ATLANTA — Here's the HME industry's response to CMS, the GAO and the Obama administration: We're not giving up on a repeal of competitive bidding.
Last year, H.R. 3790, which would have repealed the entire bidding program, gained 259 cosponsors in the House but never made it to the floor. Last week, just as the American Association for Homecare announced a renewed "full-court press" to stop the CMS project, the industry was again hit by a slew of negative announcements.
On Feb. 14, President Obama unveiled his 2012 budget, which would tie federal payments for Medicaid to Medicare's bid rates and put all power wheelchairs through prepayment review. The same day, the General Accountability Office called on CMS to further slash oxygen reimbursements. Later in the week, the Medicare Fraud Strike Force made national headlines when it nailed 111 people for more than $225 million in Medicare fraud. The bad news was, some of those accused were HME providers.
Despite the tough climate, stakeholders said Friday they were not deterred in the competitive bidding battle.
"Congress has been debating a long list of budget cuts, and, of course, we'll fight any proposals to make more cuts to our sector. But budget proposals or agency reports calling for cuts don't always make it out of the parking lot," said Michael Reinemer, vice president, communication and policy, for the American Association for Homecare.
"On the other hand," he added, "the bidding system is the mother of all threats. It's real, it's now, it's wreaking havoc, it's spreading."
"While the confluence of yet another prepayment review, the potential of further cuts to oxygen and yet another fraud report will again tax the tolerance of the HME community, these companies are a hardy bunch," Mark Higley, vice president for development for the VGM Group, Waterloo, Iowa, said of home medical equipment providers. "The industry will deal with each of these threats, but certainly there will be no reduction in efforts to derail competitive bidding."
Implemented in nine cities Jan. 1, the DMEPOS bidding program has already seen its share of casualties as businesses have closed, jobs have been lost and Medicare beneficiaries have experienced longer hospital stays.
Rob Brant of City Medical Services in Miami said his company has heard from Medicare patients who cannot find anyone to service or even provide their equipment.
"We have CMS saying, 'We have created this bidding utopia and everything is perfect,' and it is far from the truth," Brant said. He refers the frustrated beneficiaries who call him to the Medicare answer line, he said, but often they call back even more frustrated because they have been steered to "companies that don't answer the phone or companies that didn't win contracts."
Some give up trying to find a legitimate provider, Brant said, and pay out of pocket.
"It isn't right," he said. "And what about those others who can't afford to pay out of pocket and have just given up? Those are the ones we will never know about."
It is incumbent upon the industry to fight to repeal competitive bidding before more serious problems erupt and before Round 2 gets underway later this year, Brant and other advocates said. Many are looking to AAHomecare's March Legislative Conference as the vehicle for driving home to legislators the need for a repeal.
"The bottom line is, now more than ever we need everyone in the country to come to the Legislative Conference," Brant said. "It seems the Obama administration feels that all the health care problems can be resolved by beating up the HME industry. We are not the problem. We are the solution."
The Legislative Conference will be held March 16-17 at the Westin Washington, D.C. Speakers include Reps. Jason Altmire, D-Pa.; Phil Gingrey, R-Ga.; Tom Price, R-Ga.; Heath Shuler, D-N.C.; and Glenn Thompson, R-Pa. But the event's focus will be taking the industry's positive message — and how it will be affected by competitive bidding — to lawmakers on Capitol Hill.
"No amount of misguided policies or reports can undermine the fact that home care is vastly more cost-effective than the alternative, it's vastly preferred by the people and it's clinically proven to produce good outcomes," Reinemer said.
"We need to remind each legislator and their staff both in Washington and back home about the value of home care and about the severe downside of this bidding system," he said. "For new members in the House and Senate, it may be the first time they hear about this problem. So we need to quickly get the full volume of our complaints and concern to these offices now, and again during the March Legislative Conference, and again after that."
While some have wondered if, at this point, getting competitive bidding repealed is too much of a long shot, others are hankering to push the effort against the Medicare bid.
"We were really happy to hear the news that that is what we are taking to the Hill in March," said Karen Estrella, executive director of the New England Medical Equipment Dealers association. "A lot of people think it's a pipe dream that we can get it repealed. A lot of us are saying, 'Give us that fight. That's a fight that we want.'"
Higley also thinks it is the right tack.
"We as an industry need to continue to drive this point forward to both the legislative and executive branches that the CMS competitive bidding rule costs jobs," he said.
"A task force of industry stakeholders is leading an effort to convince Congress that it must act now to repeal the program via legislation," he said. "I believe the industry is making headway in suggesting that the bidding program stands squarely in the way of saving thousands of small businesses and tens of thousands of jobs."
As to whether or not it will be hard to find a champion to carry a new repeal bill, Brant thinks not.
"I don't perceive it as a problem," he said. "Obviously, we have new legislators and people who are no longer in Congress, but there are so many from the Round 1 areas that are aware of this problem, I really don't perceive it as a problem in finding someone."
Reinemer is even more optimistic.
"In terms of timing, we hope to have a bill introduced by the Washington Legislative Conference," he said.
For details or to register for AAHomecare's Legislative Conference, go to http://www.aahomecare.org/cde.cfm?event=306263.
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