Medicare Procurement Program Creates Extreme Hardships For North Carolina Patients, Says AAHomecare

NEW BERN, N.C., Oct. 29, 2013 /PRNewswire-USNewswire/ -- More than 2,000 Medicare patients, including dozens of North Carolina residents, have called an organization, People for Quality Care, desperately seeking assistance because their health and quality of life is being jeopardized by Medicare's bidding program for home medical equipment. Yet, the Centers for Medicare & Medicaid Services (CMS), insists there have only been a few complaints associated with the bidding program.

But Joseph Metts, 73, of New Bern, N.C., is one of many Medicare beneficiaries, who are suffering because they can't get repairs or new home medical equipment through the badly flawed bidding program that expanded to 91 new areas on July 1.

Metts has had non-Hodgkin's lymphoma for twenty years and diabetes for just as long, mainly as a result of his cancer treatments. He can't get his blood sugar testing strips sent to him anymore. When the Medicare bidding process started in his area in July, he and his daughter started making calls, hoping to stay ahead of the curve. They were given the phone numbers of five different dealers and contacted them all, but three didn't carry Joseph's equipment, one never answered, and the last didn't have them in stock and didn't know if they ever would.

So far, it doesn't appear that he'll ever be able to get them without driving to another town to pick them up.

This change will be difficult for Joseph, whose cancer has recently returned, and whose wife is homebound on a ventilator and feeding tube—Joseph is her primary caretaker. "We choose to have her at home," says Joseph's daughter, Tina Metts, "because the closest nursing home that allows for ventilators is three hours away. There are no home help agencies in our area that work with ventilator patients. Everything is out of pocket, so he stays home with her 24 hours a day. The cost of care is so burdensome. We can't get any help, they're using their life savings, and he's sick, too."

Despite CMS claims to the contrary, people like Metts are suffering because of the badly mismanaged Medicare bidding program. It has put hundreds of providers of durable medical equipment (DME) out of business, created equipment shortages, and left beneficiaries without doctor-prescribed equipment, such as oxygen tanks, power wheelchairs, hospital beds, walkers, and diabetic supplies.

AAHomecare has contacted several Medicare patients who are not receiving quality service or equipment because of the bidding program. Mett's story is one of many.

"It's disturbing that CMS is claiming everything is fine when people are suffering," said Tom Ryan, president of the American Association for Homecare (AAHomecare). "The bidding program is bad public policy that needs to be fixed or stopped. CMS must acknowledge the real problems that Medicare patients are encountering. How can they expect anyone to believe that they have only received a handful of complaints when more than 2,000 people have reached out to a private organization for help addressing their problems?"

According to a May 2012 Government Accountability Office report titled Review of the First Year of CMS's Durable Medical Equipment Competitive Bidding Program's Round 1 Rebid, the agency may be intentionally undercounting the number of problems. "CMS's definition of inquiry and complaint may be an optimistic characterization of beneficiary calls," the report states. "According to CMS, all calls are first classified as inquiries and are only classified as complaints when they remain unresolved by CSRs [customer service representatives]." However, CMS considers giving a caller a list of companies to research on their own sufficient. There is no assistance given and no follow-up done to ensure that beneficiaries get what they need.

Ryan said that CMS hasn't changed the way it classifies calls from beneficiaries or the level of assistance they give, so it is not surprising that their numbers are unrealistically low. However, he believes that even the People for Quality Care number is "just the tip of the iceberg."

Meanwhile, Joseph's sisters, who are also diabetic, have had the same trouble getting their supplies that Joseph has had, which leads Tina to believe the problem is widespread. "The sad thing," she says, "is that the people we're supposed to be taking care of, our seniors, don't make a very loud voice, so they're getting treated wrong. It's sad. Thankfully we have a family and can lean on each other, but I'm pretty sure there are lots of people out there that don't have that luxury."

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 www.aahomecare.org.

SOURCE American Association for Homecare

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