Competitive bidding: 'It's not going away'

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Friday, May 31, 2002

WASHINGTON - Even if industry leaders manage to derail President Bush's call to roll out a national competitive bidding program for Medicare this year, don't think you've seen the last it.

"It's not going away," said Tom Connaughton, AAHomecare's CEO. "In the long term, we need to develop a philosophy of what reimbursement makes sense, but I think that will be an effort that takes us a year or two before we come up with a consensus."

Such a consensus, while difficult to establish, will be crucial if the industry's to have a hand in crafting Medicare's future reimbursement methodology, sources say.

In fact, if the industry fails to eventually come to the table with a compromise or alternaqtive, it risks being frozen out of the reimbursement debate altogether, said healthcare attorney Tom Antone. In which case, he added, lawmakers are likely to cut with "a meat ax and not a scalpel."

"I would much rather us play a major role in helping to craft the legislative language than simply do what we always do....react and defend," MED Group CEO David Miller.

Miller's developed a reimbursement plan that unbundles the service component from the product, which he unveiled at the AAHomecare Leadership Conference in February.

At the moment, AAHomecare staffers, with an urgency reminiscent BBA '97, are lobbying lawmakers against competitive bidding, pointing out that it will drive some providers out of business and decrease patient choice. They're encouraging state associations to do the same. Until CMS completes its Polk County, Fla., and San Antonio demonstration projects, it's "irresponsible" to be talking about implementing a national program, said Asela Cuervo, AAHomecare's senior vice president of government relations.

"They need to continue studying this, and that is what we are reminding Congress of," Cuervo said.

At this point, talk of approaching lawmakers with a competitive bidding compromise is premature, say AAHomecare officials. Originally, it looked like the House might come out with a bill supporting competitive bidding prior to is Memorial Day break. As of press time, it didn't look like the House was going to make that deadline, Connaughton said.

"Tactically, I'm comfortable with where we are," he said. "But the industry should be looking at where it is going in the long run and where it wants to go. Our board is very interested in that. But on this issue at this moment, I think our members need to be educating Congress on what all the problems are with a national program." HME

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