From: HME News
By Theresa Flaherty, Managing Editor
WASHINGTON – Industry stakeholders greeted lawmakers who returned to Congress last week with new data in the fight against competitive bidding.
Claims for home medical equipment in Round 1 bid areas plunged by as much as 82% in 2011 compared to 2010, according to data obtained and analyzed by Prof. Peter Cramton, a vocal critic of competitive bidding as it’s currently designed. That points to access problems for beneficiaries in those areas, stated AAHomecare, which released the data in a bulletin to members last week, and other stakeholders.
“There are serious, serious problems,” said Wayne Stanfield, president and CEO of NAIMES. “You can’t have claims volume go down by that much. This is potentially a smoking gun.”
Cramton found that claims subject to bidding fell by the following percentages: complex rehab, 82.1%; CPAP devices, 63.7%; diabetes supplies, 74.1%; enteral nutrition, 65%; hospital beds, 63.7%; oxygen, 61.7%; standard power, 81.5%; support surfaces, 73.8%; and walkers, 71.5%.
Stanfield theorized several possible reasons for the decline in claims, most notably that beneficiaries can’t find contract suppliers. That means they are: obtaining needed equipment from non-contract suppliers who can’t bill for it; obtaining it from charity organizations; paying for it out-of-pocket; or doing without.
The new data should energize efforts to gain support for the industry’s alternative to competitive bidding: a market pricing program or MPP. Stakeholders would like to see MPP incorporated into a final bill on the tax cut and “doc fix” due in February.
While provider Bernie Zimmer was readying himself to submit a bid for Round 2, he also did his part to lobby against the program.
“We are absolutely talking to our lawmakers,” said Zimmer, officer at California Home Medical Equipment in Foster City, Calif. “I haven’t really had much feedback other than ‘We understand the message and we are working on it.'”