not reduce access to care.
Subject the CMS Program Advisory and Oversight Committee on
competitive bidding to the Federal Advisory Committee Act, which
requires public access to meetings and proceedings.
Require that competitive bidding not be implemented until
quality standards are in place.
The House bill would require Congress to specifically
re-authorize the program after the 10 initial sites before CMS
could more broadly conduct competitive bidding.
Medicare Access to Complex Rehabilitation and Assistive
Technology Act of 2007 (H.R. 2231)
Congress should pass H.R. 2231 so Medicare beneficiaries will
continue to have access to high-quality products and services. This
bill would carve out high-end power wheelchairs (and accessories)
from competitive bidding.
Complex rehab technologies are not commodity products that are
easily interchangeable. Each consumer of the technology has
individual, specialized needs requiring extensive
customization.
Competitive bidding fails to allow for the level of services and
significant costs associated with the delivery of complex rehab
technology to people with disabilities.
Properly fitted equipment has a significant role not only in
providing consumers with their greatest level of independence but
also in preventing or delaying related medical complications, which
can increase health care costs significantly.
Significant savings will not be achieved by including complex
rehab in competitive bidding. CMS has acknowledged that the complex
rehab product category is “small,” and CMS' data
demonstrates that utilization of complex rehab products is low. An
industry-commissioned study estimates the cost of the exemption
over the first five years of the CB program to be $46 million.
A specialist in health care legislation, regulations and
government relations, Cara C. Bachenheimer is vice president,
government relations, for Invacare Corp., Elyria, Ohio.
Bachenheimer previously worked at the law firm of Epstein, Becker
& Green in Washington, D.C., and at the American Association
for Homecare and the Health Industry Distributors Association. You
can reach her by phone at 440/329-6226 or by e-mail at cbachenheimer@invacare.com.
