Debt talks dampen efforts

Thursday, July 28, 2011

WASHINGTON  With lawmakers consumed by the looming debt-ceiling crisis, there wasn't a lot of movement last week on HME issues, including repealing competitive bidding.

"It's like somebody threw a wet blanket on everybody here," said Walt Gorski, vice president of government affairs for AAHomecare. "Nothing is happening other than debt ceiling talks."

At press time, both House Speaker John Boehner, R-Ohio, and Senate Majority Leader Harry Reid, D-Nev., were still trying to advance their respective debt packages. 

Neither plan contains immediate cuts to DME, says Seth Johnson, vice president of government affairs for Pride Mobility, but threats to Medicare remain.

"Both packages include the establishment of a committee that would be required to find nearly $2 trillion in cuts over a 10-year period," he said. "That's where the real threat comes in. Medicare is where the committee would start."

Out on the West Coast, members of AMEPA on July 28 wrapped up a two-week lobbying trip that took them from San Diego to Seattleall metropolitan statistical areas that are included in Round 2 of competitive bidding.

"We've been hammering home the fact that the program allowed inexperienced, financially bankrupt companies to win bids in Round 1 and Medicare has done nothing to change that in Round 2," said Rob Brant, AMEPA's past president. "Some of these legislators are hearing this for the first time. They had no idea they were in Round 2."

During meetings, members presented Prof. Peter Cramton's June letter to Pres. Obama, which was signed by 244 leading economists and expressed concerns with competitive bidding. Cramton, an outspoken critic of the program, has advocated for a redesign of the program. That raised this question from healthcare staffers: Can the program be fixed?

"The industry has already taken an across-the-board cut of 9.5%," said Brant. "If we adopt Cramton's idea, are we going to have to pay to delay it again?" 

Any kind of a pay cut is going to be a tough sell for providers, say HME stakeholders. Wayne Stanfield, executive director of NAIMES, is conducting a survey asking providers if they would agree to a pay cut. Although he said the response so far has been too small for a real sampling, 60% of respondents so far have said "no."