Washington Wit & Wisdom

Message to Congress:

The DME bid program is anti-competitive and will hurt seniors.

Last year's success in getting Congress to delay the “competitive” bid program was undoubtedly due to the incredible grassroots effort that our industry pulled off. This year we must do the same, or more.

One of the biggest challenges is to communicate effectively with members of Congress and their staff about the ill effects of the program. Specifically, we must convey in lay person's terms why CMS' implementation of the program will be harmful to seniors and local providers. Here are a request and talking points to use.

  • Overview and Request to Congress

    “Competitive” bidding will hurt seniors, patients and thousands of HME businesses nationwide, many of which are small businesses. The program selectively contracts with a limited number of HME providers based on the lowest bid prices, drastically reducing patient access to, and choice of, quality care.

    If CMS does not make changes that will ensure access and minimize business closures, Congress must intervene and require those changes. If the changes cannot be made, Congress must reconsider the bid program and repeal it in its entirety.

  • The bidding program is bad for patients.
    • It forces out providers who utilize high-quality medical equipment, and forces patients to switch from providers they trust.

    • It ignores providers' ability to serve a geographic market, resulting in fewer home visits to patients in rural areas.

    • A total of 2.6 million eligible beneficiaries will be impacted in the first nine markets.

    • The drastic reduction of eligible suppliers will result in an average increase of 339 percent in the ratio of beneficiaries per supplier, overwhelming the patient referral system and resulting in increased hospital stays since winning suppliers may be unable to handle the increased volume.

  • Bad for patient access (anti-competitive).
    • “Competitive” bidding is actually anti-competitive. It is a selective contracting program that will lead to massive consolidation in the home medical sector.

    • Ninety percent of qualified HME and service providers were shut out of Medicare during the 2008 initial bid program, including 4,200 small businesses.

    • When fully implemented, the bid program will reduce up to 80 percent of the local businesses across the country — approximately 12,000 firms.