Combine more than 160 home care advocates with a House hearing on competitive bidding this week, and it adds up to considerable pressure. For Julie Weidemann, it was a rare opportunity to testify before the Subcommittee on Rural and Urban Entrepreneurship, which convened to examine the first round competitive bidding process. “Subcommittee Chairman Rep Heath Shuler (D-NC) [pictured, left] really understood the gist of what we were getting at,” said Weidemann, director of Iowa-based Palmer Home Medical. “If my company has to take a 26% reduction [if CMS applied an inherent reasonableness standard on the whole industry], I’ll have no choice but to decrease the level of service I currently provide. And what is going to happen to those patients in outlying areas?”

Later on, Weidemann visited with two staff members of Senator Charles Grassley (R-Iowa). Also along for the meeting were: Cara Bachenheimer, senior VP of government relations for Invacare; John Gallagher, VP of government relations for VGM; and Walt Gorski, VP of government relations for AAHomecare. In that meeting, Weidemann says Grassley staffers were initially under the impression that the majority of the HME industry was not, in fact, behind a competitive bidding delay. “We really tried to drive home the point that yes, 90% to 95% of the industry is in support of this delay,” said Weidemann, who made the trip to DC with help from VGM and MAMES. “And AAHomecare’s position is that in return for a delay, we will agree to an across-the-board cut on the HME fee schedule – to help offset the cost of the delay.”

As a respiratory therapist, Weidemann also devoted part of her comments to the 36-month oxygen cap. Later in the day, her comments paid off when she got a call from a member of Rep Tom Price’s (R-Ga) (pictured, right) staff. “A representative from Rep Price called and said she had heard my testimony on the oxygen cap,” said Weidemann, “and they are sending around a dear colleague letter to try to get that 36-month cap out of there and just put it back to the way it used to be."

Also at the subcommittee hearing, panelists heard from other representatives of the medical community, who agreed that CMS must fix the problems made during round one. Advocates characterized comments from Chairman Shuler as encouraging. “There are nearly 5,000 small DME suppliers across the country. They are an essential source of health care services—particularly in rural areas,” said Shuler. “By pushing to expand this project without addressing the harm it is likely to cause entrepreneurs, CMS is undermining their ability to serve patients and their key role in strengthening the economic base of local communities. Clarity and fairness are essential to the integrity of a program like this, but the bidding process CMS has put in place lacks both. Now they want to expand it without first examining the process and results?  It’s incredible.”

Rep Nydia Velazquez (D-NY), who chairs the full Small Business Committee, noted that HME is a “vital part of this nation’s health safety net. Why has the agency ignored the impact of small business in healthcare?” Her sentiments were mirrored by many of the Reps’ opening remarks, and again reflected in their questions to first panel member, Laurence Wilson, CMS director of Chronic Care Policy Group. Wilson talked about the aggressive education and outreach CMS has done for beneficiaries and providers, and stated that CMS will track the first round carefully through beneficiary satisfaction surveys.

Tough questions from the subcommittee included: How CMS will ensure beneficiary safety and quality of service with subcontractors?  Is CMS completely prepared for round two? How many patients will end up in hospitals as a result of fewer available homecare providers and services under the bidding program? Was the higher hospitalization rate factored into the savings estimates for round one? 

Prior to the hearing and the Hill vistis on Wednesday, AAHomecare Chairman Alan Landauer, of Landauer Metropolitan, noted that the efforts to stop round one of the Medicare competitive bidding program “started with a groundswell of grassroots noise.”  And now, “We stand on the precipice of a delay of round one and round two and defeat of competitive bidding.”

Landauer thanked all the stakeholders that have worked hard to keep up the momentum, including the state associations, MED Group, and VGM. The fly-in, scheduled just weeks ago, aimed to generate enough awareness about the program problems to delay bidding for at least a year. Delegations of providers from many states were represented including California, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Missouri, Mississippi, North Carolina, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Utah, and Virginia. Tyler Wilson, AAHomecare president, recited a list of recent positive steps and momentum toward “stopping the clock” on competitive bidding. “Now we need to finish the job,” he said.

Also testifying before the subcommittee were: North Carolina Association of Medical Equipment Services (NCAMES) member Heath Sutton with Mountaineer Oxygen Services; and NCAMES/VGM/AAHomecare member Casey Hite with Aeroflow. 

To view Julie Weidemann’s full testimony on YouTube, click here.
To view other speakers at the Subcommittee on Rural and Urban Entrepreneurship, click here.