Competitive bidding: VGM helps beneficiaries, providers file lawsuit

Sunday, June 17, 2007

DALLAS - A group of Medicare beneficiaries and HME providers, with financial help from The VGM Group, filed a lawsuit in a Dallas U.S. District Court last week seeking to stop national competitive bidding.

"I feel like one, if we don't do it, who will; and two, we're willing and able," said Mike Mallaro, president of VGM's Last Chance for Patient Choice (LCPC), a nonprofit that lobbies for industry interests.

VGM plans to help beneficiaries and providers in Cleveland file a similar lawsuit. Dallas and Cleveland are two of the 10 cities where CMS will kick off competitive bidding April 1, 2008. Attorneys for Brown & Fortunato in Amarillo, Texas, represent the plaintiffs.

In the lawsuits, beneficiaries and providers argue that competitive bidding will reduce choice and services, resulting in a two-tiered healthcare system--one tier for beneficiaries in the competitive bidding areas (CBAs) and another tier for everyone else.

"We encouraged the plaintiffs to stand up for their own rights," said Jim Walsh, VGM's general counsel, during a legislative update at VGM's Heartland Conference last week. "(Congress and CMS) are forcing this system on beneficiaries."

The beneficiaries and providers have a "tough case," Walsh conceded. VGM officials hope for the "right judge," one who believes the case merits further review.

"If we raise enough awareness, we could at least cause a delay," Mallaro said.

Walsh agreed: "Even if we don't get (a favorable ruling), it adds more attention to our cause."

Some of that attention may not be positive, VGM officials admit.

"Some of the reaction (to the lawsuit) will be negative, and we understand that," Mallaro said. "There are those in the industry and in Congress who prefer an incremental approach."

But VGM officials believe the industry should cover all bases: regulatory, legislative and legal.

Providers at the Heartland Conference, June 11-14 in Waterloo, Iowa, applauded the news.

"I'm excited--it's the best news I've heard in a long time," said provider Joan Cross, who helped beat back several attempts by Florida to implement competitive bidding in recent years. "It's about time we get mad. I'm sick of being the bad guys."

Another provider said: "There's a reason why I pay LCPC $15 a month every month. We needed this."