Rep. Kendrick Meek, D-Fla., introduced a bill this afternoon to repeal DMEPOS competitive bidding, offering a series of minor cuts and a Consumer Price Index freeze as a "pay for" instead. The provisions would replace the bidding process currently mandated by Congress.

"I think the chances of passing are going to be very good," said Barry Johnson, president of the Texas Alliance for Home Care Services (TAHCS). "We have been meeting with folks on the [House Ways and Means Committee], and we have found very little resistance to a bill that accomplishes the same thing that the competitive bidding process was designed to accomplish, but without all the flaws and problems — and without restricting patient access to care."

According to Sean Schwinghammer, an advisor to the Accredited Medical Equipment Providers of America (AMEPA), H.R. 3790 is budget-neutral, calling for cuts in all DME — except group 3 complex rehab — of 0.25 percent for three years and a single 0.5 percent cut two years later, combined with a CPI freeze.

"AAHomecare reviewed the actuary figures, which, when added to the 9.5 percent cut we took in January 2009, is equal to 19.5 percent," Schwinghammer said in a release issued by AMEPA. "That's the same savings projected from the demonstration projects, which the program was based on."

In a letter to members of Congress asking for support of his legislation, Meek wrote:

"The Medicare competitive bid program for durable medical equipment and services (Title XVIII of the Social Security Act) began in July 2008 as a well-intentioned effort to improve quality of service and eliminate excess costs in Medicare. However there was nothing competitive about the misconceived program. There are serious flaws in the bidding process which produced few competitors, fewer home care services and a decrease in the quality health care [for] those with disabilities who require the right care and equipment in order to live.

"Congress delayed the program only two weeks after it began, in a clear acknowledgement that the bidding process was deeply flawed and needed fixing. For example, contracts were awarded to suppliers without a physical location in or near the bid area and who were unable to provide the equipment or services to patients; unlicensed providers (in violation of state standards); and fly-by-night operations with no experience in providing bid items.

"However, in the 14 months since the competitive bidding program has been delayed, no significant improvements have been made to the process. In October 2009, the program is due to begin again. We cannot allow it to restart."

CMS has set Oct. 21 as the target date for opening the Round 1 rebid. In the 2008 Round 1, reimbursement reductions averaged 26 percent. According to a recent HomeCare survey in conjunction with global investment firm William Blair and Co., 26 percent of participating providers believe a winning bid this time around would have to be at least 20 percent or more under current allowables; another 23 percent think a successful bid would have to be at least 15 percent lower.

The new bill has 16 initial cosponsors, including at least one representing every Round 1 competitive bidding area:

Jason Altmire, D-Pa.
John Boccieri, D-Ohio
Jo Ann Emerson, R-Mo.
Sam Farr, D-Calif.
Marcia Fudge, D-Ohio
Alcee Hastings, D-Fla.
Eddie Bernice Johnson, D-Texas
Ron Klein, D-Fla.
Dan Maffei, D-N.Y.
John Murtha, D-Pa.
Tim Ryan, D-Ohio
Heath Shuler, D-N.C.
Glenn Thompson, R-Pa.
Patrick Tiberi, R-Ohio
Debbie Wasserman Schultz, D-Fla.
Robert Wexler, D-Fla.

TACHS' Johnson hopes to see at least 100 cosponsors. "That would certainly be dramatic," he said. "Bills that have 100 cosponsors generally don't fail."