In a flurry of budget deals in mid-February, Congress eliminated the 27 percent physician payment cut for 10 months, through the end of this calendar year. This occurred on the eve of the American Association for Homecare’s Washington Legislative Conference, at which more than 300 HME providers made about 350 Hill visits, pushing Congress to support and pass the proposed Market Pricing Program (MPP). With 535 offices between the House and the Senate, that’s a 65 percent penetration rate. Not too bad for starters. Now let’s make sure we double back with those 350 offices and hit the remaining 105 offices.
MPP legislation would require the Centers for Medicare & Medicaid Services (CMS) to replace the current bidding program with a modern auction system. More than 200 economists and auction experts have publicly stated that the existing Medicare Competitive Bidding Program is unsustainable. It will create significant barriers to access and will destroy the DME infrastructure upon which our seniors and people with disabilities rely.
The MPP would replace the current bid program with a sustainable bid system, based on the detailed structural and operational recommendations of these experts. More than 30 disability and consumer groups also support the MPP.
The CMS Dynamic
At every turn, CMS pursues its own public relations campaign to engender support on Capitol Hill for what it touts as a “highly successful” competitive bidding program.
Officials with CMS issue press releases, send e-mail blasts to congressional offices and conduct briefings on Capitol Hill to further their message that the bidding program has eliminated fraud, raised quality and reduced Medicare payments by more than 30 percent. That is the message we, and by that I mean you, must counter.
How do we move forward? If we are to be successful this year in convincing Congress to pass the MPP, we must pursue every lobbying strategy available: grassroots, grasstops, professional lobbyists, political support and more. Believe it or not, congressional members really do respond to squeaky-wheel constituents.
Industry leadership continues to lobby Congress. This includes the national associations, AAHomecare and NAIMES; state and regional associations; buying groups like VGM and the MED Group; manufacturers like Invacare and Pride; and others. Still, our success will be based on whether we can raise the noise level enough to get every member of Congress asking, “What is this Market Pricing Proposal and why is it better than the CMS program?”
It’s up to you to contact your legislators about MPP now. Urge your senators and representative to pass the MPP. Here is the message every HME provider must deliver:
- The current competitive bidding system has failed and must be replaced at the earliest legislative opportunity.
- MPP is a sustainable market pricing system for HME.
- MPP includes the same HME items as the current bidding program and is implemented across the country in the same time frame.
- Two product categories are bid per geographic area. Eight additional product categories in that same area would have prices reduced based on auctions conducted simultaneously in comparable geographic areas.
- Bid areas are smaller than metropolitan statistical areas (MSAs) and more homogeneous.
- Bids are binding and cash deposits are required to ensure only serious bidders participate; the bid price is based on the clearing price, not the median price of winners.
- The same areas that are exempted under the current bidding program will be exempted under MPP.
When Congress in mid-February patched together yet another temporary fix for the physician payment formula, we lost a potential legislative vehicle for MPP. While some despaired, it is not our last opportunity. This is an election year, when Congress tends to pass fewer laws. But there will be additional legislative vehicles. We must garner support to have our proposal attached to another piece of legislation this year. We are also pursuing a parallel strategy of getting “stand-alone” bills introduced in both the House and the Senate. Don’t delay—contact your legislators today.
HomeCare, March 2012
