CMS Can’t Handle the Truth About Round 2

Less than two weeks after implementation, problems with Round 2 of the bidding program are becoming increasingly evident. AAHomecare is receiving reports of delays, equipment shortages, and contractors refusing services in bid areas around the country. Yet, CMS is reporting just a few dozen complaints.

It is critical that home medical equipment providers report problems with the bidding program to their representatives, especially in cases where patients are seeing new barriers and complications in getting the products, services, or maintenance they need.

In congressional hearings and on Capitol Hill visits made by the HME community and the AAHomecare lobbying team over the past year, many members of Congress and their staffs expressed sympathy for the effects of the bidding program on our sector, but they were not convinced that patients would suffer significant disruptions. Now that the program is lurching forward and is indeed causing serious problems for Medicare patients, we need to make sure Congress is fully aware that these disruptions are taking place.

AAHomecare is coordinating efforts with VGM, The MED Group, and state associations to hold a virtual fly-in next Thursday, July 18, for providers and patients from all across the country. This virtual fly-in is the perfect opportunity to tell Congress about problems you or your patients have experienced since the implementation of Round 2.

You can use the AAHomecare Action Center to quickly send a message directly to your congressional representatives, or look up phone numbers to call those offices on July 18. Email Gordon Barnes at gordonb@aahomecare.org if you need any assistance.

In the meantime, we are still collecting information about provider problems through our dedicated email address: CBRound2Problems@aahomcare.org.  Don’t worry though, we won’t use any details about you or your company when we talk to members of Congress unless we have your permission first.

Don’t let CMS pull the wool over Congress’ eyes! Representatives and Senators MUST hear from you and your patients—current or former—about problems with the bidding program.  Please add your voice to our efforts on July 18. Mark your calendar!

Was That the Earth Moving Under Our Feet?

Although you may not have felt it, on July 1, 2013, the earth certainly moved under the feet of DME suppliers across the country. It was the beginnings of a tectonic shift in how consumers will get their home medical equipment and supplies. Cracks began to show up on the surface of the DME world over the past months but on July 1, fissures began to open up that will swallow a large number of suppliers and the patients they serve. How bad this movement will be is uncertain and it will be weeks before the impact will be known. In the meantime, there is work to do.

The last thing this industry can afford to do is let the shock of July 1 cloud the more urgent need to take every possible action to expose the truth about the CMS DME bidding program. Never has the need for DME suppliers to not give up the fight been greater.

Transition to this new world order for DME will be anything but smooth, and every supplier has a duty to not only insure that the problems are exposed, but also to insure that every member of Congress is engaged. 

We must somehow help Congress get past partisan politics, past the purported savings touted by CMS, and past the mid-term election blinders. We know that literally hundreds of members of Congress agree that there are problems with the current DME bidding program, now we must get them to act.

Remember that most action by Congress is constituent driven; in other words, voter driven. Since a third of the Senate and the entire House will be campaigning to keep their jobs, we must make sure that the problems with the DME bidding program are laid squarely at the feet of these elected officials.

Do not give up the fight until we have lost this war, and we have not lost yet, we just have to change our battle plan. The flawed bidding program has begun, but it will not succeed. If we believe that it is wrong, then we also believe it will not serve patients well. The problems and patient complaints must be gathered and shared with Congress.  Additionally, the impact on suppliers, both contract winners and those not receiving contracts, must be shared with Congress.

State associations and suppliers everywhere must step up their advocacy game. Yes, we are all weary of the fight that has been raging for years, but we have the forces of good on our side. Yogi Berra said, “it ain’t over til it’s over,” and this fight is far from over.

Here’s what you can do:

1. Contact Congress—demand a delay for Round 2 and ask for support of H.R. 1717
2. Get patients involved—ask them to make three calls to register their complaints

a.       Congress (1-202-224-3121)

b.      People for Quality Care Medicare beneficiary hotline  (1-800-404-8702)

c.       CMS (1-800-Medicare / 1-800-633-4237)

If you need help with how to fight back, contact Wayne Stanfield, the vice president of provider relations at AAHomecare. His email address is waynes@aahomecare.org and his phone number is 202-372-0757.

American Association for Homecare – President and CEO Search Update

JDG Associates has been engaged by Washington, DC-based American Association for Homecare (AAHomecare) to conduct the search for the position of President and CEO.

Representing healthcare providers, equipment manufacturers, and other organizations in the homecare community, AAHomecare works to preserve and strengthen access to care for the millions of Americans who require medical care in their homes. AAHomecare members provide oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion equipment, therapies, services and supplies. AAHomecare membership reflects a broad cross-section of the homecare community, including providers of all sizes operating in approximately 3,000 locations in all 50 states. Benefits to membership in AAHomecare include representation in Washington on legislative, regulatory and industry affairs, ready access to experts and information on developments in these areas, education programs and services, professional recognition and visibility, a job board, as well as leadership and networking opportunities.

AAHomecare has six Councils (Complex Rehab and Mobility, Home Medical Equipment/Respiratory Therapy, Medical Gases, Medical Supplies, Regulatory, State Leaders) through which members with common interests in homecare can influence the Association’s advocacy, communications and education programs. The Councils also serve as venues to share and promote best practices in homecare, provide insights to members facing common business challenges and helping to maintain the quality of care for the elderly. AAHomecare has an annual budget of approximately $4 million and a staff of 13 in four functional areas – organizational leadership/administration, government relations, communications, and membership. For further information please visit www.aahomecare.org.

The Position

The President and CEO serves as the principal spokesperson for the Association, able and ready at all times to promote and protect the interests of the Association and the industry it represents. Key among AAHomecare’s current representational efforts is its Market Pricing Program (MPP) initiative. Developed in response to a national bidding program introduced by the Centers for Medicare and Medicaid Services (CMS), MPP is consistent with Congress’ original intent to create a program based on competition and market prices while maintaining sustainable beneficiary access to quality items and services. The position is also charged with building AAHomecare’s membership, i.e., reaching out to current and potential member companies to promote and raise awareness in the industry of the Association’s impact on policy makers and regulators and the beneficial effect member company support can have in these efforts, for those they serve in their homes as well as the homecare community. 

Principal Responsibilities

• Work with respective market groups to develop and execute the Association’s legislative and regulatory strategies, coordinating with industry lobbyists, AAHomecare members and coalition partners to establish the “value of homecare” among policymakers in Washington. 
• Direct and energize AAHomecare’s membership retention and recruitment efforts, to include seeking opportunities to reach out and meet with members and potential members at their places of business. 
  Serve as the key spokesperson and advocate for the Association in conjunction with the Chairman, working with staff to raise the profile of the Association and the homecare sector with policy makers.
• Represent AAHomecare in negotiations with government, business, labor, and other organizations, cultivating existing and new relationships with Congress and Centers for Medicare and Medicaid Services (CMS), testifying and lobbying as needed to present the Association’s viewpoints and encourage the acceptance of its goals and objectives. 
• Maintain regular contact with the Board of Directors, its committees, the membership, manufacturers, and state associations to ensure AAHomecare’s value and effectiveness is fully understood and appreciated.
• Plan, develop, and implement strategic initiatives, new programs and ideas, conferring with the Executive Committee to evaluate services and recommend methods to promote/increase membership involvement, reviewing and updating AAHomecare’s strategic plan annually.
• Oversee AAHomecare’s finances including long-range forecasting as well as monthly and annual budgets for review and approval of the Board of Directors.
• Champion and uphold the high ethical standards for the Association and the homecare industry and ensure the legal integrity of the Association.

Requirements

Strong leadership and demonstrated success in relationship development and outreach activities associated with success in an issues-driven trade association. Strategic perspective and impact. Excellent oral and written communication skills. Highly effective in an advocacy role with a solid understanding of the legislative process and access to policy makers on Capitol Hill and CMS. Experience in an association and/or healthcare is very helpful. High degree of initiative necessary, as is a creative approach to problem solving. 

Paul A. Belford, Principal
JDG Associates, Ltd.
1700 Research Boulevard
Rockville, MD 20850
(301) 340-2210
belford@jdgsearch.com

Push Back When Congress Pushes Back

Homecare advocates are in grassroots mode and are sending letters by the thousands to members of Congress asking them to support H.R. 1717, the market pricing program bill, and this is a good thing. The AAHomecare “Action Center” has recorded over 9,000 letters sent to Congress since the bill was introduced.

One of the problems we are hearing is that advocates are receiving generic form letters, or the Representative or their staff is pushing back with incorrect responses and bad facts.

With July 1 coming quickly, we must increase the sense of urgency. We must push back to such responses and correct their misinformation. We can be firm and clear without being rude or disrespectful, but we must let Congress know that the current bidding program is bad policy and must be replaced with the sustainable market pricing process in H.R. 1717.

Advocates should respond promptly if they receive Congressional responses with statements showing that their Representatives clearly are uninformed. Responses should provide details of the impact of this program on beneficiaries. We know the program is flawed. We know the contracted suppliers are unable or unwilling to serve the market. We know the reimbursement rates are below cost.

So when lawmakers push back, we must also push back with urgency and inform them that when providers go out of business, it is patients who suffer. Access and quality will be drastically reduced when local providers stop working with Medicare or the contract winning providers are hundreds of miles away.

Congress still doesn’t get it and only you can help. Work hard to get cosponsors for H.R. 1717, and push back with urgency when necessary.

Small Business Perspective on the Bidding Program, Part 4: Where Are Our Statesmen? and The Solution

You’ve heard plenty about the extraordinary challenges that Medicare’s competitive bidding program will cause for home medical equipment providers in our first three chapters of this series:

• A Small Business Story and An Alphabet Soup of Regulation
• Fraud Alert and A Fly in the Ointment
• What the Experts Say and What the Government Says

Today, Mark Richardson offers a better alternative to CMS’ unsustainable and poorly designed scheme.

Where are Our Statesmen?

I get it that Congress has to delegate the administration of the Medicare Program to CMS.  But I don’t think Congress wanted to devastate an entire industry when it mandated CMS to implement a Competitive Bidding Program for the home medical equipment industry.  So when CMS goes too far, and fails to use conventionally accepted auction processes—and instead creates a system which all the experts agree will fail—who’s responsibility is it to step in and protect our homecare businesses, our employees, and ultimately Medicare beneficiaries?

Of course the answer is, our Statesmen and Stateswomen.  In these dark hours for homecare, we need our Congress to come forward and fix this.  We need them to deliver a fair solution for all—not just hide behind the CMS promises of easy cost-savings.  Of course CMS is promising cost-savings with reductions of 45%!  But at what cost?  The devastation of an entire industry?

The Solution

By and large, Congress has been deaf to the pleas of our industry because they want to believe the easy claims of CMS that Medicare is saving money with their “Competitive Bidding Program”.  And in this day and age, it seems Congress will grasp at any straw that technically allows spending cuts, whether it’s right or not (big example: Sequestration).  However, there have been a few statesmen that have come forward with a way of deliverance for our industry.  Congressman Tom Price (R-Ga.), a physician who understands the Home Medical Equipment industry, along with 184 other members of Congress who have co-sponsored legislation with him in the last session of Congress, are dedicated to stopping the current bidding program and replacing it with an economist-created alternative bidding program called the Market Pricing Program (MPP).  This legislation is budget neutral and will require CMS to make some fundamental changes to ensure that a financially sustainable program results and layoffs and closings will not be the order of the day in the Home Medical Equipment industry.  It is supported by all of the industry’s stakeholders and all of the national associations representing the industry.

My hopes and certainly no less than the hopes of our entire industry are pinned to this MPP legislation.  Please tell your Congressmen to support it, get it to the floor, and then vote for it.  Tell them to be Statesmen because that’s what we need in times like these.  We need them to implement a competitive bidding process that actually supports a robust provider community that partners with CMS to produce savings for the Medicare program—not the current one-sided, adversarial process that does nothing but dictate artificially low prices to a noble  industry that’s already under siege.

AAHomecare thanks Mark Richardson, owner of Home MediService in Havre de Grace, MD, for sharing his perspectives and passion.  We urge you to do the same at CBRound2BiddingProblems@aahomecare.org and learn more about what you can do to Help Save Homecare today!