Editor's Note

Your August Marching Orders

August offers a golden opportunity to fight bad policies on various fronts.

• By David Kopf
• Aug 01, 2014

Today’s work environment is one fraught with constantly changing priorities and mounting to-do items that overwhelm a person’s calendar. It’s amazing that HME professionals can get anything done given how much they have to manage. Well, your workload just got bigger — but in a good way.

Are you sick to death of audits and competitive bidding? Good news: you have new ways that you can fight these policies, and August is the month in which you must wage that battle. Both the House and the Senate will be taking their recesses this month, which means your lawmakers from both chambers will be back in their home offices, taking meetings and working with their legislative staff.

So, the industry has cooked up two new bills (and possibly has two more as this issue goes to press), for fighting competitive bidding and CMS’s haywire audit system. Moreover, you have ways to respond to CMS’s plan to take competitive bidding national. Let’s review them one-by-one:

Binding Bids

A quick review of recent events shows that the industry is shifting its strategy in the fight against competitive bidding. After many years, it’s becoming clear that trying to repeal or replace the program is not working.

So the industry has worked with champions Reps. Pat Tiberi (R-Ohio) and John Larson (D-Conn.) to introduce H.R. 4920, the binding bids bill, which would require all bidders to have a surety bond that would ensure they live up to their bid amounts and accept contracts for those amounts. It eliminates the biggest problem with competitive bidding: suicide bids by speculative bidders. Better yet, industry’s legislative leaders are working to introduce a Senate companion bill that should hopefully enter the docket by the time you read this.

This is critical legislation that many are saying is the industry’s best hope for getting relief, but it needs your support. Make sure to contact your Representative (and hopefully Senators) and get them to back this legislation. And if your Representative already backed H.R. 1717 (the MPP bill), then he or she is an easy convert to H.R. 4920, as it is one component of the broader MPP bill.

Audit Relief and Reform

For many providers, audits are an even bigger threat to their businesses than competitive bidding. We already know the system compensates auditors for finding errors, but overloads the appeals system because many of those errors are technicalities at worst. The system is unfair and unjust, and it needs massive reform.

To fight that, Reps. Renee Ellmers (R-N.C.) and John Barrow (D-Ga.), have released H.R. 5083, the Audit Improvement and Reform Act, which addresses many key problems with Medicare’s audit program. This is another bill that you can help back today. All you need to do is call. Need help shaping your argument? Well, the American Association for Homecare has launched FixMedicareAudits.org, a site designed to help providers advocate on behalf of the bill. And, like the binding bids bill, you might see a Senate companion this month.

National Expansion

Lastly, you might recall that CMS made an advanced notice back in February that it was gearing up to take competitive bidding national by 2016. Well, the agency has released its proposed rule, and it is indeed planning to apply competitive bidding’s existing rates to non-bid areas by Jan. 1, 2016. In less than 18 months rural providers must provide DME to beneficiaries at suicide rates, with no way to build additional volume to compensate for the loss.

Now is the time to go to www.regulations.gov, read the proposed rule, and follow the “Submit a comment” instructions to respond. The deadline is Sept. 2. Better yet, at press time the VGM Group was working on creating an online resource at that would help facilitate providers getting their response to CMS, so take advantage of that.

I know that you’re busy already. It’s hard enough running a company, especially under the crazy funding and regulatory environment that CMS has created. But as a smart HME professional, you also know that’s exactly why you need to take the time to advocate on these three agenda items. Your industry, your patients and your business depend on it.

This article originally appeared in the August 2014 issue of HME Business.