Pittsburgh Post-Gazette Reports Patient Impact of Bidding Program

When speaking of the Medicare competitive bidding program for durable medical equipment, " 'Competitive' is a misnomer of Orwellian proportions," said John Shirvinsky, executive director of the Pennsylvania Association of Medical Suppliers. "You cannot eliminate nine out of 10 competitors from the market and expect to achieve a competitive result."

Shirvinsky was quoted in a November 29 article titled “Upcoming limits worry device providers” in the Pittsburgh Post-Gazette. The article describes western Pennsylvania as home to 479 durable medical equipment providers who are gravely concerned about the new bidding process which will limit the number of companies that can serve Medicare patients.

Bidding for the program will close December 21 and CMS will announce next year the successful bidders for contracts, which will begin in January 2011.

"We're very concerned that if we again end up with a small number of inexpert bidders that we're going to consistently be getting equipment that isn't right for us," said Lucy Spruill, a cerebral palsy patient and director of public policy for United Cerebral Palsy of Pittsburgh.

The article and Spruill’s quotes were prompted by a recent conference call organized by Shirvinsky to examine the misguided bid program and push congressional legislation to end it. The article explains:

“A bill introduced in the House of Representatives by Rep. Kendrick Meek, D-Fla., would repeal the competitive bid program. It has garnered 75 co-sponsors, including Reps. Jason Altmire, D-McCandless; Tim Murphy, R-Upper St. Clair; John Murtha, D-Johnstown; Kathy Dahlkemper, D-Erie; and Glenn Thompson, R-Centre. The bill also would phase in price reductions, which Mr. Shirvinsky said would produce the same savings without upending the industry.

‘I understand why in terms of the Deficit Reduction Act and with this competitive bidding why this was looked at, but really it was misguided,’ said Mr. Thompson, who worked in rehabilitation services before running for Congress.

In 2008, Mr. Altmire played a role in pushing back the implementation of competitive bidding because, he said, the focus on cost was too shortsighted. ‘Cost is certainly a part of it, but so is the quality of care you're seeing, so is the fact that local suppliers are a part of our communities,’ Mr. Altmire said.”

To read the full article, visit http://www.post-gazette.com/pg/09333/1017132-114.stm#ixzz0YGzkifJE.

"Oxygen Rules Pinching Patients," Reports Wall Street Journal

A Wall Street Journal piece, "Oxygen Rules Pinching Patients," published Nov. 24, 2009, outlines the challenges faced by both patients and durable medical equipment providers due to new Medicare oxygen policies.

The article states the rules are "leaving patients scrambling to find new providers. The new payment rules, effective Jan. 1, affect the more than one million people who rely on Medicare to pay for oxygen services, which relieve the symptoms of conditions such as emphysema and chronic obstructive pulmonary disease.

'It's totally penny-wise and pound-foolish,' says Barbara Renzullo, a nurse and case manager at Massachusetts General Hospital in Boston. Some patients, unable to find a new supplier because their reimbursement rate has fallen so far, 'wind up in the hospital.'"

To read the full article, visit
http://online.wsj.com/article/SB10001424052748704779704574553853254763272.html

For further information about oxygen policy changes, visit www.aahomecare.org/oxygen.

CBS Affiliate in Knoxville, Tenn. Explores Value of Homecare

“The place you often get the most bang for your buck is the home,” said Randy Wolfe of Lambert’s Health Care in a television news segment about home medical equipment that aired Monday on WVLT, the CBS affiliate in Knoxville, Tenn.

WVLT zeroed in on the fact that home medical services have been disproportionately cut in the past few years despite the fact that homecare is cost-effective. The TV crew interviewed F. Scott Tygert, a 72-year old patient with sleep apnea who appreciates the price and independence that homecare provides. In addition to several quotes from Randy Wolfe, owner and president of Lambert’s Healthcare in Knoxville, the segment used footage from the Lambert’s facility in Knoxville.

“Part of the solution is to drive people away from … expensive care when they don’t need it, and keep them healthy and active at home as long as they can. Part of the solution in reform is reform where health care is taking place,” said Wolfe.

The segment also included a comment from Congressman Jimmy Duncan (R-Tenn.). To view the segment and leave a comment, visit http://www.volunteertv.com/health/headlines/70247582.html.

November is National Homecare Month--Sign the Petition to Save Homecare

During November – National Homecare Month – the American Association for Homecare celebrates the thousands of dedicated professionals who provide cost-effective and consumer-preferred homecare. Thanks to home medical equipment and service providers, millions of seniors and people with disabilities will share Thanksgiving and other holidays with their families in the comfort of their homes.

Homecare provides tremendous value to more than eight million Americans who require some type of medical care in the home. A cost-effective alternative to institutional care, home medical equipment can be provided and maintained for just dollars a day, which is why homecare is an important part of the solution to our nation’s healthcare crisis.

Over recent years, however, the homecare sector has been the target of a long series of deep and disproportionate cuts by Congress. These cuts have a negative impact on the ability of homecare providers to furnish high-quality equipment and services to the people who require them.

In honor of National Homecare Month, the American Association for Homecare urges homecare patients, their families, and care providers to speak up for homecare and call or email their members of Congress and ask them to “Please stop cuts to homecare.” Sign the online petition to Save Homecare at http://www.thepetitionsite.com/1/save-homecare.


To learn more about how you can help save homecare, please visit: www.aahomecare.org/athome.

Representatives Altmire and Thompson Address the Value of Homecare and the Importance of Eliminating the Flawed Bidding Program

During a call with the media this week, U.S. Representatives Jason Altmire (D-PA-04) and Glenn “GT” Thompson (R-PA-05) voiced support for H.R. 3790, a bill that would eliminate the bid program and at the same time reduce Medicare spending, preserve access to quality homecare, and save thousands of small businesses. The bill, introduced by Rep. Kendrick Meek, D-FL, on October 13th, has already gathered strong bipartisan support from 70 members of Congress, and numerous national disability groups.

“CMS’s competitive bidding program was flawed from the beginning, and unfortunately it is has not improved over time,” U.S. Congressman Jason Altmire (PA-04) said. “There is still ample reason to believe that CMS’s competitive bidding program would greatly hurt small businesses and make it harder for seniors to obtain the specialized medical equipment that they need. The common sense legislation we have proposed would eliminate this flawed program and protect seniors and small businesses without adding one penny to the federal deficit.”

“Competitive bidding, as CMS has framed it, is anything but competitive,” said U.S. Congressman Glenn “GT” Thompson (PA-5). “Looking at savings solely on a balance sheet is not a smart government solution. If the number of smaller home providers of durable medical equipment declines, I’m concerned that more home care patients will need to be hospitalized, particularly in rural areas because of their distance from one of the massive contract holders. CMS should be working to keep homebound Medicare recipients in their homes—the quality of life is better for the patient and will involve an overall cost savings to Medicare.”

The Congressmen were joined on the call by Lucy Spruill, Director of Public Policy and Community Relations, United Cerebral Palsy of Pittsburgh; Georgie Blackburn, VP Government Relations and Legislative Affairs, BLACKBURN'S, and John Shirvinsky, Executive Director, Pennsylvania Association of Medical Suppliers.

“As a power wheelchair consumer, I am very concerned about the small number of providers that will be available as a result of competitive bidding,” said Lucy Spruill, Director of Public Policy and Community Relations, United Cerebral Palsy of Pittsburgh. “We already experience long waits between ordering equipment and actual delivery. This will take a very bad situation and make it intolerable. Medicare needs to be concerned with secondary conditions that may arise due to fewer providers being available to serve our needs. Bed sores, pneumonia and depression due to longer stays in the house are all very costly conditions for the Medicare system to treat.”

To learn more about the Representatives support of this bill and conversation with the media, visit the AAHomecare Newsroom. H.R. 3790 has 70 cosponsors as of November 18, 2009.

Poynter Institute Encourages Second Look At DME Fraud Story—Legitimate Homecare Providers Are Hurt by Medicare Fraud

The Poynter Institute, a school and resource for journalists, recently posted a story idea for journalists which included the suggestion that all providers in the HME sector are, by definition, criminals. AAHomecare responded to their mistake, and the Poynter Institute’s Al Tompkins posted the following update:

I heard from a group called the American Association for Homecare http://www.aahomecare.org/stopfraud, which represents business that sell home medical equipment. The spokesman for the group, Michael Reinemer, says journalists should look into how Medicare fraud is hurting legitimate medical equipment providers. He commented on the piece I wrote about the investigation (http://www.poynter.org/article_feedback/article_feedback_list.asp?user=614470) and sent me an e-mail with his thoughts.

In his e-mail, Reinemer said these providers furnish "... not just the equipment but all the accompanying, required services that allow seniors to get the care they need and remain independent at home."

The legitimate businesses, Reinemer said, have actually asked Medicare to be more strict in its oversight (http://www.aahomecare.org/displaycommon.cfm?an=1&subarticlenbr=496) and to try to do something to weed out what the federal government says is $60 billion in Medicare fraud. Reinemer wrote:

"There is a terrific story to be told, but it won't help the public understand this issue if you leave out the fact that the vast majority of home medical equipment providers are scrupulously honest, pray to actually get reimbursed for equipment and services they have in fact furnished, and have fought for decades for Medicare to adopt higher standards for those businesses to whom they give Medicare a supplier number (the credential to bill Medicare). Moreover, as of 2009, home medical equipment providers (DMEs) must be accredited by a federally recognized accrediting agency, they must meet surety bond requirements, and meet a host of other mandated standards. We were gratified to see that you told the story of one beneficiary who complained for years that a supplier company was charging Medicare for things she didn't need or receive. "

Why does Medicare support homecare? Because if a patient can get health care at home rather than in a hospital, it is a huge cost savings and often is more comfortable. Here are some basic stats about homecare that provide additional insight, as well as information about how home health care can help save money http://thinkhomecare.wordpress.com/2009/09/10/hampshire-daily-gazette-home-health-care-saves-money-serves-people-well/.

I think Reinemer is right. His arguments address an interesting part of the health care reform story. As American ages, homecare suppliers will become increasingly important.

Pittsburgh Post-Gazette Prints Piece on Home Medical Equipment Services

"Home medical equipment services firms not the villain" was printed in the Business Forum of the Pittsburgh Post-Gazette on Saturday, November 07. The piece, written by Georgie Blackburn of BLACKBURN's in Tarentum, Pa., states the following:

The home medical equipment industry has become the scapegoat du jour in the cost-savings debate over health care reform.

The false narrative in circulation is that the home medical equipment sector has escaped reimbursement cuts -- most pointedly by persuading Congress to prevent competitive bidding.

The reality is the bidding program is on track, even though home medical equipment services already have been cut by legislation passed in 2003, 2005 and 2008. Additionally, two items that help beneficiaries remain independent by keeping them out of institutional care -- power wheelchairs and home oxygen therapy -- were cut by 26 percent in 2007 and 27 percent in 2009.

While the controversial bid program was delayed by Congress last year in order to address numerous flaws, the home medical equipment sector paid for the delay through a nationwide 9.5 percent reimbursement reduction on all bid-upon items.

Home medical equipment represents less than 2 percent of Medicare spending and is one of its slowest-growing segments, increasing by just 0.75 percent annually compared with the more than 6 percent annual growth for overall Medicare spending, according to National Health Expenditures data from Medicare.

Home care providers compete daily on the basis of speed and quality of service, since Medicare dictates the fee schedule and pays at the identical rate. The bidding regulations would eliminate as many as 90 percent of qualified providers through selective contracting and prevent us from caring for our customers for a three-year contract period. This reduces local patient access to quality care and removes a patient's right to choose a provider.

Competitive bidding is similar to a closed-model HMO and would result in government-mandated consolidation in the home medical equipment and services sector. Over the long run, the bid program will increase costs by complicating the transition from hospital to home, lengthening hospital stays and increasing the likelihood of re-hospitalizations.

The reality is that our sector's reimbursement has been cut many times in this decade alone. Many members of Congress oppose additional cuts because those reductions will erode the nation's battered infrastructure for providing home care. Both the Bush administration and President Barack Obama have publicly stated the obvious: home-based care is the most cost-effective setting for health care.

We are all for increasing competition and cutting costs, but not through a flawed bid system that reduces patient care and precludes 90 percent of existing providers.


Georgie Blackburn is vice president, government relations and legislative affairs, for home medical equipment and service provider Blackburn's in Tarentum.

Read more: http://www.post-gazette.com/pg/09311/1011500-432.stm#ixzz0WAyi7tJV

New “Homecare Works!” Logo Illustrates Benefits of Home Medical Equipment

AAHomecare, Medtrade, and other HME sector leaders have developed a new logo for homecare. It shows the words “Homecare Works!” in the center of triangle, and the three sides of the triangle feature the phrases: better outcomes, cost effective, and patient preferred. This represents the “trifecta” of benefits that the HME community delivers.Kevin Gaffney, Medtrade’s Group Show Director, said, “The Homecare Works! message is straight-forward and understandable and the new logo reinforces this message. Our hope is to see the logo on Websites, letterhead and marketing materials throughout the industry and that the message begins to resonate with Congress and others involved in healthcare reform.”

AAHomecare urges HME providers, clinicians, manufacturers, and other stakeholders to put the logo to good use in educating the public, the media, and policymakers about the value of homecare.

Update: As of March 2012, the old logo has been replaced by a newer one (shown above).