In the midst of a round one re-bid cycle for Medicare’s durable medical equipment competitive bidding process, a bill calling for its elimination has been introduced in the House of Representatives.
The California Association of Medical Product Suppliers and the American Association for Homecare are backing the bipartisan bill, H.R. 3790, which would reduce Medicare reimbursements to home medical equipment providers from 2010 to 2015.
This is expected to ensure that seniors and taxpayers receive the savings projected for the bid program. It would also prevent medical suppliers from being forced to close their doors when not chosen in the competitive bidding process and allow patients to use the supplier of their choice.
Homecare and healthcare groups are calling the DME bidding process “controversial” and “deeply flawed.” Home-based care is a cost-effective alternative to institutional care, but without DME products such as oxygen, wheelchairs, and diabetic supplies, seniors would have a hard time staying home.
“I have first-hand experience that tells me that many of the issues that were present in the first round will likely recur in the re-bid because adequate, meaningful changes have not been made to the program to prevent such recurrence,” said Esta Willman, president of Medi-Source Equipment and Supply in Yucca Valley, Calif., and a representative of the California Association of Medical Product Suppliers.
Combined with the impact of declining Medicare reimbursement rates and accreditation and surety bond requirements, the result will be that many suppliers will close down or withdraw from Medicare, critics of the re-bid process say. Patient access will be jeopardized in many sectors of the healthcare industry.
“A ‘competitive’ bidding program that relies solely on the price of a winning bid simply cannot guarantee quality of, and access to, the care our members need,” said K. Eric Larson, executive director of the National Spinal Cord Injury Association. “This bidding program needs to be repealed before the program creates human tragedies across the country.”
“We recognize the need to control costs in Medicare. However, the home medical equipment sector has seen far more than its share of reimbursement cuts over the past 10 years,” said Tyler J. Wilson, president of the American Association for Homecare. “This bidding program is designed to selectively contract with a small fraction of the nation’s home medical equipment providers and put the vast majority of them out of business even if they agree to new, lower reimbursement rates.”
Home medical equipment and care is the most cost-effective, slowest-growing portion of Medicare spending, increasing only 0.75 percent per year, according to the most recent National Health Expenditures data. That compares to more than 6 percent annual growth for Medicare spending overall. Home medical equipment represents only 1.6 percent of the Medicare budget.
“This bidding program will produce a bureaucratic, anti-competitive system that will have the unintended consequences of reducing quality and access to care,” said Wilson.