Home Care Magazine
ATLANTA — Providers’ hopes of eliminating or delaying competitive bidding before Jan. 1 might have been dashed by the election, the evaporation of time and CMS’ full-steam-ahead attitude, but they can’t afford to give up now, industry lobbyists said last week.
“The train is on the track heading toward a tunnel that is not finished — and you’ve got another train — Round 2 — right behind it, ” said John Gallagher, vice president, government relations, for Waterloo, Iowa-based VGM Group. “This is a major tragedy waiting to happen.”
Providers need to buttonhole their legislators — both new and returning — in the next weeks to spell out the impact of the project if they want to avoid calamity, he said. “We’ve got about four weeks to get to [members of Congress], to educate the new folks. We need to be particularly focused on jobs, jobs, jobs and also the impact [competitive bidding] is going to have on beneficiaries.”
The HME sector had hoped a hearing tentatively scheduled by Rep. Pete Stark, D-Calif., chair of the House Ways and Means Subcommittee on Health, would spark congressional action at least to delay implementation. It also hoped that H.R. 3790 might be attached to the Medicare doc fix bill, which must be passed by Nov. 30 in order for physicians to sidestep a significant reimbursement cut.
“Regarding a hearing, it’s unclear right now,” said Cara Bachenheimer, senior vice president of government relations for Invacare, Elyria, Ohio. “Nobody on the Hill really knows the schedule when Congress returns [this] week, except that it will be very short. It’s not looking good, though.”
The industry also must be watchful about what happens with elimination of the first-month purchase option for power wheelchairs and a possible reduction to 13 months for the 36-month oxygen rental cap, both of which could become pay-fors for the doc fix. Ironically, the doc fix is also the best vehicle this year to carry a delay of the purchase option elimination, said Pride Mobility Products’ Seth Johnson, vice president of government affairs.
As for H.R. 3790, Bachenheimer said, “Congress has a very short must-do list” before the end of the session. “The doc fix is one of the must-do items — but it will be a tall order to attach H.R. 3790. We’d need to make sure it’s budget neutral, which means tacking on a bunch of payment cuts that are simply not feasible for the industry.”
The industry would have to come up with $20 billion in cuts over 10 years — the amount the Congressional Budget Office estimates the bid program would save — to pay for its elimination.
Now, said Johnson, “our best opportunity to halt the program prior to implementation remains regulatory relief, but CMS seems more committed than ever to advance its fundamentally flawed bidding program.”
That means H.R. 3790 is likely to expire once the new Congress is seated, meaning the industry would need to seek another champion to carry a new bill. With the Nov. 2 elections, 60 of the 257 cosponsors for the bidding repeal bill were lost.
“We have our work cut out for us,” Gallagher said.
Even as providers continue to fight the looming bid program, they must also get ready for its implementation, Gallagher said, and begin to educate beneficiaries about what competitive bidding will mean to them.
VGM has announced a new advocacy group called People for Quality Care (www.peopleforqualitycare.org/) that will “educate those with disabilities, their families and Medicare beneficiaries about health policy changes that affect their freedom of choice,” the group said in a legislative update last week.
“We need to prepare beneficiaries to be engaged come Jan. 1,” Gallagher said. “Most will not do anything until it hits the fan. When they’ve got three providers instead of one and two are out of state and delivering by [mail] … We’ve got to get them screaming mad. That’s when things will happen.”
Tell AAHomecare about Bid Problems: AAHomecare wants to hear from both providers and patients about “any problems or anomalies (for example, unknown companies that win bids) associated with the announcement of Round One contracts and the scheduled Jan. 1, 2011 start of the bidding program.” Click here for an online reporting form. The association will share examples of shortcomings and errors with lawmakers, researchers and the media “to strengthen the argument that the bid system is fatally flawed.”
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