Congressman Rothfus vows to modify Medicare bidding plan

U.S. Rep. Keith Rothfus told local business owners on Wednesday that he’ll lobby to change Medicare’s rules governing bidding by medical equipment suppliers.

Rothfus, R-Sewickley, said he is one of 150 co-sponsors of a House bill that would change a controversial federal bidding plan that allows successful bidders to become the sole supplier of products ranging from wheelchairs to diabetic supplies for Medicare beneficiaries in their area.

“This is really a by-product of the Affordable Care Act where everything is given a one-size-fits-all approach,” Rothfus said of the competitive bidding system.

“Hopefully, HR 1717 will curb some of the harmful effects placed on the industry and get businesses like Blackburn’s going like they deserve to be.”

Rothfus toured Blackburn’s Tarentum headquarters on Wednesday.

The owners are imploring the first-term congressman to push policies that would debunk Medicare’s competitive bidding system — a system they say punishes high-performing providers and pigeonholes Medicare recipients into undesirable services.

“It’s ripping the rug out from under our feet,” said Georgie Blackburn, company vice president. “Companies are forced to make impossibly low bids for the quality of service they provide, and when lesser providers win the bids, the Medicare recipients are forced to use services they’re unfamiliar with and they don’t want.
“It’s not fair to the providers and its not fair to the patients.”

With no mandatory minimums, the system was designed to save the government and Medicare recipients — who typically pay 20 percent of fees — billions of dollars in medical equipment and supplies.

The market pricing program (HR 1717) establishes a new bidding system that Rothfus said will facilitate free enterprise among competing providers.

Included in the bipartisan market pricing program are provisions that will purportedly increase bidder accountability and transparency, and reduce market areas to smaller, more homogenous pockets that local providers are accustomed to serving.

The resolution is under review by the Energy and Commerce and Ways and Means committees, as is HR 942, known as the Ensuring Access to Quality Complex Rehabilitation Technology Act.

Chuck Blackburn, board of directors chairman at Blackburn’s, said he hopes the legislation passes before the complex rehab technology products are absorbed into the current competitive bidding system.

“Our mantra is continuity and care,” he said. “Unfortunately, through these bidding acquisitions, people on Medicare are forced into whatever provider in the area won the bid, and they’re forced to transfer over.”

Lucy Spruill, 68, of Squirrel Hill joined Medicare this year after a lung condition required her to receive oxygen. Diagnosed with spina bifida at birth, Spruill has used a power wheelchair for a significant portion of her adult life.

When she joined Medicare this year, Spruill said she chose a program that wasn’t necessarily her first choice but allowed her to remain with her provider of 15 years.

“That’s how important it is to people,” she said. “The added stress is ridiculous. When you get switched over, it’s like having the same doctor for 20 years and your insurance company suddenly saying you’re not allowed to go there anymore.”

Spruill, who worked for a nonprofit organization that assists adults with physical disabilities, said she knows people who have been forced to use three different providers for three pieces of medical equipment since competitive bidding began in 2011.

Rothfus assured the Blackburns that he’ll continue to push for the changes.

“It’s not a Republican plan,” he said. “It’s an American plan. We need to stop reducing services to the lowest common denominator and get health care in this country back on track.”

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