Tuesday, July 5, 2011

What CMS is Not Saying About the Competitive Bidding Program

In contrast to CMS reports that there have been no changes in beneficiary health outcomes resulting from the Medicare competitive bidding program for durable medical equipment, AAHomecare and other members of the homecare community are hearing a markedly different story from patients and providers affected by the program.

People for Quality Care has captured a particularly appalling story from Jim Kokenge, president and CEO of PAX Medical Supply, a DME provider in Cincinnati, Ohio. Jim's story illustrates the impact that the confusing and poorly-implemented bidding program is having on patients -- and clearly shows a wide discrepancy between the picture painted by CMS and the reality of this bidding program.

"I am offended when I hear CMS putting out statements that there are no problems when we're getting calls on a weekly basis, daily actually, from therapists who we had dealt with as referral sources who don't know who to go to," says Kokenge.

While there's plenty in this story that causes alarm, we're especially struck by the primary concern of the higher-level CMS staffer who Jim talks about in the latter stages of the video.

Legislation to repeal the bidding program, H.R. 1041, was introduced after hundreds of patients and providers reported problems with the program in the wake of its January 1 implementation. As designed by CMS, the bidding program severely and arbitrarily restricts the number of companies that are allowed to provide commonly used medical equipment and services. Since the program began, patients, clinicians, and homecare providers have reported:

  • Difficulty finding a local equipment or service provider;
  • Delays in 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.

The legislation has strong bipartisan support in the House, with over 130 cosponsors. AAHomecare would like to thank those members of Congress who have cosponsored H.R. 1041, which will protect Medicare patients' access to home medical equipment.

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