Main Category: Medicare / Medicaid / SCHIP
Also Included In: Caregivers / Homecare
Article Date: 01 Apr 2011 – 2:00 PDT
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Citing reduced access to care and higher costs, two dozen consumer and patient advocacy organizations sent a letter of thanks this week to Reps. Glenn Thompson (R-Pa.) and Jason Altmire (D-Pa.) for introducing H.R. 1041, a bipartisan bill to repeal the controversial Medicare “competitive” bidding program for home medical equipment and services (HME). To read the full letter and to see the full list of supporting organizations, visit here.
Among the groups signing the letter are the Muscular Dystrophy Association, the American Association of People with Disabilities, and the National Family Caregivers Association. Titled the “Fairness in Medicare Bidding Act,” H.R. 1041 was introduced on March 11 and has already gained 53 cosponsors, including 30 Republicans and 23 Democrats.
The Medicare bidding program applies to home medical equipment and services, such as medically required oxygen therapy, enteral nutrients (tube feeding), continuous positive air pressure (CPAP) and respiratory assistive devices, power wheelchairs, walkers, hospital beds and support surfaces, and mail-order diabetic supplies. The bidding program was implemented on January 1, 2011 in nine metropolitan areas including Charlotte, Cincinnati, Cleveland, Dallas-Fort Worth, Kansas City, Miami, Orlando, Pittsburgh, and Riverside, California. The program is scheduled to expand to an additional 91 areas later this year.
The letter underscores the challenges that Medicare beneficiaries and homecare providers face as a result of Medicare’s controversial bidding program. The letter states:
“The competitive bidding program is a fundamentally flawed pricing mechanism that will create significant obstacles to quality patient care and needed services while threatening the homecare infrastructure for our nation’s seniors and persons with disabilities. Competitive bidding restricts access to, and choice of, HME items and services by forcing consumers to use certain home medical equipment providers whether they furnish the products and services that provide the most benefit to patients or not. In addition, rather than lowering costs, competitive bidding is increasing them.”
The organizations signing the letter in support of H.R. 1041 include:
– ALS Association,
– AlphaOne (Maine Center for Independent Living),
– American Association of People with Disabilities,
– American Foundation for the Blind,
– American Sleep Apnea Association,
– American Therapeutic Recreation Association,
– Association of Assistive Technology Act Programs,
– Association of Programs for Rural Independent Living,
– Association of University Centers on Disabilities,
– Brain Injury Association of America,
– Christopher and Dana Reeve Foundation,
– International Ventilator Users Network,
– Long Island Center for Independent Living,
– Muscular Dystrophy Association,
– National Association of the Deaf,
– National Council on Independent Living,
– National Emphysema/COPD Association,
– National Family Caregivers Association,
– National Spinal Cord Injury Association,
– Post-Polio Health International,
– Statewide Independent Living Council of Georgia,
– Three Rivers Center for Independent Living,
– UCP/CLASS (formerly UCP Pittsburgh), and
– United Spinal Association.
In addition to the patient groups listed, several medical and long-term care groups support H.R. 1041, including the American Association for Homecare, the National Association for Home Care and Hospice, the National Association for the Support of Long Term Care, and UPMC (University of Pittsburgh Medical Center).
By design, this new Medicare program severely restricts the number of companies that are allowed to provide the equipment and services that are subject to bidding. Since the bidding program began in the initial nine areas on January 1, 2011, patients, clinicians, and homecare providers have reported:
– Difficulty finding a local equipment or service provider;
– Delays in beneficiaries obtaining medically required equipment and services;
– Longer than necessary hospital stays due to trouble discharging patients to home-based care;
– Far fewer choices for patients when selecting equipment or providers;
– Reduced quality; and
– Confusing or incorrect information provided by Medicare.
In November, 2010, 167 leading economists including two Nobel laureates and auction experts who have experience in the design and application of auctions around the world warned Congress that Medicare’s bidding design for medical equipment will fail. Those experts, who design market-based auction systems and do not oppose the concept of using a competitive bidding system to set Medicare prices, found that this particular bidding program has irreparable flaws that will prevent it from achieving its objectives of low cost and high quality equipment and services.
Tyler J. Wilson, president and CEO of the American Association for Homecare, commented, “Homecare is already the most cost-effective setting for post-acute care, and total Medicare spending on home medical equipment and services has dropped severely in recent years. This bidding system is merely a badly designed solution in search of a problem.”
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