Industry talks tough

WASHINGTON - The HME industry's efforts to fight competitive bidding have taken on a new tone.

With about four months before Round 2 goes into effect, stakeholders are no longer mincing words with lawmakers, telling them that if the program moves forward as planned, the blood will be on their hands.

“We're telling them, 'Don't call us in July about all the Medicare beneficiaries who are no longer able to get equipment and services,'” said Wayne Stanfield, president and CEO of NAIMES. “You have to fix this—not us.”

Stakeholders say they've given lawmakers plenty of evidence that the program is flawed (bids aren't binding, pricing is based on a non-weighted median) and a valid tool to make it right (the market-pricing program or MPP).

During a planned “fly-in” the week of Feb. 25, stakeholders plan to emphasize how the expanded program will dismantle an industry that provides important equipment and services to beneficiaries. Since more than 450 providers in the nine cities included in Round 1 closed or downsized, stakeholders believe at least 4,000 providers in the 91 cities included in Round 2 will do the same.

“It'll probably be more than that,” said Jay Witter, senior director of government affairs for AAHomecare. “We're getting calls and emails about businesses closing. These are powerful stories of businesses that have been around for 80 years. We tried to get stories like this from Round 1, and we didn't get much of a response. This time, we're getting constant calls and emails.”

While questions about paying for MPP and getting a bill introduced and passed in Congress loom large, stakeholders say the No. 1 priority right now is hitting home the destructiveness of the Round 2 reimbursement cut of, on average, 45%.

“The rub is, no one wants to take a 45% cut until MPP is implemented,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “We're in a rock and a hard place, but there are other solutions being looked at. I don't know what the answer is in the end, but right now, we need to get Congress to fix this and that won't happen unless we inspire them that this is terribly wrong. It's one step at a time.”

Stakeholders say lawmakers are increasingly taking notice, not only of the potential impact of Round 2 but also of how, under CMS's leadership, competitive bidding has run amok.

“One point lawmakers really seem to understand is the need for congressional oversight of the program before a tenfold expansion,” said Seth Johnson, vice president of government affairs for Pride Mobility Products. “To provide that kind of oversight, there's going to need to be some sort of delay. Congress seems to want a high level of confidence before any program of this magnitude moves forward.”