The HME industry suffered a setback last week when Congress reached a quick and unexpected agreement on the so-called “doc fix” bill. HME advocates had hoped to attach a replacement for competitive bidding on the measure, but it moved forward without the replacement, the Market Pricing Program (MPP).
The setback occurred as the American Association for Homecare (AAHomeCare) convened its annual Washington Legislative Conference. About 300 HME providers attended and expected to push their representatives and senators to include MPP in the doc fix legislation.
AAHomecare leaders quickly shifted strategies, and directed conference participants to press representatives and senators for a “score” from the Congressional Budget Office (CBO) on the MPP proposal.
“It could be worse,’’ Joel Marx, chairman of AAHomecare, told the providers. “We have strong bi-partisan support for the value of home care. We need to pull out all the stops in Washington. We need to knock on every door.’’
The CBO score is needed to show that the MPP proposal would be budget neutral, which is essential for its passage. Conference participants then descended upon Capitol Hill to visit representatives and senators.
Speaking to a delegation of providers from Alabama, an aide for Sen. Jeff Sessions, R-Ala., expressed guarded optimism that the CBO could be encouraged to evaluate the MPP proposal for budget neutrality. Sessions is the ranking Republican member of the Senate Budget Committee, which can exert influence on the CBO. “We know the CBO pretty well,’’ the aide said. “Perhaps we can push this along.”
The aide said that the House and Senate may remain in session until June or July, and the MPP proposal might have a chance at being attached to some other legislation moving through the process during that period.
However, the aide said, CBO will be busy over the next six weeks scoring President Obama’s budget proposal. After that, there will be a narrow window of opportunity for MPP to get scored and attached to some other piece of legislation. The aide stressed the importance of MPP being budget neutral and having bi-partisan support.
Michael Hamilton, executive director of the Alabama Durable Medical Equipment Association, assured the aide that the MPP measure would maintain the current levels of savings estimated for the Competitive Bidding Program and does have support from both Democrats and Republicans.
Hamilton stressed the urgency in getting the MPP measure passed.
“We just want to spread the pain around,’’ he said. “Competitive bidding is literally going to kill people. It’s also going to cost 100,000 jobs.”
Hamilton said the only serious opposition to MPP is coming from the Centers for Medicare & Medicaid Services (CMS).
In fact, CMS issued a preemptive press release just before conference participants headed to Capitol Hill. The press release said CMS had data showing that competitive bidding was having no impact on the health of Medicare beneficiaries. CMS has been monitoring some health metrics in Round 1 areas of competitive bidding, and routinely reporting that there are no problems. Its new press release said it had released a much broader analysis data showing there were no problems with competitive bidding.
AAHomecare officials said they needed time to study the data released by CMS, and noted that the agency was taking extraordinary steps to save a badly flawed program.
Meanwhile, two economists speaking at the conference—Peter Cramton of the University of Maryland and Brett Katzman—also sharply criticized the Competitive Bidding Program.
Cramton spoke out against the expansion of competitive bidding from nine metropolitan areas in Round 1 to another 91 metropolitan areas in Round 2. “Now is not the time to scale up a program that everybody but CMS has agreed is flawed.”
Katzman said it was a misnomer to call the CMS program competitive bidding. “I am a proponent of competitive bidding,’’ he said. “What you have now is not competitive bidding.”
“This can be done right by the right people,’’ Katzman said. “This is about getting it done right; not protecting your profits.’’
It was clear from comments made at the conference that MPP would still result in significant cuts in reimbursements for the HME industry, but it would allow more providers to sell products and services to HME beneficiaries at prices that are more sustainable.
Also at the AAHomecare conference, Malachi Mixon of Invacare and Rob Brant, founding president of the Accredited Medical Equipment Providers of America, received Advocate of the Year awards.
- Dave Parks is editor of HomeCare