Moving the HME Industry Forward


On the Brink of Change

June 1, 2018

NEW BEDFORD, MA – I made my 18th trip to Washington D.C. last week for the AAHomecare Legislative Conference – and competitive bidding has always been part of the conversation. We have been fighting this program since the demo projects in Polk County, Fla, and San Antonio, Tex (remember those?).

I don’t know about you, but I’m tired. I’m tired of trying to debunk the inaccurate information that CMS continues to spew to Congress. They have said that the bidding program has had no negative impact on beneficiaries, hospital discharges, product quality, etc. when we all know otherwise. However, as tired and frustrated as we may be, we must keep fighting because we are on the brink of change.

The cracks in this program are beginning to show. Everything that Dr. Peter Cramton predicted in his letters to Congress, CMS, and President Obama has come to fruition. Customer service has suffered. Medicare beneficiaries do not get the level of service that they received prior to the bidding program. Product quality has suffered.

Beneficiaries are buying equipment that is covered under their Medicare benefit – if they have the financial resources. Access to care issues are beginning to happen. The local hospital in Calais, Maine, can’t discharge patients who need medical equipment because the only HME provider left in that area closed its doors a few months ago with no notice and the closest provider is at least two hours away.

But what was really eye-opening was the recently announced Interim Final Rule. While it is disappointing that the rule does not go far enough to help all providers in non-bid areas, language in the IFR indicates that there are problems with the program.

We carried this information into our conversations with Congress. I came away from the conference with the feeling that we made an impact. The members of Congress we met with want to help. I don’t think they’ll be forgetting our discussions any time soon.

Now we need to build on the momentum of these meetings. All providers should be regularly emailing their representatives and senators with the issues they are experiencing. Ask them to sign H.R. 4229 if they haven’t already.

The full impact of the bidding program is being felt across the country with the implementation of the Cures Act that is having a negative impact on State Medicaid programs. It is time to keep the pressure on. Keep sharing your stories. Don’t let up now!

Karyn Estrella, CAE, is president & CEO of the Home Medical Equipment and Services Association of New England, New Bedford, Massachusetts.