Editor's Note

Defeating Defeatism

We have a bill in-hand; let’s get it passed.

• By David Kopf
• Jun 01, 2013

“If you want to secure the certainty of competitive bidding’s nationwide implementation, make sure to do one thing: nothing.” A very smart person involved in our industry’s advocacy recently told me that, and nothing could be more true. Not doing anything to protect the HME industry will certainly ensure its threats succeed.

And that’s the dilemma with H.R. 1717, otherwise known as the Medicare DMEPOS Market Pricing Program Act of 2013, which calls for repealing CMS’s national competitive bidding (NCB) program and replacing it with the market pricing program (MPP). While we have a nice piece of legislation in-hand, there is a decent-sized population within the HME industry that aren’t feeling so optimistic about the bill’s fate.

Don’t believe me? Then believe the numbers. We recently posted an online survey at hme-business. com that asked providers, “Can the industry secure H.R. 1717’s passage before competitive bidding Round Two implementation?” Their answers proved vexing: 27 percent said “yes,” and 72 percent said, “no” (with 1 percent lost to rounding).

Moreover, in the wake of the announcement of the Round Two bid winners, the industry has seen some of the providers not holding Round Two contracts selling their businesses for less than they should to buyers from outside the industry; mostly from the investor community. That’s disturbing, not just because they’re giving up, but because what does it tell you when equity investors want to buy your business? That it has value and they believe it will grow. So why sell what you worked so hard to build now, when others are willing to shell out for it even in the face of NCB?

But what really astounds me is the fact that this defeatism flies in the face of the industry’s progress. Over the past five years, HME providers and their associations have worked incredibly hard on numerous fronts to advance legislation that would either delay or stop competitive bidding. Whether it was the Medicare Improvements for Patients and Providers Act, the Meek bill, or H.R. 6490, the industry has made massive political gains to stop competitive bidding.

“But those bills didn’t stop competitive bidding,” you say. I understand. That’s correct, those bills didn’t end NCB, but legislation isn’t typical won on the first round. Sometimes, it takes multiple attempts through multiple Congresses to build the ranks of supporters and allies that eventually see a bill passed. That’s what we’re doing.

If you don’t believe me, just look at H.R. 1717’s ranks of supporters. Since it was launched in the House roughly three weeks ago (at press time) by Rep. Tom Price, M.D. (R-Ga.) and Rep. John Larson (D-Conn.) — both senior members of the House Ways and Means Committee, it’s worth noting — the bill has acquired 44 co-sponsors. That’s an encouraging pace of support.

We cannot let that momentum slow. I get it: this has been a tough slog; it feels like implementation is going to happen any second; and CMS’s continual refusal to be transparent, or to acknowledge any of NCB’s flaws has been maddening. No wonder people feel worn out from fighting so long, and from a general sense of “outrage overload.”

But it’s time to move past that and resume the fight, because your businesses and your patients’ well-being are at stake. Make it your mission to ensure your Representative supports the bill. This issue’s “Industry Newsmaker” (page 14) is John Shirvinsky, the executive director, of the Pennsylvania Association of Medical Suppliers, and he has some great advice when it comes to taking ownership in the fight for H.R. 1717, and the urgency to pull out all the stops in support of the bill. I hope you’ll read it and put it to use.

H.R. 1717 is in an excellent position to succeed, if providers back it with vigor. HME Business will continue to help you advocate on behalf of your industry by providing regular updates on the bill’s progress, as well as key legislative activities in support of H.R. 1717, along the way. You can do this — I know you can.

This article originally appeared in the June 2013 issue of HME Business.