Editor's Note

This Is Your Fight

The only way the industry can maintain Meek bill momentum is with your help.

• By David Kopf
• Apr 01, 2010

Do you know how you can tell when you’re really in for a fight? When you didn’t start it. You can try running and you can try hiding, but if a bully has a bone to pick with you, that antagonist isn’t going to stop chasing you. No matter how much you want out of that fight, you’re stuck right in he middle of it. That’s exactly where providers find themselves with competitive bidding: CMS is the bully and you are its target. You didn’t ask for this fight, but it has been forced upon you. So how are you going to fight back?

As the playground bully in this scenario, CMS continues to push for its ill-conceived and poorly run national competitive bidding program. Despite the terrible experience HMEs and CMS had with the first failed attempt at competitive bidding, the Round One re-bid is well underway — and is already getting negative reviews. Some of the more shocking news regarding NCB came out in a report issued last month, “The Impact of Competitive Bidding on the Market for DME – An Update,” from Brian O’Roark, Ph.D., one of the four economist that found the program deeply fl awed during CMS’s first attempt at Round One.

In the new report, O’Roark says that despite any changes, the re-bid of Round One will still result in decreased competition and lead to a concentrated HME industry with higher prices and reduced services. “There appears to be no honorable explanation for why this bidding process is being used,” O’Roark states in the report, which is available as a PDF from the VGM Group’s website.

Notably, VGM also released its own findings on how greatly competitive bidding will impact the ranks of HME providers. VGM Group says that NCB will result in 93 percent of local providers not winning contracts, which will eliminate more than 80,000 American jobs in competitive bid areas over the next three years. VGM group added that the total job losses related to NCB will ultimately exceed 100,000 positions in all areas.

However, CMS has turned a deaf ear to any dire predictions about NCB and is ramping up Round Two of the program. During the March 17 Program Advisory and Oversight Committee meeting, CMS released a timetable for Round Two, as well as details on how the large metropolitan MSAs will be broken into smaller competitive bidding areas.

Indeed, you are in a fight to save your livelihood and protect your patients’ access to the quality care you provide. Make no mistake: you cannot sit this one out. The weapon that will help you win this fight is the H.R. 3790, the bill introduced by Rep. Kendrick Meek (D.-Fla.) that calls for Congress to repeal NCB.

First off, go to the Library of Congress Thomas search and look up H.R. 3790 to see if your Representative has or hasn’t cosponsored the bill.

If he or she has not, then now is the time to contact your Representative and start building a relationship with his or her staff and legislative aids, and hopefully the lawmaker, as well. Go to the websites for the American Association for Homecare, The National Association of Independent Medical Equipment Suppliers and your state association web site and download any and all materials that will help you make a strong case to your lawmaker about the value of homecare to his or her constituents; the threat posed to them by NCB; and why he or she must cosponsor the Meek bill.

But don’t stop there. Enlist your patients to help. No one can make a stronger argument to a lawmaker about how competitive bidding can negatively impact healthcare access and quality than the recipients of that care.

And if your representative has cosponsored the bill? Then get a commitment from him or her to help you convince the other Representatives in your state to cosponsor the bill.

No one can win the fight against competitive bidding for you. You have to put up your dukes and see it through to the end.

This article originally appeared in the April 2010 issue of HME Business.