NCB bill: 'We have a long way to go and a short time to do it'

Sunday, October 18, 2009

WASHINGTON - Rep. Kendrick Meek, D-Fla., introduced a bill in the House of Representatives last week that would get rid of national competitive bidding for good.

The bill, H.R. 3790, has 16 co-sponsors right out of the gate, at least one from each Round 1 competitive bidding area.

"(The number of original co-sponsors) is a good sign," said Seth Johnson, vice president of government affairs for Pride Mobility Products. "We're going to need that kind of support to work in the tight timeframe that we have to advance this bill this year."

The industry's goal: Get the bill attached to the House's healthcare reform bill. Then, when the House and Senate meld their bills, make sure it stays in there.

The budget-neutral bill includes the following offsets, according to AAHomecare:

.     A consumer price index (CPI) freeze for DME in 2010, 2011, 2012 and 2015;

.     No 2% increase for competitively bid items in 2014;

.     A 0.25% cut for DME in 2010, 2011 and 2012; and

.     A 0.5% cut for DME in 2015.

(One exception: complex rehab. It would receive CPI updates in 2010-2015, plus a 2% increase in 2014.)

"While there are concerns with including an offset in the legislation itself, it was a necessity based on what we were hearing from lawmakers," said Walt Gorski, AAHomecare's vice president of government affairs. "They were saying, 'I don't like this program, but how are you going to offset (the cost savings it will produce)?'"

It may be hard for providers, especially those in non-competitive bidding areas, to swallow another cut--they've already swallowed a 9.5% cut this year to delay the program--but they need to think long term, industry stakeholders say.

"Providers in rural areas may be thinking, 'Why do I care about his,'" said John Gallagher, vice president of government affairs for The VGM Group. "But they should because Congress wants to expand the program (from 79 to 100 cities in rounds 1 and 2) and CMS could use the competitive bidding fee schedule as the fee schedule for everyone come 2014."

While the bill will likely be well received in the House, the industry has its work cut out for it in the Senate, some sources say.

"It's unfortunate that bills have to pass both chambers," one source said. "(Sen. Max Baucus, D-Mont., chairman of the Finance Committee) thinks competitive bidding is the best thing since apple pie and so do most other Democrats on the committee."

The industry also has CMS to contend with, some sources say.

"They don't want what happened last year to happen this year," one source said. "Their media relations staff is going to keep pumping out anti-HME stories about how the industry is fraught with fraud and how competitive bidding is going to fix everything."

But the industry plans to pull itself up by its boot straps, stakeholders say.

"We have a long way to go and a short time to do it," said Johnson.

CMS plans to re-start Round 1 of competitive bidding Jan. 1, 2011.