Washington

In an Oct. 3 report, the U.S. Department of Health and Human Services gave Congress, the Centers for Medicare and Medicaid Services, and other regulators a glimpse of what many in the HME industry long have feared: national competitive bidding for durable medical equipment could decrease beneficiaries' access to quality services.

HHS' second annual report to Congress regarding the two competitive bidding demonstration projects revealed the following problems:

• New home-oxygen beneficiaries in Polk County experienced a decline in access to the portable oxygen that enables patients with disabilities to function outside the home;

• Polk County beneficiaries who are new users of medical equipment were more likely than existing users to have their equipment delivered by someone other than their provider; and

• Beneficiaries who are new users of medical equipment reported a reduction in maintenance visits, and beneficiaries requiring surgical dressing reported a substantial reduction in the number of contacts with the supplier.

HHS attempted to disqualify some of the findings, claiming that evaluations of the two projects remain incomplete. The agency is planning to conduct further research next year.

“With only two years of experience under the demonstration, it is premature to conclude what the long-term effects of competitive bidding on the evaluation issues will be,” HHS said.

Drawing similar conclusions, opponents of competitive bidding have argued that it is premature to implement competitive bidding without properly evaluating the demonstration projects.

According to Tom Connaughton, chairman of the Coalition for Access to Medical Services, Equipment and Technology, and president of the Alexandria, Va.-based American Association for Homecare, “This report supports CAMSET's position, further acknowledging the fact that it is too soon to extend competitive bidding nationally. Before implementing this program, we must understand its effects on the welfare of beneficiaries who rely on this important Medicare benefit.”

“This report makes clear that there is still much we don't know,” said John Kemp, voluntary chair of the American Association of People with Disabilities (AAPD), a CAMSET member. “We have serious concerns with proceeding with a national competitive bidding program when important questions about access, quality and choice of provider have not been fully answered.”

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