The good news is that Congress is hearing from home medical equipment providers, consumers and other stakeholders concerned about the impact that will result if the Round 2 Medicare bidding program is implemented July 1. The challenge is Congress has many other important items on their agenda, so our collective outreach efforts must continue in earnest until they take action to stop the program. Many in Congress seem genuinely concerned with the current structure of Medicare’s program and are supportive of the industry’s alternative, but they will only act if we keep the pressure on them to do so.
What messages are resonating best with Congress?—From the provider perspective, outlining the impact a 45 percent (on average) payment cut will have on the jobs created by local businesses and the inability to serve beneficiaries is the best place to start. The consumer message that really has Congress concerned is the impact the program will have on access to products and services from local providers, including repairs.
What is the solution and can it be advanced prior to implementation?—The solution is the Market Pricing Program (MPP) that includes fixes to the fundamental flaws of competitive bidding identified by economists and auction experts. Advancement of this alternative is predicated on a delay or stopping implementation of the current program, which is the real challenge. Support for this is gaining strength in the House and Senate to give Congress more time to hold hearings and investigate the program prior to the ten-fold expansion into the Round 2 areas. We can get this done, but it will require everyone’s ongoing communication with legislators.
How will the alternative fix the program and why should I support it?—The MPP alternative was designed to fix the fundamental flaws built into the structure of the Medicare bidding program. Under the MPP program:
Bids would be binding commitments, so those awarded a contract would not be able to turn it down without a stiff financial penalty and loss of bid bond/bid guarantee.
The clearing price would be used to set the single payment amounts rather than the median. This not only provides a price based on the bids submitted, but is also a true reflection of market based pricing.
The entire bid process would be completely open and transparent. Bidders would know the status of their bid almost instantly and have opportunities to modify their bid amount at various intervals prior to the bid window closing, like a reverse auction.
Bid areas would be smaller (county), which better resembles health care markets, and the number of items bid per area would be limited to two (of the eight) items. This is designed to help small businesses who do not cover the entire massive competitive bid areas (CBAs). Medicare would achieve savings by applying the prices to surrounding areas (counties) where the items were not bid.
Budget neutrality—In order for MPP, or any alternative, to stop the Medicare bidding program from being implemented July 1, it must be budget neutral according to the Congressional Budget Office (CBO). While the Round 2 payment rates make that more difficult, the revised MPP legislation accomplishes that goal in a manner that provides a bridge to allow MPP to move forward.
Continue to communicate with legislators—Call your Representative and Senators and schedule a meeting to discuss the Medicare bidding program and its impact on your company. If you have already met once or twice, meet again to update them on the alternative and need for Congress to take action prior to July 1 to stop the program. The meeting can occur in Washington, D.C. or back in one of their local offices. Talking points, position papers and the latest updates are available on the AAHomecare website, www.aahomecare.org. Don’t delay; reach out to your federal legislators today. We can and will stop this program. However, in order to do so, prior to implementation we must remain vigilant and continue regular outreach efforts to keep this issue at the forefront.
