LONG BEACH, Calif. – With the Medtrade Spring exhibit hall just a few hours from opening, American Association for Homecare (AAHomecare) President/CEO Tyler Wilson urged DME providers on May 7 to keep working with their legislators, local media and Medicare beneficiaries on a number of urgent industry issues.
Despite a 7:30 a.m. starting time, AAHomecare’s semi-annual Washington Update session was packed, and not surprisingly, the hot topic of debate was the Center for Medicare & Medicaid Services’ (CMS) controversial competitive bidding program.
“The leadership of AAHomecare views competitive bidding as a train wreck,” Wilson said. He also noted, “At every turn, CMS has effectively ignored the PAOC (Program Advisory & Oversight Committee). That was a group CMS was supposed to be relying on.”
Wilson said AAHomecare had considered how to allocate its resources to fight competitive bidding – “Do we focus on Round 1, do we focus on Round 2?” – but then said, “The problems in Round 1 have been so severe, so acute, we had to seize the moment.”
Wilson also discussed a May 6 House Ways & Means sub-committee meeting in which CMS Acting Administrator Kerry Weems was pointedly questioned about potential competitive bidding problems, including endangered access for Medicare beneficiaries in competitive bidding areas and the large percentage of Round 1 bidders disqualified. Wilson said CMS figures show that 630 out of 1,000 Round 1 bidders were disqualified from consideration.
“Mr. Weems encountered quite a bit of headwind in reading those statistics,” Wilson noted.
Despite the fact that Weems faced tough questioning from sub-committee members, Wilson noted Weems “essentially said there are no problems.”
Former AAHomecare Chairman Tom Ryan testified before the sub-committee on the organization’s behalf and was asked if the DME industry was willing to accept reimbursement cuts in possible lieu of a competitive bidding program. Wayne Stanfield, president of the National Association of Independent Medical Equipment Suppliers (NAIMES), was also present at the meeting and said Ryan’s response to that question was “Yes,” to which sub-committee Chairman Pete Stark (D-Calif.) replied, “That’s all I want to hear.”
In an impromptu poll of the Washington Update audience, Wilson asked if they’d be willing to accept a 5-percent Medicare reimbursement cut in lieu of competitive bidding – and most responding suppliers said yes. A number of suppliers in the room favored even a 10-percent reimbursement cut in lieu of competitive bidding.
Wilson lauded the newly introduced Senate bill, S. 2931, that seeks to exclude complex rehab equipment from the competitive bidding program. The Senate bill is a companion to the House’s rehab carveout bill, H.R. 2231.
Wilson reported that AAHomecare is also working to educate legislators on a surety bond proposal that would increase bond requirements for suppliers to $65,000 from the current $50,000. The association is urging CMS to use other measures to police suppliers, such as conducting surprise visits to new DME suppliers within their first six months of operations, instead of raising the surety bond requirement to levels that many suppliers would find impossible to meet. A recent proposal suggested raising the bond level to $500,000 per supplier.
“There are things (CMS) can do well short of increasing surety bond (requirements) to $500,000,” Wilson said.
Wilson urged suppliers to keep educating their senators and representatives and to “think seriously about coming to our fly-in (on May 21).” That AAHomecare-hosted lobbying event in Washington, D.C., was scheduled to give suppliers yet another chance to talk to legislators about competitive bidding. Wilson indicated that more than 100 people have already signed up for the fly-in, which is sponsored by Covidien and Medtrade (go to www.aahomecare.org/cde.cfm?event=213751 for more information).
“You really are on the front lines,” Wilson noted. “You need to be in touch with your representatives and keep up the grass-roots pressures.”