Beneficiaries Cite Flaws in Medicare Bidding Program that Restrict Access to Medical Equipment and Services, Says American Association for Homecare
WASHINGTON, March 8, 2012 /PRNewswire via COMTEX/ — Many Medicare beneficiaries face obstacles that either delay or prevent them from obtaining critical durable medical equipment and services (DME) in nine regions of the country where a controversial procurement system was implemented a year ago, according to data collected by the American Association for Homecare (AAHomecare).
Medicare beneficiaries submitted comments to AAHomecare sharply contradicting assurances by the Centers for Medicare and Medicaid Services (CMS) that the well-being of Medicare patients wasn’t compromised by the competitive bidding system.
CMS says access to DME equipment and services such as oxygen therapy, walkers, respiratory devices, hospital beds, and power wheelchairs hasn’t been restricted. But in a recent statement, CMS acknowledged “a significant decrease” in DME utilization by Medicare patients in the nine bidding areas. CMS contends there was “a lack of evidence of adverse beneficiary impacts.”
In the nine affected metropolitan areas – Charlotte, Cincinnati, Cleveland, Dallas, Kansas City, Miami, Orlando, Pittsburgh and Riverside, Calif. – patients tell a far different story. And government data from the areas demonstrate a steep reduction in the number of providers allowed to supply products and services to Medicare patients, which is preventing senior citizens and people living with disabilities from receiving the essential equipment they need.
The complaints from beneficiaries are widespread. Some patients now need to travel long distances for prescribed equipment and repairs. Many are unable to find providers in their area who have the equipment they need. Others have found that local providers have gone out of business.
“I’ve called a lot of the numbers on the Medicare website, and none of them have what I need,” laments a Medicare beneficiary from Leesburg, Fla.
“My new supplier is all the way in Miami, which is too far for me to drive,” says a Green Acres, Fla. beneficiary.
“We had four providers in the city and two have been driven out of business already by this competitive bidding,” says a Decatur, Texas beneficiary. “There’s no one in my entire county that can provide [the equipment that I need] and be covered by Medicare.”
The anecdotes underscore the trend that has developed in areas where this bidding program has been operating: Medicare patients are not receiving the critical equipment that they need to remain in their homes. This drives up Medicare costs in other categories because low-cost DME equipment will be replaced with much more expensive emergency room visits and hospital stays. Now CMS is on the verge of expanding this program to 91 more metropolitan areas nationwide.
Tyler J. Wilson, president of the American Association for Homecare, says his biggest concern is that in trying to cut costs, CMS is jeopardizing the health of seniors and people living with disabilities. “Their system reduces choice, access, and quality of care for seniors and people with disabilities who require home medical equipment and services. Medicare has to ensure that beneficiaries can receive oxygen therapy, wheelchairs, respiratory devices, and diabetic supplies in a timely manner. But there is no longer any confidence that medical equipment and services can be obtained when they are needed.”
“The objective of a ‘competitive’ bidding system should be to increase competition,” Wilson said. “But the current Medicare bidding system for home medical equipment allows for non-binding bids that encourage irresponsible bidding and unsustainable prices. Moreover, the current system does nothing to ensure that winning bidders are qualified to provide products and services to Medicare beneficiaries in the specified market areas.”
Beneficiaries, homecare providers, consumer advocates, and hundreds of economists are calling on Congress to stop the current bidding program and enact an alternative – the Market Pricing Program – which features an auction system to establish market-based prices around the country.
Wilson said, “This alternative auction program would help Medicare make fundamental changes to lower costs to preserve the economic viability of home-based care and ensure that millions of seniors and people with disabilities retain the option of remaining safe and independent at home.
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