Medicare

WASHINGTON — It looked like both houses of Congress were going to adjourn last month without deciding the fate of competitive bidding. But it wasn't for lack of trying nor is the issue even close to being dead. The House adjourned Oct. 16, and as of press time it appeared the Senate would adjourn by Oct. 23. Both houses will convene after the Nov. 5 election, and there's a chance that competitive bidding could pass in some form during that lame duck session. If nothing happens, competitive bidding won't resurface until after the new Congress is sworn in, probably in February. If the latter scenario occurs, "we have 90 days to think about it and figure out if we can live with it, or can we offer a legitimate compromise," said Dave Williams, Invacare's director of government relations. Leading up to lawmakers departing D.C. in October to do some last minute campaigning, a flurry of activity engulfed competitive bidding. On Oct. 10, Senators Bob Graham (D-Fla.) and Phil Gram (R-Texas) introduced a bill that would impose national competitive bidding on DME. That proposal came about two weeks after Sens. Max Baucus (D - Mon.) and Charles Grassley (R-Iowa) proposed a competitive bidding program for DME in metropolitan areas that contain 500,000 or more people. Lawmakers see competitive bidding as a way to pay for givebacks to doctors, rural hospitals and Medicare + Choice companies. In fact, while Sen. Grassley was scheduled to speak at Medtrade and in the past seen as an industry supporter, his desire to boost payments to rural hospitals in Iowa apparently trumped his desire to join those opposing competitive bidding for DME. "The definition of friend is a relative one," said AAHomecare CEO Tom Connaughton. "He is sympathetic with home care. He has lots of questions of competitive bidding, but I think the need in Iowa for aid for rural hospitals was so great he had to trade off with a competitive bidding provision that exempted Iowa. He knew it, and he did it." Sens. Graham and Gramm introduced their competitive bidding legislation as a stand-alone bill, and industry watchers give it little chance of passing. After the elections, however, during a lame duck session, when lawmakers don't have to worry about the voters, anything can happen. That's why it's critical that providers continue to contact their senators and representatives urging them to oppose efforts to implement competitive bidding, Connaughton said. HME