Washington

If U.S. Senate leaders decide to combine the remaining appropriations bills into one omnibus bill, competitive bidding could pass the Senate this session without debate, according to David Williams, director of government relations at Elyria, Ohio-based Invacare.

Speaking to Medtrade attendees in Atlanta Oct. 31, Williams and Cara Bachenheimer, an attorney with the law firm Epstein, Becker & Green, estimated that competitive bidding has a 50/50 chance of passing the Senate during a two-week lame duck session slated to begin early in December.

“There is a real possibility that the 11 appropriations bills [currently on the table] will be rolled into one omnibus bill,” Williams said.

Calling this practice “the Christmas tree process,” Williams went on to explain that the resulting legislation could be 13 to 14 inches thick, and could include many of the pet projects that Senators do not want to debate. According to the rules, omnibus bills are not up for debate, he noted. Senators can vote only yes or no for an omnibus bill.

However, “there's so much in [the omnibus bill], it will be pretty much impossible to vote against it,” Williams said.

Certain to be a part of any omnibus bill is the provider giveback legislation that the American Medical Association and many key Senators support, Williams and Bachenheimer continued. One provision of that bill calls for a national competitive bidding program for durable medical equipment, inhalation drugs and orthotics.

Unlike its counterpart, which passed the House of Representatives earlier this session, the Senate's competitive bidding provision would limit the program to metropolitan areas with a population greater than 500,000. Of note is the fact that this stipulation excludes the states where the bill's authors — Max Baucus, D-Mont., and Chuck Grassley, R-Iowa — live, Bachenheimer said.

In essence, Baucus and Grassley are saying, “It's good for everyone else in the country, but not for our constituents,” she added.

Hesitant to sing the praises of competitive bidding when he addressed Medtrade attendees Oct. 29, Grassley said that the Congressional Budget Office's predictions are “gospel” on Capitol Hill. In July, the CBO predicted that DME competitive bidding could save the federal government $7.7 billion during the next 10 years, and that prediction convinced many senators the program is viable.

Grassley also explained that ensuring a Medicare reimbursement increase for doctors in Iowa is his first priority.

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