This Just In

I don't like to blog every day because some of what I say can take a while to digest. Too much of a good thing can be a bad thing; if you don't believe me, go eat a whole cheesecake by yourself in one sitting. Cheesecake is wonderful stuff, but not in large quantities.

I feel the same way about my blog as I do cheesecake. It's wonderful stuff, but not in too-frequent doses.

Yesterday I discussed a proposed competitive procurement of incontinence supplies in Texas. There was a meeting held in Austin yesterday of the Texas HHSC's MCAC (which is the Medical Care Advisory Committee), and the proposed initiative was on the agenda.

MESA was there, and has sent an update to its Texas members; it was kindly forwarded to me (many thanks to the people who sent it to me!). It says:

"Thanks in large part to testimony from concerned providers-many of whom were MESA members (particularly John Calhoun, Owner/President of Houston-based Medco Medical Supply, and Chris Yule, President of Travis Medical, in Austin), and with a little help from your Executive Director, through pre-submitted written comments and oral testimony, the Texas MCAC voted unanimously yesterday to not approve the rule submitted to institute competitive procurement of incontinence supplies. The statistics provided through the surveys that many of you sent us were also very helpful.

The MCAC further recommended that the Texas Comptroller Public Accounts (TCPA) (the agency responsible for the initiative) form a work group of TEXAS providers and other interested parties, to discuss reduction of fraud and abuse, other ways to cut costs and/or an "acceptable" version of competitive procurement-one that might include out-of-state providers, but would not be single-source, and would ensure that more stakeholders are included.

The MCAC also asked the TCPA to provide more accurate figures on fraud and abuse, as well as documentation as to cost involved to implement a competitive procurement program, and a better analysis of how patients would be assured of access to care and quality products.

This Rule may still come before the Texas HHSC in October, or resurface in some other form at some future date, despite the MCAC's ruling, but at the very least, we feel it lost some momentum yesterday. We will continue to monitor the matter and update you as news comes in."

This is really good news for Texas incontinence suppliers. The coordinated efforts of those present appear to have paid off. Even if the procurement threat hasn't disappeared entirely, the initiative has suffered a set-back, and that's more than anyone could have hoped for considering the very short notice (and very small amount of time they had to pull together).

Nosy Parker
I admit that I'm nosy; I have to be to write this blog. If you're a regular reader and are at all perceptive, you have to know what one of my discreet questions was when digging for more information on this particular issue.

We know from MESA's update to its members that the association was represented by its Executive Director, and that there were MESA members present and participating. The last place I'd expect to see any mention of TAHCS is in a MESA release (for good reason!), so my inquiring mind wanted to know if TAHCS was there, if TAHCS participated, and if TAHCS was part of the process.

All appearances are that TAHCS, the group that calls itself the state association serving Texas, was not there. No one identified as a TAHCS representative testified or made any public statement for the record.

MESA serves five states; TAHCS claims to serve one (and has made uninformed, misleading and disparaging remarks about what MESA does and does not do). MESA managed to be there to serve its Texas members very well and very publicly.

Who is the association serving Texas providers? I'll leave my readers to decide that.

From the Southwest to the Northeast
I invited readers in my last blog to tell me about any other state issues they'd like to see highlighted, and someone took me up on my invitation.

Competitive procurement is moving into the private sector if the RFI (request for inquiry) sprung on BCBS participating suppliers in Massachusetts is any indication. The similarities between the Texas incontinence initiative and the RFI in MA are, to my informant, pretty clear; the problem with this type of scenario is that a private insurance company has more autonomy than a state-run, government-funded program like Medicaid.

Kudos to NEMED for its hard work and dedication; my informant couldn't say enough about how supportive and how active NEMED has been in that struggle (the efforts of those in the fight have been rewarded with a delay in the process).

If I can dig up added details on this issue I will do so and discuss it further here. We can all learn from the examples set and be inspired by NEMED and MESA; these stories demonstrate how active participation and professional leadership can make a difference and why you should be supporting your state (or regional) association (if it's a useful one, of course).