| Re: More on O2
Posted by John O. on 5/22/2008, 11:31 am, in reply to "More on O2"
69.129.197.8
I haven't read the fine print yet but judging from the item below the bidding process isn't set in stone, else why would the House be still having hearings like this? (The item is from COPD Council).
Small Business Subcommittee Says Bid Program Is Not Good for Patients, Taxpayers, or Small Business
In a hearing today about the DME competitive bidding program, members of the Small Business Subcommittee on Rural and Urban Entrepreneurship peppered the Centers for Medicare and Medicaid Services (CMS) witness with a bipartisan barrage of sharp questions. Subcommittee members poked holes in the sweeping claims by CMS that the bid program “has proven to be successful.”
By the end of the hearing, in a standing-room only committee room on Capitol Hill, the subcommittee had raised grave doubts about CMS claims of improved accuracy, savings for taxpayers, fairness to small businesses, and ensured access and quality for beneficiaries.
The subcommittee also heard testimony from homecare providers and other members of the healthcare system concerning flaws of the competitive bidding for durable medical equipment program.
Subcommittee chair Heath Shuler (D-N.C.) said in a statement that it was not clear how CMS would be able to deliver on its promise of reducing costs, improving effectiveness, and ensuring access to care for seniors “without driving small health care providers out of business and limiting access to care.” Shuler noted that “CMS has incorrectly disqualified some companies from participating due to clerical errors” and that “limiting suppliers could have a devastating impact on rural communities.”
Rep. Nydia Velazquez (D-N.Y.), who chairs the full Small Business Committee, noted that home medical equipment is a “vital part of this nation’s health safety net. Why has the agency ignored the impact of small business in healthcare?” Her sentiments were mirrored by many of the Representatives opening remarks, and again reflected in their questions to the first panel member, Laurence Wilson, CMS director of Chronic Care Policy Group. Wilson talked about the aggressive education and outreach CMS has done towards beneficiaries and providers, and stated that CMS will track the first round carefully through beneficiary satisfaction surveys and number of complaints received to decide whether companies chosen are fulfilling their commitments.
Tough questions from the subcommittee included: How CMS will ensure beneficiary safety and quality of service with subcontractors? Is CMS completely prepared for Round Two? How many patients will end up in hospitals as a result of fewer available homecare providers and services under the bidding program? Was a higher hospitalization rate for beneficiaries factored into the savings estimates for Round One?
Describing himself as a conservative Republican, subcommittee member Rep. David Davis (R-Tenn.) noted that the competitive bidding program, “doesn’t seem like a good program for the American taxpayer.” Davis said the home medical equipment benefit is a hands-on benefit. “It’s not just a piece of equipment that you drop off.” He said the government should not create policy that “punishes” legitimate homecare providers. “Don’t go after the 97 percent of suppliers who are doing the right thing” he told Wilson.
Velazquez questioned Wilson about CMS Administrator Kerry Weems’ assertion earlier this week that “nearly 90 percent” of bidding contract winners are from areas in which they won bids. She also asked whether all contract winners are licensed within the state where they won contracts. When Wilson was unable to answer the question, the Velazquez asked him to report back in one week with an answer. Representative Yvette Clarke (D-N.Y.) also grilled Wilson on licensure, asking more specifically about the lack of policies concerning subcontractors and saying that it is “critical that we have our finger on the pulse of every party in the system.”
During the second panel, Casey Hite, Vice President of Aeroflow Healthcare in Asheville, North Carolina, spoke on behalf of AAHomecare and the North Carolina Association of Medical Equipment Services. Hite stated, “We believe that the Medicare bidding program will radically change the HME marketplace and dismantle the nation’s home medical infrastructure, if implemented in its current form.”
Heath Sutton, owner of Mountaineer Oxygen Services in Waynesville, North Carolina, provided testimony on behalf of NCAMES. “Any system which disqualifies almost two of every three qualified providers should be questioned as to its validity and serviceability. We strongly implore you to reconsider competitive bidding,” he told the committee.
Julie Weidemann, director of Palmer Home Medical Supply in West Union, Iowa spoke on behalf of VGM during a third panel. “The cost for providers is not in the equipment being provided, but in the service,” she testified. “Homecare companies currently provide 24-hour, emergency on-call service to assist patients with trouble-shooting equipment problems, improper use, equipment failures, and we provide clinical assessments by respiratory therapists and registered nurses.”
For copies of the full testimony by the three homecare providers, please contact Alex Bennewith at AAHomecare at alexb@aahomecare.org.
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