When It Rains … CHAMP Pours

Robert D. Hoover Jr., MD, MPH, FACP, chief medical officer for DeVilbiss Healthcare, Somerset, Pa.

As if competitive bidding isn't enough to deal with, the Children's Health and Medicare Protection Act of 2007 (H.R. 3162), also known as the CHAMP Act, has become another serious issue for the HME industry.

Drafted as the House version of legislation to expand the State Children's Health Insurance Program, Dr. Robert Hoover explains, “the bill includes a provision that reduces the reimbursement cap on oxygen concentrators, liquid and gaseous systems from the 36 months legislated by the Deficit Reduction Act to 18 months. However, it preserves the 36-month payment cap for oxygen generating portable equipment.”

But he adds that “despite industry efforts, it [does] not include a provision to eliminate the transfer of title to the equipment.” The bill would also eliminate the first-month purchase option for power wheelchairs.

“Although much has been said about CHAMP and its potential impact on the industry, it has not passed into law yet,” notes Hoover.

“The industry does have friends in the House and Senate that have pledged to work on keeping further oxygen reimbursement cuts out of any final legislation. Then, assuming the worst case and that an oxygen and/or wheelchair provision remains in the bill that is ultimately passed, President Bush could still veto the bill and has pledged to do so with the current Senate version.”

Bidding Is Good — For Office Furniture

Darren Jernigan, director of government affairs, Permobil, Lebanon, Tenn.

There's no sarcasm lost when Darren Jernigan speaks about competitive bidding. “Competitive bidding is slowly becoming a reality. All the arguments remain the same, and CMS continues not to deal with hypothetical situations,” he says.

“Wait … this just in. CMS has extended another deadline. Could this mean some of the hypothetical arguments are coming true? Could there really be a burden on the provider? Will the end-user really lose choice or be harmed from such a policy?”

Jernigan says competitive bidding is a good financial strategy, just not for health care. “Don't get me totally wrong. I am all about the concept of competitive bidding,” he explains. “I think there is a place for cost-effective programs in government. For instance, buy the cheapest toilet paper or the cheapest desk or office chairs or items shipped in bulk.”

But Jernigan quickly gets serious about the ramifications of competitive bidding for complex rehab products. He fully supports H.R. 2231, a bill before Congress that would carve complex rehabilitation out of competitive bidding.

“Complex rehab, which involves fitting wheelchairs for the most vulnerable of our citizens, should be included as an exemption from competitive bidding,” he says.

Notwithstanding the notion of dignity and independence, Jernigan says, “health and safety must always be on the forefront when considering the lowest price.”