South Carolina Home Medical Providers Call on Congress to Preserve Home-care as an Option for Seniors and People with Disabilities.
Providers of home medical equipment and services across South Carolina are proposing a fiscally responsible alternative to the mislabeled "competitive" bidding scheme currently under way in Medicare that will actually discourage competition, reduce access to care for many of the more than 700,000 Medicare beneficiaries, and put dozens of South Carolina home-care providers out of business.
"Round One of Competitive Bidding and the looming threat of Round Two, coupled with the 9.5% cut in Medicare Reimbursement, has already put four providers who were members of the South Carolina Medical Equipment Services Association (SCMESA) out of business," said Bobby Horton, executive director of SCMESA. "The current situation of South Carolina home-care providers being required to pay state retail sales tax on Medicare and Medicaid items, which they cannot recoup from the patient, and having to compete with out-of-state providers in Round Two, which covers all major urban areas of South Carolina, likely will result in more than 50 percent of current South Carolina providers going out of business."
The Medicare bidding program encourages "suicide bidding," using economic coercion by forcing providers to submit unsustainable bids necessary to win a contract. Although Congress delayed the implementation of the selective contracting program in 2008 to allow for needed changes, the Centers for Medicare and Medicaid Services (CMS) ignored congressional intent and did not address the flaws that precipitated the delay.
The bidding process for durable medical equipment and services is now underway in nine metropolitan statistical areas in the U.S. with an additional 91 areas scheduled to be affected next year in Round Two. Columbia, Charleston and Greenville are included in Round Two and research shows these three cities could lose more than 900 jobs due to implementation of this program.
This bidding program will trigger a race to the bottom in terms of quality for home medical equipment and services. With a loss of providers, expedient deliveries of items and services will suffer and Medicare costs will increase.
The South Carolina Medical Equipment Services Association supports H.R. 3790, a bipartisan bill that would preserve access to home-care and provide a cost-effective alternative to a misguided Medicare "competitive" bidding program for durable medical equipment. H.R. 3790 replaces the Medicare bidding program with other types of cost-savings that will reduce reimbursements to home medical equipment providers but preserve patient access to medically required equipment and services in the home.
So far, the bill has 242 cosponsors in the U.S. House of Representatives with broad bipartisan support. More than half of both the Democratic and Republican delegations in the House support the bill.
In South Carolina, Representatives Gresham Barrett , Henry Brown, Jr. , Bob Inglis , and Joe Wilson have all shown support as cosponsors of the legislation.
Patient and consumer groups that support the elimination of Medicare's "competitive" bidding program for durable medical equipment include the ALS Association, the American Association for Respiratory Care, the American Association of People with Disabilities, International Ventilator Users Network, the Muscular Dystrophy Association, National Emphysema/COPD Association, National Spinal Cord Injury Association, and Post-Polio Health International, among others.
Proponents of the Medicare bidding program for durable medical equipment have perpetuated several myths about the program. However, the reality is quite different.
MYTH: The bidding program will be good for Medicare beneficiaries.
REALITY: It will, in fact, reduce access to medically required equipment and services.
MYTH: The program will eliminate Medicare fraud in the durable medical equipment sector.
REALITY: The solution to fraud is better screening of providers, real-time claims audits, stiffer penalties, and better enforcement mechanisms for Medicare - steps that the home medical providers support.
MYTH: The bidding program helps businesses by creating a more competitive environment.
REALITY: The program coerces providers to bid at unsustainable Medicare reimbursement rates and will force thousand of businesses to close, reducing competition in the long term.
MYTH: Providers will be competing on quality and price.
REALITY: The bidding program will ration care. Home medical equipment providers already compete on the basis of quality and help move people smoothly from hospitals to cost-effective care at home.
MYTH: The bidding program will make healthcare more cost-effective.
REALITY: The home is already the most cost-effective setting for post-acute care. As more people receive good equipment and services at home, the U.S. will spend less on longer hospital says, emergency room visits, and nursing home admissions.
The South Carolina Medical Equipment Services Association is composed of providers of home health care including durable medical equipment and services. Home medical equipment and services include oxygen therapy, wheelchairs, hospital beds, inhalation therapy, and other medically required supplies and services for people with conditions such as chronic obstructive pulmonary disease (COPD), multiple sclerosis, Lou Gehrig's disease, spinal cord injuries, congestive heart failure, and diabetes. The association was established in 1987 to provide mechanism for communication, planning, education and research in matters relevant to home health care needs. The objective is to improve the health of citizens of South Carolina by providing high quality home health care and improve economic security of the HME industry in South Carolina. This mission is accomplished through frequent seminars, newsletters, legislative activities, and Medicaid and Medicare Advisory Committee activities.
For more details on the bidding program, visit www.aahomecare.org/competitivebidding.
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