There Is No Breathing Easy with Competitive Bidding

MIAMI — Even as CMS maintains it hasn’t received many complaints about competitive bidding — 43 out of 54,000 calls, agency officials said at last month’s Program Advisory and Oversight Committee meeting — problems continue to surface. Reported by the Accredited Medical Equipment Providers of America, here’s one from a North Miami, Fla., woman who just wanted to breathe.

Under the program, Wanda Revercomb had such problems getting oxygen service that she took her story to Sen. Bill Nelson, D-Fla., a member of the Senate Finance Committee. Revercomb, an oxygen patient from North Miami, told a Nelson aide April 26 that two months ago, she was feeling short of breath and noticed her oxygen concentrator was low on oxygen. She called her provider.

“They used to come around every few months to change the filters and check my machine and they were past due for service,” AMEPA reported Revercomb as saying.

“I called the phone number on the top of the machine for days, but no one answered,” Revercomb continued. “There was not even a recording to leave a message. My home health nurse called Medicare and they explained that my oxygen supplier closed their account and that I had to find a new supplier, one that won a bid in their new competitive bidding program.”

From Medicare, she got a list of contracted suppliers, but each one refused her because of her location and the fact that she had already been on oxygen for two years, she told Nelson’s staff. Under Medicare’s 36-month oxygen rental cap, a new supplier would be paid for only 12 months but would be required to service Revercomb for the two years after that.

She finally found City Medical Services of North Miami Beach, a contracted supplier. But the company was prevented from providing immediate service because Revercomb was “now caught up in the system’s red tape,” AMEPA reported.

She needed a new examination from a pulmonologist to prove her oxygen use was medically necessary, and she had to have new diagnostic tests to support the physician’s order for oxygen. It took her nearly a month to satisfy the Medicare requirements. She told Nelson’s staff she was “so short of breath she nearly went to the hospital, but she was concerned about calling for an ambulance” and its expense. She also did not want to worry her son.

“I thought it would be such a waste of time and money to go to the hospital for my oxygen needs,” AMEPA quoted her as saying.

City Medical serviced Revercomb through Saturday. Then that company also closed its doors, a victim, said owner Rob Brant, of competitive bidding. Where Revercomb will go next is uncertain.

Revercomb’s story illustrates the complaints that numerous industry organizations, including the American Association for Homecare, say they are hearing about competitive bidding. AAHomecare officials reported in March that the association had received hundreds of complaints since the program’s implementation in January.

Those complaints include: difficulty finding a local equipment or service provider; delays in obtaining medically required equipment and services; longer than necessary hospital stays due to trouble discharging patients to home-based care; fewer choices for patients when selecting equipment or providers; reduced quality; and confusing or incorrect information provided by Medicare.

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