We need to get rid of the "suicide bidding" program once and for all.
by Cara C. Bachenheimer

We have a time-limited opportunity over the next weeks to get
rid of what we now call the "suicide bidding" program (what has
traditionally been misnamed "competitive bidding"). With the
January 2011 implementation date coming fast and furious and
Congress' legislative session now in full gear, we must seize the
opportunity to have Congress repeal this ill-fated program once and
for all.

When Rep. Kendrick Meek, D-Fla., introduced the bill to repeal
the "competitive" bid program (H.R. 3790) last October, he set in
motion a steady stream of grassroots efforts to gain additional
congressional support of the bill.

While there is no "magic" number of cosponsors, the more the
better to demonstrate to House leadership that there is significant
support for the bill to move forward. Over 200 cosponsors would be
ideal. At press time, the bill's sponsors were an almost equal
representation of both Democrats and Republicans, demonstrating
this is not a partisan issue.

If your members of Congress have not signed on to H.R. 3790, you
have work to do. To check, go to Congress' official Web site at
http://thomas.loc.gov, and enter the
bill number in the search area. (Make sure you check the box
labeled "bill number.")

If you are unsure who your representatives are — remember,
you should contact those who represent where you live as well as
where your business is located, and the areas your business serves
— go to one of the industry organizations' Web sites:
AAHomecare, www.aahomecare.org (click on
"Advocacy/Gov't Relations" and then on "Action Center"); The MED
Group, http://capitol.medgroup.com/; or
VGM Group, www.vgm.com.

On these sites you can also find draft letters, position and
issue papers and other material to help you craft your message in
the best possible way.

Here's a summary of the key argument and points to communicate
to your congressional representatives and their staff to get them
to understand that this program will be harmful to their
constituents — to the consumers who rely on HME providers, to
HME providers and to those such as referral sources who rely on HME
providers to provide quality care to seniors and people with
disabilities.

The program is fatally flawed. Although
Congress delayed implementation of the bidding program to allow for
necessary improvement, CMS has ignored Congress' intent with the
delay and has not made changes that will address the program's
fundamental flaws. Therefore, we anticipate the same problems that
plagued the initial rollout of the program to re-occur.

  • The program encourages "suicide bidding" and
    uses economic coercion by forcing suppliers to submit unsustainable
    bids necessary to "win" a contract. If a provider is unsuccessful
    in securing a contract under the program, the chance of survival is
    nil. Moreover, since Medicare is the largest purchaser of HME items
    and services, CMS is using economic coercion to force unsustainable
    bids from home care providers desperate to maintain cash flow in
    the hopes of staying in business.

  • The program will cause significant job loss.
    The bid program is actually anti-competitive because it reduces the
    number of market competitors. Eighty to 90 percent of HME providers
    would have been barred from the Medicare program in the first round
    of bidding. This program has proved it will cause job losses and
    business failure for thousands of small providers at a time of
    severe economic hardship across the country.

  • The program will hurt seniors and people with
    disabilities.
    Competitive bidding will prevent access and
    choice for HME items and services. The program will trigger a race
    to the bottom in terms of quality, with less expensive items being
    provided to Medicare patients.

    With the projected loss of providers, expedient deliveries of
    items and services will be eliminated and Medicare costs will
    increase. In the initial 2008 bid round, patients were confused
    about the restricted list of contracted home medical providers,
    hospital discharges were delayed and unnecessary emergency room
    visits were triggered.

    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.