Problems Obtaining Needed Home Medical Equipment Services under Controversial Medicare Bidding Program
Author: American Association for Home-care
Original Publication Date: 2011-02-10
Synopsis and Key Points:
Medicare beneficiaries report problems receiving home medical equipment and services following implementation of Medicare new competitive bidding program.
Main DigestSeniors in Dallas-Fort Worth Report Problems Obtaining Needed Home Medical Equipment Services under Controversial Medicare Bidding Program.
Medicare beneficiaries are reporting problems receiving medically required home medical equipment and services following the January 1, 2011 implementation of Medicare's new "competitive" bidding program in nine regions across the U.S., including the Dallas-Fort Worth area, where 565,000 Medicare beneficiaries live.
The bidding program is scheduled to start up in an additional 91 areas later this year including six metropolitan areas in Texas - Austin, Beaumont, El Paso, Houston, McAllen, and San Antonio - where more than 850,000 Medicare beneficiaries live.
The bidding program will affect seniors and people living with disabilities covered by Medicare who require oxygen therapy, enteral nutrients (tube feeding), continuous positive air pressure (CPAP) and respiratory assistive devices, power wheelchairs, walkers, hospital beds and support surfaces, and mail-order diabetic supplies.
"Medicare's competitive bidding program works against the best interests of the patient by eliminating the access to care that beneficiaries require," said Barry Johnson, president of the Texas Alliance of Home Care Services. "For instance, in Dallas-Fort Worth, we had 300 oxygen providers prior to competitive bidding implementation. Now, as a result of the program, the area will have only a maximum of 52 providers to service this entire area." More than 100,000 Medicare beneficiaries in Texas depend on home oxygen therapy.
By design, this new Medicare program severely restricts the number of companies that are allowed to provide the equipment and services subject to bidding, which hurts both patients and providers.
Since January 1, patients, clinicians, and home-care providers have already reported:
Difficulty finding a local equipment or service provider;
Delays in obtaining medically required equipment and services;
Longer than necessary hospital stays due to confusion in discharging patients to home-based care;
Far fewer choices for patients when selecting equipment or providers;
Reduced quality; and
Confusing or incorrect information provided by Medicare.
"By limiting providers, this bidding program is actually hurting patients. This program leaves no alternatives for our nation's seniors and people living with disabilities and puts people out of jobs in an already rough economic environment," said Johnson. "When our businesses close, patients will have to turn to expensive hospital visits and long term stays because Medicare will have nowhere to turn if the smaller pool of 'winning' businesses is unable to meet the region's increasing demand for home-based care."
The American Association for Home-care shared a number of problems with the Centers for Medicare and Medicaid Services (CMS) earlier in January, such as:
Winning companies awarded contracts by Medicare that are bankrupt.
Winning companies that are not licensed to provide items or services.
Winning companies that have credit problems.
Incorrect information distributed by Medicare about the contract winners and which beneficiaries need to change home medical equipment providers.
The design and implementation of the bidding system alarm Johnson, his Texas colleagues, and more than 167 leading economists and auction experts, including two Nobel laureates, who warned Congress that this bidding system will fail. The economic experts who predict failure are not opposed to competitive bidding for Medicare, and in fact many of them design market-based auction systems. But they found that this particular bidding program, as it is designed by CMS, has irreparable flaws that will prevent it from achieving its objectives of low cost and high quality equipment and services.
Also opposing the controversial bidding program are more than a dozen national consumer and patient advocacy groups including the ALS Association, American Association of People with Disabilities, Muscular Dystrophy Association, National Council on Independent Living, National Spinal Cord Injury Association, and United Spinal Association. Last year, a bipartisan group of 257 members of the U.S. House of Representatives supported legislation to repeal the controversial bidding program.
Medicare beneficiaries, family members, caregivers, hospital discharge planners, and clinicians can report problems, concerns, and feedback about this bidding system by calling a toll-free number, 1-888-990-0499, or by visiting the website: www.biddingfeedback.com. To learn more, visit www.aahomecare.org/competitivebidding.
The American Association for Home-care represents durable medical equipment providers, manufacturers, and other organizations in the home-care community. Members serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other medical equipment and services in their homes. The Association's members operate more than 3,000 home-care locations in all 50 states. Visit www.aahomecare.org/athome
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