ALBANY, N.Y., Aug. 5 Providers of home medical equipment and services across New York are proposing a fiscally responsible alternative to the mislabeled "competitive" bidding scheme currently under way in Medicare. The bidding program will actually discourage competition, reduce access to care for many of New York's nearly three million Medicare beneficiaries, and put hundreds of homecare providers in the state out of business.
"As a result of CMS' inability to create an equitable reimbursement for certain durable medical equipment items, Congress intervened and mandated competitive bidding as an alternative to the long standing methodology," said Carol Napierski, executive director of the New York Medical Equipment Providers Association (NYMEP). "The bidding program, which is scheduled to begin in several cities in New York in 2011, will change how services are provided. This complex program may result in patients needing to change their current provider. In some cases, depending upon the services, patients may have more than one provider of medical equipment."
The bidding process for home medical equipment and services (HME) is now under way in nine metropolitan statistical areas in the U.S., with an additional 91 "round two" areas scheduled to be affected next year. A recent study showed that round two areas in New York, including New York City, Albany, Buffalo, Poughkeepsie, Rochester, and Syracuse, will see more than 14,000 jobs lost.
The U.S. Department of Health and Human Services (HHS) announced last month that the first round of bidding in nine of the country's largest metropolitan areas could reduce Medicare spending for home medical equipment and services. But those savings would result from "suicide bids" from providers in this ill-advised race to the bottom that will put thousands of homecare providers out of business and reduce patients' access to care. Although Congress delayed the implementation of the bidding program in 2008 to allow for needed changes, the Centers for Medicare and Medicaid Services (CMS) ignored congressional intent and did not address the flaws that precipitated the delay. Even though the bidding was delayed in 2008, Congress cut Medicare reimbursement rates nationwide for home medical equipment in order to save the dollars the flawed bid program had been projected to save.
"As a provider in the New York Metro area who has been competing on the premise of patient accessibility to the latest technology, encouraging our patients to continue to have an active lifestyle, these rates have me very concerned," said Tom Ryan, president and CEO of Farmingdale-based Homecare Concepts, Inc. "These reimbursement rates will not sustain the required services and they will in fact create a new second tier of service and equipment choices for the elderly population in this country, mandated by a government that has decided the lowest bidder should service our most needy citizens."
"The medical equipment provider sector is offering an alternative to this complex bidding program that will yield the savings necessary while preserving the quality services for the patients and preserve the home-based benefit," added Napierski. The New York Medical Equipment Providers Association supports H.R. 3790, a bipartisan bill that replaces the Medicare bidding program with other types of cost-savings that will reduce reimbursements to home medical equipment providers but preserve patient access to medically required equipment and services in the home.
So far, the bill has 254 cosponsors in the U.S. House of Representatives with broad bipartisan support. More than half of both the Democratic and Republican delegations in the House support H.R. 3790, including two-thirds of New York's delegation. New York cosponsors of the bill include Reps. Gary Ackerman (D), Michael Arcuri (D), Timothy Bishop (D), Yvette Clarke (D), Joseph Crowley (D), John Hall (D), Brian Higgins (D), Maurice Hinchey (D), Steve Israel (D), Peter King (R), Christopher Lee (R), Dan Maffei (D), Carolyn Maloney (D), Carolyn McCarthy (D), Gregory Meeks (D), Bill Owens (D), Paul Tonko (D), Nydia Velazquez (D), and Anthony Weiner (D).
"Competitive bidding is not mother, the flag, and apple pie," said Alyce Crossman, RRT, MPS, who is vice president of Upstate HomeCare, which serves much of update New York. "It's not good old American ingenuity and free-market competition. Competitive bidding is doublespeak for a low-ball, price-fixing, company-eliminating, job-destroying program destined to degrade and diminish the choices and services provided to the sick and elderly. Such a con, spun to a money-saving tune, will result in increased expenditures due to unmet home care needs. Apparently CMS would prefer an ER visit over quality home care."
Patient and consumer groups that support the elimination of Medicare's "competitive" bidding program for durable medical equipment include the ALS Association, the American Association for Respiratory Care, the American Association of People with Disabilities, International Ventilator Users Network, the Muscular Dystrophy Association, National Emphysema/COPD Association, National Spinal Cord Injury Association, and Post-Polio Health International, among others.
Proponents of the Medicare bidding program for durable medical equipment have perpetuated several myths about the program. However, the reality is quite different.
MYTH: The bidding program will be good for Medicare beneficiaries.
REALITY: It will, in fact, reduce access to medically required equipment and services.
MYTH: The program will eliminate Medicare fraud in the durable medical equipment sector.
REALITY: The solution to fraud is better screening of providers, real-time claims audits, stiffer penalties, and better enforcement mechanisms for Medicare - steps that the home medical providers support.
MYTH: Providers will be competing on quality and price.
REALITY: The bidding program will ration care. Home medical equipment providers already compete on the basis of quality and help move people smoothly from hospitals to cost-effective care at home.
MYTH: The bidding program will make healthcare more cost-effective.
REALITY: The home is already the most cost-effective setting for post-acute care. As more people receive good equipment and services at home, the U.S. will spend less on longer hospital says, emergency room visits, and nursing home admissions.
The New York Medical Equipment Providers Association (NYMEP) was organized in 1991 as a statewide professional association for providers, manufacturers and distributors of home medical equipment. The Association represents over 160 companies throughout New York State and is committed to provide timely information, communication and education on Medicare and Medicaid reimbursement, state and federal regulations and legislation affecting the HME industry. NYMEP is the ONLY statewide HME association in New York State. NYMEP continues to provide a strong, unified voice for its members in an effort to affect adverse regulatory and legislative issues at both the federal and state level.
For more details on the bidding program, visit www.aahomecare.org/competitivebidding.
SOURCE New York Medical Equipment Providers Association