Thursday, July 31, 2008

NBC Nightly News Botches Story on Competitive Bidding

NBC Nightly News aired a piece on competitive bidding on Saturday, June 26, 2008. To view the piece visit:

AAHomecare responded to the piece with the following e-mail on July 29:

NBC News
Washington, DC

Thanks for hearing me out regarding your segment on Saturday, July 26, “Congress delays Medicare cost-savings bill.” [NBC Nightly News, link:] As I mentioned, your segment is wrong on the central issue – savings for taxpayers, and it is misleading on other points. We would appreciate a correction or a follow up segment that adequately addresses at least these two issues:

First, you do not explain the full cost savings in the recent Medicare bill, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). In order to get the reforms and delay in the competitive bidding program under congressional pay-go rules, the durable medical equipment (DME) industry agreed to a nationwide reimbursement cut, plus it will forgo a CPI reimbursement adjustment, which will, according to the Congressional Budget Office, completely offset and possibly over pay for the savings that the flawed bidding program would have reaped. If you need documents from CBO to review, we would be happy to provide them. As you should know, CBO is the final word – the only word – when it comes to what a law will cost. MIPPA saves taxpayers more than a billion dollars in lower reimbursement payments to the DME industry. That makes the title of your segment, and the entire point, misleading at best. Again, the bidding program was not “stopped dead in its tracks” as the lead-in suggests. It was delayed in order to correct the massive problems associated with its implementation.

Second, you fail utterly to account for services required in providing home oxygen therapy or a walker, the two examples of “over-payment” that you cite. As you well know, you can’t just leave an oxygen concentrator at the front door of a senior with COPD who depends on oxygen in order to live. It requires 24-7 on-call service, patient education and compliance, maintenance, delivery, and of course all of the required paperwork if the provider is to have a prayer of getting reimbursed by Medicare. Even a walker ($110) must be delivered, often in conjunction with hospital discharge which can occur at virtually any time (Friday evenings, weekends), it must be adjusted for the height of the user, and instruction is required. The whole point of a walker is what? To prevent falls. To promote safety and independence in the home. To keep the person out of the ER or nursing home. So the typical Medicare user does not have the luxury of driving to Wal-Mart (which charges $70, you say) and taking it home and setting it up on the day they arrive home from the hospital. The higher price in Medicare offsets the delivery and services tailored to the Medicare beneficiary, who is in the cheapest care setting possible – his or her own home. Moreover, the government study you cite only examined equipment costs, by their own admission, leaving an incomplete accounting of what it costs to actually provide these items in the manner required to Medicare beneficiaries.

Finally, your contention you made over the phone that the Centers for Medicare and Medicare Services (CMS) is transparent in its information and decision-making is sadly wrong. And you seem to assume that there are no politics or spin in play from your government sources.

Our industry, which represents about $8 billion in annual Medicare spending (out of about $430 billion annually in Medicare), just agreed to give up $1 billion, which will reduce taxpayers’ burden. That will be a hard pill to swallow from many of our mom-and-pop providers who have served their communities for decades, and we have heard an earful from them since it’s gotten much harder to stay in business given lower Medicare and Medicaid reimbursement rates and skyrocketing transportation costs. But in the meantime, we help save Medicare money by keeping people out of institutions, receiving quality services and equipment at home. It’s a shame you were not able to convey any information along those lines.

Your viewers deserve to understand what’s going on in Washington and they can’t do that without accuracy and context, both sorely lacking in your piece.

1 comment:

Anonymous said...

Well done follow up, an additional aspect I'd like to see discussed in future conversations is the Medicare payment delays and issues we face in reimbursement; in the favored scenario of a Wal-Mart purchase, the beneficiary/consumer pays right then and the transaction is closed, not so with us. It's another consideration and a valid one when it comes to justifying the higher costs we bear and charge.