Competitive Bidding: Not the Right Program for America

U.S. Representative Tom Price, R-Ga.

Receiving health care is personal. Someone with a chronic illness or disability should be able to choose who enters their home to discuss health care issues and plans of care, according to Rep. Tom Price, a physician. He believes that is just one of the reasons why competitive bidding in its current form is not best for Medicare beneficiaries.

“Home care and durable medical equipment are areas of treatment that are most trusted to folks that are close to you,” he says. “The competitive bidding program that is required in the plan by CMS would make it so that it is an issue that is based at the federal level and not at the local level.”

And when decisions about health care are made at the federal level, there is a disconnect that does not benefit patients, Price continues. “Very few people have a real appreciation for what happens on the ground — what happens in the day-to-day aspects and the logistics of providing sick people with care.

“I don't think that [competitive bidding] was intended to do what it has done and will continue to do unless corrected. The result will be that somebody in Washington will decide what's best for somebody in small-town Georgia, Nebraska or Washington State. It simply can't work,” says Price.

“This notion that Washington can be the end-all and be-all in decision-making for health care is fundamentally flawed,” he continues. “When Congress adopts bills that put its faith and trust in the bureaucrats in Washington, they can't get to the right answer because [the bureaucracy] is not responsive.”

Price — lead sponsor of the Home Oxygen Patient Protection Act (H.R. 621), which would remove the DRA's oxygen cap and restore ownership of equipment to providers — reminds that it all comes back to patient care and relationships.

“There is no way for anybody in Washington to be able to appreciate the decades-long relationships that people build up with their local pharmacists, with their local health care provider, that can be pulled right out from under them with some ‘competitive bidding’ decision at the federal level. That's not the kind of care that anybody envisions being appropriate for America.”

U.S. Representative John Tanner, D-Tenn.

There are no bones about it, says Rep. John Tanner. Competitive bidding will lead to a limited choice of providers and limited consumer access to high-quality products and services, especially for those consumers in rural areas.

According to Tanner, the program has flaws that are readily apparent. “We are already seeing problems with the program because [CMS] has already had to extend the time periods for bids to be entered,” he points out. “Additionally, multiple problems have been identified by suppliers as they continue to try to participate in the bidding process. If CMS is having this many problems just getting the bidding process to work, I don't think that bodes well for the future of the program.”

Tanner, along with Reps. David Hobson, R-Ohio, and Mike Ross, D-Ark. (who owns an HME business), introduced H.R. 1845, which includes what they deem sensible changes to help protect consumers and still allow the marketplace to work.

“Changes such as allowing all qualified providers to participate at the selected award price and requiring that certain savings be demonstrated before moving forward are important to ensuring continued consumer access, and also ensuring that small DME providers are not totally forced out of the system,” he explains.

While Tanner says he is optimistic about a good outcome for the measure, he says that he and his cosponsors need the industry's help.

“We are still hopeful that we can get some or all of the provisions of H.R. 1845 enacted. We continue to highlight the problems that we think will be the result of the competitive bidding program,” he says.

Along with others interested in HME's future, Tanner issues an urgent appeal. “It would be helpful if beneficiaries and DME providers would contact their member of Congress and share their support of our bill and urge them to work with us on this issue by cosponsoring H.R. 1845.”