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Competitive Bidding Delay: 'This Is Crunch Time'
The first three weeks of June present a narrow window for the HME industry to convince Congress to delay the implementation of competitive bidding.
"This is crunch time," says Cara Bachenheimer, senior vice president of government relations, Invacare, based in Alexandria, Va. "This is the most critical time for people to be informing their members of Congress about this program because we do have an opportunity to delay it, to extend the implementation. But it literally is something that every member of Congress needs to hear (about) from their constituents."
In fact, Congress will be working on Medicare, specifically a delay for the physician fee schedule, this month. Don Clayback, vice president of government relations, The MED Group, based in Buffalo, N.Y., says the hopes are to get a delay for competitive bidding attached to that bill. If that doesn't happen, he says, Congress likely won't visit Medicare until next year because of elections.
At press time, Rep. Pete Stark, D-Calif., and David Camp, R-Mich., had just introduced a bill, H.R. 6252, into the House to delay bidding by 18 months, and the industry was looking for a similar mechanism in the Senate. According to Wachovia Capital Markets, based in New York, the delay might require offsets of either a 5-percent cut to all DME or a 7- to 15-percent cut to DME in the bidding categories. The "pay for" for the Stark bill would be a 9.5-percent reduction in 2009 for items that CMS included in round one. The CPI update would then resume in 2010 for these same items, as well as all other DMEPOS items. Items not included in round one (e.g., manual wheelchairs) would not be cut in 2009, and would receive a full update in 2009.
As for the Senate, last week Senate Finance Committee Chair Max Baucus, D-Mont., said he would add language to delay competitive bidding in his Medicare bill, S. 3101, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). This support for a delay comes in addition to recent expressions of support for a delay from Sen. Charles Grassley, R-Iowa. At press time, 40 senators had signed on to a letter, generated by Ohio Sen. George Voinovich, supporting a legislative delay of the bid program.
"We've really got a finite window I think to make some impact during the month of June," Clayback says.
In recent weeks, Congress has conducted hearings and briefings with the Centers for Medicare & Medicaid Services (CMS) to address concerns regarding the competitive bidding program.
"CMS got a lot of pressure from Congress," Clayback says. "They were asked some very pointed questions, and being objective, CMS didn't handle it very well. Congress saw that there are some gaps here. CMS was doing a bit of a soft shoe. I think that has garnered us more support in Congress in terms of the problems with competitive bidding, the immediate problems with round one and then the significant potential problems with round two."
Clayback predicts awareness of the competitive bidding issue on the Hill has increased by two- or three-fold.
According to the Congressional Budget Office (CBO), a one-year delay in bidding would cost $3 billion.
