New Program Puts Millions at Risk

From: Front Page Magazine

Posted By Tait Trussell

A bipartisan House bill to be introduced this week aims to block a new ObamaCare program that’s putting the health and often the lives of millions of Americans at risk. The program was launched in the nation’s nine largest cities in January, with 91 other major cities forced to comply later in 2011.

The program affects millions of Medicare beneficiaries who must have oxygen therapy, tube feeding, breathing assistance devices, and diabetic supplies, as well as those needing wheelchairs and hospital beds. It severely restricts the access, quality and choice of both the elderly and the disabled by limiting the number of companies allowed to furnish equipment and services necessary for living and well-being. In some cases to ill-equipped providers are chosen.

The new bill, HR 1041, could fight its way through Congress against Administration forces; but meanwhile damage is being wrought. The bill intends to repeal the new ObamaCare project.

The Affordable Care Act (ObamaCare) is now one year old. It’s being driven like an out-of-control race car by Health and Human Services Secretary Kathleen Sebelius to push as much cost-laden bureaucracy into the economy as possible. She’s trying to have its plethora of provisions inflicted on the citizenry before the law is declared unconstitutional—as is quite possible.

This rush to instill more health-care woe from Washington goes on despite the fact that 62 percent of voters now favor repeal of the whole law, according to a March 14 Rasmussen Reports opinion poll, and 51 percent are “strongly in favor” of repeal.

The new government callousness which began this year deals with competitive bidding. Competitive bidding among providers of equipment and services to Medicare has been used since 2003. But the new program under the Obama Administration’s Centers for Medicare and Medicaid (CMS), because of its provisions, spells trouble and danger for those most dependent on medical care.

It could have drastic results: Not only “unsustainable price reductions” but, more importantly, “eroding supplier competition based on quality…(resulting in) “Medicare’s most vulnerable beneficiaries experiencing medical complications, increasing their use of hospital, emergency room, and physician care…” said a study by health economics and research firm Dobson DaVanzo & Associates.

The research firm was hired by the American Association for Homecare (AAH). It represents durable medical equipment providers, manufacturers and other organizations involved in home care. It also operates 3,000 homecare facilities in 50 states.

The Association reports that in the first weeks after the new competitive bidding program began, it was flooded with complaints from patients, clinicians, and home-care providers reporting: Difficulty finding a local equipment or service provider, delays in getting medically required life-sustaining equipment or services, fewer choices, reduced quality, and confusing or incorrect information from Medicare.

Two Nobel Laureates, were among 166 experts who warned Congress last year that the new bidding system would fail because of serious flaws that wouldn’t allow for a pool of capable suppliers.

Specifically, what is required is bidding by suppliers to get the bottom price for contracts to supply durable medical equipment including breathing equipment and wheel chairs, prosthetics (devices implanted in the body or for missing body parts), orthotics (customized devices to relieve pain), and supplies. This complex is known in the medical field as DMEPOS.

The Administration program is rooted in the notion that low price is everything; let’s just forget about adequacy and quality of either product or service. The new bidding program represents a change from Medicare’s long-standing policy that any qualified provider can participate in Medicare.

“Unlike the competitive acquisition programs under Medicare Advantage [where recipients have the option of getting their benefits through private insurance plans] and Medicare Part D [for prescription drugs], the DMEPOS competitive bidding program lacks basic safety and other consumer safeguards that have become staples of the modern market-based competitive purchasing arrangements” including “standards for quality and safety,” the Dobson/DaVanzo study warned.

The American Association for Homecare found, and shared with CMS, earlier this year: winning providers awarded contracts by Medicare that are bankrupt, winning companies were not licensed to provide medical products or services, some winning companies have serious credit problems, and incorrect information was distributed by Medicare about the contract winners and which beneficiaries need to change home medical equipment providers.

The typical Medicare home oxygen beneficiary, for instance, is 73 and suffers from late-stage COPD, chronic inflammation of the air passages. It’s the only leading cause of death for which both prevalence and mortality are rising. About 12 million Americans have been diagnosed with COPD. Another 12 million remain undiagnosed, oxygen therapy specialists say. Patients must rely on companies that have back-up tanks in case of power failures.

Marilyn Graham, one of the 250,000 people on Medicare in the Charlotte, N.C., area, accidentally tore the face mask which pumps oxygen into her lungs at night. She has apnea, the breathing-while-sleeping malady. When she called her provider, she was told that the business couldn’t help her any more. It didn’t win the competitive bid. Another patient in the Charlotte area had to stay hospitalized for several extra days because a new low-bid supplier couldn’t get oxygen equipment to her home.

Gary Bajusz, president of Integrated Medical in Cleveland, serving patients for the past 12 years, is quoted as saying after losing in the bidding process, he had to close a branch, resulting “in the loss of three full-time positions” as well as two more employees in Cleveland. “The government is pushing hardworking Americans out of jobs and working against the best interest of our seniors and people with disabilities.”

Similar impediments face Medicare residents in Cincinnati, Dallas-Fort Worth, Kansas City, Miami, Orlando, Pittsburgh, and Riverside, CA. Soon patients in 91 other cities will join them as bureaucracy fumbles again.