I haven't had much to say lately because there hasn't been that much going on, and I can only talk about competitive bidding just so much before even I become bored repeating myself.
This morning I had two emails forwarded to me, and I read an article in HME News (print edition, May 2011). I've got something to say about each one.
Winners
The first email sent to me was one from MESA, telling its members that the Texas Comptroller of Public Accounts (TCPA) had announced that it was not going to go through with the competitive bid on incontinence products.
Here, minus the text from the TCPA, is what MESA sent out:
"MESA is very pleased to announce that the procurement initiative, developed and driven by the Texas Comptroller of Public Accounts (TCPA), with the assistance of Texas Health and Human Services Commission (HHSC), has been deemed unnecessary, and is no longer looming over Texas incontinence suppliers.
Persuading the TCPA that the initiative was not in the best interests of the agency or beneficiaries was a team effort, and MESA deeply appreciates the participation of all who helped shape its policy, and all who helped to deflect this initiative.
It is our further understanding that this decision means that this item will be withdrawn from the agenda of the MCAC meeting of June 9. So, it will not be necessary for providers to attend that meeting if their purpose in going was to testify about this particular matter.
Moving forward from this point, MESA looks forward to representing its members as it participates and cooperates with the Texas HHSC in upcoming workgroups, and the implementation of the viable alternatives to competitive procurement."
Though the efforts of MESA to combat the bid were, I'm reliably told, diligent and consistent, there is no chest-beating in their email release, and no claims of being the reason (or the main reason) for the success of defeating the incontinence bid. MESA makes it clear that it was a team effort, and thanks all involved.
MESA is and always has been a class act, and from what I'm able to gather from MESA members I know in Texas, the association was instrumental in stopping the incontinence bid as well as doing a great job representing members with a rate-reduction work-group held in a series of meetings in April.
MESA worked hard; MESA worked well and effectively with others; MESA served its members in Texas very well; and MESA did it all without in-your-face, hooray-for-us posturing.
Losers
By "losers" I mean TAHCS. The other email forwarded to me was the one TAHCS sent out. The first problem with their release is the subject line: TAHCS - WE STOPPED COMPETITIVE BIDDING.
Pardon me while I stop and roll my eyes at that ridiculous bit of fiction. TAHCS stopped competitive bidding? TAHCS can't even get a member base because no one takes them seriously; I doubt the TCPA or the HHSC takes them anymore seriously than the rest of us.
TAHCS was one of many working on the incontinence bid problem. I was intrigued by their claim that representatives of the organization "participated in numerous public and private meetings to address the budget shortfall and how Medicaid would be affected," but then I learned that the meetings to address the budget shortfall had nothing to do with the incontinence bid, and realized that it was TAHCS trying to make themselves look more important and more active than they really are.
Again.
The meetings TAHCS is babbling about in the release were the April HHSC work-groups that MESA and other stakeholders participated in to save money for the state to avoid a totally different bid threat.
I really loved this one:
TAHCS' input began in September 2010 and concluded in April 2011 with our last meeting being with HHSC. "We have been working long and hard to find an alternative to competitive bidding and have been met with some success," said Barry Johnson, President TAHCS.
TAHCS' input began in September 2010 and concluded in April 2011 with our last meeting being with HHSC. "We have been working long and hard to find an alternative to competitive bidding and have been met with some success," said Barry Johnson, President TAHCS.
Others involved can say the same thing (only it would be true in their cases), but I don't recall any word that TAHCS turned in an alternative proposal like MESA did. Barry Johnson, you shouldn't be allowed to communicate without a keeper to make sure what you spout is honest, because every time you and the folks at TAHCS send something out, my BS meter goes wild.
Fools
If you have a copy of the May 2011 edition of HME News, turn to page 13 and read Rob Brant's sob story at the bottom.
It's a shame that competitive bidding puts anyone out of business and that it forces beneficiaries to use different providers. But the truth is that although the current bid system is flawed, any bid system would end up putting some providers out of business.
There are real costs to operating a DME, as Brant rightly pointed out in his little speech at the PAOC meeting. The question in my mind, though, is this: Why did Brant accept a contract if he knew he couldn't afford to do business at the bid rate? How is he more responsible than the out-of-state, inexperienced, or bankrupt companies he rails against?
If Brant knew he couldn't provide oxygen for under $28.77 per month, then accepting a contract with a rate of $21.66 makes absolutely no sense. I understand that he laid off half of his staff and moved into a smaller space. But from the way I read his speech, he knew in July of 2010 that he couldn't operate on what Medicare was willing to pay him. Why delay the inevitable through April of 2011?
Brant didn't get into the industry activism game until mid-2008; he sat on his hands until then, figuring that someone else would do something that he was just too busy with everyday life to do. Eventually it dawned on him that doing nothing was going to have a direct impact on his own wallet, so that's when he launched AMEPA. He proclaimed loudly that AAHomecare wasn't doing the job (they weren't), yet he's been in bed with them for quite some time now, actively assisting them with their failing strategies and policies.
The result? AMEPA has accomplished nothing, and AAHomecare still isn't doing the job. This makes sense; I can offer the following mathematical equation to explain the results from the Brant/AAHomecare match-up:
0 + 0 = 0
Liars may figure, but figures never lie.
Rob Brant, "better late than never" works fine when applied to arriving at parties, but not when your livelihood is on the line and the fight needs every person involved. I don't think that your personal activism earlier on would've saved the industry (you're obviously not saviour material), but if all the people sitting on their dead butts would've been consistently active in 2001 and 2002, the industry might not be in the sorry shape it's in today.
You, Rob Brant, were part of the problem, and it was too late by the time you finally got off the spectators' bench for you to be a part of the solution.
So you'll pardon me for not feeling terribly sorry for you, Rob Brant. I feel sorry for the providers who have been in the trenches for almost a decade and who can't seem to find a win no matter how hard they try because so few fight with them. I feel sorry for the beneficiaries who have had problems with the changes caused by competitive bidding. I feel sorry for the people who have believed in you during the last three years and ended up with nothing to show for that belief but your hot air. But I don't feel sorry for you.
The possible silver lining I see from the shut-down of City Medical, Rob Brant, is that you could end up doing us all a favor by going away.
Please take Barry Johnson with you.
