Rep. Kendrick Meek, D-Fla., introduced a bill to repeal DMEPOS competitive bidding, offering a series of minor cuts and a Consumer Price Index freeze as a "pay for" instead.

Rep. Kendrick Meek, D-Fla., introduced a bill this afternoon to
repeal DMEPOS competitive
bidding
, offering a series of minor cuts and a Consumer Price
Index freeze as a "pay for" instead. The provisions would replace
the bidding process currently mandated by Congress.

"I think the chances of passing are going to be very good," said
Barry Johnson, president of the Texas Alliance for Home Care
Services (TAHCS). "We have been meeting with folks on the [House
Ways and Means Committee], and we have found very little resistance
to a bill that accomplishes the same thing that the competitive
bidding process was designed to accomplish, but without all the
flaws and problems — and without restricting patient access
to care."

According to Sean Schwinghammer, an advisor to the Accredited
Medical Equipment Providers of America (AMEPA), H.R. 3790 is
budget-neutral, calling for cuts in all DME — except group 3
complex rehab — of 0.25 percent for three years and a single
0.5 percent cut two years later, combined with a CPI freeze.

"AAHomecare reviewed the actuary figures, which, when added to
the 9.5 percent cut we took in January 2009, is equal to 19.5
percent," Schwinghammer said in a release issued by AMEPA. "That's
the same savings projected from the demonstration projects, which
the program was based on."

In a letter to members of Congress asking for support of his
legislation, Meek wrote:

"The Medicare competitive bid program for durable medical
equipment and services (Title XVIII of the Social Security Act)
began in July 2008 as a well-intentioned effort to improve quality
of service and eliminate excess costs in Medicare. However there
was nothing competitive about the misconceived program. There are
serious flaws in the bidding process which produced few
competitors, fewer home care services and a decrease in the quality
health care [for] those with disabilities who require the right
care and equipment in order to live.

"Congress delayed the program only two weeks after it began,
in a clear acknowledgement that the bidding process was deeply
flawed and needed fixing. For example, contracts were awarded to
suppliers without a physical location in or near the bid area and
who were unable to provide the equipment or services to patients;
unlicensed providers (in violation of state standards); and
fly-by-night operations with no experience in providing bid
items.

"However, in the 14 months since the competitive bidding
program has been delayed, no significant improvements have been
made to the process. In October 2009, the program is due to begin
again. We cannot allow it to restart."

CMS has set Oct. 21 as the target date for opening the Round 1
rebid. In the 2008 Round 1, reimbursement reductions averaged 26
percent. According to a recent HomeCare survey in
conjunction with global investment firm William Blair and Co., 26
percent of participating providers believe a winning bid this time
around would have to be at least 20 percent or more under current
allowables; another 23 percent think a successful bid would have to
be at least 15 percent lower.

The new bill has 16 initial cosponsors, including at least one
representing every Round 1 competitive bidding area:

Jason Altmire, D-Pa.
John Boccieri, D-Ohio
Jo Ann Emerson, R-Mo.
Sam Farr, D-Calif.
Marcia Fudge, D-Ohio
Alcee Hastings, D-Fla.
Eddie Bernice Johnson, D-Texas
Ron Klein, D-Fla.
Dan Maffei, D-N.Y.
John Murtha, D-Pa.
Tim Ryan, D-Ohio
Heath Shuler, D-N.C.
Glenn Thompson, R-Pa.
Patrick Tiberi, R-Ohio
Debbie Wasserman Schultz, D-Fla.
Robert Wexler, D-Fla.

TACHS' Johnson hopes to see at least 100 cosponsors. "That would
certainly be dramatic," he said. "Bills that have 100 cosponsors
generally don't fail."

According to Roger Ribas, president of FAHCS, "Meek would have
filed this bill alone if it was not for the hard work and
dedication of the state associations represented in Round 1 and
beyond. AAHomecare has been working with the state leaders for
months now, and tremendous thanks goes to AAHomecare, CAMPS, MAMES,
NCAMES, NYMEP, OAMES, PAMS and TAHCS for getting those additional
cosponsors.

"With the expansion of Round 2 MSAs," Ribas continued, "the
threat of Medicare implementing Round 1 prices nationwide and the
examples of other insurance carriers mimicking competitive bid
prices, this is a bill that the entire industry can stand behind.
Even though providers are working harder than ever to just survive
and preparing to place their rebid in a few weeks, it will take the
efforts from everyone, regardless of where they are located, to
enact this into law."

According to a bill summary from AAHomecare:

The pay-for competitive bidding repeal legislation would
eliminate the CPI-U updates for all DME in 2010, 2011, and 2012
(i.e., no update in these years). Then, the DME fee schedule would
be reduced by 0.25 percentage points in each of these three
years.

  • Complex rehabilitative power wheelchairs recognized by the
    Secretary as classified within group 3 or higher would receive a
    CPI-U update in 2010, 2011 and 2012.

  • In 2013, all DME would receive a CPI-U update.

  • In 2014, all DME would receive a CPI-U update. Complex
    rehabilitative power wheelchairs recognized by the Secretary as
    classified within group 3 or higher would receive a CPI-U update
    plus 2 percentage points. All other DME would receive the CPI-U
    only with no additional 2 percentage point increase.

  • In 2015, complex rehabilitative power wheelchairs recognized by
    the Secretary as classified within group 3 or higher would receive
    a CPI-U update. All other DME would receive no CPI-U update as well
    as a 0.5 percentage point reduction in fee schedule payments.

  • In 2016 and subsequent years, all DME would receive the CPI-U
    update annually.

    "Remember," said Rob Brant, president of AMEPA, and a
    constituent of Rep. Meek, "you will have little chance of winning
    the bid, and no chance to survive it. If you actually took the time
    to get a surety bond this year, then take a few minutes to contact
    your legislator about repealing competitive bidding."

    To contact your representatives, call the Capitol switchboard at
    202/224-3121. Ask your representative to be a sponsor of H.R. 3790
    and have him or her call Peter Gwynn-Sackson at 202/225-4506 in
    Meek's office or e-mail him at peter.gwynn-sackson@mail.house.gov.

    View H.R. 3790, Meek's complete letter to colleagues and
    target="_blank">talking points about the bill on the VGM Web
    site.

    View more competitive
    bidding
    stories.