Beneficiaries face disruption in care, service

Sunday, April 20, 2008

MIAMI - Medicare beneficiaries in Miami and Orlando, two of 10 first round national competitive bidding areas, have no idea what's coming their way, industry leaders said at a press conference last week.

AAHomecare hosted the press conference to discuss potential problems for more than 700,000 beneficiaries in the areas.

Tyler Wilson, AAHomecare president and CEO, said the program's low reimbursement rates and small number of contract providers could disrupt patient access to care.

"There is confusion and there has been poor education of the beneficiaries," he said. "Existing patient relationships are going to end in many cases. I think we will see a serious interruption in continuity of care."

While the purpose of competitive bidding is to save money, there are other ways to do that, said Raul Lopez, president of the Florida Association of Medical Equipment Services and operations manager of Bayshore Dura Medical in Miami Lakes.

"They already had the ability to (lower costs) by reducing the fee schedule," he said. "Unfortunately, they've competitively bid services based on price instead of allowing providers to compete against each other based on service."

Lopez's company won contracts in eight of the 10 product categories it bid on, but he said the process was rife with errors from the start. Most recently, hundreds of providers nationally--about 60 in Florida--had their bids unfairly disqualified, he said.

"One provider in Orlando won a bid in one category and was disqualified in two other categories, (because the CBIC) claimed he did not submit financial documentation," Lopez said.

AAHomecare is asking CMS to suspend the program until basic questions regarding fairness, access to care, quality of care and system integrity are answered.

"We want to make sure we don't have a catastrophe when this is implemented," Wilson said.