Florida and National Homecare Groups Applaud Bill to Eliminate Misguided
Medicare Bidding Program Coming to Miami, Orlando
Flawed Bid Process Began October 21 in Orlando, Miami; H.R. 3790 Would
Eliminate the Bid Program, Reduce Medicare Spending, Preserve Access to
Quality Care, and Save Thousands of Small Businesses
MIAMI, Oct. 22 /PRNewswire-USNewswire/ -- The Florida Alliance of Home Care
Services, the American Association for Homecare, and other homecare groups
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 Miami and Orlando metropolitan statistical areas
and seven other MSAs across the U.S. So far, a bipartisan group of eight
members of Congress from Florida have signed onto the bill, representing
one-third of Florida's House members.
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 was introduced by Florida Congressman Kendrick Meek (D-Fla.) on
October 13 and has strong bipartisan support from 30 Representatives in the
House including seven cosponsors from Florida: Democrats Alcee Hastings, Ron
Klein, Debbie Wasserman Schultz, and Robert Wexler and Republicans Lincoln
Diaz-Balart, Bill Posey, and Adam Putnam. 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
Miami and Orlando. 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.
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.
Rob Brant, a home medical equipment provider in Miami and board member of the
Florida Alliance of Home Care Services said, "We are gravely concerned that
this bid program continues to lack transparency and fairness to small
businesses and that it will erode access to quality care for seniors in
Florida. Allowing inexperienced, out-of-state providers to replace the
existing home medical equipment providers who have excellent track records
serving their communities will not improve health outcomes in Florida."
During the 2008 implementation of the bid program, serious problems emerged,
including:
-- Disruption to patient services - Patients were forced to go to
multiple,
unfamiliar providers for different items and services. Informal
surveys
showed that some winning providers were unable to provide care to
beneficiaries.
-- Greater costs to Medicare due to longer hospital stays - Confusion
about
the restricted list of contracted home medical providers delayed
hospital discharges and triggered unnecessary emergency room visits.
-- Non-local providers - Providers with no history of servicing a
geographic area or no operations in a bidding area were awarded
contracts.
-- Inexperienced/unlicensed providers - Companies were awarded Medicare
contracts to provide equipment and services for which they were not
licensed in their states and for which they had no previous experience
providing.
-- Desperation bidding - Structural flaws in the bidding program caused
providers to submit artificially low bids because they were faced with
the threat of losing their businesses if not awarded a contract.
Winning
contracts also were viewed as commodities that could be sold once a
bid
was won.
Due to these problems, Congress delayed the bid program when it enacted the
Medicare Improvements for Patients and Providers Act of 2008, in hopes that
the federal Centers for Medicare and Medicaid Services would substantially
improve and reform the program. However, the fundamental problems still remain
in the bid program. The congressional action last year to delay the bidding
program also required that the home medical equipment sector accept a 9.5
percent Medicare reimbursement cut effective January 1, 2009 to pay for the
savings the bid program would have reaped.
"We recognize the need to control costs in Medicare. However, the home medical
equipment sector has seen far more than its share of reimbursement cuts over
the past 10 years," said Tyler J. Wilson, president of the American
Association for Homecare. "This bidding program is designed to selectively
contract with a small fraction of the nation's home medical equipment
providers and put the vast majority of them out of business even if they agree
to new, lower reimbursement rates. That's not good for the seniors and people
with disabilities who depend on quality home medical equipment and services in
order to remain independent."
K. Eric Larson, executive director of the National Spinal Cord Injury
Association, said, "A 'competitive' bidding program that relies solely on the
price of a winning bid simply cannot guarantee quality of, and access to the
care our members need. Home medical equipment providers offer quality items
and service to beneficiaries living with paralysis and complex conditions such
as amyotrophic lateral sclerosis (ALS), muscular dystrophy, and spinal cord
injuries who rely on customized mobility equipment, life-dependent oxygen, and
other life-preserving medical equipment, service, and care. This bidding
program needs to be repealed before the program creates human tragedies across
the country."
"This bidding program will produce a bureaucratic, anti-competitive system
that will have the unintended consequences of reducing quality and access to
care for patients," said Wilson. "The result would be similar to a
closed-model HMO and will have the effect of government-mandated consolidation
in homecare. There are far better ways to save money than destroying the home
medical sector."
Home medical equipment and care is already the most cost-effective,
slowest-growing portion of Medicare spending, increasing only 0.75 percent per
year according to the most recent National Health Expenditures data. That
compares to more than 6 percent annual growth for Medicare spending overall.
Home medical equipment represents only 1.6 percent of the Medicare budget.
Visit www.aahomecare.org/competitivebidding for details about the bid program.
The American Association for Homecare represents durable medical equipment
providers and manufacturers serving the medical needs of millions of Americans
who require medical oxygen, wheelchairs, medical supplies, inhalation drug
therapy, home infusion, diabetic supplies, and other medical equipment and
services in their homes. Association members operate more than 3,000 homecare
locations in all 50 states. Visit www.aahomecare.org.
SOURCE American Association for Homecare
Rob Brant, Florida Alliance of Home Care Services, +1-305-629-8306; or Michael
Reinemer, American Association for Homecare, +1-703-535-1881,
michaelr@aahomecare.org
