The North Carolina Association for Medical Equipment Services and the American Association for Homecare praised a bipartisan bill in Congress, H.R. 3790, to eliminate the deeply flawed "competitive" bidding program for durable medical equipment and services in Medicare. The bid process for this controversial program began October 21 in Charlotte and eight other metropolitan areas across the U.S (see also Medicare and Medicaid).

Durable, or home medical equipment, such as oxygen, wheelchairs, diabetic supplies, and hospital beds, enables seniors and people with disabilities to receive quality care at home. Home-based care represents a cost-effective alternative to institutional care, and seniors prefer to receive care at home rather than in an institution.

To ensure that seniors and taxpayers receive the savings projected for the bid program, the bill would reduce Medicare reimbursements to home medical equipment providers in 2010, 2011, 2012, 2014, and 2015. At the same time, the bill will allow thousands of home medical providers to keep their doors open to serve the millions of Americans who require home-based care and will allow patients to continue to receive services from the providers of their choice.

H.R. 3790 has bipartisan support from two dozen cosponsors in the House of Representatives including North Carolina Congressman Heath Shuler (D-N.C.). The introduction of the legislation came just before the start-up of the bidding process for the bid program for home medical equipment. The process began on October 21 in nine metropolitan statistical areas (MSAs) across the U.S. including Charlotte. The bid prices and bid winners would be selected in 2010 and new prices would become effective January 1, 2011. Another round of bidding would begin after that in 100 MSAs across the U.S.

"Although 'competitive bidding' sounds good, what it really does is destroy about 90 percent of small businesses, remove healthy competition, limit patient choice, and limit patient access to care," said Beth Bowen, executive director of the North Carolina Association of Medical Equipment Services. "At the end of the day, that strategy will prove more costly than the alleged savings of the bid program. Congress and administrators at Medicare must understand that the durable medical equipment sector saves money by providing quality care in the home, rather than in costly institutions."

Categories subject to the bid program include medical oxygen, which is a highly regulated prescription drug, complex rehabilitative power wheelchairs, enteral nutrients (used in tube feeding), and hospital beds, among other categories.

The initial roll-out of the bidding program in 2008 produced disastrous results for home medical equipment patients and for providers (mostly small businesses) who were excluded from Medicare as a result of the first round of bidding.

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