Hearing pits NCB vs. MPP

Friday, May 4, 2012

WASHINGTON – A May 9 congressional hearing on national competitive bidding (NCB) could be the HME industry’s big break in getting lawmakers to embrace its market-pricing program (MPP), stakeholders say.

Stakeholders plan to use the hearing as a platform to highlight the flaws of the current program and to explain how MPP, which features binding bids and other safeguarding measures, addresses those flaws.

“It’s a big deal,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “We’ve been told this is part of the regular order of things, that we have to go through a hearing process to air the issue.”

The hearing, which is being held by the Subcommittee on Health of the House Ways and Means Committee, will include testimonies from no more than a handful of witnesses. Representatives from CMS and the HME industry are expected to have seats at the table.

The timing of the hearing couldn’t be better, stakeholders say. The industry has been pressuring the Congressional Budget Office (CBO) to score MPP—another part “of the regular order of things”—and if the program is well-received during the hearing, subcommittee members may step in to help.

“Any time Congress has a hearing or is poised to move on legislation, that does have a tendency to increase the priority level at the CBO to get the score done,” said Seth Johnson, vice president of government affairs at Pride Mobility Products. “We’re hopeful that this will lead to a score.”

In addition to promoting MPP during the hearing, the industry needs to be ready to play good defense, stakeholders say.

“This will give CMS the chance to testify about how wonderful the program is and how much money it’s saving,” said Wayne Stanfield, president and CEO of NAIMES. “We need to counter that.”

One thing in particular that stakeholders want to counter: The low number of complaints from Medicare beneficiaries that CMS claims to have received in the first year of competitive bidding.

“I’d like to have a phone brought in and to have them call 1-800 Medicare and see how hard it is to navigate,” said John Gallagher, vice president of government relations for The VGM Group. “Let’s see how far they get.”

Stakeholders expect the industry to get a fair shake at the hearing. Subcommittee Chairman Wally Herger, R-Calif., says he wants to hear about the “successes and challenges of Round 1 before the program’s scheduled significant expansion next year.”

“I believe strongly in the competitive forces of the private market and the first year of the program shows this process has resulted in lower costs for Medicare and its beneficiaries,” he stated in an announcement on the hearing. “While this is encouraging, it is important to ensure the process by which suppliers compete is fair and that beneficiaries receive needed care.”