Get in the fight now

By Robert Steedley
Robert Steedley is vice chairman of the American Association for Homecare

Earlier this month, the home medical equipment sector had the opportunity to present the case against competitive bidding at a hearing before the House Ways and Means Health Subcommittee. The American Association of Homecare was represented, as was NAIMES. Both did a great job articulating the critical issues and concerns for providers and patients.

But unfortunately, as we have seen over and over, we also saw a split message presented to Congress. Also testifying was an Ohio provider who praised the bidding program and a group purporting to represent Medicare beneficiaries that also supports the current Medicare bidding system.

As I watched the video of the hearing, I tried to put myself in the place of the members of Congress listening to testimony. What were they thinking? Did they see a united sector working dynamically to improve a flawed program? Or did they see two very different points of view from within HME that left them wondering if one side is just whining? And then what comes next? Those members of Congress have to decide, even if the decision is to do nothing.

All of this left me deflated and angry, knowing about all the hard work that goes into HME meetings with members of Congress and their staff, the clear dangers that the bidding program presents to patients, the phone calls and emails. Plus there are a lot of humble, quiet providers who have worked tirelessly behind the scenes to furnish the best care possible to beneficiaries—while Medicare continues to make that job harder and harder. This shows a real disconnect between all this work to improve homecare policy on one hand and the efforts to derail the whole effort by a small handful of companies. Is AAHomecare in the minority? Does the HME sector want bidding to this bidding program to continue? These are the questions that every provider needs to answer now.

Any further dissent or split message is, in my opinion, a death sentence to a lot of HME providers, which will have terrible consequences for home-based care in America. And I don’t believe the burden should be on AAHomecare to get everyone on board. I want AAHomecare to spend its time and resources influencing policy that benefits the HME sector—not trying to corral its members or other providers.

How long can we tolerate a passive, hands-off attitude among HME providers? When is enough enough?

As an HME provider, I implore every HME company to get in the fight now! Membership with AAHomecare is the best course for supporting this fight. But if you choose not to be a member, at least don’t work against the very organizations and people who are working on your behalf. You can help by holding other providers accountable for their actions.

Time is short and our options are narrowing. But in the face of those factors, many people in our sector are throwing their full weight behind efforts to fix the bidding problem and preserve access to cost-effective care for our seniors.


Agreed on all points. Two follow on points. (i) If you are in the camp that believes achieving significant reform to the existing competitive bidding program is impossible, although I believe you are wrong, then fine. But as long as the HME sector is reimbursed by federal programs there will be additional legislative fights ahead so you better get involved with your legislators and industry associations. Now. (ii) If you operate a HME that is reducing its federally reimbursed business and you think all this "inside the beltway" business isn't going to have a big impact on your business you are wrong. Private insurers establish coverage criteria and payment rates in large part based upon the policies established by CMS. Policies established at CMS and laws that impact the Medicare DME benefit have a huge impact on HME coverage and reimbursement regardless of what entity actually pays for the item. So get involved!

I am shocked that DME industry is inept considering the fact that DME biz services most. Of the senior n other patients .
I am politically involved in CONGRESS. I hve emailed suggestions to AAHomecarw but no response.
My suggestion
Approach key congressman with several thousand signatures.
Organize senior march on the capital.
U will get ur issues addressed.
My suggestion is that Medicare shd negotiate with manufacturer as volume buyer n then set reimbursement.
Let dme suppliers buy at Medicare negotiated price, service pt n get paid.
Now dme competes on patient service.
This is simple grassroots DME SOLUTION .
I do not know if AAHOMECARE is interested as it is supported by large biz n already are getting big discounts.
My proposal is to keep small biz in biz
God Bless America