Two Pennsylvania Congressmen – from opposite sides of the aisle – have filed a bill seeking to eliminate a competitive bidding program for durable medical equipment that has frustrated providers and consumers.
If enacted, the "Fairness in Medicare Bidding Act," a deficit-neutral bill proposed by Congressmen Glenn Thompson (R-Pa.) and Jason Altmire (D-Pa.), would repeal the Centers for Medicare and Medicaid Services' Durable Medical Equipment, Prosthetics, Orthotics and Supplies competitive bidding program.
"Medicare beneficiaries are entitled to high-quality, low-cost medical equipment and we intend to deliver on this promise by reforming the current bidding program," Thompson said in a statement.
"CMS' competitive bidding program limits seniors' ability to buy highly specialized medical equipment from the local suppliers they know and trust," Altmire added. "We have introduced legislation to repeal this misguided program at no new cost to taxpayers."
Created under the Medicare Modernization Act of 2003, the bidding program was launched in January in Charlotte, N.C., Cincinnati, Cleveland, Dallas/Fort Worth, Kansas City, Kan., Miami, Orlando, Fla., Pittsburgh and Riverside, Calif. The program is scheduled to expand to 91 more locations later this year.
The program was designed by the CMS to provide high-quality home medical equipment supplies – such as power wheelchairs, walkers, oxygen, CPAP and respiratory assistive devices, hospital beds, enteral nutrients (tube feeding), support surfaces and mail-order diabetic supplies – and services to millions of seniors and people with disabilities while reducing costs. However, the program has generated many complaints.
[See related story: Competitive bidding program disappoints]
The American Association of Homecare set up a website, biddingfeedback.com, for Medicare patients, providers and case managers to share their experiences with the program. Reported problems include difficulty finding a local equipment or service provider, delays in obtaining medically-required equipment and services, longer-than-necessary hospital stays due to confusion in discharging patients to home-based care, few choices for patients when selecting equipment or providers, reduced quality and confusing or incorrect information provided by Medicare.
"We are an industry that supports robust competition," said John Shirvinsky, executive director for the Pennsylvania Association of Medical Suppliers, in a statement. "But the use of the term 'competitive' is hardly descriptive of what this program actually does."
"You cannot eliminate 80 (percent to) 90 percent of competitors and expect to arrive at a competitive outcome," Shirvinsky continued. "It's fundamental: Competition requires competitors. Competition also requires free access to growing markets, which this program prohibits."
The Pittsburgh market, which includes all of Altmire's district and part of Thompson's, is already seeing layoffs and salary reductions because of the competitive bidding program, Shirvinsky said.
Before the program began, the AAH, members of Congress, national and consumer advocacy groups and economic experts had warned there would be significant problems with the design of the program, including "strong incentives to distort bids away from (actual) costs" and a lack of transparency.
Since Altmire and Thompson introduced their bill, a number of organizations, including the AAH, the Brain Injury Association of America, the International Ventilator Users Network, the Muscular Dystrophy Association, the National Council on Independent Living, the Christopher and Dana Reeve Foundation, the National Association for Homecare and Hospice and the National Association for the Support of Long Term Care, have declared their support.