Fwd: [RD] Equipment suppliers seek Medicare fairness

[Guest guest]

Equipment suppliers seek Medicare fairness

By Lydell C. Bridgeford

Published 8/2/2005 6:38 PM

WASHINGTON, Aug. 2 (UPI) -- When Medicare implements a

competitive-bidding program in 2007 for homecare devices, there is

concern that many small providers will be squeezed out of the market.

For

this reason, two members of Congress have introduced a bill to amend the

program.

The " Medicare Durable Medical Equipment Access Act of 2005, " H.R. 3559,

was introduced last week in the House by Reps. L. Hobson, R-Ohio,

and S. Tanner, D-Tenn.

Currently, durable-medical-equipment suppliers are reimbursed by

Medicare

based on a fee schedule that is updated annually.

In 2007 Medicare, which covers 40 million Americans, will begin a DME

competitive-bidding program in the nation's 10 largest metropolitan

statistical areas. By 2009 officials will competitively award contracts

in 80 metropolitan areas.

Physicians typically prescribe DME -- such as wheelchairs, diabetic

supplies and oxygen scooters -- to patients for home use. The items,

which also include nebulizers, bed pans and heat lamps, can be rented or

purchased by beneficiaries from DME suppliers.

The proposed bill modifies in part the Medicare Prescription Drug,

Improvement and Modernization Act of 2003 by allowing DME suppliers who

fail to win Medicare contracts on certain products to remain in the

Medicare market. The bill does not repeal the competitive process.

The legislation " will impact me as a small provider, knowing that if

I do

lose the bid, I still have the opportunity to compete at the bid

rate, as

opposed to closing my business, " , president and chief

executive officer of Homecare Concepts Inc. in Farmingdale, N.Y., told

United Press International.

Otherwise, " I am ... at risk of losing 65 percent of my current revenue

that comes from the Medicare arena, " said , who also is chairman of

the American Association of Homecare in andria, Va.

According to the trade group, the industry's key sectors -- respiratory

therapy, infusion therapy, mobility devices and other DME -- generated

about $18 billion in revenues in 2004. A small provider is a firm with

annual revenues under $10 million.

The Hobson-Tanner measure, which mainly addresses accessibility

concerns,

comes at a time when a growing number of people with disabilities

ages 50

and older are opting to live at home instead of in assisted-living

facilities or nursing homes.

DME and assistive technology are vital to helping older Americans with

disabilities with everyday tasks, such as answering the phone and

picking

up their mail, Clemmer, associate director of AARP's Public

Policy Institute, told UPI.

In 2003 the advocacy group for older Americans issued the results of a

survey in a report, " Beyond 50.03: A Report to the Nation on Independent

Living and Disability, " in which 33 percent of 1,102 respondents said

they had utilized some type of special equipment or assistive devices to

help with daily activities.

Also in that group nearly 70 percent said they had used a walker,

cane or

crutches, while 51 percent said they employed aids for bathing and using

the toilet. The survey, of persons 50 and older with disabilities, also

acknowledged that 47 percent had used wheelchairs and scooters, 14

percent used oxygen or respirator devices and 13 percent used hearing

aids.

The competitive-bidding program will allow Medicare officials to award

contracts based on geographic needs and collect bids reflecting

composite

market prices for products, which will serve as reimbursement rates.

DME suppliers awarded contracts can participate in Medicare for up to

three years, while vendors who fail to make the cut will be prohibited

from participating for the same period.

In March the Centers for Medicare and Medicaid Services issued a notice

on the 2007 competitive acquisition process, saying, " Competitive

bidding

provides a way to harness marketplace dynamics to create incentive for

suppliers to provide items and services in an efficient matter and at

reasonable prices. "

The program is intended to " limit the burden on beneficiaries by

reducing

their out-of-pocket expenses, " the notice continued, and added that

competitive bidding will reduce the cost Medicare pays for DME and

" bring

the reimbursement amount more in line with that of a competitive

market. "

Hobson and Tanner are concerned that awarding competitive contracts will

eliminate many small suppliers, particularly those serving beneficiaries

in rural and urban areas with low populations.

Their legislation aims to ensure that Medicare seniors who relied on

small DME providers will retain access to quality and cost-effective

medical devices, even if their suppliers are not awarded a contract,

Hobson and Tanner told reporters at a news briefing.

" I like to see people ... have the same level of access wherever they

live, " said Hobson, who serves on the House Appropriations Committee.

If a contract is awarded to a supplier in Memphis and a beneficiary

lives

90 miles away, " my concern is, 1) they can't get it there, 2) they won't

service it, and 3) it will be more expensive, " said Tanner, who

serves on

the House Ways and Means Committee.

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Lydell Bridgeford is an intern for UPI Science News. E-mail:

sciencemail@...

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