AAHomecare: Moment for Action Is Upon Us

ARLINGTON, Va.–In a special update sent to members on Friday,
American Association for Homecare Chairman Alan Landauer and
President Tyler Wilson explained provisions of H.R. 6252,
legislation introduced last week to delay competitive bidding–and
the industry’s work in bringing it about.

According to the message:

The legislation has been under development for some time.
However, AAHomecare only received the final details of the proposal
late in the day on June 11. The leadership of the Committee on Ways
and Means, who were instrumental in putting the legislation
together, wanted AAHomecare’s reaction to the proposed bill
in less than 24 hours.

Over a month ago, anticipating that the final legislative
proposal would come together quickly, AAHomecare’s executive
committee began conferring with several other key industry
stakeholders. These other groups included The MED Group and VGM.
This task force has focused on the end-game strategy for
successfully delaying competitive bidding. While the
industry’s government relations and grassroots campaign to
beat back the implementation of bidding has been underway for
several years, many critical issues have crystallized in just the
past 30 days after the high-profile hearing before the Ways and
Means Committee on May 6.

With the pace of events in the House and Senate moving very
fast, the opportunity for this industry to have the competitive
bidding program examined and addressed by Congress before July 1
has been quickly drawing to a close. At the same time, the
membership of AAHomecare has consistently been very clear that it
wanted competitive bidding delayed, the implementation problems
examined, and the entire program reassessed.

It is under the foregoing circumstances that the AAHomecare
executive committee and other participants in the task force
reviewed the final Ways and Means proposal on June 11. After
careful consideration, AAHomecare announced its support of the
impending legislation. In announcing our support, we made it
conditional upon no other cuts being leveled on the industry this
year.

In sum, H.R. 6252 does not include everything the industry
requested during its many discussions with Ways and Means about how
best to delay the start of round one. The payment reduction in the
bill targets only the competitive bidding product categories and is
not across-the-board as we urged from the outset. Round one will be
delayed 18-24 months and then re-bid, and round two contracts will
not take effect until 2011. The legislation lists numerous
improvements including the exclusion of complex rehab from any
future bidding program.

The cost of the delay is a 9.5 precent payment reduction in
2009 for those items subject to competitive bidding in round one
and no CPI update in 2009 for those items. All other items will
receive a CPI update in 2009. In 2010 through 2013 all items will
receive a CPI update. In 2014, the items subject to a reduction in
2009 will receive a 2 percent update over the CPI–except in areas
where competitive bidding contracts are in place.

The industry has made tremendous strides in putting our
concerns about competitive bidding before Congress, and the moment
for action is upon us. While few legislative initiatives are
perfect and this current proposal is no different, AAHomecare
believes that H.R. 6252 is the best option for a majority of the
HME community at this time. Put differently, if the industry were
to indicate ambivalence or disapproval of the House legislation,
there is considerable downside risk that we might see both
product-specific cuts (e.g. in oxygen) and competitive bidding
moving forward without pause and unchanged. The prospect of either
or both would be very problematic for many providers across the
country.

Rarely in the recent history of the HME industry have so
many different organizations, individual companies and other
stakeholders come together to challenge such a fundamental and
monumental threat to our livelihood and to the Medicare
beneficiaries we serve. We have received the attention of Congress
and we have shown that we can work through an issue and present a
consensus position on Capitol Hill.

AAHomecare hopes all of its member companies will work
quickly and vocally to support the House legislation. You should
urge your representatives in Congress to sign on to H.R. 6252 and
to support final passage of the Medicare DMEPOS Competitive
Acquisition Reform Act of 2008.