Dear Congressman: Home Care Works

ATLANTA — CMS released a timeline for Round 2 of competitive bidding at a recent
meeting
of the Program Advisory and Oversight Committee, and a
provision in the nation’s newly signed health care reform law adds
21 cities for a total of 100 in the program. With these new
developments, you might think optimism was at a low ebb. In fact,
the opposite is true among HME advocates.

When it comes to getting their federal representatives signed on
as cosponsors to H.R. 3790, Rep. Kendrick Meek’s (D-Fla.) bill to
repeal the bidding program, providers are just getting more
creative.

In Warner Robins, Ga., father-and-son team Ronald Street and
Scott Street of Street Home Medical took matters into their own
hands in the form of a sign in front of their business, which is
located on a busy highway.

The Streets were having a difficult time getting Rep. Jim
Marshall to sign on to the bill. Marshall’s district is not in
either Rounds 1 or 2 of the bidding program, and the conservative
Blue Dog Democrat had not responded to letters from the company’s
employees or to a visit from members of the Georgia Association of
Medical Equipment Services on AAHomecare’s March 3 lobby day in
Washington.

So the Streets put up a sign in front of their business that
read: “Dear Congressman, home care works. Support H.R. 3790.”

The Streets took a picture of the sign and sent it to Marshall’s
legislative aide. On the fourth day after the sign went up, they
received a call from the aide with news that Marshall had signed
on.

“He listened,” said Scott Street. “After we got word, we changed
the sign and thanked him for his support. It is getting very hairy
with competitive bidding, but I think we are getting momentum. I
think others will follow Marshall. I just hope with health care
reform going through that this is not going to get lost.”

Diana Guth, RRT, believes the best hope to repeal competitive
bidding lies in portraying the program as a job-killer.

“I’m hoping members of Congress will gain the wisdom and
understand that most, if not all DME companies, will be forced out
of business, leaving the beneficiaries high and dry if this
ill-conceived plan goes forward,” said Guth, owner of Home
Respiratory Care in Los Angeles. “This will be a tragic, true-life
Humpty Dumpty scenario. There will be no winners. The excluded
bidders are out of the Medicare game entirely. The included bidders
will rapidly find that their low bids will not generate enough
revenue to remain in business …

“We must try to pass H.R. 3790 ASAP.”

Miriam Lieber of Sherman Oaks, Calif.-based Lieber Consulting,
agrees that the race to add cosponsors to the bill is more urgent
than ever.

“If we thought it was too late or futile to act, we would get
nowhere in the HME industry,” said Lieber. “Just when we thought
competitive bidding was well on its way, it was postponed. Is CMS
that much better prepared this time around?

“Regardless, the HME industry can’t focus on the negatives of
health care reform. Rather, the industry has to rally and persist
in providing quality HME to well deserved Medicare recipients,”
Lieber said. (Nonetheless, she added, diversifying payer mix “is
prudent and a safe precaution in the face of the latest Medicare
challenges.”)

Don White, CEO of Associated Healthcare Systems, Amherst, N.Y.,
said he regained some of his “natural optimism” following the
AAHomecare
Legislative Conference earlier this month, where a concentrated
effort by the industry added more than 30 representatives to H.R.
3790. As of Friday, the cosponsor count for the bill stood at
185.

“It is not too late for the industry to stop this round of
competitive bidding by gaining support for repeal through H.R.
3790,” said White. “Maybe the time has come to let this terrible
policy take its course — but I really hope not. It appears
that CMS may only give up when competitive bidding is implemented
and has failed.”

If competitive bidding does move forward, said Jim Greatorex,
owner of Black Bear Medical in Portland, Maine, “I believe it will
fail so miserably in the first three months that Congress will be
forced to step in and restore order to the DME benefit.

“With politics,” Greatorex said, “it’s never too late. The fat
lady may be dressed up and ready to go out, but she isn’t singing
yet. We owe it to all involved to fight this mess.”

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