Caught on tape: Criticism of bid program mixed in with criticism of Obamacare

WASHINGTON - When HHS Secretary Tom Price took to Twitter last week to post several videos of small business owners speaking on the negative impact of Obamacare, one in particular caught the eye of social media-savvy HME providers.

Dudley Hoskins Bostic, owner of Hoskins Drug Store in Clinton, Tenn., said, “There is an access issue. It's not available—it is actually not available to the residents and the citizens of Tennessee. And it's narrowing as we speak.”

The video, only a few seconds long, had providers wondering whether Bostic was talking about Obamacare—or Medicare's competitive bidding program.

“My daughter just pulled it up and my mouth fell open,” said Bostic, who hadn't seen the video until provider Tyler Riddle called her to tell her it was on Twitter. “I know that (Price) is an advocate for us, and I've always liked him, even more now, since I've met him. He's such a smart man. But it was DME bidding and rates that I was talking about. They must have chopped that out.”

Bostic says she was part of a recent roundtable discussion in Tennessee hosted by Price and CMS Administrator Seema Verma. While she was fully aware that the focus of the meeting was the Affordable Care Act, she went off script because it's competitive bidding that has had the most significant impact on her 87-year-old business.

For Hoskins Drug, one of the biggest impacts of the program has been how it limits the ability of the company, which was awarded contracts for several but not all items, to fully take care of beneficiaries.

“They don't want multiple providers in and out of their homes—it's supposed to be a calming time for them, not a revolving door,” she said. “They need everything. I can do beds and support surfaces, but I can't do oxygen. What goes with oxygen, but a bed? It makes no good sense.”

More ominously, Bostic notes that with 40% of HME companies choosing to close their doors, competitive bidding is wreaking havoc on small businesses—and small town America.

“Every community that is thriving has a corner store and a pharmacy,” she said.

During the roundtable discussion that preceded the video taping, Bostic says she told Price and Verma that Hoskins Drug's two priorities are getting pharmacists recognized as healthcare providers and securing the reimbursement that goes along with that; and repealing and replacing the competitive bidding program.

“He pointed his finger at me and said, 'Yes ma'am,'” she said.

And therein lies the rub for providers like Riddle. While providers have been assured repeatedly in private that Price and Verma are working on competitive bidding reform, they have yet to acknowledge on the record, since taking office, that there are issues with the program.

That acknowledgement came on June 8, however, when, during a hearing on the fiscal 2018 budget by the Senate Finance Committee, Price said HHS is “looking very seriously” at the access issues created by the bid program, especially in rural areas, according to news reports.

In what turned out to be a big week for DME, providers are latching on to Bostic's video and this acknowledgement.

“(Bid reform) is very much on (HHS's) radar,” agreed Riddle, vice president of MRS Homecare in Tifton, Ga. “But what that doesn't do is motivate a provider that's barely hanging on. What that doesn't do is put CMS on public notice. What that doesn't do is say to third-party payers that they're applying rates based on a flawed program. We get it; it's on their radar. But a public statement that says, 'This program is screwed up,' is more beneficial.”

When Price's acknowledgement began circulating on Twitter on Friday, provider Gary Sheehan tweeted: “This is all I wanted, public acknowledgement of serious issues. My sincerest thanks @SecPriceMD—now let's get about a fix!”