DALLAS — Just a few weeks after being introduced, the bill
that would eliminate DMEPOS
competitive bidding is gaining traction among legislators.
As of Friday, H.R.
3790, introduced on Oct. 13 by Rep. Kendrick Meek, D-Fla., had
garnered 53 cosponsors.
"This places us over halfway to our goal of 100 cosponsors
within only three weeks," said Barry Johnson, president of the
Texas Alliance for Home Care Services and one of the bill's
originators. "We expect more congressional support as members fully
understand the tremendous cost savings of our budget-neutral
The goal, Johnson said, is to see the bill "signed and enacted
on Jan. 1" — or the first business day after Jan. 1. "In the
words of Larry the Cable Guy," he said, "we need to get 'er
With the Meek bill, providers are finally armed to fight the
battle against competitive bidding, according to Johnson, who
stressed that more providers are needed on the front lines. "We
need more providers to step up to the plate and tell the story," he
said. "It's an education process."
He knows it's tough for providers who have never been
politically active before. Johnson said when he visits a
legislator's office, "I say, 'I'm not here to bother you; I'm here
to tell you something that is going to make everyone's life
A respiratory therapist for 40 years, Johnson is a salesman when
it comes to the Meek bill because he believes it gives CMS just
what it wants and protects patients and providers at the same time.
"The point of competitive bidding was to reduce the number of
providers out there. Competition reduction. Well, OK," said
Johnson. "Reduce fraud and abuse — absolutely. Get more for
your money. I'm a taxpayer and I'm all for that.
"But what if I could do all that stuff better, faster, quicker
and give you back $25 million? Would you go for that? Well, welcome
to H.R. 3790."
Johnson ticked off the bill's selling points:
Significant savings. "First off, we have a bill
with a number on it. It's pretty tough to see the light when no one
turns the light bulb on," Johnson said. Up to this point, industry
representatives could only provide legislators with information and
particulars about the devastating problems competitive bidding
would create for small business providers and Medicare
beneficiaries, he said.
"But how can they really properly evaluate what you are telling
them? Now they have the legislation and they can see the
legislation," Johnson said. "We have had it scored by an
independent actuary, and it's coming in about 10 percent [savings
for Medicare]. We've had a 9.5 percent cut already. That's 19.5
percent, a half percent greater than the [savings from the] first
round of demonstrations in Polk County, Fla."
Combined with the 25 percent savings on oxygen from the 36-month
oxygen cap implemented in January, Medicare is already seeing a
substantial savings that is far beyond the average 26 percent
savings on DMEPOS items in the aborted Round 1 of competitive
bidding last year.
"We're rolling back the prices to 1998. We're better than
Walmart," Johnson said.
Access to care. The Meek bill would preserve
patients' access to care because it would not eliminate thousands
of providers, Johnson pointed out. "When you're reducing the number
of providers by 90 percent, you are asking 10 percent of the
providers to take care of 100 percent of the population. That's a
tough deal," he said.
His own Dallas County is 9,000 square miles and, under
competitive bidding, would have only about 40 providers, he
estimates. "It's going to be difficult to get from one corner to
another in a timely manner … Now we have a patient risk issue
here because we are limiting access to care."
Medicare is very likely to see more trips to the emergency room
and more hospitalizations because there will be too few providers
to attend to them quickly, a problem that would worsen dramatically
in cases of thunderstorms, hurricanes, snow and heavy winds,
Elimination of the Competitive Bidding Implementation
Contractor. "The CBIC can go away, and the cost of the
CBIC is $25 million annually," Johnson said. "We truly have a
bipartisan bill which will achieve the same results as competitive
bidding while returning $25 million to the taxpayer annually. These
administrative funds are simply being wasted to administer the
severely flawed competitive bidding program."
Curb fraud and abuse. "We want to start a
fraud-and-abuse program that works with the $25 million," Johnson
said. Because of mandatory accreditation, surety bonds, onsite
visits, stiffer standards and post-payment audits, inroads are
already being made into the fraud-and-abuse arena, he said.
"There was a reduction of providers, on average, of about 40
percent," he said. "We think what has happened is that those people
who were less than responsible, those people have dropped out.
"Congress is seeing that," he continued, noting that despite the
derogatory stories popping up all over the media — the most
recent being a "60 Minutes" piece on Oct. 25 (see '60 Minutes' Points
TV Finger at Medicare Fraud) — legislators are beginning
to understand that most of the fraud that is surfacing is being
perpetrated by "Nigerian scam artists and the Russian mob, not the
majority of the independent mom-and-pop, dedicated providers"
serving local areas.
"This is good news for our industry," he said. "They know it's
Johnson is hopeful that other organizations such as the AMA will
get on board and help champion H.R. 3790 with legislators. Last
week, the 5,000-member National Association for Support of Long
Term Care threw its support behind the bill. The group is
encouraging a grassroots effort and is sending an "advocacy
message" to legislators through the NASL Advocacy
Such support could help to make H.R. 3790 a standalone bill
rather than one that would need to piggyback on another measure
such as health reform legislation. "I personally would like to see
it as an independent-status bill," Johnson said. "There are too
many problems associated with the health reform package."
He's proud of the Meek bill, which he noted was forged over
seven months with important input from industry stakeholders and
help from the American Association for Homecare. There's much good
in it, he believes. But in the end, the biggest reason to eliminate
the DME bid program is "to save the beneficiary" because
competitive bidding is unsafe for patients, Johnson said.
"Rather than go through this gyration with competitive bidding
and all the problems associated with it, let's just go with 3790
and make everybody happy," he said. "It's a way to save for the
Medicare program. This is a bipartisan bill that does something for
"We've kept access, lowered the patients' copay by reducing the
fee schedules and, Grandma, we are not throwing you out with the
bathwater … We do all that independently, with one swoop of
the pen and without asking for any assistance from any government
agency and no new taxes for any taxpayer."
Johnson has a personal interest in all this that goes beyond his
business. His father is 86 and needs oxygen. He does not want to
see what happens to his dad if competitive bidding goes
Elimination of the program is "just something that has to
happen," he said. "We owe this to the American taxpayer, we
certainly owe it to the beneficiary and we owe it to Congress to
come up with a bill where we can continue to provide the services,
protect the elderly and prevent fraud.
"If they can pass this bill, they will definitely be a Medicare
View more competitive bidding
To contact your representative in support of H.R. 3790, call the
U.S. Capitol switchboard at 202/224-3121. The operator will connect
you directly to your congressman's office using your ZIP code.
CMS has scheduled its eighth and final Special Open Door Forum
on the Round 1 rebid Wednesday, Nov. 4, from 2 to 3 p.m. ET. To
participate in the call, which will be devoted to questions about
bidding, dial 800/837-1935 and reference Conference ID 23045924. As
a reminder, Nov. 4 marks the
close of bidding registration.