Bid fix earns place in ‘doc fix’

Friday, December 13, 2013

WASHINGTON – The HME industry scored a small victory last week when an amendment to fix a problem with Medicare’s competitive bidding program was included in a markup of the “doc fix” bill passed by the Senate Finance Committee on Dec. 12.

“The goalposts are a little closer,” said Tom Ryan, AAHomecare president and CEO. “By no means are we putting up a mission accomplished flag, but the fact that there’s a mention of a fix for competitive bidding in the markup is an achievement.”

The amendment, offered and supported by a bi-partisan group of four senators led by Sen. Rob Portland, R-Ohio, would require providers to prove they meet licensure requirements in states where they don’t have a presence before they’re allowed to submit bids.

Stakeholders say, however, that the language in the amendment isn’t carved in stone.

“It’s very fluid right now,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “It’s difficult to pinpoint what will happen but it gives us a placeholder to build on.”

In fact, going into last week’s vote, the amendment was more expansive. It also sought to prohibit providers from expanding into more than five new areas and adding any more than two new product categories in any single year.

“The Congressional Budget Office indicated that there were administrative costs associated with CMS having to rewrite the regulation to meet that part of the amendment and due to that they had to gut it to only include the licensure requirement,” said Seth Johnson, vice president of government affairs for Pride Mobility.

Ultimately, the Senate bill will need to be reconciled with the House bill—which didn’t include any amendments related to competitive bidding—when lawmakers return to work in January. A three-month patch to the “doc fix,” also voted on last week, means they’ll be working on the bill well into March, stakeholders say.

“Being in there this early is good,” Johnson said. “As it works its way through, we can try to add more substantive relief.”

For providers struggling to survive in areas already included in competitive bidding, these developments may not mean much, acknowledges Ryan, but it’s the big picture that the industry needs to focus on.

“Sen. Portman, in his opening statements in a packed room, talked about the fact that we have to recognize that there’s been an issue with the DME benefit with competitive bidding and the licensure issue,” he said. “That’s significant.”