A Call for Repeal

Congress must enact legislation that ends bidding for home medical equipment.

The philosophy behind bidding as a way for Medicare to manage, deliver and reimburse home medical equipment and services is simply wrong-headed and misguided. The only way to stop competitive bidding problems is to stop the program.

If Congress fails to act, the economic fallout and harm to the home care system and those that rely upon it will be irreversible.

Since the bidding program began on January 1, the Association has heard from more than 300 patients, clinicians, and home care providers who have reported problems and complaints about difficulties receiving the home medical equipment and services prescribed by physicians:

• Difficulty finding a local home care 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 and providers;
• Reduced quality; and
• Confusing or incorrect information provided by Medicare.

For instance, a patient in Charlotte was required to stay in the hospital for several extra days because of delay in delivery of oxygen equipment to the patient’s home.

A Medicare beneficiary in Florida said, “I don’t like that the local people were cut out. In our area, there are very few suppliers to choose from.”

An HME provider in the Kansas City area said hospital discharge planners are sending patients only to those equipment providers that won contracts for multiple categories under the bidding system, effectively excluding those companies that only won contracts for one or two service categories. This further shrinks the pool of home care providers available to serve Medicare beneficiaries and does nothing to protect small providers.

And numerous home medical equipment providers in Cleveland, Cincinnati, and Dallas have laid off staff because of the bidding program.

AAHomecare is focusing all of its energy on convincing Congress that it must repeal competitive bidding. A full court press is underway to get the House and Senate to consider legislation to end the program. Congress needs to act fast — while there is still a community of home care providers that can put the pieces of a robust home care system back together.

This effort needs the full support of everyone in the home care community. Whether in a Round 1 or 2 area, whether a bidding loser or “winner” of one or several contracts, whether a full-line HME provider or a specialized supplier, the fight to repeal bidding is a cause for everyone.

We need the full involvement of every member of the extended home care community. Let law- makers in the House and Senate hear our call for repeal.

Remember, we are not alone in this effort. Numerous patient advocacy and related industry groups oppose the bidding program, including the ALS Association, American Association of People with Disabilities, Muscular Dystrophy Association, National Association for Homecare and Hospice, National Association for the Support of Long Term Care, National Council on Independent Living, National Emphysema/COPD Association, National Spinal Cord Injury Association and United Spinal Association.

Just last year, 259 members of the U.S. House of Representatives went on record opposing the bidding program. And 167 economists and auction experts warned Congress that the bidding system would not only fail and reduce quality — it would increase fraud and abuse in Medicare.

Medicare beneficiaries, family members, caregivers, hospital discharge planners and clinicians as well as HME providers should report problems, concerns and other feedback about this bidding system by calling a toll-free number, 888/990-0499, or by visiting www.biddingfeedback.com.

To learn more about this effort, visit the Association website at www.aahomecare.org/competitivebidding.

Read more AAHomecare Update columns. View more competitive bidding stories.

Tyler J. Wilson is president and CEO of the American Association for Homecare, headquartered in Arlington, Va. You can reach him at [email protected]. For more information on critical home care issues, visit the association’s Web site at www.aahomecare.org.