Industry keeps close watch

WASHINGTON - As the deficit reduction committee last week continued wrangling over a deficit reduction plan, HME industry stakeholders played a combination of offense and defense.

"We are trying to get the (the competitive bidding alternative) in the super committee plan, which is not an easy task," said Cara Bachenheimer, senior vice president of government relations for Invacare. "At the same time we want to keep any ugly (HME) provisions out of there."

The bipartisan committee has until Nov. 23 to find a way to cut at least $1.2 trillion from the federal deficit over 10 years. Failure to do so could trigger an automatic spending cut, including a 2% across-the-board cut to all Medicare providers effective Jan. 1, 2013.

Committee negotiations have been kept tightly under wraps, but proposals from both Republicans and Democrats have suggested as much as $500 billion in savings from Medicare and Medicaid. Those savings could come from proposals to apply competitive bid rates to Medicaid, as well as a prepay review requirement for power wheelchairs.

"Everything is on the table," said Bachenheimer.

The deficit reduction plan--if it even materializes--is the best vehicle for the industry's market pricing program (MPP) for competitive bidding. MPP still needs a score from the Congressional Budget Office, but that hasn't kept stakeholders from building support for the program.

"Among HME providers and staff on Capitol Hill, there is broad acceptance of the plan--even from staff that a year ago thought competitive bidding was going to work," said Jay Witter, senior director of government relations for AAHomecare.

Also last week, on Nov. 9, Sen. Robert Casey, D-Pa., sent a letter to Laurence Wilson, director of CMS's Chronic Care Policy Group, urging the agency to create a separate category for manual wheelchairs under competitive bidding, and to remove complex rehab products from the program. While industry and consumer groups have weighed in on the issue, this is the first such letter from a lawmaker, stakeholders say.

"There have been efforts under way to apply political pressure on the agency to make the right decision," said Seth Johnson, vice president of government affairs for Pride Mobility. "This is the first of what we hope will be quite a few letters supporting removal of those items from competitive bidding."

Competitive bidding continues to draw interest from those outside the industry, as well. On Nov. 14, The Heartland Institute, a non-profit think tank, will hold a panel discussion on Capitol Hill: "Containing Medicare/Medicaid Costs." One of the featured speakers is Dr. Peter Cramton, an outspoken critic of the program as it's currently designed.

"It's a matter of advancing the case for what we've got now and moving forward," said Wayne Stanfield, president and CEO of NAIMES. "I hope Prof. Cramton's presentation gives a shot in the arm to MPP."