While much of the political conversation this summer has been focused on President Bush's Supreme Court nominee, it's time for us to focus on an issue
by Cara C. Bachenheimer, Esq.

While much of the political conversation this summer has been focused on President Bush's Supreme Court nominee, it's time for us to focus on an issue that will have a nearer-term impact on our businesses and the consumers we serve: competitive bidding.

It's now less than 18 months until CMS will begin implementation of this ill-conceived policy, which Congress mandated in 2003 under the Medicare Modernization Act, and we have much work to do to make better of a bad situation. What can you do? Plenty.

Since Reps. David Hobson, R-Ohio, and John Tanner, D-Tenn., are proposing a bill in the House of Representatives that would modify national competitive bidding for DME, it is time for you to make sure your state's representatives sign on to that bill as co-sponsors. At press time, a companion bill in the Senate also was expected. You should do the same thing with your senators to get co-sponsors to this bill.

CMS will soon issue its proposed regulation on competitive bidding, and there are opportunities to make sure your voice is heard in that forum.

Start with this action plan:

First, communicate with your members of Congress, both representatives and senators, how you feel about competitive bidding. Write a letter, make a visit to the district office or pick up the phone and call the health staff.

When your congressional representatives hear nothing, they assume that everything is fine. Remember that you are the ones who need to keep your representatives informed. If you are not happy with a particular policy, i.e., competitive bidding, let your representatives know.

Second, enlist your congressional members to sign on as co-sponsors to the bills that have been introduced in the House and Senate. Need talking points about the bills? Try these:

  • The bill does not repeal “competitive acquisition” (the government's term for competitive bidding) for DME. It simply seeks to make modest changes to the structure of the bidding program in order to ensure that beneficiaries' access to DME is maintained, to protect small business providers of DME and foster a dynamic marketplace for Medicare-reimbursed DME.

  • Any proposed change in the Medicare program can be a difficult adjustment for seniors. Whenever possible, Medicare policy should not disrupt established relationships between seniors and their health care providers, including DME providers. These bills aim to minimize the impact that any senior may see from competitive acquisition of DME.

  • The most innovative and cost-effective health care marketplace is one in which a large number of suppliers are competing for business. Approximately 80 percent of DME suppliers are small businesses that may be ill-equipped to participate in the federal contracting process. Additionally, they are less likely to be able to withstand significant disruptions to their businesses. However, small providers are an important part of the DME marketplace, so this legislation aims to make competitive acquisition work for them.

Seniors are the real benefactors here. If a significant portion of small suppliers are eliminated because of the federal contracting process, competition in the marketplace will diminish, prices will increase and quality will erode. Rep. Hobson's bill aims to prevent that.

On the regulatory side, it is important that as many suppliers as possible participate in CMS' meetings on the draft regulation on competitive bidding to provide comments and recommendations for any changes to the proposed rule.

CMS has said it will publish the proposed regulation later this summer. After publication, CMS will hold another meeting of the Program Advisory and Oversight Committee, which is advising the agency on the implementation of DME bidding, as well as an Open Door meeting. Anyone can attend these meetings, and it is a great way to provide CMS with your reaction to the details in the proposed rule, as well as your recommendations for changes.

To keep track of CMS' announcements on DME competitive bidding, check its Web site at: http://www.cms.hhs.gov/suppliers/dmepos/compbid/default.asp.

A specialist in health care legislation, regulations and government relations, Cara C. Bachenheimer is vice president, government relations, for Invacare Corp., Elyria, Ohio. Bachenheimer previously worked at the law firm of Epstein, Becker & Green in Washington, D.C., and at the American Association for Homecare and the Health Industry Distributors Association. You can reach her by phone at 440/329-6226 or by e-mail at cbachenheimer@invacare.com.