The American Association for Homecare Washington Legislative Conference on Feb. 15 and 16 attracted 300 HME advocates. There were eloquent speakers, heated political conversations and meetings on Capitol Hill. There was also a surplus of Notable & Quotable comments, including:

“Who would think that I’d go to Washington, D.C., to get away from government regulations?” – Comment from HME provider taking a break from work on competitive bidding to attend the conference.

“We will fight them until hell freezes over, and then we’ll fight them on the ice.” – Paraphrase of a Civil War quote uttered by Tyler J. Wilson, AAHomecare CEO and president, after a setback getting the Market Pricing Program pushed through Congress.

“We don’t have any direction in our country right now. We’re cutting anything that raises its head up. It’s like Whac-A-Mole.” – A. Malachi Mixon III, of Invacare, while accepting an Advocate of the Year Award from AAHomecare.

“There’s clearly a problem here. All the efforts seem to go after the honest, hardworking people who are doing what you would want them to do.” – U.S. Rep. Michael Burgess, R-Texas, talking about the government’s effort to fight fraud, waste and abuse in Medicare.

“I realize that the issue of competitive bidding has been for you a real source of indigestion.” – U.S. Rep. Phil Gringrey, R-Ga., addressing the conference.

“Now is not the time to scale up a program that everybody but CMS agrees is flawed.” – Peter Cramton, a University of Maryland economist, talking about competitive bidding.

“What is absolutely perfect may not be feasible. Even if it’s not perfect because of political problems, it’s still going to be good.” – Brett Katzman, a Kennesaw State University economist, talking about plans to fix competitive bidding.

“Our efforts have kept us from being cut even more.” – Joel Marx, chairman of AAHomecare, speaking at a luncheon.

“The MPP (Market Pricing Program)—I think that’s a great compromise. It’s a good way forward.” – U.S. Rep. Glenn Thompson, addressing the conference.

HomeCare, March 2012

Amid skepticism from the HME industry, registration just closed, and the bid window is open for Round 2 of Medicare’s Competitive Bidding Program. Many providers are busy working out strategies and calculations. Just before all this activity, HomeCare Monday surveyed HME providers on competitive bidding’s impact on their businesses. Here are two questions asked, and a sampling of responses:

Q: In general, were you prepared for competitive bidding, and do you find the process manageable?

Answers:

• “No. I was not prepared. I do not find the process manageable. In fact I find it very confusing.”
• “I think you have it backwards. The system is managing us.”
• “We decided not to participate upon implementation of Round 1. We are in a Round 2 area. It has been a great relief to us, stress wise, and financially as well, to focus on non-bid items.”
• “No one can be prepared as the current program design provides incentives for supplies to irrationally bid below their costs.”
• “It takes a large amount of effort to prepare for, but with education and effort from VGM and Medgroup I believe it’s manageable.”
• “We do not feel this is an industry to stay in after competitive bidding.”

Q: What is your No. 1 complaint about or difficulty with competitive bidding? Please try to be specific and brief.

Answers:

• “Ignorance on both sides—supplier communities and CMS regarding how the program works, and how bidding a too low price hurts everyone.”
• “The lack of response from Medicare when information about your company is missing. You are automatically eliminated from the bidding system.”
• “Not being able to get a straight answer from government agencies when I inquire.”
• “It requires covering an unrealistically large service area as what will probably be substantially reduced prices.
• “Non-binding bids because they offer an incentive for suppliers to bid below their cost and hope the contracted amount is higher than their bid. This process results in irrationally low contracted prices.”
• “Impossible for a small HME business to be able to afford the expertise it takes to understand, calculate and submit bids.”