Vacuum Cleaner Noise

I was hoping by the time I wrote this column the industry might be celebrating the demise of competitive bidding or, at least, its delay. No such luck.

As the days rush toward the July 1 implementation date, CMS continues to barrel through its rollout of the program. And Kerry Weems, the agency’s acting administrator, continues to insist that everything is fine.

The problem is, since it will literally take an act of Congress to slow or repeal the project, many of our federal legislators seem to believe him.

On top of the issues raised by the program’s inherent concept — turning over Medicare beneficiaries’ health needs to the lowest bidders — problems with the incredibly botched process keep piling up as round one unfolds. Not the least among them is serious evidence of possible bidding improprieties in the Riverside CBA that, to date, has not been addressed.

HME advocates have made some headway. At press time, there was a chance that language to slow the program would be inserted in Medicare legislation in the Senate. And in the House, Rep. Pete Stark, D-Calif., was poised to introduce a bill mandating its delay.

I got an interesting phone call recently from Western Health Care’s Vince DeStigter, a California provider who has been following the round one bid — and Stark. Vince, who has been in the HME business 47 years, told me that Stark had been his banker long ago. Since then, he said he has visited with Stark many times to offer the thought that providers should be able to charge customers the difference if they feel prices set by the government aren’t adequate to cover costs and make a living.

“If I couldn’t beat other providers on price, I would win patients with my service,” Vince said. “Now that’s competitive.”

It’s doubtful we’ll ever see that scenario, and whether the Senate legislation or Stark’s bill will make it through Congress in time to help the industry before July is definitely a toss-up. Nevertheless, Vince’s story is a reminder that talking directly to those shaping HME policy helps, even if it does take years.

Who knows, maybe those heart-to-hearts were part of what led Stark to call the bidding program “somewhere between flawed and lousy” in a congressional hearing last month. Stark even told CMS’ Weems, who testified on competitive bidding’s theoretical money-savings at the hearing, that he was a “useless witness.”

If you could talk directly to acting Administrator Weems, what would you tell him about competitive bidding?

Earlier this year, HomeCare asked that exact question in a survey of our readers. We got an earful from several hundred providers who took the time to send us their answers, and you can read a representative sample of those responses in this issue. I’ll give you a hint: Not even one had anything favorable to say.

If, over the past few years, you have not figured out what I think about competitive bidding, then let me present the answer from one provider who wrote succinctly, “It’s like a vacuum cleaner — it sucks.”

Perhaps not the most delicate choice of words, but I have to agree.