Industry Pounds Away at Competitive Bidding IFR

ATLANTA — With just days left before the interim final
rule goes into effect, the HME community is hammering away to get
the specter of DMEPOS competitive bidding eliminated.

“We are expecting an announcement [this] week from [the
Department of Health and Human Services or the Centers for Medicare
and Medicaid Services] on the competitive bidding IFR,” said Seth
Johnson, vice president of government affairs for Pride Mobility
Products, Exeter, Pa. “If they don’t make that announcement,
then the IFR goes into effect on April 18.”

The rule calls for a rebid of Round One in 2009.

“We have been strongly advocating that the IFR be rescinded,”
Johnson said. “We continue to say that because in order to fully
address problems embedded into the structure of competitive
bidding, it really will require new rulemaking. If all you do is
delay and no changes are made… we will have the same program
rolled out later this year.”

Several legislators agree:

• In March, Sen. Arlen Specter, R-Pa., sent a letter to HHS Acting
  Secretary Charles Johnson expressing his concerns
  about the program. Just last week, Sen. Bob Casey Jr., D-Pa.,
  followed suit, urging the interim HHS head to delay implementation
  of the IFR “for a minimum of 90 days to allow for a full analysis
  of the program and its impact on providers and Medicare
  beneficiaries.”

  Other Pennsylvania legislators are planning to write their own
  letters, Pride’s Johnson said. “There are multiple letters in play
  carrying the same message that the IFR needs to be rescinded prior
  to the effective date. Congressional support is continuing to build
  throughout the country, and that is exactly what is necessary in
  order to stop this competitive bidding program from restarting,” he
  said.

• Last week Rep. Betty Sutton, D-Ohio, circulated a “Dear
  Colleague” letter calling for
  the IFR to be rescinded. “The agency’s rush to implementation
  provides no opportunity for public comment and subverts the will of
  Congress,” she wrote. “The interim rule will have a detrimental
  effect on the quality and access to care for beneficiaries of
  durable medical equipment.”

  The letter had garnered 21 signatures on Thursday, with the
  deadline for representatives to sign on extended to Tuesday, April
  14.

• In late March, Dallas/Ft. Worth HME providers gathered at a town
  hall forum hosted by The Scooter Store of New
  Braunfels, Texas, crafted their own letter to legislators.
  Twenty-six signatures of company leaders representing thousands of
  employees accompanied the letter, which said, in part:

  “This well-intentioned, but fundamentally flawed program will
  cause irreparable harm to the Dallas/Ft. Worth region, as well as
  the rest of the country. If implemented, this fatally flawed
  program will: eliminate over 90 percent of the legitimate suppliers
  in Dallas/Ft. Worth; eliminate thousands of jobs; cause artificial
  and malicious restriction in access to medically necessary
  equipment; cause costly delays in the delivery of medically
  necessary products and services to disabled elderly beneficiaries;
  force thousands of Medicare beneficiaries prematurely out of their
  homes and into costly institutional care; waste billions of
  taxpayer dollars on institutional care instead of more efficient
  home care.”

  Mark Leita, senior director of government relations for The
  Scooter Store, said he had already heard back from the legislative
  director for Rep. Pete Sessions, R-Texas. “I received an e-mail
  … stating ‘the congressman supports you in this endeavor, as
  we look for a delay and restructuring plan from CMS,’” Leita
  said.

• “Competitive bidding is a flawed policy that does not take the
  beneficiary into account,” Rep. Jason Altmire, D-Pa., told 120
  attendees at an “HME Survival Summit” in Harrisburg April 6. Held
  by the Pennsylvania Association of Medical
  Suppliers, the event drew providers and members of patient
  advocacy groups to focus solely on competitive bidding. Rep. Tim
  Murphy, R-Pa. also attended the event.

• In Waterloo, Iowa, VGM Group held an April 7 fundraiser for
  Iowa Sen. Charles Grassley, the ranking Republican on the Senate
  Finance Committee, that “morphed into a town hall meeting,”
  according to the group. After providers from Iowa, Detroit and
  Georgia told their stories, VGM’s John Gallagher, vice president of
  government relations, asked Grassley to send a letter to Nancy-Ann
  DeParle, director of the White House Office of Health Reform,
  urging that the competitive bidding IFR be rescinded.

  The American Association for Homecare, the American Medical
  Equipment Providers Association, the National Independent
  Association of Medical Equipment Suppliers and others also
  encouraged providers to make the case face-to-face while
  legislators are in their home districts during Congress’ Easter
  recess, which continues this week. The groups called on providers
  to ask their legislators to sign on to at least one of the
  circulating congressional letters or to write on their own to HHS,
  CMS and the Obama administration asking that the IFR be
  rescinded.

  With enough pressure, Johnson said, “we are confident there will
  be action at a minimum to delay implementation and, hopefully, to
  rescind the IFR in its entirety to address the fundamental problems
  that are built into the bidding program.”

  For contact information or direct connection to members of
  Congress, call the U.S. Capitol switchboard at 202/224-3121.