Do or Die

We have a time-limited opportunity over the next weeks to get rid of what we now call the “suicide bidding” program (what has traditionally been misnamed “competitive bidding“). With the January 2011 implementation date coming fast and furious and Congress’ legislative session now in full gear, we must seize the opportunity to have Congress repeal this ill-fated program once and for all.

When Rep. Kendrick Meek, D-Fla., introduced the bill to repeal the “competitive” bid program (H.R. 3790) last October, he set in motion a steady stream of grassroots efforts to gain additional congressional support of the bill.

While there is no “magic” number of cosponsors, the more the better to demonstrate to House leadership that there is significant support for the bill to move forward. Over 200 cosponsors would be ideal. At press time, the bill’s sponsors were an almost equal representation of both Democrats and Republicans, demonstrating this is not a partisan issue.

If your members of Congress have not signed on to H.R. 3790, you have work to do. To check, go to Congress’ official Web site at http://thomas.loc.gov, and enter the bill number in the search area. (Make sure you check the box labeled “bill number.”)

If you are unsure who your representatives are — remember, you should contact those who represent where you live as well as where your business is located, and the areas your business serves — go to one of the industry organizations’ Web sites: AAHomecare, www.aahomecare.org (click on “Advocacy/Gov’t Relations” and then on “Action Center”); The MED Group, http://capitol.medgroup.com/; or VGM Group, www.vgm.com.

On these sites you can also find draft letters, position and issue papers and other material to help you craft your message in the best possible way.

Here’s a summary of the key argument and points to communicate to your congressional representatives and their staff to get them to understand that this program will be harmful to their constituents — to the consumers who rely on HME providers, to HME providers and to those such as referral sources who rely on HME providers to provide quality care to seniors and people with disabilities.

• The program is fatally flawed. Although Congress delayed implementation of the bidding program to allow for necessary improvement, CMS has ignored Congress’ intent with the delay and has not made changes that will address the program’s fundamental flaws. Therefore, we anticipate the same problems that plagued the initial rollout of the program to re-occur.
• The program encourages “suicide bidding” and uses economic coercion by forcing suppliers to submit unsustainable bids necessary to “win” a contract. If a provider is unsuccessful in securing a contract under the program, the chance of survival is nil. Moreover, since Medicare is the largest purchaser of HME items and services, CMS is using economic coercion to force unsustainable bids from home care providers desperate to maintain cash flow in the hopes of staying in business.
• The program will cause significant job loss. The bid program is actually anti-competitive because it reduces the number of market competitors. Eighty to 90 percent of HME providers would have been barred from the Medicare program in the first round of bidding. This program has proved it will cause job losses and business failure for thousands of small providers at a time of severe economic hardship across the country.
• The program will hurt seniors and people with disabilities. Competitive bidding will prevent access and choice for HME items and services. The program will trigger a race to the bottom in terms of quality, with less expensive items being provided to Medicare patients.

With the projected loss of providers, expedient deliveries of items and services will be eliminated and Medicare costs will increase. In the initial 2008 bid round, patients were confused about the restricted list of contracted home medical providers, hospital discharges were delayed and unnecessary emergency room visits were triggered.

Read more Washington Wit & Wisdom columns. View more competitive bidding stories.

A specialist in health care legislation, regulations and government relations, Cara C. Bachenheimer is 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 at 440/329-6226 or [email protected].