From: Home Care Magazine

ATLANTA — With the Jan. 1, 2011, implementation date for Round 1 of competitive bidding coming up in only weeks, the Medicare bidding project continues to dominate industry headlines. Following is a collection of HME advocates’ comments on the program, along with excerpts from several recent studies on its effects:

“We have received hundreds of calls on our toll-free hotline from people concerned about what the Medicare competitive bidding program would mean for health and their peace of mind. Many of the callers expressed concern and fear that the competitive bidding program would mean that they would lose access to the DME care providers they know and trust.”

Jim Tozzi, Center for Regulatory Effectiveness, in comments to the House Energy and Commerce Committee Subcommittee on Health

“While it may appear at first glance that competitive bidding will not impact rural areas since competitive bidding does not initially apply in those areas, I believe competitive bidding will, in fact, have a significant impact on rural areas.”

Ken Brown, Lawrence M. Jepson Professor of International Economics at the University of Northern Iowa, in a study of the effects of competitive bidding in five rural states. Brown’s findings indicate a 40 to 50 percent decline in HME providers in Iowa, Montana and West Virginia; a 15 to 25 percent decline in North Dakota and a 35 to 45 percent decline in Wyoming.

“I am angry that lawmakers have not engaged the HME industry in how to reduce costs. I’m angry that competitive bidding will result in less competition, the rise of monopolies and reduced access for people who need our help. I’m sad that a family business we built is being destroyed, and that thousands of others like us will no longer be around to fill a need in underserved areas.”

From an HME provider participating in HomeCare’s 2010 Salary & Benefits Survey, September 2010

“We can no longer let CMS put a positive spin on everything that they do. Now is the time to take OUR patients and educate them, let them understand how this process will affect them and let them voice their concerns to CMS.”

Tyler Riddle, MRS Homecare, Albany, Ga., founder of (

“There are several problems inherent in CMS’s design of the competitive bidding process that create perverse incentives and may result in unsustainable low bids from suppliers. Furthermore, the competitive bidding program design does not provide beneficiaries with adequate protections against degradation in care or service … This could result in Medicare’s most vulnerable beneficiaries experiencing medical complications, increasing their use of hospital, emergency room, and physician care, and losing their ability to live independently.”

Washington, D.C.-based actuarial firm Dobson DaVanzo & Assoc. in its study titled “The Risks to Medicare Beneficiaries of DMEPOS Competitive Bidding — Considerations for the Round 1 Re-Bid and Beyond”

“The program over time may degenerate into a ‘race to the bottom’ in which suppliers become increasingly unreliable, product and service quality deteriorates, and supply shortages become common. Contract enforcement would become increasingly difficult and fraud and abuse would grow … We recommend that the government fix the flaws in the current auction program and develop a new design that emphasizes the key features of successful designs. Implementation of the current design will result in a failed government program.”

166 economists and competitive bidding experts in a letter to Rep. Pete Stark, D-Calif., chairman of the House Ways and Means Committee Subcommittee on Health

“We’re still fighting this thing. We’ve got to get it killed.”

Wayne Grau, vice president of supplier relations and government affairs, The MED Group