Competitive Bidding Advocacy Letter July 2011

Don’t know what to write in a letter to your representative and senators regarding competitive bidding concerns? Don’t worry, we have you covered. Simply copy and paste the letter and fill in the blanks for the letter below. Then send the letter to your congress people. To find out who your US Representative and Senators are and how to contact them visit http://www.contactingthecongress.org/.

_________________________________________________________

<DATE>

 

The Honorable __________

______________<Senate / House> Office Building

Washington, DC 20515

Dear <Senator / Representative> _________________:

I am writing to express my concern regarding adjustable skin protection seat cushions being included in the second round of Medicare’s Competitive Bidding Program.  Clearly there is a wide disparity of opinions regarding this program for durable medical equipment (DMEPOS).  However, there is one thing on which everyone appears to agree.  For the DMEPOS competitive bidding program to be considered a success it must:

• Produce real cost savings for the Medicare system and beneficiaries.
• Insure that beneficiaries have ongoing access to the quality goods and services that they need. 

In order to achieve these goals bidding rules and product specifications must be clear, concise and distinct.  If this does not occur bidders would be incented to factor minimal service and only the cheapest products into their bids resulting in a race to the bottom regarding quality and access.

Currently Medicare is using Healthcare Common Procedure Codes (HCPCS) to bid products.  The HCPCS codes that adjustable skin protection seat cushions are assigned to (E2622-E2625) are not clear and concise.  There is a wide variety of products assigned to these codes comprised of various materials, shapes, sizes, performance, durability, adjustability and, subsequently, bidder cost.  Yet, these codes were included in round one of bidding.  The evidence from round one reinforces the concern that beneficiary access will be restricted to products that cost the winning bidders the least to obtain, rather than those that most effectively address the beneficiaries’ needs.  As such, the program goal to maintain beneficiaries’ access to quality goods and services they need will not be achieved.

In addition, the intent of adjustable skin protection cushions is to reduce the incidence of skin breakdown.  Wheelchair bound individuals over the age of sixty-five are at the highest risk for skin breakdown and have the greatest incidence of breakdown.  Skin breakdown in and of itself is debilitating; however, it can also lead to numerous other complication, including death.  Further, the cost to treat and heal skin breakdown can cost over one hundred times more than the cost of a cushion that may have prevented skin breakdown from occurring.  Any increase in the incidence of breakdown resulting from bidding these under-defined codes could actually produce an increase in costs to the Medicare system and beneficiaries.   As such, the program goal to reduce cost is unlikely, and costs may actually go up.

For these reasons we would ask that you reach out to CMS and direct them to work with experts in the field of adjustable seating to enhance the definitions and minimum specifications for the adjustable seat cushion HCPCS codes in order to insure that these codes do represent distinct, homogenous groups of products.  Further, the adjustable seat cushion HCPCS codes (E2622-E2625) should be excluded from future rounds of competitive bidding until such enhancements to these codes are implemented.

Thank you very much for your time, consideration and support in this matter.

Sincerely,