Home Health & Hospice Week

Congress considers bill to exempt rural areas, make other changes.

Suppliers may get a reprieve from some of the most onerous aspects of competitive bidding under bipartisan legislation recently unveiled in Congress.

U.S. Reps. Dave Hobson (R-OH) and John Tanner (D-TN) on July 28 introduced H.R. 3559, the "Medicare Durable Medical Equipment Access Act of 2005." The legislation would modify many of the competitive bidding requirements for durable medical equipment that were included in the Medicare Modernization Act of 2003.

Though the bill does not repeal competitive bidding for DME, it changes the program's structure to ensure beneficiaries' access to DME, protect small DME providers and generally promote a strong market for Medicare-reimbursed DME.

"This bill goes a long way toward rectifying many of the concerns about 'competitive acquisition' for homecare in the Medicare Modernization Act," says Kay Cox, president and CEO of the American Association for Homecare, which prefers to call the practice "restrictive contracting."

AAHomecare and the VGM Group of Waterloo, IA are urging DME suppliers to lobby their members of Congress to back the bill.

The Bill's Particulars The Hobson-Tanner bill would amend the MMA to:
  Require that competitive bidding not be implemented until quality standards are in place;
  Exempt metropolitan statistical areas with populations under 500,000;
  Allow all qualified providers that are small businesses and that submitted a bid below the current allowable to participate at the selected award price;
  Restore the right of providers participating in the program to administrative and judicial review;
  Exempt items and services unless the Centers for Medicare & Medicaid Services can dem-onstrate savings of at least 10 percent compared to the fee schedule in effect on Jan. 1, 2006;

Require CMS to conduct a comparability analysis for areas that are not competitively bid to ensure the rate is appropriate to costs and does not reduce access to care; and

  Subject the CMS Program Advisory and Oversight Committee on competitive bidding to the Federal Advisory Committee Act, which requires public access to meetings and proceedings.

"Our goal is to make sure that seniors who depend on quality durable medical equipment can continue to have access to it through Medicare," says Hobson, who was recently named AAHomecare's "Legislator of the Year" for his efforts on the industry's behalf. "Part of making that happen is to ensure that small suppliers can continue to compete in Medicare's bidding process, which is what we are doing with our bill."