Taking the Reins

The home medical equipment industry is facing some of its biggest challenges ever, as Congress and the White House propose cuts to the Medicare program that will impact everyone from providers and manufacturers to beneficiaries. It’s critical that the DME industry be unified in fighting policies and reimbursement cuts that can jeopardize the health of Medicare patients. Moreover, we must make Congress understand the ramifications of the dangerous and defective bidding program that has inflicted arbitrary reimbursement cuts on the industry.

Yes, this is a rallying cry. We need your help. There comes a time in every public policy battle when the outcome is determined by the grassroots, by constituents. As former House Speaker Thomas “Tip” O’Neill, Jr., famously declared, “All politics is local.” What that means is that stakeholders, such as providers and manufacturers, must get in touch with their representatives and senators and let them know how much the bidding program and future cuts will hurt their constituents.

For too long we have allowed others to define the issues around oxygen therapy, power wheelchairs and other DME that allows some of the most vulnerable people in our nation to age gracefully in their homes. That’s where they want to be and that’s also the most cost-effective setting for them to receive care.

Going forward we must control the narrative, and we have the voices and stories to do so. Mike Cobb, who has owned Crest Medical in Birmingham, Ala., for more than 30 years, says, “The 45 percent cut in Medicare, Medicare Advantage and other insurances that use the Medicare allowable basis for reimbursement will reduce our annual receivables by about 30 percent whether we accept these contracts or not. In order for us to have a chance at remaining viable, we will be forced to lay off all part-time and at least two full-time employees. The good service reputation that we now pride ourselves on will be gone.”

Bill Baker, president of RxO2 Oxygen & Medical Equipment Supply Co., Inc. in Tucson, Ariz., says, “My wife and I are a small ‘Mom and Pop’ respiratory therapist-owned and operated business. I’m a Vietnam combat veteran. We have 12 full-time employees who will lose their jobs with some additional layoffs pending in the near future. Still, we will likely be out of business before the end of the year. We have invested everything in our business so if it closes we’ll be moving out of our home as well. So with me just four years away from 65, and my turn to use Medicare, I’ll have a complete understanding of why I won’t get the care I need.”

Mark Gielniak, president of Diabetes Plus, Inc. in Warren, Mich., says, “Because of the ridiculously low bid rates for diabetes supplies we will lose approximately 1,200 customers, which is 45-50 percent of our business. We will have to lay off 50 percent of our staff. Most of our Medicare customers pick up their name-brand supplies at our store. But, when July 1, 2013 rolls around they will have to deal with a mail order company and they most certainly will not be receiving name-brand products. This will be confusing to them, as well as force them to use inferior products. This will probably lead to poor diabetes control and more complications, which will lead to more doctor and hospital visits.”

When stories like these are told to lawmakers, it can make a difference. Now is not the time to sit on the sidelines and rely on others to do the heavy lifting. Now is the time to be politically active. We need the voices of providers like Mike, Bill and Mark to demonstrate the impact of this destructive bidding program.

Rep. Tom Price (R-Ga.) is reintroducing the Market Pricing Program (MPP) legislation in the 113th Congress. But for MPP to be implemented we need your support. Your representatives and senators need to recognize that their constituents are losing their jobs and their businesses, and that their constituents are being endangered by lower-quality goods and services.