WASHINGTON (March 10, 2015—Since the implementation of the Medicare Durable Medical Equipment Competitive Bidding program which first began implementation 2008, several serious instances have occured where patients have suffered a disruption of service and access to care as it relates to durable medical equipment, particularly many patients who require supplemental being denied their accustomed and prescribed modalities of supplemental oxygen.
The COPD Foundation has worked with the Medicare system and patients to ameliorate these problems and has supported policy changes to improve the competitive bidding program. With the understanding that supplemental oxygen is a critical component of a lung-impaired individual's health, wellbeing and quality of life, and in an continuing effort to mitigate the detrimental effects our patient community is experiencing as result of the new competitive bidding program, the COPD Foundation is partnering with People for Quality Care, an organization focused on educating Medicare beneficiaries regarding health policy changes and their rights under the current Medicare rules and regulations.
This partnership will afford the ability to jointly collect data on patient access issues to aid conversations with the Centers of Medicare and Medicaid (CMS) and Congress about how patients have been impacted by competitive bidding. By collecting patient stories, the COPD Foundation and People for Quality Care are demonstrating that, while competitive bidding may be saving CMS money, it is harming patients across America.
Competitive bidding has changed the way that CMS pays for home oxygen supplies by requiring durable medical equipment (DME) companies, who provide home oxygen supplies, to compete for, and be awarded contracts by CMS in order to be providers for CMS patients. Since companies have to bid to receive CMS contracts, DME companies who lose their bids are no longer eligible to continue supplying for Medicare or Medicaid patients; meaning some beneficiaries will have to change DME companies to continue to receive their current home medical equipment. This has resulted in service disruptions and confusion for patients. Many smaller and local DME companies are being forced to close their doors because they are unable to compete with the low bids of some larger national companies.
As competitive bidding begins its last stage in the coming year, rural DME suppliers, in particular, may no longer be able to provide the services their clients require, and many will no longer be able to remain in business.
"It is unfortunate how this policy has changed the landscape of health care in the United States," comments Kelly Turner, director of advocacy from People for Quality Care. "As we embark on an exciting partnership with the COPD Foundation, we look forward to coming up with strategies to ensure that health care remains local and accessible for Medicare patients."
Many patients depend on the more portable, yet more expensive, liquid oxygen in order to manage their disease while remaining active. But, unfortunately, in order to maintain profitability, many DME companies are no longer offering liquid oxygen, forcing many high-flow and physically challenged individuals to experience the loss of their mobility outside the home. Maintaining productive and active lifestyles is a key component in the management of COPD.
"Isolation and depression are common side effects of COPD and are robbing patients of many years of their productive [lives], said Dan Buck with the PEP Pioneers, one of the nation's longest running COPD support groups. By impeding mobility we are in fact putting these patients at severe risk.
COPD Foundation state captain Jim Nelson worries about the long term effects on both COPD patients and our healthcare system; "given the inability to obtain adequate oxygen and supplies, the patient will become more homebound, more invisible. With the resultant lack of activity and social interaction, many patients will grow weaker, more susceptible to exacerbations. This will likely result in the necessity for much more expensive medical treatment in an ER or hospital setting. Thus, any money saved through the DME bidding program will be vastly overshadowed by the increased costs of the more dramatic procedures." Bill Clark, COPD Foundation director of patient support and outreach, stated,"This is not a war against oxygen suppliers; it is about giving our patients the quality of care they need and are indeed entitled to. Many COPD patients are looking to experience a higher quality of life, and in many cases are still in the workforce. We owe it to these individuals to provide for their mobility and not just try and keep them alive. Savings are nice, but not when they impair the physical and mental health and quality of life of millions of Americans...We can and must do better."
Together, the COPD Foundation and People for Quality Care are working with other partner organizations and patient advocates to focus on the needs of patients as the Competitive Bidding program expands with the goal of protecting patient access to quality care.
