H.R. 1041: If You Pushed Before, Push Harder

WASHINGTON — Members of the House of Representatives are
steadily signing on as cosponsors of H.R.
1041, but getting a companion Senate bill going — well,
that’s a longer story, stakeholders say.

As of Friday, 90 House legislators had signed on to the competitive bidding repeal bill,
introduced in mid-March by Reps. Glenn “GT” Thompson, R-Pa., and
Jason Altmire, D-Pa.

“We’re making good progress,” said Cara Bachenheimer, senior
vice president, government relations, for Invacare, Elyria, Ohio.
“It’s member by member … We started out with a bang and now
it’s sort of a steady accumulation. We need to keep that up.”

“I think 90 within the time frame is not bad,” agreed Wayne
Stanfield, president and CEO of the National Association of
Independent Medical Equipment Suppliers. “The signatures have been
going very well. Obviously, we’ve got to keep pushing for more and
more. But I think progress has been steady.”

He said there was “a little pushback on the floor from some
people because the government is so conscious of the deficit and
trying to save every penny it can.”

Still, Bachenheimer said she was “hopeful that we’re going to
hit 100 by the two-month mark” this week.

It is critical that the number continues to climb, she noted. “A
lot of bills have only a few cosponsors,” Bachenheimer said, “so
the number is of high importance … It sends a strong message
to the leadership that this is something they need to do something
about.”

While members of the House have been responsive, that has not
been the case in the Senate.

“We have a short list of pretty supportive senators but we are
having real difficulty getting one of them to say, ‘I’ll take the
lead,’” Bachenheimer said. “We’re having a tougher time than I
would have liked.”

Republicans, she said, do not want to spend money, and on the
Democratic side, “we have the Max Baucus” issue. Chairman of the
powerful Senate Finance Committee, which has jurisdiction over
Medicare, the Montana Democrat has long been a foe of the HME
industry and is a champion of competitive bidding.

In addition, there are other objections to the repeal bill,
including its pay-for from undesignated discretionary funds, the
notion from CMS that Round 1 of competitive bidding is going fine
and fear that supporters of a repeal would come off as being
against competition.

While last’s year’s H.R. 3790, a similar repeal bill, garnered
more than 250 House supporters, it failed to attract a champion in
the Senate and died with the old Congress.

This time around, Round 1 is at full throttle in the nine
competitive bidding areas and business casualties are mounting.
Many companies have closed their doors, and beneficiaries have
reported problems finding providers to serve them or do
repairs.

Industry advocates point out the situation is getting worse.
Last week, several HME organizations reported that some independent
insurers are copying the competitive bidding reimbursement rates,
which in some cases are below cost.

“One private health insurance company that operates in 11 states
already announced it will begin to pay HME items at 70 percent of
the new, 32 percent-reduced competitively bid rates,” the American
Association for Homecare told members in its May 4 newsletter.
“That means their payment rates for HME will drop to 48 percent of
the 2010 Medicare allowable.”

Said the association, “This is an alarming trend as HME
providers in the next 91 bidding areas prepare for a second round
of bidding.”

The only way to sidestep the issue is to get competitive bidding
repealed, stakeholders maintain.

“It’s going to be a tough fight,” Stanfield admitted. “Without a
Senate companion bill, it will be very difficult to move [the
repeal] forward.”

“We’ve got to keep going!” urged Bachenheimer.

In an action alert last week, AAHomecare called on
“everyone who values good home care” to call or email U.S. senators
and ask them to stop competitive bidding. You can reach
your senators through the Capitol Hill switchboard at 202/224-3121,
or to email, go to www.capwiz.com/aahomecare.

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