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Medicare's competitive bidding program disappoints

The American Association of Homecare says the competitive bidding process initiated for Medicare patients at the start of 2011 is not working.

Problems reported by Medicare patients, providers and case managers through the AAH's biddingfeedback.com website include difficulty finding a local equipment or service provider; delays in obtaining medically-required equipment and services; longer-than-necessary hospital stays due to confusion in discharging patients to home-based care; few choices for patients when selecting equipment or providers; reduced quality; and confusing or incorrect information provided by Medicare.

"By limiting providers, this bidding program is actually hurting patients," said Barry Johnson, president of the Texas Alliance of Home Care services, in a statement describing his state's experience with the new bidding program. "This program leaves no alternatives for our nation's seniors and people living with disabilities and puts people out of jobs in an already rough economic environment."

"When our businesses close, patients will have to turn to expensive hospital visits and long-term stays because Medicare will have nowhere to turn if the smaller pool of 'winning' businesses is unable to meet the region's increasing demand for home-based care," he added.

The bidding program was designed by the Centers for Medicare and Medicaid Services to provide high-quality home medical equipment and services to millions of seniors and people with disabilities while  reducing costs.

[See related stories: Competitive bidding rules will challenge DME makers; battle over DME competitive bidding rule]

"Competitive bidding is unfairly harming the health of Medicare patients in Florida and hurting local businesses in an already struggling economy," said Sean Schwinghammer, executive director of the Florida Alliance of Home Care Services, in a statement. "In Miami and Orlando, we are seeing patients being sent to emergency rooms to receive services that were once standard at-home procedures for them. We are witnessing local providers that have been around for more than 20 years being put out of business by out-of-area companies. Patients are calling us on the phone in tears, and we've heard from doctors and other providers who are worried as well."

Medicare's competitive bidding program for durable medical equipment and supplies – items such as power wheelchairs, walkers, oxygen, CPAP and respiratory assistive devices, hospital beds, enteral nutrients (tube feeding), support surfaces, and mail-order diabetic supplies – was launched at bthe beginning of the year in Charlotte, Cincinnati, Cleveland, Dallas-Fort Worth, Kansas City, Miami, Orlando, Pittsburgh and Riverside, Calif.

The AAH and others, including members of Congress, national and consumer advocacy groups and economic experts, had voiced concerns about the competitive bidding initiative prior to its implementation.

The AAH set up a toll-free number (888-990-0499) and website to log concerns from Medicare beneficiaries, family members, caregivers, hospital discharge planners and clinicians. In a statement released February 25, the AAH said it had received more than 250 complaints since the beginning of the year.

"Competitive bidding is an utter disaster, yet Medicare says there are no reported problems," said Schwinghammer. "Congress must take action and repeal this program before the situation becomes even more dire."