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Thank You. Madonna Long
Round One DME Competitive Bidding must be Suspended
And Changes Made Prior to Expansion of the Program
Pride Mobility request that Congress strongly communicate to HHS Secretary Michael Leavitt support for the immediate suspension of the implementation of Round One of the Medicare competitive bidding program for durable medical equipment, orthotics, prosthetics and supplies (DMEPOS).
You could lose the right to choose the Provider of your medical equipment.
The Centers for Medicare and Medicaid Services (CMS) has improperly rejected over 200 qualified Medicare providers from the first stage of the program due to procedural flaws and operational problems. As a result, Medicare beneficiaries who depend on home medical equipment products and services will be prevented from doing business with their local provider for competitively bid products and services.
Without adequate procedural controls, CMS is rushing to implement the program in ten metropolitan areas around the country and with equal haste is moving forward to expand the program under Round Two in another 70 areas across the country in 2009. Plans for Round Two are proceeding without a thorough examination of the serious, systemic problems being encountered now in Round One.
What can be done to fix this?
Unless Congress exercises oversight and delays the implementation of Round One, fundamental mistakes will be imbedded in the program and perpetuated in Round Two of competitive bidding.
What is the Medicare Competitive Bidding Program?
The Medicare Modernization Act of 2003 mandated that CMS begin implementation of a durable medical equipment, orthotics and supplies (DMEPOS) competitive bidding program for certain DMEPOS items and services in 10 of the largest metropolitan statistical areas (MSAs) in 2007, 70 additional areas in 2009, and be expanded to other areas as early as 2010.
Where will this happen first? Are YOU in a competitively bid area?
The first 10 areas (CBAs) where the program is scheduled to be implemented July 1, 2008 include:
Charlotte, NC (parts of SC) 6. Miami, FL
Cincinnati, OH 7. Orlando, FL
Cleveland, OH 8. Pittsburgh, PA
Dallas, TX 9. Riverside, CA
Kansas City, MO (parts of KS) 10. San Juan, Puerto Rico
What products were competitively bid? Do YOU use any of these products and services?
1. Oxygen and oxygen equipment 6. CPAP and Respiratory Assist Devices
Standard power wheelchairs and accessories 7. Hospital Beds
Complex rehab power wheelchairs and accessories 8. Negative Pressure Wound Therapy
Mail order diabetic supplies 9. Walkers
Enteral nutrition and supplies 10. Support Surfaces (Miami and San Juan only)
On March 21, CMS notified all bidding home medical equipment providers of the competitive bidding results. Many providers received notices that they had been disqualified from participating. A considerable number of those notified contest the grounds by which they have been disqualified. If it is found that providers were erroneously disqualified from the program this will severely limit patient choice and access to your provider if they met the bid requirements.
How will this affect YOU?
1. You may no longer be able to choose YOUR provider for medical equipment and services.
2. You may not know your new provider, or you may know them but not want to work with them.
3. You may have problems obtaining previously purchased items that are now up for bid.
4. If you need a Power Wheelchair and you are in a Competitive Bidding Area you may have a difficult or lengthy time receiving the correct chair for YOUR disability.
5. Your current Provider may not sell YOU a competitively bid product if the delivery date is expected to be on or after July 1.
6. If you have a power wheelchair on order from your current provider they will not get paid for it if they are not a bid winner in Round one and it is delivered on or after July 1.
7. Providers who won the bids may not be able to service the volume of new patients they will acquire as the number of providers in the area will be significantly reduced.
8. YOU may have to use a different provider for each product/service you need because different providers “won” different categories.
9. Providers who won the bids may substitute products with lower quality and less expensive equipment and reduce the non-equipment services.
10. You may not get the bid winning Provider to visit YOU at home to take care of your needs like your former Provider was able to because they will not have time and are not paid for this service.
11. You may have problems finding a new Provider who is willing to repair YOUR Power Wheelchair because the contract providers are not required to service the items they sell.
12. The new single payment amounts on replacement parts are unreasonably low.
13. Your former provider is not under any obligation to service the power wheelchair they sold YOU and they may not be able to afford to fix it for YOU.
14. YOUR Part A expenditures may increase because of YOUR need for ambulance services, hospital emergency room visits, extended in-patient days in the hospital or skilled nursing facilities and additional physician’s fees due to limited access to appropriate medical products and services.
CMS is heading into uncharted territory with the implementation of a Medicare competitive bidding program where the government discriminates against who can provide items and services to Medicare beneficiaries. CMS has an obligation to determine whether the bidding program will be effective and achieve the goals that were originally intended and expected. Based on CMS’s failure to adequately respond to questions about the program and the errors and program flaws that have been identified, Pride strongly requests that lawmakers urge CMS to delay round one immediately and stop plans to expand the program to 70 more areas until a thorough review and analysis of Round 1 is conducted.
Please contact your Congressional Members TODAY and let them know how this will affect YOU!
Congressional switchboard number 202-224-3121
US Senate Members US Senate members
US Congress Members US House of Rep members/
“HOW TO” lobby your members of Congress
Telephone calls are often taken by a staff member and not the actual legislative member.
Ask to speak with the Health Legislative Aide when calling about healthcare issues you wish to comment on. If they are not available, you may also leave a message.
If you speak with someone other than your legislator, take down their name and title.
Upon reaching your state legislator’s office on the phone, it's easiest to follow these four basic steps:
IDENTIFY yourself by name and the organization (if any) that you represent or the town from which you are calling.
EXPLAIN why you are calling: "I am calling to talk to you about the Medicare National Competitive Bidding Program" Be polite and concise.
Create 1 or 2 talking points that will focus the content of your message. Too much information may confuse your message.
Point 1: Congressman or Senator to strongly communicate to HHS Secretary Michael Leavitt support for the immediate suspension of the implementation of Round One of the Medicare competitive bidding program for durable medical equipment, orthotics, prosthetics and supplies (DMEPOS).
Point 2: You are worried that you are going to lose the provider that you have known and they know your needs and disability for your DME supplies.
Ask your legislator his/her position on this issue. Congressman/ Senator how do you feel about Competitive bidding and my chance to not have service in an area or someone who knows my disability
Don't assume that your legislator has prior knowledge of your issue. Be calm, respectful, and be prepared to educate, using local examples to accentuate your point.
REQUEST a written response to your phone call if you did not speak to your legislative member. If the legislator requires further information, provide it as soon as possible.
THANK the person who took the phone call for their time and consideration.
If you have any questions Please email or call me.
Thank you for your help in keeping AMERICA MOBILE...
Madonna Long
Consumer Advocate
Pride Mobility
MadonnaL37@aol.com
