New Version of Bill to Ease NCB Expected This Week

WASHINGTON–Athough CMS has yet to issue its final rule on
national competitive bidding, the industry is moving ahead with
renewed plans to ease its effects.

Last year Reps. David Hobson, R-Ohio, and John Tanner, D-Tenn.,
introduced a bill that would have softened several provisions of
the Medicare Modernization Act’s DME competitive bidding mandate.
While H.R. 3559, which came to be known as the Hobson-Tanner bill,
picked up 151 cosponsors in the House and a companion bill in the
Senate, Congress adjourned with no action on the proposed
legislation.

But according to some in Washington, many of those cosponsors
are ready to sign on again to a new version of the bill, which
could be introduced as soon as this week.

With more than 130 cosponsors of H.R. 3559 who returned to
office, “we believe that there already is a base of strong
support,” said Walt Gorski, vice president of government relations
for the American Association for Homecare.

While efforts to repeal competitive bidding continue, he added,
“based on the political environment here in Washington, if repeal
is not achievable, efforts must be made to modify competitive
bidding so that it does not adversely impact beneficiaries and
suppliers.”

Much of the new bill, this time around with Tanner as the lead,
will mirror H.R. 3559, but there are some changes, Gorski said. The
new proposal would allow any willing provider–that is, any
qualified home care company that submitted a bid below the current
allowable–to continue to supply equipment under Medicare at the
bid rate that is set. A similar exemption in H.R. 3559 would have
applied only to small providers, then defined as those with
revenues under $6 million.

Under MMA, bidding must start in 10 of the country’s largest
MSAs (also yet to be announced) in 2007, then expand to encompass
80 areas in 2009.

Gorski said another new provision of this year’s bill would
require Medicare to conduct an impact analysis on beneficiary
access to quality products and services after competitive bidding
has been fully implemented in the first 10 cities. The bill also
would prohibit HHS from expanding the bid program to additional
MSAs, or applying bid rates to non-bid areas, unless specifically
authorized by Congress.

As far as passage of the new bill this year, “I really think our
chances are good,” said Seth Johnson, chairman of AAHomecare’s
Rehab and Assistive Technology Council and director of government
affairs for Pride Mobility. However, he cautioned, it’s still early
in the congressional session and lawmakers “haven’t started having
specific hearings on developing Medicare legislation yet.

“The main thing we need to do in order to ensure success this
time is to get the cosponsors that are still in office to sign on
to the bill again, and then we need another 80 or so
[representatives] to support it,” Johnson said.

Johnson said Sen. Orrin Hatch, R-Utah, who introduced the Senate
companion to H.R. 3559 last session, is expected to champion the
measure again in that chamber with Sen. Kent Conrad, D-N.D.