Our industry has been working double-time to convince Congress to delay competitive bidding and raise awareness about bidding problems. Efforts to educate policymakers and the consumer press have produced a lot of good will in Congress and better coverage of the issue in the media. But the heavy lifting is not over.
During the American Association for Homecare Medicare Bidding Fly-in on May 21, more than 160 home care advocates lobbied Congress, asking for an 18-month delay in round one of bidding. The purpose for the delay is to give Congress both an opportunity to assess the many complex problems with competitive bidding and provide some time to determine how to address those issues.
AAHomecare Chairman Alan Landauer, of Landauer Metropolitan, noted during the fly-in that the efforts to stop round one of the Medicare competitive bidding program “started with a groundswell of grassroots noise.” And now, he said, “We stand on the precipice of a delay of round one and round two and the potential to defeat competitive bidding.”
The home care advocates asked their U.S. representatives to sign a letter addressed to leaders of the House Ways and Means Health Subcommittee asking them to “support legislation this year to delay the implementation of this program until outstanding issues can be resolved.” Nearly 130 members of the House agreed to sign the letter in support of a delay.
For the home care community to have a reasonable chance for achieving a legislatively mandated delay, we must be willing to pay the cost of postponing the program. This is the reality of working within the “pay-as-you-go” fiscal environment imposed by Democrats in Congress as well as the general belt-tightening in Washington.
Under the direction of the AAHomecare Executive Committee, the association has indicated to the House and Senate its willingness to discuss an across-the-board reduction in Medicare payments for all HME items as an offset for the cost of delaying competitive bidding. At press time for this column, the industry is awaiting credible dollar figures from the Ways and Means Committee as to the actual offset needed to pay for the proposed delay in bidding.
With those numbers in hand and with our own independently conducted assessment of the costs, we will be able to determine the magnitude of an across-the-board reduction needed and whether it is practical for the industry to agree to such a cut. In broaching the subject of a broad cut to HME, we have insisted to the House and Senate that our assent to such a reduction is contingent upon that particular cut being the only one imposed on the industry this year.
At the same time advocates were having meetings with their members of Congress during the May 21 fly-in, the House Small Business Subcommittee on Rural and Urban Entrepreneurship was holding a hearing on competitive bidding.
Small providers representing the American Association for Homecare, the North Carolina Association for Medical Equipment Services (NCAMES), and VGM presented testimony on the many problems and harms created by the bidding program. Casey Hite, vice president of Aeroflow Healthcare in Asheville, N.C., spoke on behalf of AAHomecare and NCAMES, saying the bidding program is showing the serious breakdowns that the industry had predicted.
All of this momentum has accelerated discussions in the House and Senate. We continue to press our case for a delay with key forces on Capitol Hill through the industry's substantial grassroots network and through the media.
Let's keep up the momentum and stay committed to this race by continuing to contact legislators, stressing the importance of a delay. Also, talk to others in your community who will be affected by competitive bidding — patient groups, associated health professions and seniors groups.
Emphasize the urgency of stopping this program. The harm from the bidding program extends far beyond our industry.
Tyler J. Wilson is president and CEO of the American Association for Homecare, headquartered in Arlington, Va. He may be reached at tylerw@aahomecare.org. For more information on critical home care issues, visit the association's Web site at www.aahomecare.org.
