Congressman Ross: tap dissatisfied seniors to fix NCB

Sunday, June 12, 2005

WASHINGTON -- When seniors feel the impact of the prescription drug benefit hustled into law by the MMA, a chorus of dissatisfaction should open a door to legislative remedies for HME suppliers, Congressman Mike Ross, D-Ark, told AAHomecare legislative conference attendees last Thursday.

Ross, who owns a pharmacy and home medical equipment supply business in Arkansas, said seniors would begin to rebel against provisions of the MMA after they realize that Medicare will only pay 30% of the first $5,100 they spend on drugs.

Under the drug plan that goes into effect Jan. 1, 2006, seniors will pay a $35-$50 monthly co-pay. After a $250 deductible, Medicare will cover 75% of all drug costs until a beneficiary has paid $2,250. After a beneficiary pays $2,250 he will have to pay 100% of his drug costs, as well as the co-pay, until he reaches the next threshold of coverage at the $5,100 mark.

"It was a bad bill then, and it's a bad bill now," Ross said.

Ross expects legislative action to commence as soon as seniors feel the real-life pinch of these new provisions. And that's when the industry will have its next best chance to redress competitive bidding, a provision that the Congressman lambasted as "the dumbest thing I ever heard of in my life."

As an HME supplier, Ross said, he feared the possibility of exclusion from the program if his business was not a successful bidder.

"Am I going to stay in business to serve [non-Medicare] patients if I don't get the bid?" he asked rhetorically.

Ross objected to Medicare's in-the-home rule, which he said "must be eliminated."

He also took issue with the rising healthcare costs in general. In his own district, he said, a company that employs 2,000 of his constituents was building a $1.6 billion plant in China and moving operations overseas because the costs of insuring employees was so high.

"We're the only government that puts the burden [of healthcare coverage] on the employer, and so these multi-national companies are looking to other countries where they don't have to pay for healthcare," Ross said.