Competitive bidding: The best of a 'bad situation'

WASHINGTON -- As much as some providers may like to think it could happen, chances that lawmakers will scuttle national competitive bidding for DME are slim to none, say industry leaders. "Public law and Rep. Bill Thomas [R-Calif.] are behind it," said Michael Reinemer, AAHomecare's communications director. "There is no leader in Congress that is going to say, 'Oh, we changed our mind.' But there is a lot we are doing to make the best of a bad situation." CMS and its competitive bidding advisory committee met Feb. 28 to March 2 -- the last meeting before CMS unveils a draft bidding plan sometime this summer. The Medicare Modernization Act of 2003 mandated that CMS roll out competitive bidding for DME in 10 of the country's largest metropolitan statistical areas in 2007 and expand the program in 2009. Providers like Jim Greatorex, president of the New England Medical Equipment Dealers association, believe that eliminating competitive bidding, if there is any chance, should be the industry's "number one goal." "There are still a lot of unknowns and maybe they will ease a lot of these worries," said Greatorex, co-owner of Black Bear Medical in Portland, Maine. "But the one known is that not everyone will win the bid, and there will be a lot of small companies put out of business, and that is what runs this country. How is that good policy?" When CMS does release its draft bidding program, chances are good that it will include several scenarios. The final proposal, scheduled for release in early 2006, will be crafted in part based on industry comments on the draft. Invacare's vice president of government relations, Cara Bachenheimer, hasn't closed the door on the possibility that Congress could pass legislation that decreases the pain competitive bidding might inflict on providers and beneficiaries. It's unrealistic, however, to think it would be repealed altogether, she said. With that in mind, it's important that the industry work with CMS to craft the best competitive bidding program possible, said Kay Cox, AAHomecare's CEO. AAHomecare plans to offer CMS input on a host of competitive bidding issues. They include: provider standards, product selection, protection for small providers and a possible exemption for rural, low-density areas. "As much input into the process that we can have, the better off we are going to be," Cox said. "If we sit here and say, 'We don't like it and don't want to do it,' and waste a year without any input, we are not serving our members."