DME bidding program puts out hospitals, physicians and beneficiaries
The Centers for Medicare and Medicaid Services' competitive bidding program for durable medical equipment has "created concern and chaos for beneficiaries, physicians, hospital discharge officials and home medical equipment providers" since it was implemented in 10 metropolitan areas on July 1, according to the American Association for Homecare.
Critics of the DME bidding program have reported widespread disruptions in service to beneficiaries who require oxygen therapy, power wheelchairs, CPAPs, diabetic supplies and other items and services. This could potentially eliminate thousands of qualified providers from Medicare and reduce services and access to care for Medicare beneficiaries.
"It's imperative that the Senate move as quickly as possible to impose a moratorium in the program so that critical reforms to the program can occur," said Tyler J. Wilson, President and CEO of the AAH. "We are facing a potentially dangerous situation in which some of the most vulnerable people in our society are having difficulty getting the medical equipment that they need. Those who are in hospitals are being forced into longer stays in those expensive institutions because equipment can't be obtained in a timely manner to sustain them in their homes. This is a dire situation that must be corrected."
The 10 metropolitan areas re Charlotte, N.C.; Cincinnati and Cleveland, Ohio; Dallas-Fort Worth, Texas; Kansas City, Mo. ; Miami and Orlando, Fla. ; Pittsburgh, Pa. ; Riverside, Calif. and San Juan, Puerto Rico. Seventy additional areas are scheduled to expand in 2009.
The AAH has reportedly received many complaints about the bidding program: Delays in patient discharges from hospitals because proper equipment can't be obtained for home use; Medicare beneficiaries calling their previous providers frustrated because they can't find new providers to deliver equipment they need; and providers making referrals for their previous patients but finding that providers who won bids are unwilling or unable to service the patients' needs.
"We found that none of the companies we called carry liquid oxygen systems. I found out that with the goal of finding the lowest bidder companies can sub-contract specialized oxygen services through un-accredited companies. They are not required to have the equipment set-up by or have the patient trained or evaluated by a respiratory therapist," said Dr. Natarajan Rajagopalan, MD, chief of staff at a hospital in Miami-Dade County, Fla. "Typically oxygen is delivered to a patient in hours, not days. The policy will create countless problems for our hospital and the other hospitals in the area. We cannot wait days for equipment to be delivered to the hospital or to the patient's home before they are discharged."
The Senate is expected to vote soon on the Medicare bill that contains reforms to the bidding program, HR 6331. The House has already approved the legislation by a 355-to-59 margin, with strong bipartisan support.
The measure is supported by AAHomecare as well as the ALS Association, Muscular Dystrophy Association, National Spinal Cord Injury Association, Paralyzed Veterans of America and the United Spinal Association, among others.
How is your practice being affected by the DME bidding program? Send your comments to Associate Editor Chelsey Ledue at chelsey.ledue@medtechpublishing.com.
