An Industry Turning Point

May 2008 marked a major turning point for the industry and its campaign against the durable medical equipment bidding program that CMS is planning on starting July 1.

For years, we have been trying to engage organizations representing consumers about the ill effects of this bid program on seniors and people with disabilities. Until last month, those organizations had perceived this issue as one focused only on “payment” and not impacting consumer access to quality items and services.

At a May 6 hearing of the House Ways and Means Subcommittee on Health examining the bid program, the Consortium for Citizens with Disabilities’ (CCD) Health Task Force presented testimony. The CCD is an impressive coalition of over 100 national disability-related organizations with members such as the National Multiple Sclerosis Society, the Brain Injury Association of America, United Cerebral Palsy Associations, United Spinal Association, the Epilepsy Foundation and others.

I believe the testimony of the CCD is tremendously important, and in conjunction with the massive grassroots efforts in our industry, may be a key reason why we have been able to obtain so much congressional support in opposition to the DME bid program.

If you haven’t yet provided your senators and representatives with a copy of the CCD statement, do it today. This statement is available on the CCD Web site at www.c-c-d.org. (Click the “Task Force” button, select “Health” and scroll down to “Activities.”) A corresponding CCD letter to the House leadership is available on the American Association for Homecare Web site at www.aahomecare.org.

In testimony, CCD representative Peter Thomas told the subcommittee the bid “program disproportionately impacts and unfairly places at risk some of Medicare’s most vulnerable beneficiaries — individuals with disabilities and chronic conditions.”

Thomas went on to explain:

“The hallmark of the Medicare fee-for-service program is patient choice of provider/supplier. Accessing the provider of choice is an important quality assurance mechanism, as any beneficiary can simply choose another qualified provider if their current provider is not meeting their needs. The current fee schedule makes price a constant variable and makes suppliers compete for Medicare beneficiaries by providing excellent service, meeting patients’ needs, establishing reliable and long-standing relationships with physicians who refer patients to suppliers.

“When competitive bidding is employed, the sole variable becomes price, while service, patient satisfaction, patient choice and access are presumed to be equivalent from one supplier to another. As such, the fee schedule amount of an assistive device may decrease, but so will the quality of care. This is particularly important to beneficiaries who have significant health care needs on an ongoing basis …

“CMS is about to begin a massive experiment, and individuals with disabilities and chronic conditions are the unwitting participants. The public awareness of this program is extremely low, and we are convinced that many thousands of Medicare beneficiaries with long-term disabilities and chronic conditions will awake on July 1 to find that they no longer have access to their trusted DME supplier.

“These beneficiaries will have to start anew with another supplier, one who may be less convenient and less familiar with beneficiaries’ specific needs. We as consumers must underscore at this point that assistive devices and technologies are not interchangeable luxury items, but, instead, are essential tools with which we create independent lives. In our opinion, experimenting with the quality of and access to these devices is risky and simply not reasonable.”

Finally, Thomas summarized the CCD’s key concerns with the bid program: the quality of available technologies will decrease; access to necessary related services and quality suppliers will decrease with the minimal number of available suppliers in the bid markets; beneficiary-supplier relationships will be severed; and consumers will lose access to brand name devices.

A specialist in health care legislation, regulations and government relations, Cara C. Bachenheimer is senior vice president, government relations, for Invacare Corp., Elyria, Ohio. Bachenheimer previously worked at the law firm of Epstein, Becker & Green in Washington, D.C., and at the American Association for Homecare and the Health Industry Distributors Association. You can reach her by phone at 440/329-6226 or by e-mail at [email protected].