Unintended Consequences: Medicare Beneficiaries in Rural Areas are Being Systematically Denied Access to Care

Peter Thomas from the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition recently wrote an op/ed for The Hill on the effects of competitive bidding in rural areas and the application of competitive bid rates to CRT accessories.

The impact of competitive bidding and increased scrutiny on mobility providers have forced providers into three options when providing mobility products:

  1. Charge the patient more due to the reimbursement rate reduction. This has resulted in more out-of-pocket expense for the Medicare beneficiaries.
  2. Provide the patient with a lower quality item. This has resulted in more frequent repairs (cost) and inconvenience to the patient AND has resulted in more mobility products being manufactured overseas.
  3. Not provide the product to those where their insurance (e.g., Medicare/Medicaid) has reduced the reimbursement rate to an amount that is no longer feasible to accept. This has resulted in reduced access to mobility products and for those who do obtain them the ability to get those products repaired.

While CMS’ intentions may not have been to increase beneficiaries out-of-pocket expense, to reduce the quality of the products, or to reduce access to beneficiaries, these ARE the unintended consequences of the competitive bidding program.

Read the opinion piece here

Legislation has been reintroduced in the House (H.R. 1361) and the Senate (S. 486) to permanently prevent the application of competitive bid rates to CRT accessories. The inclusion of this piece in this publication is significant. It shows that our issues are remaining prominent to legislators and congressional staff and allows a broader audience to learn and understand our issues. We must continue to keep our issues on the forefront of our legislators’ minds.