Where will you be on September 26 and 27? Will you be sitting in your office bemoaning that competitive bidding is scheduled to go into effect on January 1, 2007? Will you be talking to a broker about selling your business before you go bankrupt? Will you be trying to figure out ways to stay in the HME business without participating in the Medicare program?

Yes, it is true! The Medicare Modernization Act of 2003 (MMA) is now the law of the land, and competitive bidding is supposed to start in less than 18 months. Some providers are holding on to the faint hope that Congress will realize the error of its ways and reverse itself on this controversial program. That just is not going to happen.

Congressmen David Hobson (R-Ohio) and John Tanner (D-Tenn) have introduced legislation that would significantly restrain some of the unbridled authority given to CMS in the MMA, but the future of that legislation is uncertain. We all need to be asking our members of Congress to cosponsor that bill if we are to have any realistic hope that it will pass into law before January 2007 (this is the first of a 2-year Congressional session, so the bill will stay “alive” as we move into early 2007, assuming Congress does not pass the law this year). But that is another topic for another column.

In the meantime, CMS will soon issue a proposed regulation providing additional details about how it plans to implement nationwide competitive bidding in 2007. (That regulation will likely be published by the time you read this.) The proposed regulation will include CMS’ proposed criteria for selecting products to include in competitive bidding, proposed criteria for selecting geographic areas, and a proposed bidding structure. At the same time, we expect CMS to issue its “quality standards” with which suppliers will have to comply.

The next step in the process is a continuation of CMS’ Program Advisory and Oversight Committee (PAOC) at CMS headquarters in Baltimore. The next PAOC meeting is scheduled for September 26 and 27, at which time the discussion will focus on the CMS proposed regulation, quality standards, and a series of panels regarding the various product categories potentially subject to competitive bidding.

CMS is trying hard to publish a “proposed rule” before the September PAOC meeting. If they are unable to accomplish this task, they will hold an additional PAOC meeting shortly after publication of the proposed regulation.

Once a proposed rule is published, it must remain open for comment, or from 30 to 60 days, the agency must review all written comments and all oral comments from the public hearing and respond to them when publishing the Notice of Final Rulemaking. CMS expects to publish a final regulation in the spring of 2006.

Knowing this, where will you be during the public PAOC meetings in Baltimore this month? If you care, really care, about your business, about your customers, and about fairness—you will be in Baltimore! There are cheap flights into and out of Baltimore-Washington International Airport (BWI) from almost every city in the United States. (Southwest has cheap cheap flights to BWI.) Filling the PAOC meeting room with providers and consumers will send an indelible message to CMS and to Capitol Hill.

If you can’t be in Baltimore, be prepared to write brief, dispassionate, and clear comments that respond to the issues discussed in the CMS proposed rule and at the PAOC meeting. Do not ramble, do not yell, and do not accuse CMS staff of being callous or indifferent. (Remember, CMS does not have a choice; they are simply doing what the law tells them to.)

Providers who have been in the HME business for a long time can probably list dozens of examples when trade associations, consultants, trade publications, and even commentators like ourselves have admonished them that the future of their industry is in their own hands. There has never been more truth in these words than at this moment in history. It is up to you. You can be either part of the solution or part of the problem. When you look back a year from now, what role would you like your contemporaries to say you played at this important time?

Cara C. Bachenheimer, JD, is vice president of government relations for Invacare Corp, Elyria, Ohio. David T. Williams is a consultant for political and legislative strategy.