Competitive Bidding Repeal Effort Regains Steam

ATLANTA — Here’s the HME industry’s response to CMS, the
GAO and the Obama administration: We’re not giving up on a repeal
of competitive
bidding.

Last year, H.R.
3790, which would have repealed the entire bidding program,
gained 259 cosponsors in the House but never made it to the floor.
Last week, just as the American Association for Homecare announced
a renewed “full-court press” to stop the CMS project, the industry
was again hit by a slew of negative announcements.

On Feb. 14, President Obama unveiled his 2012 budget, which would tie
federal payments for Medicaid to Medicare’s bid rates and put all
power wheelchairs through prepayment review. The same day, the
General Accountability Office called on CMS to further slash oxygen
reimbursements. Later in the week, the Medicare Fraud Strike
Force made national headlines when it nailed 111 people for more
than $225 million in Medicare fraud.
The bad news was, some of those accused were HME providers.

Despite the tough climate, stakeholders said Friday they were
not deterred in the competitive bidding battle.

“Congress has been debating a long list of budget cuts, and, of
course, we’ll fight any proposals to make more cuts to our sector.
But budget proposals or agency reports calling for cuts don’t
always make it out of the parking lot,” said Michael Reinemer, vice
president, communication and policy, for the American Association
for Homecare.

“On the other hand,” he added, “the bidding system is the mother
of all threats. It’s real, it’s now, it’s wreaking havoc, it’s
spreading.”

“While the confluence of yet another prepayment review, the
potential of further cuts to oxygen and yet another fraud report
will again tax the tolerance of the HME community, these companies
are a hardy bunch,” Mark Higley, vice president for development for
the VGM Group, Waterloo, Iowa, said of home medical equipment
providers. “The industry will deal with each of these threats, but
certainly there will be no reduction in efforts to derail
competitive bidding.”

Implemented in nine cities Jan. 1, the DMEPOS bidding program
has already seen its share of casualties as businesses have closed,
jobs have been lost and Medicare beneficiaries have experienced
longer hospital stays.

Rob Brant of City Medical Services in Miami said his company has
heard from Medicare patients who cannot find anyone to service or
even provide their equipment.

“We have CMS saying, ‘We have created this bidding utopia and
everything is perfect,’ and it is far from the truth,” Brant said.
He refers the frustrated beneficiaries who call him to the Medicare
answer line, he said, but often they call back even more frustrated
because they have been steered to “companies that don’t answer the
phone or companies that didn’t win contracts.”

Some give up trying to find a legitimate provider, Brant said,
and pay out of pocket.

“It isn’t right,” he said. “And what about those others who
can’t afford to pay out of pocket and have just given up? Those are
the ones we will never know about.”

It is incumbent upon the industry to fight to repeal competitive
bidding before more serious problems erupt and before Round 2 gets
underway later this year, Brant and other advocates said. Many are
looking to AAHomecare’s March Legislative Conference as the vehicle
for driving home to legislators the need for a repeal.

“The bottom line is, now more than ever we need everyone in the
country to come to the Legislative Conference,” Brant said. “It
seems the Obama administration feels that all the health care
problems can be resolved by beating up the HME industry. We are not
the problem. We are the solution.”

The Legislative Conference will be held March 16-17 at the
Westin Washington, D.C. Speakers include Reps. Jason Altmire,
D-Pa.; Phil Gingrey, R-Ga.; Tom Price, R-Ga.; Heath Shuler, D-N.C.;
and Glenn Thompson, R-Pa. But the event’s focus will be taking the
industry’s positive message — and how it will be affected by
competitive bidding — to lawmakers on Capitol Hill.

“No amount of misguided policies or reports can undermine the
fact that home care is vastly more cost-effective than the
alternative, it’s vastly preferred by the people and it’s
clinically proven to produce good outcomes,” Reinemer said.

“We need to remind each legislator and their staff both in
Washington and back home about the value of home care and about the
severe downside of this bidding system,” he said. “For new members
in the House and Senate, it may be the first time they hear about
this problem. So we need to quickly get the full volume of our
complaints and concern to these offices now, and again during the
March Legislative Conference, and again after that.”

While some have wondered if, at this point, getting competitive
bidding repealed is too much of a long shot, others are hankering
to push the effort against the Medicare bid.

“We were really happy to hear the news that that is what we are
taking to the Hill in March,” said Karen Estrella, executive
director of the New England Medical Equipment Dealers association.
“A lot of people think it’s a pipe dream that we can get it
repealed. A lot of us are saying, ‘Give us that fight. That’s a
fight that we want.’”

Higley also thinks it is the right tack.

“We as an industry need to continue to drive this point forward
to both the legislative and executive branches that the CMS
competitive bidding rule costs jobs,” he said.

“A task force of industry stakeholders is leading an effort to
convince Congress that it must act now to repeal the program via
legislation,” he said. “I believe the industry is making headway in
suggesting that the bidding program stands squarely in the way of
saving thousands of small businesses and tens of thousands of
jobs.”

As to whether or not it will be hard to find a champion to carry
a new repeal bill, Brant thinks not.

“I don’t perceive it as a problem,” he said. “Obviously, we have
new legislators and people who are no longer in Congress, but there
are so many from the Round 1 areas that are aware of this problem,
I really don’t perceive it as a problem in finding someone.”

Reinemer is even more optimistic.

“In terms of timing, we hope to have a bill introduced by the
Washington Legislative Conference,” he said.

For details or to register for AAHomecare’s Legislative
Conference, go to http://www.aahomecare.org/cde.cfm?event=306263.

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