Bidding Slowdown Not Likely, Lobbyists Say

ATLANTA — Providers’ hopes of eliminating or delaying
competitive bidding
before Jan. 1 might have been dashed by the election, the
evaporation of time and CMS’ full-steam-ahead attitude, but they
can’t afford to give up now, industry lobbyists said last week.

“The train is on the track heading toward a tunnel that is not
finished — and you’ve got another train — Round 2
— right behind it, ” said John Gallagher, vice president,
government relations, for Waterloo, Iowa-based VGM Group. “This is
a major tragedy waiting to happen.”

Providers need to buttonhole their legislators — both new
and returning — in the next weeks to spell out the impact of
the project if they want to avoid calamity, he said. “We’ve got
about four weeks to get to [members of Congress], to educate the
new folks. We need to be particularly focused on jobs, jobs, jobs
and also the impact [competitive bidding] is going to have on
beneficiaries.”

The HME sector had hoped a hearing tentatively scheduled by Rep.
Pete Stark, D-Calif., chair of the House Ways and Means
Subcommittee on Health, would spark congressional action at least
to delay implementation. It also hoped that H.R. 3790 might be
attached to the Medicare doc fix bill, which must be passed by Nov.
30 in order for physicians to sidestep a significant reimbursement
cut.

“Regarding a hearing, it’s unclear right now,” said Cara
Bachenheimer, senior vice president of government relations for
Invacare, Elyria, Ohio. “Nobody on the Hill really knows the
schedule when Congress returns [this] week, except that it will be
very short. It’s not looking good, though.”

The industry also must be watchful about what happens with
elimination of the first-month purchase option for power
wheelchairs and a possible reduction to 13 months for the 36-month
oxygen rental cap, both of which could become pay-fors for the doc
fix. Ironically, the doc fix is also the best vehicle this year to
carry a delay of the purchase option elimination, said Pride
Mobility Products’ Seth Johnson, vice president of government
affairs.

As for H.R. 3790, Bachenheimer said, “Congress has a very short
must-do list” before the end of the session. “The doc fix is one of
the must-do items — but it will be a tall order to attach
H.R. 3790. We’d need to make sure it’s budget neutral, which means
tacking on a bunch of payment cuts that are simply not feasible for
the industry.”

The industry would have to come up with $20 billion in cuts over
10 years — the amount the Congressional Budget Office
estimates the bid program would save — to pay for its
elimination.

Now, said Johnson, “our best opportunity to halt the program
prior to implementation remains regulatory relief, but CMS seems
more committed than ever to advance its fundamentally flawed
bidding program.”

That means H.R. 3790 is likely to expire once the new Congress
is seated, meaning the industry would need to seek another champion
to carry a new bill. With the Nov. 2 elections, 60 of the 257
cosponsors for the bidding repeal bill were lost.

“We have our work cut out for us,” Gallagher said.

Even as providers continue to fight the looming bid program,
they must also get ready for its implementation, Gallagher said,
and begin to educate beneficiaries about what competitive bidding
will mean to them.

VGM has announced a new advocacy group called People for Quality
Care (www.peopleforqualitycare.org/) that will “educate
those with disabilities, their families and Medicare beneficiaries
about health policy changes that affect their freedom of choice,”
the group said in a legislative update last week.

“We need to prepare beneficiaries to be engaged come Jan. 1,”
Gallagher said. “Most will not do anything until it hits the fan.
When they’ve got three providers instead of one and two are out of
state and delivering by [mail] … We’ve got to get them
screaming mad. That’s when things will happen.”

Tell AAHomecare about Bid Problems: AAHomecare
wants to hear from both providers and patients about “any problems
or anomalies (for example, unknown companies that win bids)
associated with the announcement of Round One contracts and the
scheduled Jan. 1, 2011 start of the bidding program.” Click here for an online reporting form. The
association will share examples of shortcomings and errors with
lawmakers, researchers and the media “to strengthen the argument
that the bid system is fatally flawed.”

View more competitive bidding
stories.