US Politics: CALL TO ACTION - Competitive Bidding
Anthony T. Barr
Description
Collection
Title:
US Politics: CALL TO ACTION - Competitive Bidding
Creator:
Anthony T. Barr
Date:
7/24/2002
Text:
The Barr Foundation applauds NAAOP's continued efforts to lobby against the
competitive bidding initative for comprehensive O&P services.
It was apparent from the discussions at the ACA Advocacy Meeting in
Anaheim,California last week, that ACA's Public Policy and Advocacy
Committee (PPAC) and the ACA leadership has the misconception that the
Competitive Bidding will not to be applied to custom O&P services.
ACA, with a membership of some 4,000 members and their Advocacy Committee
members should be informed otherwise and asked to also formally oppose the
legislative initiative.
The Barr Foundation has already provided written opposition to lawmakers and
would like to be added to the below CDC Health Task Force list of national
consumer organization whom also are in opposition.
Anthony T. Barr
President
Barr Foundation
www.oandp.com/barr
----- Original Message -----
From: NAAOP < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Wednesday, July 24, 2002 2:59 PM
Subject: [OANDP-L] US Politics: CALL TO ACTION - Competitive Bidding
> Competitive Bidding Update and Call to Action
>
> The Senate has started its second week of debate on several Medicare
> prescription drug bills. These bills do not currently contain
> competitive bidding or any other provider giveback provisions. If one
> of these drug proposals passes, it is likely that a provider package
> will be considered on the Senate floor as early as mid-week. This could
> potentially contain competitive bidding. However, should the
> prescription drug bill fail to pass in any form, it is likely that
> substantive action on competitive bidding will occur in September when
> the Senate Finance Committee is expected to markup a provider giveback
> package.
>
>
> The political situation in the Senate surrounding the ultimate passage
> of some form of competitive bidding is still very fluid, but signs are
> beginning to point toward a growing opposition to it in the Senate.
> NAAOP's own efforts along with those of other organizations are
> appearing to have some success in convincing members of the Senate that
> competitive bidding will be detrimental to patient care. To date, NAAOP
> has been actively involved in the following advocacy efforts:
>
>> CALL TO ACTION: CALLS NEEDED THIS WEEK
>
> NAAOP urges its members to contact their Senators and tell them to
> oppose Medicare competitive bidding especially for orthotics and
> prosthetics. Use the letter attached as talking points to help you make
> strong arguments. Although progress is being made, it is still very
> much an uphill battle to ensure that competitive bidding does not become
> a reality for O&P providers and our patients. Call the Capitol
> Switchboard at (202) 224-3121 to speak with your Senators' offices
> today.
>
> July 22, 2002
>
> The Honorable Thomas Daschle
> Senate Majority Leader
> C/o Jane Loewenson
> United States Senate
> 509 Hart Senate Office Building
> Washington, D.C. 20515
>
> RE: CCD Health Task Force Opposes Medicare Competitive Bidding
> Proposal
>
> Dear Majority Leader Daschle:
>
> As the Senate considers the provider payment section of the Medicare
> reform bill, the undersigned members of the CCD Health Task Force urge
> you to oppose the implementation of Medicare competitive bidding for
> durable medical equipment (DME) and some orthotics. Medicare
> beneficiaries with disabilities and chronic conditions rely on these
> devices and services to remain functional and independent. CCD believes
> that the incremental benefit that Medicare beneficiaries might realize
> from competitive bidding (as a result of slightly reduced co-payments)
> is far outweighed by the serious threat to quality, access, and choice
> of provider that this proposal represents. The House has included
> competitive bidding in its Medicare reform legislation and we strongly
> urge the Senate to oppose these provisions and not cast people with
> disabilities to the lowest bidder.
>
> CCD's Health Task Force is a coalition of national disability-related
> organizations working together to advocate for national public policy
> that ensures self determination, health, independence, empowerment,
> integration, and inclusion of children and adults with disabilities in
> all aspects of society. For too long, the DME competitive bidding
> debate has been dominated by providers and suppliers of DME, and
> disability-related organizations have not been heard on this
> important issue. Now that DME competitive bidding has been included in
> the House bill, we feel that it is time to express our views.
>
> Under the current Medicare program, the reimbursement level for DME,
> orthotics, prosthetics and supplies is set by fee schedule and providers
> and suppliers compete for Medicare patients based on the quality of the
> service they provide to the beneficiary, how quickly service calls are
> performed, how responsive the company is to the physician who refers the
> patient, and how functional the patient is with the service and/or
> device provided. Under government-imposed competitive bidding:
>
> . Price becomes the sole and determining factor in securing
> Medicare referrals and the quality of care and range of services
> provided to the patient are sacrificed in order to put forth a low bid;
>
> . The quality of care is bound to suffer as providers search for
> ways to cut corners and costs so they can make ends meet. It will not
> take long before providers discontinue product lines that are no longer
> sufficiently profitable or that require extra time or attention to the
> beneficiary, to the detriment of patient outcomes;
>
> . DME that is customized to the patient is nearly impossible to
> competitively bid as one is not comparing identical products.
> Customizing DME entails the skills of the provider, the experience of
> the provider with similar or complex patients, and different techniques
> for achieving particular therapeutic goals. This is evident in
> wheelchair design that requires customization and other DME such as
> oxygen therapy that requires a high degree of service.
>
> . Competitive bidding should never be considered for professional
> orthotic and prosthetic care due to the uniqueness of the service, the
> high degree of clinical/professional care involved, and the
> customization entailed in providing orthotic (orthopedic braces) and
> prosthetic (artificial limbs) care. Even competitive bidding of
> prefabricated orthotics is problematic because it treats orthotic care
> as the provision of a commodity rather than recognizing the
> clinical/professional judgment required to provide quality care;
>
> . Medicare beneficiaries under the fee-for-service program will be
> restricted in accessing the provider of their choice. Long-standing
> relationships between beneficiaries and familiar providers will be
> interrupted causing disruption in service and dissatisfaction for
> patients. Small, community-based providers will be displaced by larger
> chain providers that can take advantage of economies of scale, but which
> may not be in the interests of beneficiaries. Beneficiaries who do not
> value choice of provider have the option of joining the Medicare Plus
> Choice program, but the key feature of Medicare's fee-for-service
> program is choice of provider and this must be vigilantly safeguarded;
>
> . The efforts of companies, entrepreneurs, and researchers to
> innovate in this area will be significantly curtailed if there is not an
> adequate funding stream to reward innovation; and
>
> . Implementation of Medicare competitive bidding is premature in
> that the impact on beneficiaries of the two competitive bidding
> demonstration projects has not been adequately assessed. In fact, the
> only study that assessed this issue stated, It is premature to declare
> that competitive bidding is either an appropriate or an inappropriate
> reimbursement mechanism for durable medical equipment and related
> items.
>
> For these reasons, the undersigned members of the CCD Health Task Force
> strongly urge you to oppose the imposition of competitive bidding on
> Medicare durable medical equipment, orthotics and prosthetics. Thank
> you in advance for your consideration and if you have questions, please
> call Health Task Force Co-Chair, Peter Thomas at (202) 466-6550.
>
> Sincerely,
>
> Adapted Physical Activity Council
> Advancing Independence: Modernizing Medicare & Medicaid
> American Academy of Physical Medicine & Rehabilitation
> American Association on Mental Retardation
> American Association of People with Disabilities
> American Council for the Blind
> American Medical Rehabilitation Providers Association
> American Occupational Therapy Association
> American Physical Therapy Association
> American Therapeutic Recreation Association
> Association of University Centers on Disabilities
> Brain Injury Association
> Center on Disability and Health
> Disability Rights Education and Defense Fund
> Easter Seals
> Epilepsy Foundation
> Paralyzed Veterans of America
> Rehabilitation Engineering and Assistive Technology Society of North
> America
> Research Institute for Independent Living
> National Association for the Advancement of Orthotics and Prosthetics
> National Association of Protection and Advocacy Systems
> National Council on Independent Living
> National Organization on Disability
> The Arc of the United States
> United Cerebral Palsy Association
>
> cc: The Honorable Trent Lott (C/o John Mashburn)
> The Honorable Max Baucus (C/o Pat Bousliman)
> The Honorable Charles Grassley (C/o Linda Fishman)
> The Honorable Tom Harkin (C/o Peter Reinecke)
> The Honorable Bob Graham (C/o Jocelyn Moore & Lisa Layman)
> The Honorable Max Cleland (C/o Tamara Jones)
competitive bidding initative for comprehensive O&P services.
It was apparent from the discussions at the ACA Advocacy Meeting in
Anaheim,California last week, that ACA's Public Policy and Advocacy
Committee (PPAC) and the ACA leadership has the misconception that the
Competitive Bidding will not to be applied to custom O&P services.
ACA, with a membership of some 4,000 members and their Advocacy Committee
members should be informed otherwise and asked to also formally oppose the
legislative initiative.
The Barr Foundation has already provided written opposition to lawmakers and
would like to be added to the below CDC Health Task Force list of national
consumer organization whom also are in opposition.
Anthony T. Barr
President
Barr Foundation
www.oandp.com/barr
----- Original Message -----
From: NAAOP < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Wednesday, July 24, 2002 2:59 PM
Subject: [OANDP-L] US Politics: CALL TO ACTION - Competitive Bidding
> Competitive Bidding Update and Call to Action
>
> The Senate has started its second week of debate on several Medicare
> prescription drug bills. These bills do not currently contain
> competitive bidding or any other provider giveback provisions. If one
> of these drug proposals passes, it is likely that a provider package
> will be considered on the Senate floor as early as mid-week. This could
> potentially contain competitive bidding. However, should the
> prescription drug bill fail to pass in any form, it is likely that
> substantive action on competitive bidding will occur in September when
> the Senate Finance Committee is expected to markup a provider giveback
> package.
>
>
> The political situation in the Senate surrounding the ultimate passage
> of some form of competitive bidding is still very fluid, but signs are
> beginning to point toward a growing opposition to it in the Senate.
> NAAOP's own efforts along with those of other organizations are
> appearing to have some success in convincing members of the Senate that
> competitive bidding will be detrimental to patient care. To date, NAAOP
> has been actively involved in the following advocacy efforts:
>
>> CALL TO ACTION: CALLS NEEDED THIS WEEK
>
> NAAOP urges its members to contact their Senators and tell them to
> oppose Medicare competitive bidding especially for orthotics and
> prosthetics. Use the letter attached as talking points to help you make
> strong arguments. Although progress is being made, it is still very
> much an uphill battle to ensure that competitive bidding does not become
> a reality for O&P providers and our patients. Call the Capitol
> Switchboard at (202) 224-3121 to speak with your Senators' offices
> today.
>
> July 22, 2002
>
> The Honorable Thomas Daschle
> Senate Majority Leader
> C/o Jane Loewenson
> United States Senate
> 509 Hart Senate Office Building
> Washington, D.C. 20515
>
> RE: CCD Health Task Force Opposes Medicare Competitive Bidding
> Proposal
>
> Dear Majority Leader Daschle:
>
> As the Senate considers the provider payment section of the Medicare
> reform bill, the undersigned members of the CCD Health Task Force urge
> you to oppose the implementation of Medicare competitive bidding for
> durable medical equipment (DME) and some orthotics. Medicare
> beneficiaries with disabilities and chronic conditions rely on these
> devices and services to remain functional and independent. CCD believes
> that the incremental benefit that Medicare beneficiaries might realize
> from competitive bidding (as a result of slightly reduced co-payments)
> is far outweighed by the serious threat to quality, access, and choice
> of provider that this proposal represents. The House has included
> competitive bidding in its Medicare reform legislation and we strongly
> urge the Senate to oppose these provisions and not cast people with
> disabilities to the lowest bidder.
>
> CCD's Health Task Force is a coalition of national disability-related
> organizations working together to advocate for national public policy
> that ensures self determination, health, independence, empowerment,
> integration, and inclusion of children and adults with disabilities in
> all aspects of society. For too long, the DME competitive bidding
> debate has been dominated by providers and suppliers of DME, and
> disability-related organizations have not been heard on this
> important issue. Now that DME competitive bidding has been included in
> the House bill, we feel that it is time to express our views.
>
> Under the current Medicare program, the reimbursement level for DME,
> orthotics, prosthetics and supplies is set by fee schedule and providers
> and suppliers compete for Medicare patients based on the quality of the
> service they provide to the beneficiary, how quickly service calls are
> performed, how responsive the company is to the physician who refers the
> patient, and how functional the patient is with the service and/or
> device provided. Under government-imposed competitive bidding:
>
> . Price becomes the sole and determining factor in securing
> Medicare referrals and the quality of care and range of services
> provided to the patient are sacrificed in order to put forth a low bid;
>
> . The quality of care is bound to suffer as providers search for
> ways to cut corners and costs so they can make ends meet. It will not
> take long before providers discontinue product lines that are no longer
> sufficiently profitable or that require extra time or attention to the
> beneficiary, to the detriment of patient outcomes;
>
> . DME that is customized to the patient is nearly impossible to
> competitively bid as one is not comparing identical products.
> Customizing DME entails the skills of the provider, the experience of
> the provider with similar or complex patients, and different techniques
> for achieving particular therapeutic goals. This is evident in
> wheelchair design that requires customization and other DME such as
> oxygen therapy that requires a high degree of service.
>
> . Competitive bidding should never be considered for professional
> orthotic and prosthetic care due to the uniqueness of the service, the
> high degree of clinical/professional care involved, and the
> customization entailed in providing orthotic (orthopedic braces) and
> prosthetic (artificial limbs) care. Even competitive bidding of
> prefabricated orthotics is problematic because it treats orthotic care
> as the provision of a commodity rather than recognizing the
> clinical/professional judgment required to provide quality care;
>
> . Medicare beneficiaries under the fee-for-service program will be
> restricted in accessing the provider of their choice. Long-standing
> relationships between beneficiaries and familiar providers will be
> interrupted causing disruption in service and dissatisfaction for
> patients. Small, community-based providers will be displaced by larger
> chain providers that can take advantage of economies of scale, but which
> may not be in the interests of beneficiaries. Beneficiaries who do not
> value choice of provider have the option of joining the Medicare Plus
> Choice program, but the key feature of Medicare's fee-for-service
> program is choice of provider and this must be vigilantly safeguarded;
>
> . The efforts of companies, entrepreneurs, and researchers to
> innovate in this area will be significantly curtailed if there is not an
> adequate funding stream to reward innovation; and
>
> . Implementation of Medicare competitive bidding is premature in
> that the impact on beneficiaries of the two competitive bidding
> demonstration projects has not been adequately assessed. In fact, the
> only study that assessed this issue stated, It is premature to declare
> that competitive bidding is either an appropriate or an inappropriate
> reimbursement mechanism for durable medical equipment and related
> items.
>
> For these reasons, the undersigned members of the CCD Health Task Force
> strongly urge you to oppose the imposition of competitive bidding on
> Medicare durable medical equipment, orthotics and prosthetics. Thank
> you in advance for your consideration and if you have questions, please
> call Health Task Force Co-Chair, Peter Thomas at (202) 466-6550.
>
> Sincerely,
>
> Adapted Physical Activity Council
> Advancing Independence: Modernizing Medicare & Medicaid
> American Academy of Physical Medicine & Rehabilitation
> American Association on Mental Retardation
> American Association of People with Disabilities
> American Council for the Blind
> American Medical Rehabilitation Providers Association
> American Occupational Therapy Association
> American Physical Therapy Association
> American Therapeutic Recreation Association
> Association of University Centers on Disabilities
> Brain Injury Association
> Center on Disability and Health
> Disability Rights Education and Defense Fund
> Easter Seals
> Epilepsy Foundation
> Paralyzed Veterans of America
> Rehabilitation Engineering and Assistive Technology Society of North
> America
> Research Institute for Independent Living
> National Association for the Advancement of Orthotics and Prosthetics
> National Association of Protection and Advocacy Systems
> National Council on Independent Living
> National Organization on Disability
> The Arc of the United States
> United Cerebral Palsy Association
>
> cc: The Honorable Trent Lott (C/o John Mashburn)
> The Honorable Max Baucus (C/o Pat Bousliman)
> The Honorable Charles Grassley (C/o Linda Fishman)
> The Honorable Tom Harkin (C/o Peter Reinecke)
> The Honorable Bob Graham (C/o Jocelyn Moore & Lisa Layman)
> The Honorable Max Cleland (C/o Tamara Jones)
Citation
Anthony T. Barr, “US Politics: CALL TO ACTION - Competitive Bidding,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/219357.
