Reps. Hobson, Tanner, Introduce Bill to Modify NCB

WASHINGTON–Just before Congress broke for its summer recess,
Reps. David Hobson, R-Ohio, and John Tanner, D-Tenn., introduced a
bill Thursday that would modify the Medicare Modernization Act and
help to ease some effects of its DME competitive bidding
mandate.

For more than a month, the industry has been awaiting
introduction of the proposed legislation, which among other things,
aims to ensure that small providers can participate in the bidding
program, required under the MMA to begin in 10 of the country’s
largest metropolitan statistical areas in 2007.

Called the Medicare Durable Medical Equipment Access Act of
2005, or H.R. 3559, the bill would:

• require that competitive bidding not be implemented until
  quality standards are in place;
• exempt small rural (populations under 500,000) MSAs;
• allow all qualified providers that are small businesses and
  that submitted a bid below the current allowable to participate at
  the selected award price;
• restore the right of providers participating in the program to
  administrative and judicial review;
• exempt items and services from bidding unless savings of at
  least 10 percent can be demonstrated, compared to the fee schedule
  in effect Jan. 1, 2006;
• protect beneficiary access to care by requiring 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; and
• subject the Program Advisory and Oversight Committee–a
  22-member industry panel charged with advising CMS on implementing
  the program–to the Federal Advisory Committee Act, which requires
  public access to meetings and proceedings.

“Our goal is to make sure that seniors who depend on quality
durable medical equipment can continue to have access to it through
Medicare,” said Hobson, who has been one of Congress’ top HME
industry supporters. “Part of making that happen is to ensure that
small suppliers can continue to compete in Medicare’s bidding
process, which is what we are doing with our bill.”

Reaction from the industry was upbeat.

“Since we can’t make competitive bidding go away, this is the
next best thing we could have asked for,” said Karyn Estrella,
executive director of the New England Medical Equipment Dealers
Association and chair of the American Association for Homecare
State Leaders Council. “We’ve heard from some providers who have
come to the conclusion that if they lost a bid in a major product
category, their company would go out of business. It has put
everybody in a sense of panic. We need something that is going to
protect the small provider–and this legislation will really do
that.”

According to Seth Johnson, director of government affairs for
Exeter, Pa.-based Pride Mobility, “Overall it’s a really good bill.
It does not repeal competitive bidding but makes some important
modifications prior to going forward with implementation [of the
competitive bidding program].”

Johnson said he believes the bill has a “strong chance of
passing” if it receives the same or greater level of support shown
by the industry last year when Hobson introduced a bill that would
have repealed the MMA’s FEHBP-based reimbursement cuts. “There’s a
lot of work that needs to be done during the August recess to the
extent we as an industry are able to galvanize behind this bill and
meet with legislators and try to get co-sponsors,” he said.

AAHomecare, state associations and other industry leaders are
urging providers and other stakeholders to set up meetings with
their congressional members during Congress’ August recess to show
support for the measure. “As a small businessman, I know that the
small business provisions of this bill are critical to thousands of
home care providers and the patients they serve,” said Tom Ryan,
AAHomecare chair and president and CEO of Homecare Concepts,
Farmingdale, N.Y. “We will be working very hard in the months ahead
to build a groundswell of support for this vital legislation.”

“This is the exciting first step to get some real and positive
changes to competitive bidding,” said Cara Bachenheimer, vice
president of government relations for Elyria, Ohio-based Invacare
Corp. “The industry now needs to mobilize across the country,
asking each and every representative to sign on as a co-sponsor. We
need a critical mass of support to make sure these changes get made
into law, and the August recess is the perfect time to visit your
representative, write him or her, and ask them to sign on as
co-sponsors.”

The text of the H.R. 3559 should be available shortly at
http://thomas.loc.gov.

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