Flawed Bid Process Began October 21 in Riverside-San Bernardino Area; H.R. 3790 Would Eliminate the Bid Program, Reduce Medicare Spending, Preserve Access to Quality Care, and Save Thousands of Small Businesses
The California Association of Medical Product Suppliers and the American Association for Homecare praised a bipartisan bill in Congress, H.R. 3790, to eliminate the misguided and deeply flawed "competitive" bidding program for durable medical equipment and services in Medicare. The bidding process in this controversial program began on October 21 in the Riverside-San Bernardino-Ontario metropolitan statistical area and eight other MSAs across the U.S.
Durable, or home medical equipment, such as oxygen, wheelchairs, diabetic supplies, and hospital beds, enables seniors and people with disabilities to receive quality care at home. Home-based care represents a cost-effective alternative to institutional care, and seniors prefer to receive care at home rather than in an institution.
To ensure that seniors and taxpayers receive the savings projected for the bid program, the bill would reduce Medicare reimbursements to home medical equipment providers in 2010, 2011, 2012, 2014, and 2015. At the same time, the bill will allow thousands of home medical providers to keep their doors open to serve the millions of Americans who require home-based care and will allow patients to continue to receive services from the providers of their choice.
H.R. 3790 has bipartisan support from two dozen cosponsors in the House of Representatives including Congressman Sam Farr (D-Calif.). The introduction of the legislation came just days before the start-up of the bidding process, which began on October 21 in nine metropolitan statistical areas across the U.S. including the Riverside-San Bernardino MSA. The bid prices and bid winners would be selected in 2010 and new prices would become effective January 1, 2011. Another round of bidding would begin after that in 100 MSAs across the U.S.
"I wish that I could be confident that the disastrous outcomes of the first attempt at implementing competitive bidding were not about to recur," said Esta Willman, president of Medi-Source Equipment and Supply in Yucca Valley, Calif. and a representative of the California Association of Medical Product Suppliers. "As a supplier in the Riverside metropolitan area who participated in the first attempt at the bidding process, I have first-hand experience that tells me that many of the issues that were present in the first round will likely recur in the rebid because adequate, meaningful changes have not been made to the program to prevent such recurrence.
"The rebid will still likely result in a drastic reduction to the number of experienced suppliers in the Riverside-San Bernardino area and other affected bidding areas. Combine that with the impact of dramatically declining Medicare reimbursement rates along with accreditation and surety bond requirements, and the result will be that most suppliers close down or withdraw from Medicare. That means that patient access to the services of experienced suppliers and quality items will be severely jeopardized. I fear that we are about to see the beginning of the dismantling of the nation's homecare community, which helps control health care spending by keeping patients in the least costly setting for care: in their homes. H.R. 3790 provides the government with the projected savings from the program without all of the harmful impacts that will inevitably result if the program is permitted to continue as is."
Categories subject to the bid program include medical oxygen, which is a highly regulated prescription drug, complex rehabilitative power wheelchairs, enteral nutrients (used in tube feeding), and hospital beds, among other categories.
The initial roll-out of the bidding program in 2008 produced disastrous results for home medical equipment patients and for providers (mostly small businesses) who were excluded from Medicare as a result of the first round of bidding.
During the 2008 implementation, serious problems were encountered, such as: