HME Leaders Work to Devise Competitive Bidding Alternatives

ATLANTA — As the industry daily sinks deeper into competitive bidding, implemented
Jan. 1 in nine metropolitan areas across the country, a brain trust
of HME thought-leaders assembled by the American Association for
Homecare is working to determine a strategy for dealing with the
CMS project.

Two work groups have been established, according to Michael
Reinemer, vice president, communications and policy, for
AAHomecare.

“One of our member work groups is looking at alternative payment
systems for HME that don’t involve competitive bidding in any shape
or form,” said Reinemer. “Another group is looking at ways that
might be acceptable within a bidding framework, perhaps starting
from scratch on a completely new approach. Both of these work
groups are on a fast track, and we hope to be able to share some of
their thoughts and conclusions by early March.”

Georgie Blackburn, vice president of government relations for
Blackburn’s in Tarentum, Pa., and co-chair of the alternative ideas
work group with Esta Willman of Medi-Source Equipment & Supply
in Yucca Valley, Calif., said the intent is to “drive the best
ideas forward.”

“We are developing a mission statement and, over the next month,
we will be finalizing the alternative, or alternatives, we have if
we can’t get competitive bidding repealed,” Blackburn said. “March
is the deadline for putting our ideas on the table.”

Blackburn said the groups are meeting weekly via conference
calls.

“There is an undercurrent of activity,” she said. “Even though
competitive bidding appears to be here to stay, there are problems
that are being documented and there are those of us trying to get
things done who believe we will have an opportunity. When you have
a poor policy, something surfaces sometime, and it is our hope to
be there with some possibilities.”

While it is still early in the game, AAHomecare reported Jan. 26
that it had recorded nearly 100 complaints tied to the CMS program,
including difficulty finding an equipment provider,
longer-than-necessary hospital stays due to confusion in
discharging patients and confusing or incorrect information
provided by Medicare.

But Wayne Stanfield, president and CEO of the National
Association of Independent Medical Equipment Suppliers, called the
problems being reported in the competitive bidding areas “a
trickle, not the expected flood.” He added that among the reasons
— other than people not knowing how or where to report
problems — are bid winners “throwing full efforts behind
making competitive bidding work.” Another reason for the slow
reports, he said, “is the caring compassion of the suppliers
without contracts who are helping patients by providing
uncompensated services.”

Stanfield, a member of the alternative strategy task force, said
“there are only two things that can come out at this point —
it’s either going to fail or it’s not. If it fails, it will mandate
that Congress do something.” He defined failure of the bid program
as “enough chaos and catastrophes that it gets to Congress and they
say, ‘Oh, my God, what have we done?’”

At that point, Stanfield said, the industry must have a
solution. “It is my belief that a short-term plan needs to be ready
if [competitive bidding] fails,” he said. “If it fails, whenever
that is going to be, then someone is going to ask ‘What do we do
now?’ and the industry is going to have to be ready … If this
industry does not have a plan in its pocket when that occurs, we
will have missed the only opportunity we have.”

That opportunity might come sooner than many think. Blackburn
pointed to the House Republicans’ attempt to repeal the Obama
health care law. If Congress chips away parts of the reform
legislation, one of the possibilities could be a halt to its
expansion of competitive bidding to 91 more areas in Round 2.
Should something like that happen, the industry needs to be
prepared, Blackburn said.

“We want to have alternatives that are saleable to Congress, to
CMS, that [show] they will save money while we can preserve jobs
and give the care we are accustomed to providing,” she said.

“This is our business, these are our patients,” Blackburn added.
“We aren’t just going to be spoon-fed this policy.”

To report problems associated with competitive bidding, contact
AAHomecare’s toll-free number at 888/990-0499 or go to www.biddingfeedback.com.

NAIMES is also collecting information at www.competitivebiddingconcerns.com.

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