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"We have been strongly advocating that the IFR be rescinded," Johnson said.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:
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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 "There are multiple letters in play carrying the same message that the IFR needs to be rescinded prior to the effective date.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.
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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 Betty Sutton, D-Ohio, circulated a "Dear Colleague" letter calling for the IFR to be rescinded.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.
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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.
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"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.
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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.