WASHINGTON--Just before Congress broke for its summer recess, Reps. David Hobson, R-Ohio, and John Tanner, D-Tenn., introduced a bill Thursday that would modify the Medicare Modernization Act and help to ease some effects of its DME competitive bidding mandate.

For more than a month, the industry has been awaiting introduction of the proposed legislation, which among other things, aims to ensure that small providers can participate in the bidding program, required under the MMA to begin in 10 of the country's largest metropolitan statistical areas in 2007.

Called the Medicare Durable Medical Equipment Access Act of 2005, or H.R. 3559, the bill would:

• require that competitive bidding not be implemented until quality standards are in place;
• exempt small rural (populations under 500,000) MSAs;
• allow all qualified providers that are small businesses and that submitted a bid below the current allowable to participate at the selected award price;
• restore the right of providers participating in the program to administrative and judicial review;
• exempt items and services from bidding unless savings of at least 10 percent can be demonstrated, compared to the fee schedule in effect Jan. 1, 2006;
• protect beneficiary access to care by requiring CMS to conduct a comparability analysis for areas that are not competitively bid to ensure the rate is appropriate to costs and does not reduce access to care; and
• subject the Program Advisory and Oversight Committee--a 22-member industry panel charged with advising CMS on implementing the program--to the Federal Advisory Committee Act, which requires public access to meetings and proceedings.

"Our goal is to make sure that seniors who depend on quality durable medical equipment can continue to have access to it through Medicare," said Hobson, who has been one of Congress' top HME industry supporters. "Part of making that happen is to ensure that small suppliers can continue to compete in Medicare's bidding process, which is what we are doing with our bill."

Reaction from the industry was upbeat.

"Since we can't make competitive bidding go away, this is the next best thing we could have asked for," said Karyn Estrella, executive director of the New England Medical Equipment Dealers Association and chair of the American Association for Homecare State Leaders Council. "We've heard from some providers who have come to the conclusion that if they lost a bid in a major product category, their company would go out of business. It has put everybody in a sense of panic. We need something that is going to protect the small provider--and this legislation will really do that."

According to Seth Johnson, director of government affairs for Exeter, Pa.-based Pride Mobility, "Overall it's a really good bill. It does not repeal competitive bidding but makes some important modifications prior to going forward with implementation [of the competitive bidding program]."

Johnson said he believes the bill has a "strong chance of passing" if it receives the same or greater level of support shown by the industry last year when Hobson introduced a bill that would have repealed the MMA's FEHBP-based reimbursement cuts. "There's a lot of work that needs to be done during the August recess to the extent we as an industry are able to galvanize behind this bill and meet with legislators and try to get co-sponsors," he said.

AAHomecare, state associations and other industry leaders are urging providers and other stakeholders to set up meetings with their congressional members during Congress' August recess to show support for the measure. "As a small businessman, I know that the small business provisions of this bill are critical to thousands of home care providers and the patients they serve," said Tom Ryan, AAHomecare chair and president and CEO of Homecare Concepts, Farmingdale, N.Y. "We will be working very hard in the months ahead to build a groundswell of support for this vital legislation."

"This is the exciting first step to get some real and positive changes to competitive bidding," said Cara Bachenheimer, vice president of government relations for Elyria, Ohio-based Invacare Corp. "The industry now needs to mobilize across the country, asking each and every representative to sign on as a co-sponsor. We need a critical mass of support to make sure these changes get made into law, and the August recess is the perfect time to visit your representative, write him or her, and ask them to sign on as co-sponsors."

The text of the H.R. 3559 should be available shortly at http://thomas.loc.gov.

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