Administration program cuts Medicare patients off from their existing medical suppliers
Posted By Patrick Howley On 3:00 AM 11/19/2013
The Obama administration implemented a competitive bidding program that causes many Medicare patients to lose their existing health equipment providers, forcing seniors to rely on out-of-state companies that increase their medical costs and keep them waiting for essential services like oxygen.
Between 80 and 90 percent of previously-eligible providers of medical equipment and services are now excluded from serving Medicare patients in bid areas, according to figures compiled by the nonpartisan homecare advocacy group People for Quality Care (PFQC) and provided to The Daily Caller.
“Prior to competitive bidding, providers were chosen from a long list of Medicare-eligible providers. Not anymore,” PFQC executive Kelly Turner told TheDC.
And while the competitive bidding, which ignores a host of other factors in pursuit of the lowest offer, saves some money up front, anecdotal evidence suggests it may end up costing more as seniors without proper preventive care end up using more emergency room services.
The Obama administration has defended its implementation of the cost-cutting “Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies,” which was signed into law by President Bush in 2003 but only partially implemented in 2011 and more extensively implemented in the last several months over bipartisan opposition.
The program saves money for the federal government by only allowing low-bid companies to provide Medicare patients with devices, supplies, and other services.
PFQC’s telephone hotline has already yielded more than 2,500 complaints from Medicare patients losing their existing equipment and services providers and having to switch to government-contracted companies that are out of state and unable to respond in a timely manner to patient requests. Additionally, many Medicare-eligible providers are now going out of business due to the competitive bidding program.
A North Carolina woman with breathing problems who registered a complaint with PFQC said that she lost her longtime medical devices and supplies provider when it did not receive a government contract under competitive bidding. The woman now has a new provider 40 miles away from her home, and she waits up to two weeks for her supplies. Additionally, she and her elderly husband lost their “hardship case” discount when they switched providers, significantly raising their medical costs.
“If they said they were going to be there, they always were,” the woman told PFQC, referring to her former provider.
A Florida woman who registered a complaint with PFQC said that her provider told her “we have no oxygen to give you and we don’t know when we will” when she was admitted to a hospital with complications from the respiratory disease COPD. Though a Medicare official gave her names of three new eligible providers, the woman claimed that none of the three would immediately provide her an oxygen concentrator, which she has now been waiting months to receive.
“The program has saved more than $400 million in its first two years of operation in only nine areas of the country without diminishing beneficiary access to quality equipment or resulting in negative health outcomes for beneficiaries,” Centers for Medicare and Medicaid Services (CMS) deputy administrator Jonathan Blum wrote in a June Politico op-ed to announce the program would be spreading to 91 new areas on July 1.
A bipartisan congressional delegation comprised of more than 200 members of Congress quietly tried to stop the program’s implementation back in June, sending a letter to CMS administrator Marilyn Tannever.
“As you are most likely aware, many members of Congress have continued concerns about the lack of transparency, the lack of binding bids during the contract process, and the improper vetting of the financial wherewithal of many firms that have been awarded contracts to service many bid areas far from their current base of operations,” according to the letter, which pointed out that many companies were awarded contracts under the program without holding necessary licenses in the states where they’re now serving Medicare patients.
“The list of bid winners who failed to secure the necessary state licenses and product-specific accreditation includes firms that won contracts in virtually every competitive bidding area,” according to the letter.
Georgia Rep. Tom Price sponsored a bill to replace the competitive bidding program, which is currently waiting in the House with 158 cosponsors.
“The consequence to selectively contracting with a limited number of home medical equipment providers is the significant reduction in the Medicare patient’s freedom to choose a provider of their liking. In many cases, long-standing relationships between patients and providers will be severed when a provider loses” the eligibility to serve patients, Turner said.
CMS and the White House did not return requests for comment.