Grassley Levels With Medtrade Crowd
It is not that he believes passionately in competitive bidding, Senator Charles Grassley (R-Iowa) told an audience of over 100 Medtrade attendees on October 29. He actually has concerns about how it will impact small providers and has voted against previous competitive bidding proposals.
“I’ve opened myself up to some dialogue,” competitive bidding proponent Senator Charles Grassley (R-Iowa) told the Medtrade audience.
However, to ensure passage of the provider giveback package (S 3018) he and Senator Max Baucus (D-Mont) sponsored, he needed to find a place to save money and the competitive bidding proposal for Metropolitan Statistical Areas (MSAs) over 500,000 population was it. “We found ourselves trying to satisfy so many providers we were getting up into the high $40 billions and we needed an offset,” he said.
If the HME industry could come up with another way to save $5 billion in a way that could be scored by the Congressional Budget Office, Grassley said he would be willing to listen. “I’m game for that,” he said.
While the American Association for Homecare says it is not backing off in its fight against eliminating competitive bidding and reimbursement cuts, its chairman, Steve Knoll of Knoll’s Patient Supply, Topeka, Kan, said AAHomecare is willing to enter a dialogue with Grassley on other ways to create the needed savings. He pointed to the work AAHomecare member Tom Ryan of Homecare Concepts Inc, Farmingdale, NY, was doing studying reimbursement and places where money could be saved by reducing administrative costs. “We have a lot of opportunity there,” Knoll said.
Grassley also said he still hopes S 3018 will pass in a lame-duck session after the November elections. And while his message was not exactly what the industry wished to hear, it was politely received. “I think he gave us some useful clues about where to go next,” said Michael W. Hamilton, executive director of the Alabama DME Association and the Georgia Association for Medical Equipment Services after the speech.
Senator Max Cleland (D-Ga) had also been invited to speak at Medtrade but could not attend because of the tough reelection battle he faced.
| Senate Adjourns Sans Competitive Bidding |
| Can a deadlocked Senate sitting on a Medicare giveback package eagerly anticipated by health care providers ranging from hospitals to rural home health agencies be a good thing? Perhaps... if you are an HME dealer facing competitive bidding. “We are the only part [of the provider giveback package] that is being asked to make a payment, which is what gets me,” says Thomas Connaughton, president and CEO of the American Association for Homecare (AAHomecare). Senators headed home to campaign on October 17, but planned to return to Washington, DC, on November 12 for a 3-day postelection lame-duck session. The House—which adjourned October 16—also planned a lame-duck session for the same time.  At press time, it was uncertain whether Medicare issues would be addressed during the November session, but AAHomecare was still encouraging HME providers to make every effort to influence their Congressional representatives to eliminate competitive bidding this year.
“Next year our opponents will have one more year of data and the industry has show all of its cards,” says David Williams, director of government relations for Invacare Corp, Elyria, Ohio. “It is going to be a much tougher fight.” Prior to adjourning, the Senate created a competitive bidding compromise that secured the support of many rural Senators for the provider “give-back” bill (S 3018) by guaranteeing that Metropolitan Statistical Areas (MSAs) under 500,000 population would be excluded from competitive bidding for HME. In addition, Senators Bob Graham (D-Fla) and Phil Gramm (R-Tex) introduced a competitive bidding stand-alone bill without the exception for MSAs under 500,000 (S 3098). Stand-alone bills usually lack the broad support necessary to make it out of committee, but they can survive if they are attached to a larger bill. Finally, with the Senate and particularly the House so closely divided between the two parties, a few elections could change the majority party of either institution and that can change the political landscape greatly. “There might be particular difficulties if the House does indeed change hands,” says Connaughton. “Right now the leaders of the House are saying is that they are going to come back only for that week of the 12th and deal with the continuing resolutions. Now of course the $64,000 question is if they will try to put something in that continuing resolutions about competitive bidding. We just don’t know.” |
Legislative and Regulatory News
HHS Ups Medicare Premium Rates
The monthly premium Part B Medicare beneficiaries pay will increase 8.7% in 2003 to $58.70 per month. Medicare law demands that deductibles and premiums be updated annually to comply with statutory formulas. Part B is set at the amount needed to cover 25% of estimated programs costs for aged enrollees. Tax revenue covers the other 75%.
Medical Device Fee Bill Passed
Medical device manufacturers may soon have to pay a fee before the Food and Drug Administration will review their new products. The FDA already requires pharmaceutical companies to pay for product reviews and on October 9, the House of Representatives passed by a vote of 406 to 3 the Medical Device User Fee and Modernization Act (HR 3580), which extends that fee program to medical devices. The bill was taken up by the Senate, but was not acted on prior to its recess.
Pennsylvania Adopts Anti-competitive Bidding Resolution
On October 21 the Pennsylvania House of Representatives adopted by a vote of 186-5 Resolution No. 669, which memorializes the US Congress to oppose the inclusion of a national competitive bidding program in any legislation. It is uncertain how this will impact Congress, but by adding to the competitive bidding controversy it could make Senators and Representatives think twice about voting for legislation containing competitive bidding.
The resolution was introduced by Representative George Kenney, Chairman of the House Health and Human Services Committee, and the official for Northeast Philadelphia’s 170th legislative district.
“We’re really thankful for Representative Kenney’s support of the PAMS membership regarding this important issue,” says Gary Woodring, Director of Rehab, Young’s Medical Equipment, a division of American Homecare Supply, Conshohocken, Pa, and PAMS Rehab Committee member.
| News in Brief |
CHAP Settles With Former CEO
The Community Health Accreditation Program finally put its troubles with its former CEO, Melvin Lev, behind it in late September when the Manhattan-based accreditation organization reached a court-approved settlement with Lev.The seven-page agreement required Lev to resign as CEO and required CHAP to repay Lev $95,000— the remaining balance on the $250,000 Lev had loaned CHAP in 2001 minus the $45,000 Lev owed CHAP. Lev’s sons, Russell and Howard, were also required to resign from their positions at CHAP. CHAP is now turning its attention to filling the three vacancies on its board with people with strong industry experience, who can lead it through revising the organizations standards, says Mike Dietrich, secretary of the CHAP board. Accredo Sues
Med Diversified President
When John J. Collura assumed the position of president and chief operating officer of Med Diversified Inc, Andover, Mass, he breached contractual obligations relating to noncompetition and disclosure of confidential information alleges a personal lawsuit filed by Accredo Health Inc, Memphis, Tenn, in the US District Court, Western District of Tennessee, Western Division. Med Diversified is not a party to the lawsuit. Rotech CEO Resigns
Steve Linehan, president and CEO of Rotech, Orlando, Fla, resigned after an accounting scandal was uncovered at the company. Allegedly a consultant reported $30 million in nonexistent sales to the Department of Veteran Affairs. Rotech also will not renew the employment contract of Scott Novell, the company’s chief operating officer, when it expires in January. Wallace Abbott and Guy Sansone will serve as co-CEOs, and Sansone is the current interim president. ACHC Accredits Walgreens
The Accreditation Commission for Health Care Inc, Raleigh, NC, scored a coup last month when Walgreens Health Initiatives (WHI), one of the nation’s largest specializers in rehabilitation technology supplier services, picked the company as its accrediting body. “We appreciate Walgreens’ confidence in choosing ACHC. Their household name strengthens our credibility in serving large national providers,” says Tom Cesar, president/CEO of ACHC. ACHC has accredited five national providers in the past 14 months, with the most recent being United Seating and Mobility, Florissant, Mo. |
JCAHO Revamps Standards
Providers accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will soon see changes in the accreditation process, announced JCAHO on October 3. Over the next year and a half to 2 years, JCAHO will modernize how it operates through such changes as self-assessments at the halfway point between surveys, pre-survey reviews of organization information, consolidation of the standards to reduce the paperwork burden of the survey process, and revisions of the performance reports. In addition, surveyors themselves will be more educated as JCAHO is instituting an accreditation program for their own surveyors.
For more information, email sharedvisions@jcaho.org or call (630) 792-5000.
| Hall and Vergeer Win Wheelchair Open |
 Esther Vergeer also won in doubles.Australian David Hall successfully defended his Quickie US Open title last month by defeating Robin Ammerlaan of the Netherlands. Hall had reached the final without the loss of a set. This victory gave Hall his 6th US Open title. On the women’s side, Esther Vergeer of the Netherlands defeated Sonja Peters, also of the Netherlands to win the women’s open division. Both Hall and Vergeer are members of Team Quickie, which also sponsored the tournament. The event, held from October 8 through the 13 in San Diego, was one of the toughest in the history of the tournament, says Randy Snow, the retired 10-time US Open champion. “This is a great theater to find pressure and pressure helps you know where the cracks in your game are,” he says. |
State Watch
New York—State licensure is finally a reality for medical equipment providers in New York. The bill, signed into law by Governor George Pataki in early October and developed by the New York Medical Equipment Providers Association, is intended to establish licensing and regulatory procedures within the State Department of Health (DOH) that will ensure that high quality care is given to the disabled, infirm, and elderly citizens of the state.
The bill (A3116/S.2218) outlines that licensure will maintain sufficiently trained and supervised employees; create a quality assurance program and abide by set standards; and offer education and assistance on the proper use of equipment to patients and their caregivers. The bill also creates a Medical Equipment Service Agency Advisory Board within the DOH.
“Now DME is a recognized health service industry,” says Jackie Negri, executive director of the New York Medical Equipment Providers Association. “These providers want policymakers and the public to know this is not a commodity. It will educate everyone that in order to provide such services, you need to meet these criteria.”
Florida—The Florida Association of Medical Equipment Services (FAMES), Orlando, Fla, has won a partial victory in its opposition to competitive bidding. Administrative Law Judge John G. Van Landingham has ruled that the Agency for Health Care Administration (AHCA) cannot sign any contracts until the Centers for Medicare & Medicaid Services approves them. This partial ruling on the Florida Medicaid lawsuit filed on October 18, favors FAMES arguments regarding AHCA’s ability to establish a competitive bidding process without first securing a federal waiver or exemption. The ruling also suggested that AHCA may need a rule-making process to amend its handbook before entering into contracts related to the competitive bidding proposal. Florida will likely seek a waiver or exemption from CMS.
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