Navigation Links
North Carolina Business Owners At Risk Because Of Defective Medicare Bidding Program

GASTONIA, N.C. and HENDERSONVILLE, N.C., May 21, 2013 /PRNewswire-USNewswire/ -- The controversial Medicare bidding procurement program for home medical equipment is forcing many small and large providers in North Carolina to lay off employees or close their businesses, developments that will likely disrupt the quality of service and products received by Medicare beneficiaries, says the American Association for Homecare.

Under the defective and dangerous program, the Centers for Medicare & Medicaid Services (CMS) is reducing reimbursements to providers by 45% when the bidding program expands to 91 new locations in July. Due to these arbitrary cuts, many providers say they can no longer supply Medicare patients with durable medical equipment (DME); these include critical items such as power wheelchairs, hospital beds, oxygen, and diabetic supplies.

"Medicare is creating havoc for providers in North Carolina and across the country and, ultimately, jeopardizing people's health," said Tyler Wilson , president of AAHomecare. "It is time Congress and the Administration end this failed experiment and create a program that guarantees high-quality service to patients, while offering businesses fair, market-based reimbursement rates."

Wilson said there has been "complete mismanagement of the design and implementation of the bidding program." CMS basically imposes reimbursement rates that fall somewhere between the lowest and highest bids that are made by providers. But at the same time, all the bids are non-binding, which has led some providers to make desperate "suicide" bids in an effort to win contracts in enough equipment categories to keep their businesses alive.  

What destroys the integrity of the bidding process is that the suicide bids are used by CMS in their formula to establish the unrealistic reimbursement rates. "The entire process lacks transparency because CMS never discloses exactly how these unrealistic rates are calculated," Wilson said. "This is government imposed pricing, not competitive bidding. It is eliminating competition rather than increasing it. Business owners are forced to cut jobs or close their doors."

Joseph Reutter, Jr. , of Billing Specialist, Inc., a home medical equipment provider in Gastonia, N.C., sharply criticized the reimbursements cuts. "The reduction in reimbursements is ludicrous," said Reutter. "We service several thousand beneficiaries throughout North Carolina" but these reimbursement cuts "will not allow us to purchase and provide DME supplies at this new contracted pricing."

He added: "The announcement of the Round 2 competitive bidding rates struck me so hard that it literally took my breath away. My first thought wasn't about my house, my car, or my upcoming credit card payment. It was about my employees and how I'm supposed to break the news to them that I will no longer be able to afford to employ them. Our initial estimation is that we will lose 60-70% of our employees on July 1st. This is roughly 22-25 jobs. If we are lucky, we will be able to survive with the little bit of business we still have. However, our cost analysis has our survival rate as very low."

Clearly, the bidding program is impacting providers, beneficiaries, and even entire communities.

Kaye Tefel owns Care Solutions in Hendersonville, N.C., and says the reimbursement rates are unsustainable. Tefel says many Medicare beneficiaries live in rural areas and do not drive. "We are often called out on the weekend, in the evening, for repairs, for deliveries….the new cuts will mean a drastic cut in service and availability to our seniors and disabled population." She continued, "I am ashamed that our country would target the very people we should be protecting…..I am not just talking about me and my business, but my parents, my disabled sister, and my patients."

Economists, bidding experts, consumer groups, members of Congress, and the National Federation of Independent Business have all said the bidding program is defective. And after a request from AAHomecare, it will be investigated by the U.S. Department of Health and Human Services Officer of Inspector General.

As a sustainable alternative, Wilson said the DME industry supports the Market Pricing Program, a plan that was recently introduced in Congress. It is a procurement system that is based on three core principles: market-based prices, binding bids, and transparency.   

"The current procurement system is destroying the Medicare program and its network of compassionate providers, while endangering patients," Wilson said. "Medicare can no longer be depended on to provide a health safety net for our seniors and people living with disabilities. Congress has to take action."

The American Association for Homecare represents providers of home medical or durable medical equipment and services who serve the needs of millions of Americans who require prescribed oxygen therapy, wheelchairs, enteral feeding, and other medical equipment, services, and supplies at home. Visit

SOURCE American Association for Homecare
Copyright©2012 PR Newswire.
All rights reserved

Related medicine technology :

1. North America Home Healthcare Market Worth $130.4 Billion by 2017
2. Harlan Laboratories Continues Global Growth with Major Expansion of North American Facilities
3. Celladon Corporation is a Finalist for the 2013 Red Herring Top 100 North America Award
4. North America Endoscopy Devices Market Outlook to 2019 - Capsule Endoscope Systems, Endoscopic Instruments, Flexible Endoscopes, Rigid Endoscopes and Others
5. Northstar announces that its much-anticipated pet healthcare product will go on sale April 17th
6. Pharmagen Presents to North Carolina General Assembly at N.C. Bios Legislative Breakfast
7. ACTEON North America Partners with Marketing and PR Firm Verasoni Worldwide
8. Analysis of the North American Medication Management Market
9. Northridge Dentists, Dr. Ariz and Dr. Arami, Use Latest Technological Advances in Dentistry
10. Bio-Rad Receives the 2012 Frost & Sullivan North America Laboratory Researchers Choice Award for Future Market Leader
11. CIVCO Appoints Hap Peterson Vice President of North American Sales for Radiation Oncology
Post Your Comments:
(Date:11/26/2015)... 2015 ... the  "2016 Future Horizons and Growth ... Testing Market: Supplier Shares, Competitive Intelligence, ... --> ) has ... Future Horizons and Growth Strategies in ...
(Date:11/26/2015)... Research and Markets ( ) has announced the ... Type (Dressings, Therapy Devices, Active Wound Care), Application (Surgical ... Geography - Global Forecast to 2020" report to ... --> The purpose of this report is to ... advanced wound care market. It involves deep dive analysis ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 ... of the "Self Administration of High Viscosity ... ) has announced the addition of ... report to their offering. --> ... the addition of the "Self Administration of ...
Breaking Medicine Technology:
(Date:11/28/2015)... CA (PRWEB) , ... November 28, 2015 , ... Pixel ... fully customizable media panels to choose from, the possibilities are endless. Users have full ... more. With the ProPanel: Pulse masking effects, users are sure to get heads to ...
(Date:11/27/2015)... Los Angeles, CA (PRWEB) , ... November 27, 2015 , ... ... new study carried out by the University of Toronto and the University of British ... number of hospitalizations for head injuries. The article explains that part of the reason ...
(Date:11/27/2015)... ... 2015 , ... A team of Swiss doctors has released a report on ... just posted the findings on the website. Click here to read the details ... mesothelioma patients who were treated with chemotherapy followed by EPP surgery. Among the 106 ...
(Date:11/27/2015)... ... November 27, 2015 , ... Lizzie’s Lice Pickers just announced a special promotion ... off of their purchase of lice treatment product. In addition, customers will receive a ... company spokesperson. “Finding lice is a sure way to ruin the holidays, so we ...
(Date:11/27/2015)... LOS ANGELES, CA (PRWEB) , ... November 27, 2015 , ... MPWH, the No.1 Herpes-only ... age of 30 (see Table 1-1 ). More than 3.7 billion people under ... simplex virus type 1 (HSV-1), according to WHO's first global estimates of HSV-1 infection ...
Breaking Medicine News(10 mins):