Medicare is increasing mortality among seniors

December 23 01:00 2015 by ushadmin

A report just released by the National Minority Quality Forum has found that Medicare is increasing mortality among seniors. It describes how the Centers for Medicare & Medicaid Services’ (CMS’s) new reimbursement strategy for medical supplies puts the lives of Medicare beneficiaries at risk by disrupting access to those supplies.

Medicare currently covers a wide variety of medical supplies if they are medically necessary and prescribed by a physician. Historically, Medicare has paid for these supplies on the basis of fee schedules, but several studies have found that Medicare was overpaying for certain items on those schedules. The Competitive Bidding Program (CBP) is being initiated to remedy these overpayments.
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The core idea behind the CBP is to use a bidding process to create a small number of high-volume, low-margin suppliers. The calculation is that by severely restricting where Medicare beneficiaries can purchase medical supplies, winning suppliers would be handed millions of new customers who are bound by law and regulations to purchase from them. In return for a monopoly contract, CMS plans are to reimburse the winners substantially less than allowed for by the fee schedules. It is anticipated that the selected few “could adapt to the potential for increased market share by advertising, opening new locations to fill in geographic gaps left by unapproved suppliers, or improving service, thereby increasing beneficiary access.” CMS also recognizes that alternatively these bid winners “may respond to lower prices by offering lower quality products, delaying routine maintenance, or employing fewer service technicians and customer service representatives, thereby increasing the need for service calls, extending waiting times, and decreasing access.”

The Forum’s brief calls attention to the fact that the five laws that create CBP do not mandate safety monitoring to ensure that health risks for beneficiaries are not elevated by suppliers’ incentive to reduce quality and access as a reaction to lower reimbursements. The brief also notes that the authorizing statutes and other federal regulations combine to limit judicial and administrative oversight of the CBP, which restricts official safety monitoring of CBP by agencies and branches of government other than CMS…