Editor's Note

HME's Glass is Half Full

The industry has good reason to take heart.

• By David Kopf
• Apr 01, 2015

Indulge me a trifle: If you read last month’s editor’s note, then you know the subject matter was a little glum at times, but this month, I actually feel I have good reason to feel a little old fashioned optimism.

The industry wrapped up 2014 in a sort of “so close, yet so far” fashion. We had binding bids legislation that had been working its way through the House via the Binding Bids Bill, and had even picked up a Senate companion bill, and the industry had also done solid work to advance audit reforms via the Audit Improvement and Reform Act (aka, the AIR Act). But sadly, when the year drew to a close, the 113th Congress wrapped, and with it so did the industry’s bills.

So it’s not surprising that some people would have begun 2015 feeling some resignation — the industry had to restart both bidding and audit reform efforts, and right at a time when CMS was fast-tracking the re-compete of Round Two of competitive bidding. The circumstances were daunting to say the least, and it’s not overstating it to say some people felt like competitive bidding and audits were becoming the “new normal” (however horrible that version of normal might be).

Well to paraphrase Dinah Washington, what a difference a few months make.

The biggest news has been binding bids legislation. As the 114th Congress got underway, the industry and its Congressional allies quickly launched The Medicare Competitive Bidding Improvement Act (MCBIA), a pair of Senate and House bills that aimed to put an end to the plague of suicide bidding. The Act requires bidders in the Round Two re-compete and all future bids to obtain surety bonds that force them to accept bidding contracts. If a bidder declines a contract that is at or above its bid amount, the bidder forfeits the bond, simple as that.

The House bill, H.R. 284, was introduced by Reps. Pat Tiberi (R-Ohio) and John Larson (D-Conn.), who are both members of the House Ways and Means Committee. The Senate bill, S.148, was launched into the upper chamber by Sens. Rob Portman (R-Ohio) and Ben Cardin (D-Md.), who are both members of the Senate Finance Committee. To have both a House bill and a Senate bill launched in that short an order was nothing short of amazing, given that the industry had to work so hard to get a Senate companion bill in the 113th Congress.

And what’s even more impressive is that the House has passed H.R. 284 with little debate. The bill was voice voted as this issue was in its final stages (read more in “News, Trends & Analysis,” on page 8), and now the industry can concentrate its efforts on passing S.148 in the Senate. Given the bill’s non-controversial state, you’ll have to forgive me for anticipating its relative quick passage.

And, likewise, I’m feeling pretty positive that if the MCBIA comes out of Congress as smoothly as I hope it will, President Obama will see the sense in signing the legislation into law.

Similarly, we’re seeing some good news in the fight to reform CMS’s out-of-control audit program. If you turn to “Treading Carefully,” our update on the latest audit developments (page 29), you’ll read that the industry is working with Rep. Renee Ellmers (R-N.C.) and an as-yet-unnamed Democratic lawmaker to launch new audit reform legislation into the House. If anything, by the time you crack open the pages of this magazine, I might even be covering that bill on hme-business.com and in e-Source, our e-newsletter.

Given that audits pose an even greater immediate threat to providers than competitive bidding, I couldn’t be happier to know that we should soon see a bill working to rein in such an out-of-control program. So color me enthused.

And enthused isn’t exactly how trade journalists ache to be described. We’re supposed to be detached and objective, but the industry has suffered so many setbacks that it’s almost everyone’s default position to expect bad things to happen. Well, I’m sick of expecting the worst, and at the risk of coming off like a Pollyanna in writing this column, I’ve officially had more than my fill of bad news when it comes to bidding and audits, and 2015 is looking more encouraging as the days go by. Here’s to more good news.

This article originally appeared in the April 2015 issue of HME Business.