Rep Mike Ross (D-Ark) continues the good fight and plans for a fourth term in Congress.

Representative Mike Ross (D-Ark) speaks your language. Unlike some of his colleagues, if you woke him up at 3 in the morning, he could tell you what DMERC and PAOC stood for. As an owner of an HME/pharmacy in Prescott, Ark, he has lived your frustrations and triumphs.

While it helps to have a provider on the “inside,” this third-term representative (with plans for a fourth) is quick to point out that the industry must continue to band together and educate lawmakers. As the HME industry enters a critical phase, look for Rep Ross to be in the thick of the fight.

Dealer/Provider: You are the only HME provider in Congress (and probably the first ever). Is your HME/pharmacy business in Prescott still active? If so, are you able to get down there every once in a while?

Representative Mike Ross (D-Ark): Currently, serving in the United States Congress requires my full attention, but I still own an HME business with my wife and I check in on it every chance that I can.

D/P: You are currently in your third term in office. Do you plan to run for a fourth term?

Ross: Yes, I plan to run for a fourth term. I was just appointed to the Energy and Commerce Committee, which has jurisdiction over health care matters including Medicare and Medicaid. Being part of this committee puts me in a great place to address health care needs and concerns of my constituents and the nation at large. 

D/P: At the recent American Association for Homecare (AAHomecare) Legislative Conference, you called competitive bidding “the dumbest thing I ever heard of in my life.” With nationwide competitive bidding still set to go into effect in 2007, realistically what is the best-case scenario for small- to medium-size HME providers?

Ross: I stand by the statement that competitive bidding is one of the dumbest things I have ever heard. Unfortunately, quality of care for rural patients will be compromised, and they will lose access to this quality of care that they deserve. I believe any qualified provider should be able to compete and CMS should not limit the number of providers if the providers can meet prescribed prices and quality standards. With that said, I will continue to educate my colleagues and encourage revisiting this flawed policy.

D/P: Do you have any immediate plans to sponsor or cosponsor legislation that would affect the HME industry?

Ross: Currently, I am a cosponsor of the Medicare Durable Medical Equipment Access Act of 2005 (HR 3559), which would remedy many of the “competitive acquisition” provisions of the Medicare Modernization Act of 2003 (MMA). More specifically, this legislation would protect patients by requiring that “competitive bidding” not begin until quality standards are in place; exempt smaller, rural areas (metropolitan statistical areas with populations under 500,000); allow all qualified providers to participate at the selected award price; restore the rights of participating providers to administrative and judicial review; and exempt items and services unless savings of at least 10% can be demonstrated.

As I said before, I believe any qualified provider should be able to compete and CMS should not limit the number of providers if the providers can meet prescribed prices and quality standards. It is important that we continue to offer as many options to HME patients as possible, so they can receive quality care that includes choices.

D/P: In your talk at the AAHomecare Legislative Conference, you indicated that Congress may yet revisit the Medicare Prescription Drug, Improvement, and Modernization Act. What makes you think so?

Ross: I believe that Congress will have to revisit this flawed legislation. Final implementation has yet to take place, and we are already seeing problems from both beneficiaries and health care providers. Current complaints from beneficiaries include confusion on enrollment and the effect of the Medicare Part D drug benefit. Health care providers are concerned with various reimbursement policies. Once implemented, I feel that seniors are going to see how inadequate this new law is and are going to demand that Congress make improvements.

D/P: What do you think the HME products and services industry will look like in the next 5 to 10 years?

Ross: I think the effect of competitive bidding will ultimately determine how the HME business will look in the future. Many rural providers will not be able to survive competitive bidding, which in the end will only hurt patient options and care.

D/P: Among your colleagues in the Senate and House, what is the biggest misconception about HME products and services? What can providers do to correct these misconceptions?

Ross: Individuals have a better understanding of the profession they either currently work in or previously worked in. As someone who owns an HME business, I have a much better understanding of how the system works, as well as the factors that go into the business and the outcomes that result. 

I think at times HME is strictly looked at from the business standpoint rather than from the patient standpoint.  HME providers are helping millions of individuals to live more independently and with a greater quality of life, while at the same time helping to lower overall health care costs by allowing individuals to avoid longer hospital and nursing home stays. Providers can emphasize this point and educate state and Congressional officials by inviting them to visit their business, and ride along on a patient visit.

D/P: HME providers are inundated with requests to contact their Senators and Representatives, but many believe their voices are not heard. Do these calls and letters have an effect on your policy decisions?

Ross: Yes, letters and calls to your elected officials do have an impact. It is important for individuals who work directly in this business to educate representatives and their staff. Your experiences and knowledge are valuable in putting a face on the patients that you help to live better lives. I also recommend providers invite their representatives to come out and see firsthand the valuable services being provided by demonstrating services and having them meet some of the patients whose lives are being improved.  

D/P: When is the best time and what is the best approach in asking a member of Congress to visit a provider’s place of business? What tactics should providers be sure to avoid?

Ross: It is always a good time to approach your elected official about scheduling a visit. Throughout the year, Congress has certain weeks when it is in recess and members have the opportunity to travel throughout their districts. Members’ schedules tend to become full very quickly, and it is best to contact representatives as early as possible. Contact either their scheduler or the legislative assistant handling health care issues. 

D/P: Is there ever a conflict between what is right for the HME industry and what is best for the country?

Ross: The HME industry is comprised of businesses that face many of the same situations that all businesses, whether big or small, face. A business can survive only as long as it continues to make a fair profit. With that said, the HME industry is geared to improve the quality of health care for patients. I believe such goals and outcomes contribute to what is good for our country. 

D/P: How has your work in the pharmacy/HME business shaped your values and goals as a US Congressman?

Ross: It has enabled me to understand health care from not only a business perspective, but also, and most important, from a human perspective. Each day my business serves numerous individuals of all ages and of varying health conditions. From these experiences, I have seen firsthand how health care costs have skyrocketed and how more and more individuals are losing access to necessary services and medications. The majority of my experiences in this business have been with constituents from Arkansas; however, I know that these cases are representative of a national trend. I keep this in mind as I work on health care initiatives.

Greg Thompson is editor of Home Health Care Dealer/Provider.