Home Health & Hospice Week

Mystery lawmaker agrees to sponsor carve-out legislation.

Certain durable medical equipment suppliers are one step closer to escaping competitive bidding.

A U.S. congressman has agreed to sponsor legislation exempting from national competitive bidding those DME suppliers that provide specialized rehab and assistive technology adapted for a specific individual, according to Sharon Hildebrandt, executive director of the Washington-based National Coalition for Assistive & Rehab Technology. That would include items such as power and manual wheelchairs, seating and positioning products, and speech-generating devices.

But the helpful lawmaker's identity remains a mystery. "I'm not willing to divulge the name of the member of Congress, other than to say that he is on the Ways & Means Committee," Hildebrandt tells Eli.

For several months NCART has been discussing the need for a high-tech carve-out with the members and staff of that powerful committee. Last month, NCART members began sending form letters on the matter to members of Congress.

Bidding and resulting reimbursement reductions put product choice at risk, NCART warns. Bidding also threatens home evaluations for such products, the cost of which currently is bundled into the price of equipment.

"The erosion of services is a possibility under the competitive bidding process," says Eric Sokol of the Washington-based Power Mobility Coalition.

The fate of the carve-out proposal remains highly uncertain, however. It cannot be submitted as a standalone bill, and there might not be appropriate legislation to attach the proposal to, Hildebrandt says.

Look for Proposed Bidding Rule in September

Meanwhile, the Centers for Medicare & Medicaid Services has announced plans to release the proposed bidding rule in September. The agency made the announcement in its semi-annual regulatory agenda published in the Federal Register.

The proposed rule is expected to describe how CMS will implement the program, which is set to start in 10 of the nation's largest metropolitan statistical areas in 2007. The rule also is expected to detail which products will be part of the bidding process, how payments will be calculated and what requirements participating suppliers must meet.