Letters Pushing for Bidding Delay Fly Across Capitol Hill

WASHINGTON–The fierce battle to halt implementation of
competitive bidding program heated up on Friday when two senators
circulated a letter to their colleagues pressing for a delay
“until outstanding issues can be resolved.”

The American Association for Homecare and other industry
organizations immediately issued an action alert calling on all
providers to contact their senators and urge them to sign on to the
letter, which was authored by Sens. George Voinovich, R-Ohio, and
Debbie Stabenow, D-Mich.

Deadline is close of business today for signatures to the
letter, which is addressed to Sen. Harry Reid, D-Nev., Senate
majority leader; Sen. Max Baucus, D-Mont., head of the Senate
Finance Committee; Sen. Mitch McConnell, R-Ky., minority leader;
and Sen. Charles Grassley, R-Iowa, ranking member of the Finance
Committee.

Walt Gorski, vice president, government affairs, for AAHomecare,
said there is no target number of signatures. “We need to get
as many as we can possibly get in the next day-and-a-half,”
he said Friday, adding that time is of the essence because of
“how quickly things are moving.”

Both Republicans and Democrats in the Senate are attempting to
put together a Medicare package that would include a “doc
fix” provision eliminating a 10 percent cut in physician
reimbursement. A stay on that cut runs out July 1 (see top story in
this issue). Coincidentally, national competitive bidding is
scheduled to be implemented that same day in 10 MSAs.

Industry stakeholders are hoping to get a provision to delay
competitive bidding in the final Medicare package.

There is also the possibility of a stand-alone bill to stop the
program. According to industry insiders, Rep. Fortney
“Pete” Stark, D-Calif., a member of the heavyweight
House Ways and Means Committee, is poised to introduce a bill that
would delay round one for 18 months and round two for an additonal
year.

But with any legislation, success is contingent on support.

“The association believes strongly that a delay in
competitive bidding is a non-partisan issue and should be
approached as one. We are working to gain momentum in the Senate as
we have in the House,” said Gorski. “Clearly, we have
made inroads, and both lawmakers in the House and the Senate
recognize the problems that have arisen with this
program.”

Earlier last week, 132 members of the House–nearly a third of
its membership–signed a letter calling on the Ways and Means
Committee and its subcommittee on health to support a one-year
delay in implementation of the program. That letter was authored by
Reps. John Tanner, D-Tenn.; David Hobson, R-Ohio; and Jason
Altmire, D-Pa.

In addition, Rep. Nydia Velazquez, D-N.Y., who chairs the House
Small Business Committee, and Rep. Heath Shuler, D-N.C., chairman
of its subcommittee on rural and urban entrepreneurship, also sent
a letter last week pleading for a delay in competitive bidding to
Ways and Means members Stark and Dave Camp, R-Mich.

Both the House and Senate letters cite examples of significant
problems with the CMS bidding project.

“Our first concern is the alleged discrepancies between
information submitted by bidders and received by [CMS],” the
Senate letter reads. “The vast majority of rejected bidders
were informed that they have not submitted sufficient financial
information, when in many cases, bidders argue they had.”

“These rejected bidders have no appeal rights,” the
House letter points out.

The Senate letter also raises questions about the ability of
companies that won bids to service beneficiaries adequately:
“Another serious concern is the reports of companies who won bids
to serve beneficiaries in areas where the company has no proximate
physical location and where the company has no history of service.
This calls into question not only the capacity of the companies who
have won bids to service those beneficiaries, but also whether
subcontractors meet the program’s new accreditation
standards.”

Further, the Senate letter notes, “in some cases, bidding
rules explicitly allowed suppliers to offer less choice to seniors
based on their lack of experience in the market. As a result, we
are hearing from our constituents that companies who won bids have
no experience in delivering the product in which they were awarded
a contract. We have concerns these situations will lead to poor
service for our most vulnerable constituents.”

Both letters also call for more transparency from CMS regarding
“how bidders’ financial information and service capacity were
evaluated and how the single payment amount was calculated,”
according to the House letter.

With such questions unresolved, the letters recommend a delay in
bidding. “At the very least, an internal review should be
conducted to ensure the accuracy and effectiveness of the criteria
for future bidding,” the Senate letter advises.

The letters and a list of House cosignatories are posted on the
AAHomecare Web site at www.aahomecare.org.