From the Home Medical Equipment industry in Pennsylvania come these hot and accusatory words regarding CMS (known in some circles as Centers for Medicare & Medicare Services, Medicare, and The Big Bad M) and their Competitive Bidding of home medical equipment.

“The Medicare bidding program represents big government bullying at its worst,” says John Shirvinsky, executive director of the Pennsylvania Association of Medical Suppliers. “It is a program whose goal is not merely to reduce expenditures, but to decimate the ranks of local HME providers. Because Medicare is the largest purchaser of home medical equipment in the country, its threat to eliminate nine out of ten providers is not encouraging competition. It is blackmailing mostly small, independent businesses into irresponsible bids in the hope that they will simply survive. The bid numbers that we have seen so far are tantamount to economic suicide. This is a very bad and anti-competitive program that will result in business failures, job losses and reduced care for Medicare beneficiaries.”

The Medicare bidding program encourages “suicide bidding,” using economic coercion by forcing providers to submit unsustainable bids necessary to win a contract. Although Congress delayed the implementation of the selective contracting program in 2008 to allow for needed changes, the Centers for Medicare and Medicaid Services (CMS) ignored congressional intent and did not address the flaws that precipitated the delay.”
Read the entire article.

This is an old fight that goes far beneath the surface of what is written above. It may well be Big Government at its worst in the form of Big Bad Medicare looking to save bucks in an irresponsible manner. Why irresponsible? Because it ignores the needs of Medicare clients and threatens the existence of an entire industry. There are too many losers in this affair.

While I can appreciate government trying to save a couple of my hard earned bucks and some of yours, I don’t relish riding the wake they leave behind in doing so. A wake which may likely wash out thousands of small community businesses, providers and suppliers of home medical equipment. You know this one by heart- Lost tax revenues, lost jobs which mean more lost taxes, and the breaking of the stream of trickle down and squirt up dollars that is found within an active and viable segment of commerce. Basically, money changes hands many times within an industry that includes thousands of businesses, and that’s a good thing these days. So the Medicare pocket will save some money. But rest assured that some other public pockets will be paying to clean up their mess.

Even more disturbing is the realization that low-ball-bidding will certainly turn into a curve ball for clients. Can a low-baller supply the right product such as a wheelchair without having to cut corners to make the deal right? Can they supply the product without stripping and swapping for cheaper parts, without cutting back on pre and post sales services? Can they be responsive to needs and timely with service in a low-ball world? Will consistency of services erode for clients as they are bounced from one low-bidder to the next for their medical equipment needs, ricocheting between suppliers depending on what they need and who can supply it at Medicare’s self determined right price? Will any one supplier have the whole picture of the clients situation and needs?

It’s all about money anyway, and that’s not a bad thing when all parties get a fair shake. Good product and good service deserve appropriate compensation. That’s exactly what compensation should be based on. Not on some arbitrary number that is based on what Medicare would like to pay for products and services. How realistic is that? Hell, most of us would like to pay a quarter for a gallon of gas. That’s not realistic and it’s not going to happen unless your car can run on seriously watered down gas, and watered down products and services are exactly what Medicare is setting the table for.

Maybe none of us really have the answers or know how this will all play out. One thing is for sure though, we are all going to find out. If averages and odds hold up, some of us, or some of our family members and close friends will need home medical equipment and services at some time for some reason. Let’s all get back together then and compare notes on how well things worked out.