Medicare Reform Bill Passes, Includes Competitive Bidding

WASHINGTON — After months of intense debate and political infighting, including a pre-dawn vote in the House of Representatives and a day-long showdown in the Senate, Congress passed a sweeping Medicare reform bill in late November. At press time, President Bush was expected to sign the measure into law on Dec. 8.

Negotiated in conference committee since the summer, the final version of the reform package is a compromise agreement that gained late favor after endorsement by AARP, the powerful seniors group with 35 million members. The main component of the legislation, which marks the first major overhaul of Medicare in its 38-year history, is a new prescription drug benefit for the 40 million beneficiaries now covered by the vast government program. But the bill's provisions also include a number of measures — chief among them competitive bidding on DME — that involve major changes for home medical equipment providers and the way they conduct their business.

While proponents of the bill — including the President, who had repeatedly called for such a measure — say it will modernize Medicare, its opponents have grappled with the bill's scope and its costs, estimated at $395 billion over 10 years.

“The big drug manufacturers and pharmacy benefit managers hired by the big insurance companies won a major victory with the passage of the so-called Medicare Prescription Drug bill,” Rep. Mike Ross, D-Ark., said in a statement after the Nov. 22 House vote, which was held open for a record two hours and 51 minutes. “Regardless of political party affiliation, it can be agreed the Medicare Prescription Drug bill passed by the Republican leadership offers nothing more than a false hope and a false promise for our seniors.”

DME Takes a Hit

Ross, who owns an Arkansas HME business with his wife, told an audience at Medtrade in October that drug companies have more than 600 lobbyists on Capitol Hill and donated more than $100 million to political campaigns over the last three years.

Though a smaller Washington voice, the HME industry lobbied hard against competitive bidding provisions in the bill, which Ross said will limit competition, limit choice and hurt patients. A months-long grassroots effort, spearheaded by the American Association for Homecare and supported by manufacturers, buying groups and affiliated health care organizations, included more than 20,000 letters to Congress from HME providers and their customers.

DME provisions in the bill include: