Ramifications of Medicare's Competitive Bidding for Durable Medical Equipment

I work for a durable medical equipment company whomedical necessity for equipment.
specializes in wheelchairs. In the past when a patientNow Medicare has implemented a new program of
has come to us with a prescription from their doctorcompetitive bidding. This program was implemented to
for a manual or power wheelchair we would evaluatesave the government money. Competitive bidding
them for the best type of wheelchair to meet theirallows Medicare to award contracts to suppliers with
needs based on their diagnosis, lifestyle and homethe lowest bid. Now I am all for saving the government
environment. We would make our recommendationmoney and I hate to see money spent unwisely.
and order the wheelchair if the patient was inHowever, competitive bidding is not the answer.
agreement.How does this affect you?
How we were paid was based on Medicare'sMore than half of Medicare's DME providers are
allowable. Every wheelchair has a code assigned to itexpected to go out of business under this program.
and Medicare has an allowable amount to be paid forPatients will have little choice of who provides their
each code. Medicare paid 80% of the allowable andequipment. Consumer choice is reduced or eliminated.
the patient was responsible for the co-pay of 20%Patients will have to go with Medicare's winning bidder.
unless they had secondary insurance. This workedPatients will in most cases receive the lowest-cost
well and patients received the best equipment to meetequipment instead of what is appropriate for them and
their needs and all durable medical equipment providerstheir diagnosis.
were paid the same allowable so patients could useCompetitive bidding effectively eliminates free market
whoever they preferred.competition that encouraged high quality care for
The allowable Medicare pays is already lower thanpatients.
almost all other insurance companies. MedicareElderly patients should not be required to submit to the
guidelines for providers to follow in order to get theservices of the lowest bidder to Medicare. With
patient a wheelchair has become a long and tediouscompetitive bidding Medicare, not seniors, will decide
process as they have changed the documentationwhich providers seniors are allowed to purchase any
requirements. The burden of proof that the patientequipment they need from.
actually needs the equipment provided has basicallyHow can it be beneficial for seniors to lose freedom of
fallen to the provider. No matter what the doctor haschoice? Everyone deserves the right to pick their own
ordered providers must have medical exam notes,health care providers.
progress notes and other documentation to prove