WASHINGTON, DC – For those of us who work with Medicare beneficiaries on a daily basis, there is no doubt that timely access to quality medical equipment has been compromised by the competitive bidding program that was suspended, in its broken state, earlier this month.
The equipment access problem continues to persist into the so called “gap” period because of the calamitous combination of artificially low prices and unnecessarily onerous compliance regulations. Just because there are more companies available to service Medicare beneficiaries, that doesn’t address the burden of operating under prices (with the service levels expected) that are simply not sustainable.
The Center for Medicare Services (CMS) has admitted the current competitive bidding program is flawed enough to a warrant wholesale revision but still maintains that its data analytics show access is not a critical issue. The basis for this conclusion is reportedly derived from claims data that, in some cases, is over a year old.
The problem with strictly using old claims data to assess this problem is that it fails to capture information about patients who are forced to go without HME, or are so frustrated by the process that they give up and pay out of pocket.
What about the patients that accept delayed or otherwise substandard service as the norm? What is the point of an equipment benefit if access to it is degraded by price and overregulation?
AAHomecare, together with other industry stakeholders, are once again taking the lead on pressing this issue with CMS and Congress. Monitoring of access problems needs to start now, continue on an ongoing basis, and use real time information.
We have a unique opportunity as an industry to highlight the access problem with Congress during the “gap” period. Please put your Senators’ and Representative’s telephone numbers and email addresses next to anyone in your office who has regular customer interaction. When an access issue occurs, encourage it be reported.
I’ve been told repeatedly by members of Congress that “there is no problem unless we hear from the beneficiaries.” It’s time to make sure that the frustration and access issues that stem from unsustainable Medicare reimbursement rates registers more strongly on Capitol Hill and CMS.
Stephen Ackerman is CEO of Spectrum Medical, Inc. in Washington, DC. He is currently serving as chairman of the Board of the American Association for Homecare.