The Medicare Modernization Act of 2003 (MMA) required Medicare to replace the home medical equipment (HME) payment fee schedule for certain items with a ‘competitive acquisition’ or government contracting program. The bidding program was implemented on January 1, 2011 in nine cities across the U.S. and begins in an additional 91 metropolitan areas later this year.

Impact of Bidding Program on Medicare Beneficiaries

• Most beneficiaries are not able to receive their home medical equipment, supplies, and services in a timely fashion which leads to negative health outcomes where peope with disabilities are using the wrong products or not using any products.
• Consumers have fewer companies to choose from and, in some cases, have to switch to products that do not meet their needs.
• People receiving diabetic supplies through the mail are being told by Medicare to go to a retail outlet with much higher allowables when their product is unavailable through mail order.

Lack of Access to Products and Quality Service

• As part of the referral process, access to products and quality service is restricted for beneficiaries who are customers of non-contract providers.
• Due to the complexity of repairs rules for contract providers, it is difficult for people with disabilities to obtain wheelchair equipment repairs.
• There is a broad range of products under each Healthcare Common Procedure Coding System (HCPCS) code. In some cases, the least expensive product in a HCPCS code is being provided to beneficiaries, when that product may not be the best product to meet their medical needs.

Lack of Consumer Education

• Beneficiaries were told by Medicare that they would not have to switch providers when Medicare’s competitive bidding program was to begin January 1, 2011 and in January 2011, those same beneficiaries were told by Medicare that they did have to switch providers.By this time, it was too late for them to elect to switch to a contract provider from a non-contract provider. That is, it was too late to use a grandfathered provider to obtain the needed products and services.

Because the program is not sustainable, Congress must pass HR 1041 – the Fairness in Medicare Bidding Act – bipartisan legislation introduced by Representatives Glenn Thompson (R-Pa.) and Jason Altmire (D-Pa.) that would repeal the bidding program. The bill currently has 152 cosponsors; only two from California [Buck McKeon—Republican, 25th district and Susan Davis—Democrat, 53rd district].

Californians with disabilities are already being negatively impacted by the competitive bidding program. Unless HR 1041 is passed, many more will be as well. Ask your Congressional Representative to support and cosponsor HR 1041.