Industry stakeholders battle familiar foes

Friday, February 6, 2015

WASHINGTON – President Obama’s fiscal year 2016 budget rehashes an old proposal to apply competitive bidding rates to Medicaid reimbursement.

The HME industry has beat back that idea in the past and will continue to do so, say stakeholders.

“We’ve had good sound arguments for why Medicare and Medicaid are different programs with different requirements and different populations,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “We’ll beat that drum again.”

The budget, released Feb. 2, also contains a reference to the face-to-face requirement, but it doesn’t offer any details, except to say that the Office of Management and Budget estimates it would be budget neutral.

“They are finding, particularly in more rural areas where you have one of these practitioners doing the face-to-face exam, that it can be logistically difficult to get the physician to sign off on it,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Meanwhile, industry stakeholders have not let up on their efforts to push forward a pair of bi-partisan bills that would modify the competitive bidding program to require proof of licensure and binding bids. H.R. 284 has 39 co-sponsors; S. 148 has four original co-sponsors.

“The committees tell us they are looking to advance both bills at the earliest opportunity and they are well aware that the bid window is open now and time is of the essence,” said Seth Johnson, vice president of government affairs for Pride Mobility Products.

One powerful group that still doesn’t understand the problems associated with competitive bidding: the AARP. At a Jan. 22 hearing before the House Energy and Commerce Subcommittee on Health, AARP President-Elect Eric Schneidewind, spoke in favor of accelerating and expanding competitive bidding.

“Competitive bidding is already saving Medicare and beneficiaries billions of dollars,” he said. “Additional categories, such as home oxygen, clinical lab services and non-durable products, could save billions more.”

The industry has met with the AARP many times over the years, to no avail. The association is fixed on reduced co-payments, and not access issues or other costs, say stakeholders.

“The AARP has spoken out in support of the program and has said things that clearly show from our perspective that they simply are not as updated as they should be as to the current state of the bidding program,” said Johnson. “That’s certainly not due to a lack of trying our part. We need to continue our educational efforts, not only with AARP but also other organizations.”