Tuesday, August 3, 2010

The following is MAMES response to the competitive bidding issue found in the KCStar.
The hidden costs of lowering Medicare costs too far

The Medicare “competitive” bidding program for medical equipment is an ill-conceived scheme for the people who rely on these products and services and the hardworking small businesses that provide them.

A recent Star editorial (“Don’t pass up Medicare bids”) does not clearly explain the cost of doing business in a Medicare system that requires hours of paperwork to be reimbursed and hours of follow-up with the prescribing doctor’s office to ensure the paperwork is complete and accurate to meet Medicare standards.

Suppliers must also employ technicians who are trained and certified to properly deliver and set up home medical equipment and train consumers on safe and proper use of the equipment, as required by Medicare. Additionally, suppliers must provide patients with repair technicians who are available 24-hours-a-day, seven-days-a-week, including holidays.

All these costly and time-consuming Medicare requirements are covered under the single payment amount paid by Medicare — an amount that is paid 45 days later, at best, and only if everything is perfectly executed. Do you really want the lowest bidder — who has been forced to slash delivery frequencies, cut back repair staff and rely on lower-quality equipment just to stay in business — to supply your sick relative with life-sustaining equipment and services? In some cases, the lowest bidder doesn’t even operate in the local Kansas City area! The fact that Congress delayed this program two years ago is testament to how flawed it was then and continues to be today.

Once delayed, providers across the country, not just those in the nine bid areas, were hit with a permanent 9.5 percent across-the-board decrease in Medicare reimbursement rates as a compromise for delaying the program.

The editorial is correct in the statement that Medicare “expects” to pay 28 percent less in the Kansas City market for durable medical equipment.

However, what is going to happen when the desperate providers who have taken these contracts realize that they cannot sustain the rates for the next three years? What is going to happen to access to care when providers in Kansas City go out of business and those that remain can no longer fulfill unsustainable contracts?

What is going to happen to prices in three years when these contracts expire and there are only a few providers left and the competitive market place has been damaged? What Medicare “expects” to see and the reality of what’s to come are completely different things. Suppliers all across the country have worked with congressional leaders to put together a more effective cost-savings solution, HR 3790, (which today has 254 bipartisan co-sponsors), that will preserve high-quality access to care and save billions of dollars over the next 10 years while saving 100,000 jobs.

We are not beseeching Congress to support a costly status quo. We are beseeching Congress to understand and save the very health sector that can be one of the critical pieces of preserving our healthcare system. We are beseeching Congress to force the government to eliminate fraud before it starts by enforcing regulations for accreditation and surety bonds. We are beseeching Congress to recognize that home care, and the equipment and services necessary to preserve it, are the best answer to the long-term cost issues facing our system today.

Rose Schafhauser, executive director of the Midwest Association for Medical Equipment Services, lives in Stillwater, Minn.