Since the Medicare DMEPOS
"competitive" bidding program went live Jan. 1 in the initial
nine bid areas, we've been trying to keep a close watch on what is
happening with consumers, discharge planners, referral sources,
contract suppliers and providers that did not win a contract. Many
on Capitol Hill are waiting to hear, and we must be poised to relay
the information.
In the meantime, it's important to frame our competitive bidding
issues within the context of what the new House Republican
leadership has identified as its priorities for the 112th
Congress.
Jobs and spending: Both President Obama and the new House
Republican leadership have articulated that job creation is their
No. 1 priority. On Jan. 18, President Obama issued an executive
order that begins, “Our regulatory system must protect public
health, welfare, safety and our environment while promoting
economic growth, innovation, competitiveness and job
creation.”
The Centers for Medicare and Medicaid Services has developed a
regulation to implement the DMEPOS competitive bid program that
will have the exact opposite effect. Innovation, competitiveness
and job creation will be directly thwarted by the manner in which
CMS has chosen to fulfill Congress' objective.
In fact, the CMS bidding program is striking in its direct
contrast to the president's executive order, which also states in
relevant part: “I am directing federal agencies to do more to
account for — and reduce — the burdens regulations may
place on small businesses … Small firms drive growth and
create most new jobs in this country. We need to make sure nothing
stands in their way.”
Just a couple of weeks before the president issued the executive
order, Rep. Darrell Issa, R-Calif., the new chairman of the House
Committee on Oversight and Government Reform, issued a public
request to provide his committee with examples of federal
regulations that have a negative impact on job growth. Our industry
provided details of the Medicare bidding program, citing
projections that the program will likely eliminate almost 100,000
jobs once Round 2 is implemented.
We can expect this committee to take the lead in the House in
examining federal regulations that harm job growth. It will be
important to illuminate how CMS' irrational bid system will likely
eliminate almost 90 percent of the providers that have
traditionally served the bid areas (based upon the results of the
Round 1 rebid).
“Regular order:” Speaker of the House John
Boehner, R-Ohio, has announced that he intends to bring the House
back to “regular order.” This means that House
leadership will put the responsibility on the committees of
jurisdiction to develop legislation through the traditional
committee process, rather than having the leadership determine
legislative details.
Importantly, this means that the chairmen of the House Ways and
Means and Energy and Commerce committees and their Health
Subcommittee chairmen will be instrumental in determining whether
bills move through those committees for floor consideration. The
message for us is that we must work collectively to develop the
support of these chairmen and focus on the Republican members of
these committees.
The Senate still requires 60 votes to move any controversial
bill: On the Senate side, we must continue to work with every
single office to garner support. The Democrats still retain a
majority but do not hold 60 seats. This means that Republicans and
Democrats, as well as Senate leadership, will be instrumental in
moving legislation through this chamber.
On the House side, 257 Republican and Democratic members in the
last Congress signed on to H.R. 3790, the bill that would have
repealed the entire bidding program. While e lost about 60 of those
supporters, there are 60 freshmen House members who need to be
educated about the CMS program.
Let's start with the list of 91 metropolitan areas that are
slated for inclusion in Round 2 and the representatives from those
areas. This translates to a long “to do” list for
providers and state associations across the country.
Read more Washington Wit & Wisdom
columns. View more competitive bidding
stories.
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 at 440/329-6226 or cbachenheimer@invacare.com.
