‘We’re Still Fighting’

ATLANTA — With the Jan. 1, 2011, implementation date for
Round 1 of competitive
bidding coming up in only weeks, the Medicare bidding project
continues to dominate industry headlines. Following is a collection
of HME advocates’ comments on the program, along with excerpts from
several recent studies on its effects:

“We have received hundreds of calls on our toll-free hotline
from people concerned about what the Medicare competitive bidding
program would mean for health and their peace of mind. Many of the
callers expressed concern and fear that the competitive bidding
program would mean that they would lose access to the DME care
providers they know and trust.”

— Jim Tozzi, Center for Regulatory
Effectiveness, in comments to the House Energy and
Commerce Committee Subcommittee on Health

“While it may appear at first glance that competitive bidding
will not impact rural areas since competitive bidding does not
initially apply in those areas, I believe competitive bidding will,
in fact, have a significant impact on rural areas.”

— Ken Brown, Lawrence M. Jepson Professor of
International Economics at the University of Northern
Iowa, in a study of the effects of competitive bidding in
five rural states. Brown’s findings indicate a 40 to 50 percent
decline in HME providers in Iowa, Montana and West Virginia; a 15
to 25 percent decline in North Dakota and a 35 to 45 percent
decline in Wyoming.

“I am angry that lawmakers have not engaged the HME industry in
how to reduce costs. I’m angry that competitive bidding will result
in less competition, the rise of monopolies and reduced access for
people who need our help. I’m sad that a family business we built
is being destroyed, and that thousands of others like us will no
longer be around to fill a need in underserved areas.”

— From an HME provider participating
in HomeCare’s
2010 Salary & Benefits Survey, September 2010

“We can no longer let CMS put a positive spin on everything that
they do. Now is the time to take OUR patients and educate them, let
them understand how this process will affect them and let them
voice their concerns to CMS.”

— Tyler Riddle, MRS Homecare, Albany, Ga.,
founder of NoBid.org (www.NoBid.org)

“There are several problems inherent in CMS’s design of the
competitive bidding process that create perverse incentives and may
result in unsustainable low bids from suppliers. Furthermore, the
competitive bidding program design does not provide beneficiaries
with adequate protections against degradation in care or service
… This could result in Medicare’s most vulnerable
beneficiaries experiencing medical complications, increasing their
use of hospital, emergency room, and physician care, and losing
their ability to live independently.”

— Washington, D.C.-based actuarial firm Dobson
DaVanzo & Assoc. in its study titled “The Risks to
Medicare Beneficiaries of DMEPOS Competitive Bidding —
Considerations for the Round 1 Re-Bid and Beyond”

“The program over time may degenerate into a ‘race to the
bottom’ in which suppliers become increasingly unreliable, product
and service quality deteriorates, and supply shortages become
common. Contract enforcement would become increasingly difficult
and fraud and abuse would grow … We recommend that the
government fix the flaws in the current auction program and develop
a new design that emphasizes the key features of successful
designs. Implementation of the current design will result in a
failed government program.”

— 166 economists and competitive bidding
experts in a letter to Rep. Pete Stark, D-Calif., chairman
of the House Ways and Means Committee Subcommittee on
Health

“We’re still fighting this thing. We’ve got to get it
killed.”

— Wayne Grau, vice president of supplier
relations and government affairs, The MED Group

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