Moving the HME Industry Forward

Legislative/Advocacy

Round Two Rates in Effect

July 1, 2013

WASHINGTON, DC – Summer temperatures climbed and Medicare reimbursement rates plummeted as round two of competitive bidding began today. The round two rates, amounting to an average reimbursement cut of 45% across affected product categories, kicked in for 91 competitive bidding areas. 

A temporary restraining order (TRO) related to a lawsuit challenging round two failed to gain traction last week. “Unfortunately, after the TRO hearing, the judge denied the association’s request,” says Jay Witter, vice president of government affairs for AAHomecare.

According to comments reported on Law360.com, U.S. District Judge Beryl A. Howell believed the plaintiffs failed to show that they would be irreparably harmed by the program expansion. “Those contracts have been rescinded by the agency when discovered,” said Howell during last week’s hearing. “The agency may have made some implementation errors along the way, but they’ve corrected them.”

“The outcome of the lawsuit is a huge disappointment,” laments Georgie Blackburn, vice president, Government Relations and Legislative Affairs, BLACKBURN’S. “Medicare ‘mistakes’ within this program are not acceptable to me or any of my representatives in Congress. Round one was stopped two weeks after it began. The story is not over yet. It is just beginning.”
 
An analysis by Rob Brant, founder of the Accredited Medical Equipment Providers Association (AMEPA),
revealed that 121 companies were not properly licensed to provide HME and supplies in one or more states at the time they were awarded their bid contracts. “These 121 ‘bid winners’ won 7,169 contracts,” reports Brant. “That is 55% of the 13,126 round two contracts awarded.”

Considering the harsh audits blanketing the industry, Michael Hamilton found it ironic that CMS’ errors could be so readily forgiven. “I was very disappointed that CMS was not held to the same high standards that apply to suppliers,” said Hamilton, executive director of Alabama Durable Medical Equipment Association. “If we violated so many rules, we would be broke and in jail.”

Publicly and privately, many advocates were placing their hopes on beneficiaries responding en masse to lack of service and access. “There is nothing louder than the voice of the voter,” muses Louis Feuer, president, Dynamic Seminars, MEDCOMMENT CENTER. “The voice of the consumer is the greatest power source we have. We need to arm them with those numbers to call to share their shock by what has come their way.”

“We have always known that Congress wants to hear from beneficiaries,” says Karyn Estrella, CAE, executive director, Home Medical Equipment and Services Association of New England. “We couldn’t ask them to call their member of Congress about the competitive bidding program, because this would be too confusing. As of today, the message from beneficiaries becomes easier to understand. That message is, ‘I can’t get my medical equipment and/or supplies.’”

Give This Phone Number to Beneficiaries
AAHomecare and People for Quality Care (PFQC), the advocacy division of the VGM Group, have partnered to offer the Beneficiary Complaint Hotline, an 800 number dedicated to Medicare beneficiaries with complaints about their access to HME and service. The number is (800) 404-8702.

The line will be staffed 24 hours, seven days a week by a PFQC live operator who will take the beneficiary’s name, location, and a brief summary of the issue. With the caller’s permission, the complaints will be forwarded to a local Medicare ombudsman for resolution and added to a list of complaints which will be presented to Congressional members.

“We’re receiving multiple calls on a daily basis from beneficiaries who are unhappy with the lack of service and quality equipment they receive resulting from the Medicare’s bidding policy,” says PFQC Director Kelly Turner (pictured). “And yet Medicare reports to only have received one to two hundred complaints since the beginning of their program in 2011. We want to make sure that the voices of equipment users are heard in this battle, even if it means we take their complaints directly to CMS and congressional members.”