Commentary: ‘Not One Penny More!’

By Wayne Stanfield, president and CEO, National
Association of Independent Medical Equipment Suppliers, Halifax,
Va.

The DME industry paid dearly, 9.5 percent or about $7.8 billion
over 10 years to delay the “suicide” bidding program in
2009. That’s 25 percent more than the projected $5.8 billion
savings from the program as scored by the CBO in 2002.

Earlier this year the CBO scored H.R. 3790, the bill to repeal
the program, at a cost of $9.6 billion over 10 years. This score
was based on the 2008 bids that set fees at 26 percent under
Medicare.

Friday [July 30], the CBO
rescored H.R. 3790 at $20 billion in savings, which means DME
will have to offset this amount to end bidding before it goes into
effect January 1, 2011.

While Congress does not have to use this exact figure, it WILL
have to offset the cost of making the bill budget-neutral. Rarely
is a lower number used.

When the May score came out, NAIMES used data provided by the
CBO to calculate the $9.6 billion cost. The result was to give up
1.6 percent of the CPI increase each year for 10 years as an
acceptable offset. The NAIMES Board at that time said “minus 1.6
percent CPI-U — and not a penny more.”

After the $20 billion score on Friday, the Board restated their
position. The industry simply cannot afford to pay to offset this
amount. To continue to offer more money to pay for ending this
program sends the message that we are overpaid. Every time we reach
into our pockets, Congress reaches into our pockets.

The low-hanging fruit spoken of so often as the reason we keep
getting tapped is gone; the tree is bare. We have paid until
suppliers are closing in significant numbers. We have taken cuts in
this industry for 20 years, including serious cuts in the past two
years.

No one likes to draw lines in the sand, but this time it has to
be done. According to most experts and DME leaders, Round 1 will
collapse under the weight of problems. If that is the case, then
the program will end itself without us paying.

Quoting Rich Mckeown, president and CEO of Leavitt Partners, and
chief of staff for former HHS Secretary Michael Leavitt, “The train
has left the station. I have no doubt that competitive bidding is
here to stay. There will be some who will adapt and thrive in this
new structure and some will just go away. Every time there is
change there is opportunity.”

If we are to believe this prediction, offering to pay anything
to stop competitive bidding will be fruitless. His crystal ball
should be better than ours.

NAIMES will never quit fighting to end bidding, but we will
fight in other ways without agreeing to pay more than we can
afford.

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