Dave Simmons, owner of Majors Medical Supply in Clemmons, NC, has been unable to qualify as a Medicare supplier.
By David Rolfe, Winston-Salem Journal
By David Rolfe, Winston-Salem Journal
Email to a Friend
Stumble It!Most Popular Stories
BY AMY DOMINELLO
Media General News Service
WASHINGTON – Medicare recipients may soon get a break on the cost of wheelchairs, walkers, hospital beds and other medical equipment, but some suppliers warn that the more affordable equipment will come at the cost of patient care.
To crack down on fraud and save money for both the system and patients, Congress is requiring Medicare to install competitive bidding for some medical supplies.
The companies that provide these supplies – called durable medical equipment that most patients essentially rent-to-own -- say the change will hurt their livelihood and patients’ access to care.
They also say the bidding process is flawed, and they’re asking Congress to halt the bidding before it begins July 1 in 10 metro regions.
“Medicare does a lot of good things, but this competitive bidding is a mess,” said David Simmons, a co-owner of Majors Medical Supply in Clemmons, N.C.
Through lobbying efforts, suppliers are gaining support in Congress. A bill that would modify the bidding process has bipartisan support, but has yet to move forward. Republicans and Democrats have also written the Centers for Medicare and Medicaid Services, questioning the process. Two House subcommittees have scheduled hearings, the first on Tuesday.
Medicare is rolling out the competitive bidding program in 10 metropolitan areas first, including the Charlotte-Gastonia-Concord region of North Carolina. In July 2009, another 70 metropolitan areas, including Richmond and Tampa, will begin competitive bidding. After that, the program could expand throughout the nation.
Currently, Medicare uses a fee schedule based on typical charges in a geographic area. Beneficiaries are responsible for 20 percent of the cost, which can be paid out of pocket or through health insurance. Under the new system, beneficiaries will pay 20 percent of the contract price.
In 2005, Medicare spent $8 billion on durable medical equipment. Medicare anticipates savings of $1 billion a year when competitive bidding is fully in place in 2010.
That savings will come at a price, suppliers say. While conceding there is some fraud and recipients may save money, suppliers argue that competitive bidding will mean fewer choices for patients and fewer knowledgeable suppliers able to provide equipment.
Patients may have to switch from their current suppliers, and there will be fewer suppliers of equipment. This could lead to delays for Medicare recipients, suppliers said.
Medicare has already started awarding contracts, and suppliers’ groups say some bid-winners have never supplied the equipment they’ll now be providing.
“No longer will patients have the access they used to have,” said Beth Bowen, executive director of both the North Carolina Association for Medical Equipment Services and the Virginia Association for Durable Medical Equipment Companies.
Michael Reinemer, vice president for communications and policy for the American Association for Homecare, said providing medical equipment such as oxygen or hospital beds is a very service-intensive industry.
“Medicare looks at this as a commodity,” he said. “That’s the yardstick Medicare and Congress have been trying to use for this entire sector.”
Wayne Sale owns Health First, an oxygen and medical supply company in Richmond, Va. Sale said he may have to lay off some of his 16 employees due to competitive bidding.
For suppliers like Sale, Medicare is often a large chunk of business. The Association for Homecare, whose members are suppliers and manufacturers, estimates Medicare makes up 40 percent of suppliers’ business.
“The whole thing needs to be stopped,” he said. “It’s bad for business. It’s penny-wise, but pound-foolish. … I hate to see the local businesses be plowed in, just to save our country a buck.”
And while suppliers say they see problems ahead, Medicare beneficiaries may not know what’s coming.
“Many elderly and disabled people have a strong working relationship with these people and this is essentially disrupting the relationship,” said Pete Clendenin, executive vice president of the National Association for the Support of Long Term Care. “… You’re going to hear a lot of seniors complaining.”
In the 10 metropolitan areas that will begin competitive bidding in July, the suppliers have already been selected. Medicare said beneficiaries in those regions will save an average of 26 percent. Medicare says tests done from 1999 to 2002 in Texas and Florida showed prices could be lowered between 17 and 22 percent without hindering access to medical supplies
However, suppliers also say the bidding system is flawed. Almost two-thirds of the bidders were disqualified, many for what amounts to clerical errors, suppliers said.
“It has been frustrating for them to be disqualified for seemingly no reason,” said Bowen.
Simmons bid for wheelchair business in the Charlotte area, where competitive bidding will start in July. He submitted a 70-page bid but was disqualified because of a missing financial statement. It’s unclear whether he sent it or CMS lost it.
“Competitive bidding disqualified 63 percent of bidders,” Simmons said. “That says there’s something wrong with the process.”
Simmons said that after his bids were disqualified, he had no right to appeal. He worries what will happen when competitive bidding is expanded further in his core market, the Triad region.
Ellen Griffith, a spokeswoman for the Centers for Medicare and Medicaid Services, responding to questions by e-mail, said every effort was made to ensure suppliers understood what was required. The bidding process, she said, results in healthy competition that will ensure patient access at prices closer to those in the market.
Medicare has said that 64 percent of the winning bidders are small suppliers.
Suppliers want Congress to halt and revamp the competitive bidding process. If Congress doesn’t act, several groups have said they may sue.
“This is a train wreck in progress and we can see it rolling down the tracks,” said Bill Griffin, president and CEO of Griffin Home Health Care in Charlotte, N.C.
Contact Amy Dominello at 202-662-7671 or adominello@mediageneral.com
The affected products include:
Oxygen and oxygen equipment
Power wheelchairs
Mail-order diabetic supplies
Food and equipment for people with feeding tubes
Respiratory devices
Hospital beds
Negative pressure wound therapy pumps
Walkers
Media General News Service
WASHINGTON – Medicare recipients may soon get a break on the cost of wheelchairs, walkers, hospital beds and other medical equipment, but some suppliers warn that the more affordable equipment will come at the cost of patient care.
To crack down on fraud and save money for both the system and patients, Congress is requiring Medicare to install competitive bidding for some medical supplies.
The companies that provide these supplies – called durable medical equipment that most patients essentially rent-to-own -- say the change will hurt their livelihood and patients’ access to care.
They also say the bidding process is flawed, and they’re asking Congress to halt the bidding before it begins July 1 in 10 metro regions.
“Medicare does a lot of good things, but this competitive bidding is a mess,” said David Simmons, a co-owner of Majors Medical Supply in Clemmons, N.C.
Through lobbying efforts, suppliers are gaining support in Congress. A bill that would modify the bidding process has bipartisan support, but has yet to move forward. Republicans and Democrats have also written the Centers for Medicare and Medicaid Services, questioning the process. Two House subcommittees have scheduled hearings, the first on Tuesday.
Medicare is rolling out the competitive bidding program in 10 metropolitan areas first, including the Charlotte-Gastonia-Concord region of North Carolina. In July 2009, another 70 metropolitan areas, including Richmond and Tampa, will begin competitive bidding. After that, the program could expand throughout the nation.
Currently, Medicare uses a fee schedule based on typical charges in a geographic area. Beneficiaries are responsible for 20 percent of the cost, which can be paid out of pocket or through health insurance. Under the new system, beneficiaries will pay 20 percent of the contract price.
In 2005, Medicare spent $8 billion on durable medical equipment. Medicare anticipates savings of $1 billion a year when competitive bidding is fully in place in 2010.
That savings will come at a price, suppliers say. While conceding there is some fraud and recipients may save money, suppliers argue that competitive bidding will mean fewer choices for patients and fewer knowledgeable suppliers able to provide equipment.
Patients may have to switch from their current suppliers, and there will be fewer suppliers of equipment. This could lead to delays for Medicare recipients, suppliers said.
Medicare has already started awarding contracts, and suppliers’ groups say some bid-winners have never supplied the equipment they’ll now be providing.
“No longer will patients have the access they used to have,” said Beth Bowen, executive director of both the North Carolina Association for Medical Equipment Services and the Virginia Association for Durable Medical Equipment Companies.
Michael Reinemer, vice president for communications and policy for the American Association for Homecare, said providing medical equipment such as oxygen or hospital beds is a very service-intensive industry.
“Medicare looks at this as a commodity,” he said. “That’s the yardstick Medicare and Congress have been trying to use for this entire sector.”
Wayne Sale owns Health First, an oxygen and medical supply company in Richmond, Va. Sale said he may have to lay off some of his 16 employees due to competitive bidding.
For suppliers like Sale, Medicare is often a large chunk of business. The Association for Homecare, whose members are suppliers and manufacturers, estimates Medicare makes up 40 percent of suppliers’ business.
“The whole thing needs to be stopped,” he said. “It’s bad for business. It’s penny-wise, but pound-foolish. … I hate to see the local businesses be plowed in, just to save our country a buck.”
And while suppliers say they see problems ahead, Medicare beneficiaries may not know what’s coming.
“Many elderly and disabled people have a strong working relationship with these people and this is essentially disrupting the relationship,” said Pete Clendenin, executive vice president of the National Association for the Support of Long Term Care. “… You’re going to hear a lot of seniors complaining.”
In the 10 metropolitan areas that will begin competitive bidding in July, the suppliers have already been selected. Medicare said beneficiaries in those regions will save an average of 26 percent. Medicare says tests done from 1999 to 2002 in Texas and Florida showed prices could be lowered between 17 and 22 percent without hindering access to medical supplies
However, suppliers also say the bidding system is flawed. Almost two-thirds of the bidders were disqualified, many for what amounts to clerical errors, suppliers said.
“It has been frustrating for them to be disqualified for seemingly no reason,” said Bowen.
Simmons bid for wheelchair business in the Charlotte area, where competitive bidding will start in July. He submitted a 70-page bid but was disqualified because of a missing financial statement. It’s unclear whether he sent it or CMS lost it.
“Competitive bidding disqualified 63 percent of bidders,” Simmons said. “That says there’s something wrong with the process.”
Simmons said that after his bids were disqualified, he had no right to appeal. He worries what will happen when competitive bidding is expanded further in his core market, the Triad region.
Ellen Griffith, a spokeswoman for the Centers for Medicare and Medicaid Services, responding to questions by e-mail, said every effort was made to ensure suppliers understood what was required. The bidding process, she said, results in healthy competition that will ensure patient access at prices closer to those in the market.
Medicare has said that 64 percent of the winning bidders are small suppliers.
Suppliers want Congress to halt and revamp the competitive bidding process. If Congress doesn’t act, several groups have said they may sue.
“This is a train wreck in progress and we can see it rolling down the tracks,” said Bill Griffin, president and CEO of Griffin Home Health Care in Charlotte, N.C.
Contact Amy Dominello at 202-662-7671 or adominello@mediageneral.com
The affected products include:
Oxygen and oxygen equipment
Power wheelchairs
Mail-order diabetic supplies
Food and equipment for people with feeding tubes
Respiratory devices
Hospital beds
Negative pressure wound therapy pumps
Walkers