Congress has urged the White House Office of Health Reform, the Centers for Medicare and Medicaid Services, and the Department of Health and Human Services to review and rescind the controversial competitive bidding rule before it is scheduled to go into effect on Saturday.
Congress said the interim final rule published by CMS on January 16 did not allow enough time for stakeholder comment.
In a Thursday letter signed by 84 bipartisan members of Congress, including Debbie Wasserman-Schultz (D-Fla.), Marsha Blackburn (R-Tenn.) and John Lewis (D-Ga.), representatives said there will be negative impacts for patients and businesses if the rule is allowed to go into effect.
The bidding program, which was suspended by Congress in 2008, would lower quality and reduce access to care for seniors and people with disabilities, the letter said. It said the current version of the bidding program will put at least 90 percent of providers – many of which are small businesses – out of work at a time when unemployment is high and government is already fighting to protect jobs.
"As growing numbers of seniors enter the Medicare program, it is important that we take care to maintain an adequate number of qualified and capable providers to address demand for care in the home, especially in rural areas," said Rep. Betty Sutton, (D-Ohio).
According to the authors of the letter, the program's current structure bears no resemblance to 1997 and 1998 demonstration programs in Florida and Texas and is anti-competitive because it will selectively contract with a small group of homecare providers based on the lowest bid, forcing out providers who use high-quality homecare equipment or provide critical patient services. These selective contracts would result in the immediate elimination of thousands of eligible small businesses throughout the country from the Medicare program, the letter said.
"Of the more than 4,000 providers in the initial bidding areas, only 376 were deemed to have met the bidding program requirements," Sutton said, describing the implementation last year. "This is not a solution to Medicare reform and would only reduce quality and access to care for seniors and people with disabilities."
According to the American Association for Home care, spending on home medical equipment and care is already the most cost-effective and slowest-growing portion of Medicare, increasing only 0.75 percent per year according to the most recent national health expenditures data from the federal government. That rate compares to more than 6 percent annual growth for Medicare spending overall. Home medical equipment represents only 1.6 of the Medicare budget.