Chairman’s Mark Expands Bid Program: ‘We’re All in Round 1’

WASHINGTON — Sen. Max Baucus’ “Chairman’s Mark” version of
the Senate Finance Committee’s health reform bill mimics current
law and potentially subjects all home care companies to Round 1
competitive bidding rates. Rolled out Sept 16, the 220-page
proposal is called the “America’s Healthy Future Act of 2009.”

The line, found at the top of page 195, reads: Starting in
2011, the Secretary has the authority to use information on
payments determined in competitive acquisition areas to adjust
payments for items and services in non-competitive acquisition
areas.

“The way this thing reads, you could say we’re all in Round 1,”
said Rob Brant, general manager of City Medical
Services, North Miami Beach, Fla. “If the secretary wanted to,
it sounds like she [Kathleen Sebelius, secretary of Health and
Human Services] could decide that instead of doing a Round 2, she
could just take the competitive bidding rates from Round 1 and
implement them in non-competitive acquisition areas.”

In such a scenario, rural areas would not have to endure the
win/lose bidding process, but they would still have to accept Round
1 rates. And despite CMS assurances to the contrary, Brant and
others believe those rates will likely not be viable.

“The main flaw of the program is that Medicare is not going to
verify that a company can actually offer products and services at
these bid rates,” said Brant, founder of the Accredited Medical Equipment
Providers Association (AMEPA). “CMS talked about ‘bona fide’ bids,
but all they said is that they are going to check the bids against
the manufacturers’ wholesale costs; they are still not going to
look at the costs of doing business. People are still going to be
able to put in bids that they can’t afford.”

Brant himself was disqualified from the
original Round 1 due to a lack of documentation, a situation that
likely arose from CMS glitches. This time around, if providers send
in bids a month before they are due, CMS officials will notify
bidders (if necessary) that they are missing documentation.

Much like last year, the stakes are high for Brant, who relies
heavily on Medicare billings. “My business is about 80 percent
Medicare,” he said. “If I don’t win bids, I will be closing my
doors.”

Baucus, a Democrat from Montana and chairman of the Senate
Finance Committee, will meet with committee colleagues this week to
begin voting on the plan, with floor debate likely to commence soon
after.

The contentious debate is part of an already busy month for
health care reform, a month that started in earnest with President
Obama’s Sept. 9 health
care address to a joint session of Congress. As previously
noted in HomeCareMag.com, the president mentioned “waste” four
times in his comments. “We’ve estimated that most of this plan can
be paid for by finding savings within the existing health care
system, a system that is currently full of waste and abuse …,”
Obama said during his nationally televised speech. “Reducing the
waste and inefficiency in Medicare and Medicaid will pay for most
of this plan.”

Baucus’ proposal would let cooperatives sell insurance in
competition with private entities. The provision is viewed as an
olive branch to GOP officials who oppose the idea of the federal
government selling insurance (the public option). Baucus released
the following comments via press release on his Web site:

The plan will make it easier for families and small
businesses to buy health care coverage while ensuring Montanans can
choose to keep their current health care coverage if they like it,
and slowing the growth of health care costs over time. It will
block insurance companies from denying coverage because of
pre-existing conditions or imposing annual caps or lifetime limits
on the amount of coverage they will provide. The bill would also
improve the way the health care system delivers care by improving
efficiency, quality and coordination.

In addition, the Congressional Budget Office estimates the
Baucus plan would make an $856 billion investment in the health
care system over ten years. That investment would not add to the
federal deficit. Instead, the plan would be fully paid for through
increased focus on quality, efficiency, prevention and adjustments
in federal health program payments.

View the full text of the America’s Healthy Future Act.

See Chairman’s
Mark Draws Fire for AAHomecare’s summary of provisions in the
bill that would impact HME.

See Manufacturers
Marshal Forces to Battle $40 Billion Tax for discussion of the
bill’s proposed excise tax on medical device manufacturers.