McCaskill: Bid program helps regulate system

WASHINGTON - Of the two providers that were subpoenaed to testify at a second congressional hearing on HME business practices on May 22, one invoked the Fifth Amendment and the other said he “wants to play by the rules.”

Jon Letko, president of Milford, N.J.-based U.S. Healthcare Supply, invoked the Fifth Amendment before the Senate Subcommittee on Financial and Contracting Oversight, leaving Sen. Claire McCaskill, D-Mo., visibly surprised.

“We are hopeful that, at some point in time, your company will be in a position that you can speak to the committee under oath in the same manner that you were willing to speak to the press,” said McCaskill, who chairs the subcommittee.

After receiving invitations to testify at the subcommittee's opening hearing on April 24, both Letko and Dr. Steve Silverman, president of Boca Raton, Fla.-based Med-Care Diabetic Medical Supplies, declined to attend. McCaskill said she regretted that the subcommittee had to resort to issuing subpoenas.

McCaskill questioned Silverman for the better part of an hour. Of particular concern for the senator was the aggression with which Silverman's company allegedly markets its products to elderly citizens. Med-Care Diabetic was recently the object of complaints by a Missouri beneficiary and a physician for what they believe are overbearing tactics.

“Regarding the rules and regulations, we are regulated, we are inspected, and whatever rules and regulations there are, I give it my best effort for myself and all my employees for us to follow this,” Silverman said. “I want to play by the rules.”

McCaskill was not so quick to blame aggressive marketing on providers. She said it was less a symptom of unscrupulous providers than, prior to competitive bidding, an unregulated system.

“The government set up a system that people believed would be a free market of competition that would drive costs down,” she said. “It turns out that without competitive bidding and with the free-for-all among seniors with marketing, it didn't work out that way.”

She added, “We're trying to put the cow back in the barn.”

When asked to discuss competitive bidding, Silverman was guardedly optimistic.

“I'm in favor of competitive bidding, but I have some concerns based on pricing (and) I have some concerns based upon capacity,” he said. “There are 25 million diabetic patients in the country and competitive bid contracts were awarded to only 10-15 providers.”