The struggle for an alternative to the Medicare bidding program is far from over
by Seth Johnson

The battle to overturn the Medicare bidding program is gaining strength every day. We are amassing more artillery and the level of support from within Congress is continuing to build for the Market Pricing Program (MPP) alternative to address the problems embedded in competitive bidding. Do not listen to the naysayers; the battle is far from over. We can stop the Medicare bidding program from going forward on July 1. However, we must continue to pressure Congress in order to compel them to act. We can, we will and we must stop this program from being implemented.

Where are we now?—The key committees in both the House and Senate have expressed concerns with the Medicare bidding program and recognize the need for changes to be made. In addition, the committees provided guidance during the development of MPP and support the need to fix the most egregious flaws built into the Medicare bidding program. MPP would accomplish this. The committees in the House would like to have hearings to further evaluate the impact of the Medicare bidding program, and the Senate continues to make inquiries to Centers for Medicare & Medicaid Services (CMS) and request the data they need in order to determine the best mechanism to fix the problems with the program. The one common theme that all seem to be articulating is that more time is needed for Congress to conduct the necessary oversight and investigation prior to a tenfold expansion of the program that will otherwise begin this summer.

Timing—With the Medicare bidding program scheduled for implementation in less than a month, action is needed now in order to stop the program prior to July 1. Key legislators in both the Senate and House are expressing support for a delay in implementation of the program. Specifically, Representatives G.T. Thompson (R-PA) and Bruce Braley (D-IA) have drafted legislation for introduction (at the time of this writing) to delay the start of the bidding program through at least the end of this year. During the delay period a panel of economists and auction experts would be appointed to review certain fundamental elements of the program and make recommendations by the end of the year, prior to any implementation of the program.

In addition, members of the Senate Finance Committee and others recently indicated that passage of MPP prior to July 1 would be extremely difficult due to the legislative calendar and the fact that they are a much more deliberative body than the House of Representatives. A growing number of senators support a delay in order to provide them with the time necessary to review the extensive information and data they have requested from CMS regarding the program and then determine how to move forward. As an industry that is united we must signal to our senators and representatives that we support a delay in order to provide them the time needed to closely evaluate the Medicare bidding program prior to implementation.

Be persistent—It is important to continue the dialogue with your legislators and be persistent. As we know from past experience with Congress, contacting a member one, two, even three times is rarely enough to get the attention of most legislators in a manner that compels them to take quick action. That said, when industry stakeholders—consumers, clinicians, providers and manufacturers—carry a strong united message, backed up by data, along with a reasonable solution, we have had success in getting what is needed to advance a better outcome. 

Call to action—The future of the industry hangs in the balance and arguably the stakes have never been higher. Let’s all roll up our sleeves and pledge to contact our legislators weekly, expressing the local impact of the Medicare bidding program and the need to delay its implementation to provide more time for Congress to determine how they want to move forward in a manner that will preserve access to home medical equipment for their constituents. Do not be discouraged. We can, we will, we must stop this program. Do not underestimate the ability of our HME/DME industry to advance a better alternative.