At a packed Energy and Commerce Committee hearing room on Capitol Hill on September 15, Karen A. Lerner, a registered nurse and wound care specialist at Allcare Medical, in Sayreville, NJ, was the lone voice opposing the “competitive” bidding program at the health subcommittee’s hearing on the program. She told the committee members the bidding program “will not achieve its desired outcomes and will in fact reduce access to care for Medicare beneficiaries, lower the quality of that care, increase costs and kill jobs.”
Lerner is a member of the American Association for Homecare and the Jersey Association of Medical Equipment Services. See her statement in the Newsroom and full testimony under What’s New at www.aahomecare.org.
Pictured left to right, Wendy Russalesi (JAMES executive director), Richard Lerner (Allcare), Rep. Frank Pallone, Karen Lerner (Allcare), Dr. Kevin Saluck (Allcare) at the Energy and Commerce subcommittee hearing on September 15, 2010.
Drawing on Allcare’s experience serving users of wheelchairs and respiratory services in New Jersey and Pennsylvania, Lerner provided several compelling examples about the likely negative impact on patients that would result from the bidding program.
The other witnesses who testified this morning were either in favor of the bidding program or neutral. While some of the dozen-plus members of Congress at the hearing favored the bidding program, many were highly skeptical.
HME advocates who packed the hearing room burst into applause after Texas Congressman Ralph Hall (R-Texas) delivered a scathing review of all the shortcomings of the CMS bidding program during the initial Round One and the re-bid. He noted that CMS used “abandoned rates to set the fee schedule” in the re-bidding of Round One and that in its refusal to release data about Round One bidding, “CMS seems to be hiding many flaws.”
Congressman Bruce Braley (D-Iowa) described the recent University of Northern Iowa study that predicts a steep decline in HME providers in rural states due to Round One bidding. Several others, including Betty Sutton (D-Ohio), Michael Burgess (R-Texas), and Diana DeGette (D-Colo.) raised serious concerns about the bidding program.
Henry Waxman (D-Calif.), who chairs the full Energy and Commerce Committee, defended the bidding program and brushed off concerns about access to care as “speculative threats.”
In his testimony before the subcommittee, Laurence Wilson, CMS director of the chronic care policy group, opened his remarks by repeating two extensively discredited arguments: that the bidding program will reduce Medicare beneficiaries’ out of pocket costs and that the program will reduce fraud. The first statement is only true for a small number of beneficiaries (who will suffer from the decimation of the HME sector), and the second statement is simply a red herring designed to draw attention away from CMS’ embarrassing record for fraud prevention.
Dan Levinson, of the Office of the Inspector General, Department of Health and Human Services, made the eyebrow-raising claim that HME reimbursement rates encourage fraud. By that logic, fraud would have declined dramatically over the past 10 years, mirroring the sharp reductions in HME reimbursement rates. At least one member of Congress questioned the link between reimbursement rates and fraud.
A third government witness was Kathleen King, director, health care, Government Accountability Office. In the second panel, witnesses included Alfred Chiplin, managing attorney, Center for Medicare Advocacy, Nancy Schlichting, president and CEO, Henry Ford Health System, and William Scanlon, a policy consultant, in addition to Karen Lerner of Allcare.
AAHomecare encourages HME stakeholders to continue to enlist support for the elimination program and share with your members of Congress the Dobson | DaVanzo & Associates study.