Michael Reinemer

During the past few weeks, the home care community has made progress toward delaying the competitive bidding program. At press time, we did not know whether those efforts would succeed. What we did know is that bills to delay bidding, backed by powerful sponsors, have been introduced in the House of Representatives and the Senate.

If passed, the Medicare DMEPOS Competitive Acquisition Reform Act of 2008 would delay bidding for 18 months and make a number of improvements in the bidding program. The House bill is HR 6252, and the Senate companion bill was not yet numbered at press time.

As Tyler Wilson noted in a memo to AAHomecare members on June 13, "H.R. 6252 does not include everything the industry requested during its many discussions with Ways and Means about how best to delay the start of Round One. The payment reduction in the bill targets only the competitive bidding product categories and is not across-the-board as we urged from the outset."

The cost of the delay is a 9.5% payment reduction in 2009 for those items subject to competitive bidding in round one, and no Consumer Price Index update in 2009 for those items. This bill was the only option offered by Congress. The alternative is likely implementation of the bidding program and potentially additional cuts to other areas such as oxygen therapy. Wilson called it "the best option for a majority of the HME community at this time." Not a perfect solution, but a significant step for the industry.

The delay bill has already won endorsements from professional medical societies, patient advocacy groups, disability organizations, pharmacists, and nurses' organizations. This support comes on top of nearly universal support in the HME industry.

Wilson noted, "Rarely in the recent history of the HME industry have so many different organizations, individual companies, and other stakeholders come together to challenge such a fundamental and monumental threat to our livelihood and to the Medicare beneficiaries we serve. We have received the attention of Congress and we have shown that we can work through an issue and present a consensus position on Capitol Hill."

Credit for the momentum goes to grassroots efforts of hundreds of providers, state and regional associations, patient groups, buying groups, manufacturers, and others who have been working hard to sound the alarm and educate Congress and the media about the flawed structure and implementation of this bidding program.

The advocacy process to amend or delay competitive bidding has been strewn with obstacles and inevitable differences of opinion and strategy. However, approaching the crucial

July 1 milestone for the bidding program, the HME industry has demonstrated—beyond a shadow of a doubt—a historic measure of strength, commitment, and unity.

Michael Reinemer is VP of communications and policy at AAHomecare, Arlington, Va.