Stakeholders: Delay efforts don’t end July 1

Friday, June 28, 2013

WASHINGTON – After the failure of an 11th hour attempt to delay the July 1 start date of Round 2 of competitive bidding, HME industry stakeholders have set their sights on the coming weeks.

A federal judge on June 27 denied a request for a temporary restraining order (TRO) that would have prevented Kathleen Sebelius, secretary of the Department of Health and Human Services (DHHS), from implementing Round 2. The TRO request was made by AAHomecare and Home MediService. The two parties on June 19 also filed a lawsuit against Sebelius asking her to stop the expansion of the program due to “licensing irregularities.”

“We need to keep working Congress,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “We know this is a flawed program and we expect major problems.”

With the TRO out of the picture, the next best bet for relief is H.R. 2375. Introduced June 14 by Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, the bill would delay the implementation of Round 2 until Dec. 31, 2013, and the Round 1 re-compete, set for Jan. 1, 2014, until six months after Round 2.

The industry had hoped to see H.R. 2375 pass before July 1, but they’re now shooting for some time in July, after lawmakers return from the holiday recess.

“Providers need to get out to the parades and get in front of their members of Congress and say, ‘Fix this,’” said John Gallagher, vice president of government relations for The VGM Group. “I am thinking maybe by July 15 or 16, it will get passed.”

What seems less likely: an administrative delay. So far, CMS remains resolute in its refusal to delay the program. In a June 27 letter to Braley, CMS Administrator Marilyn Tavenner says that a delay in the program would lead to “a substantial loss in savings for both the Medicare program and beneficiaries,” and create confusion among beneficiaries and a hardship for suppliers.

Letting the program go forward as is will be just as harmful, stakeholders contend.

“I think a delay is a good idea given the things we’ve seen unfold,” said Carter Fuller, vice president of business development for Chattanooga, Tenn.-based Professional Respiratory & Medical.

Providers should take heart that lawmakers continue to put political pressure on CMS, say stakeholders.

“It seems like not a day goes by where we are not seeing another letter from some state delegation expressing concern with program,” said Seth Johnson, vice president of government affairs for Pride Mobility.

At this point, allowing the program to start could be exactly what is needed, say stakeholders.

“There’s got to be some blood on the floor,” said Gallagher. “Providers have to be reaching out to beneficiaries in bid areas and capture the data of the problems they see.”