Since the Medicare DMEPOS "competitive" bidding program went live Jan. 1 in the initial nine bid areas, we've been trying to keep a close watch on what is happening with consumers, discharge planners, referral sources, contract suppliers and providers that did not win a contract. Many on Capitol Hill are waiting to hear, and we must be poised to relay the information.
In the meantime, it's important to frame our competitive bidding issues within the context of what the new House Republican leadership has identified as its priorities for the 112th Congress.
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Jobs and spending: Both President Obama and the new House Republican leadership have articulated that job creation is their No. 1 priority. On Jan. 18, President Obama issued an executive order that begins, “Our regulatory system must protect public health, welfare, safety and our environment while promoting economic growth, innovation, competitiveness and job creation.”
The Centers for Medicare and Medicaid Services has developed a regulation to implement the DMEPOS competitive bid program that will have the exact opposite effect. Innovation, competitiveness and job creation will be directly thwarted by the manner in which CMS has chosen to fulfill Congress' objective.
In fact, the CMS bidding program is striking in its direct contrast to the president's executive order, which also states in relevant part: “I am directing federal agencies to do more to account for — and reduce — the burdens regulations may place on small businesses … Small firms drive growth and create most new jobs in this country. We need to make sure nothing stands in their way.”
Just a couple of weeks before the president issued the executive order, Rep. Darrell Issa, R-Calif., the new chairman of the House Committee on Oversight and Government Reform, issued a public request to provide his committee with examples of federal regulations that have a negative impact on job growth. Our industry provided details of the Medicare bidding program, citing projections that the program will likely eliminate almost 100,000 jobs once Round 2 is implemented.
We can expect this committee to take the lead in the House in examining federal regulations that harm job growth. It will be important to illuminate how CMS' irrational bid system will likely eliminate almost 90 percent of the providers that have traditionally served the bid areas (based upon the results of the Round 1 rebid).
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“Regular order:” Speaker of the House John Boehner, R-Ohio, has announced that he intends to bring the House back to “regular order.” This means that House leadership will put the responsibility on the committees of jurisdiction to develop legislation through the traditional committee process, rather than having the leadership determine legislative details.
Importantly, this means that the chairmen of the House Ways and Means and Energy and Commerce committees and their Health Subcommittee chairmen will be instrumental in determining whether bills move through those committees for floor consideration. The message for us is that we must work collectively to develop the support of these chairmen and focus on the Republican members of these committees.
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The Senate still requires 60 votes to move any controversial bill: On the Senate side, we must continue to work with every single office to garner support. The Democrats still retain a majority but do not hold 60 seats. This means that Republicans and Democrats, as well as Senate leadership, will be instrumental in moving legislation through this chamber.
On the House side, 257 Republican and Democratic members in the last Congress signed on to H.R. 3790, the bill that would have repealed the entire bidding program. While e lost about 60 of those supporters, there are 60 freshmen House members who need to be educated about the CMS program.
Let's start with the list of 91 metropolitan areas that are slated for inclusion in Round 2 and the representatives from those areas. This translates to a long “to do” list for providers and state associations across the country.
Read more Washington Wit & Wisdom columns. View more competitive bidding stories.
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 at 440/329-6226 or cbachenheimer@invacare.com.
