Amendment To Eliminate Competitive Bidding Fails

An amendment to strike competitive bidding requirements from the House Republican Medicare reform proposal was defeated June 21 by voice vote. The amendment had been offered by Sherwood Brown (D-Ohio), a member of the Energy and Commerce Committee.

Both the House Ways and Means Committee and the Energy and Commerce Committee have now approved versions of a comprehensive Medicare reform proposal, HR 4954, "The Medicare Modernization and Prescription Drug Act of 2002," clearing the way for the full House of Representatives to vote on this proposal next week, according to an Internet posting by the American Orthotic and Prosthetic Association (AOPA).

"As currently drafted, HR 4954 would require competitive bidding for 'off-the-shelf' orthotic devices that 'require minimal self-adjustment for appropriate use and does [sic] not require expertise in trimming, bending, molding, assembling, or customizing to fit to the patient," AOPA said. The good news is that when competitive acquisition for orthotic devices was first proposed in May 2002, "it was far broader and would have subjected all orthotic devices to competitive acquisition that were not molded to the patient model," AOPA pointed out.

Some aspects of the legislation related to the orthotic component of the competitive bidding program include:

Implementation period: The competitive acquisition program for certain orthotic devices that are identified by this provision would be phased in over a three-year period. The language would require that at least one-third of the competitive bidding programs be operation in 2004 and at least two-thirds operational in 2005. Terms of contract: The length of any contract entered into under this provision would be for a maximum of three years. Bidding entities would be required to meet yet-to-be-determined quality and financial standards as specified by the secretary of Health and Human Services (HHS) or developed by accreditation entities or organizations recognized by the secretary. These standards could not be less than the quality standards that would otherwise apply. Thus, state requirements such as licensure for O&P practitioners would not be preempted by this legislation. The secretary would be able to limit the number of contractors in a competitive bidding area to the number needed to meet the demand for items and services. The legislation stipulates that beneficiary access to a choice of multiple suppliers in the area would be maintained. The secretary would be required to award more than one contract in each competitive bidding area for an item or service. The secretary could exempt from competitive bidding items and services that are not likely to result in significant savings. The secretary would be required to consult with an expert outside advisory panel composed of an appropriate group of physicians, O&P practitioners, and suppliers to review and advise the secretary concerning such quality standards. The legislation would allow for the continuation of the current Medicare competitive bidding demonstration projects now underway in San Antonio, Texas, and Polk County, Florida. For more information, contact Walt Gorski, AOPA manager of legislative affairs: 571.431.0876; fax: 571.431.0899; e-mail: wgorski@aopanet.org

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