Guest blog post by Bob Vogel
For all my writing about competitive bidding, I’m embarrassed to admit I’ve never contacted my senators and representatives — the people elected to work for us — to let them know, as a voter that I’m against competitive bidding, until now!
As I wrote in my previous blog “Why You Need to Ask for Your Cushion by Name” round II of CMS (Centers for Medicare and Medicaid Services) competitive bidding is looming on the horizon and it is crucial that each one of us contact our senators and representatives and let them know we are opposed to competitive bidding.
It was time to take my own advice — make my voice heard and become part of the solution. Here is my experience and a step-by-step guide on how to contact your senators and representative and speak up against competitive bidding.
First I located my two U.S. senators and representative by going to: www.usa.gov/Contact/Elected.shtml
I clicked on “U.S. Senators” and went to the “Choose a State” bar — scrolled down to California, clicked, and up popped the contact information for my two U.S. Senators, Barbara Boxer and Dianne Feinstein.
Next I went back to: www.usa.gov/Contact/Elected.shtml and clicked on “U.S. Representatives.” When the Representative’s page opened up, I clicked on “Find Your Representative” typed in my zip code, clicked, and there was contact information for my U.S. representative, Tom McClintock.
Armed with contact information, I set about the first task — emailing both U.S. senators and my representative to explain that I am opposed to competitive bidding. The easiest way to do this is go to go to ROHO’s form, fill in the blanks and email it to your U.S. senators and representative. I chose to write my own, based on a combination of my experience of getting a pressure ulcer caused by a memory foam cushion — when I had requested a ROHO — and information from my previous blog post, “Why You Need to Ask for Your Cushion.” The total amount of time it took me to look up and email senators and congressman was 8 minutes.
I’ve heard a letter sent via U.S. mail has more power than an email so I printed out my email letters and invested $1.32 in stamps and mailed them to all three individuals. The total time to mail all three letters was 10 minutes, plus a nice walk with Schatzie — my German Shepherd service dog — to the post office.
Last but not least, I phoned all three. It’s funny, I’ve spoken in front of groups of 1,500 people with no problem. I knew when I phoned I would just be speaking with an aid — but I was still a bit nervous and had to remind myself, “they work for me, and I am making a difference.” I had my cheat sheet “bullet points” ready:
*My name, that I’m a registered voter, and my zip code.
*I’m calling about Medicare, specifically Round II of the CMS competitive bidding program. I am against CMS competitive bidding and I urge the (senator/congressperson) to speak out against competitive bidding.
* I’m a paraplegic and competitive bidding takes away my ability to choose a DME dealer that puts my health and equipment needs first. Competitive bidding will force me to use a DME dealer that may be in it for price alone.
*(I took much of this from my previous blog). The way competitive bidding is set-up encourages DME dealers that are only concerned with profit to submit a lowball bid and enables them to make a lot of profit by becoming the only dealer in town, if they provide poor service or try and make an extra buck by cutting corners, most people will just put up with it.
An example of how they can legally cut corners and make a lot of profit is by looking at the government HCPCS (Healthcare Common Procedure Coding System) code for the type of cushion that many paraplegics and quadriplegics use, E2622. Medicare will reimburse $347.69 for this type of cushion (if a person is in a manual wheelchair). For many wheelchair users, $347.69 is barely enough to cover the cost of the type of cushion they need to prevent pressure ulcers. However, Medicare’s Pricing, Data Analysis and Coding (PDAC) for E2622 includes 915 different cushions in this category. A dealer that is only in the business for profit can find a cushion on the list that retails for $39. If I had to sit on this cushion I would quickly develop a pressure ulcer that would likely land me in the hospital for months and cost taxpayers upwards of $50,000. This would likely happen to many other wheelchair users as well. But the dealer could easily continue to rack up big profits by placing these cushions under unsuspecting clients.
The aids I spoke with were very helpful and wanted to hear what I had to say. In all three phone calls I would stop and say, “Does what I’m saying make sense?” In each case they understood Round II of competitive bidding, understood that I was against it. In each case the were interested when I reiterated how crucial the proper cushion is to help me avoid pressure ulcers and if I had to sit on one of the cheaper cushions approved under code E2622 on the PDAC list I would be in danger of being hospitalized with a pressure ulcer which would put my life in danger and be a massive expense to taxpayers.
By doing this I have now officially become part of the solution. I encourage each of you to use this as a guide. Please join me and get involved. Contact your senators and representatives and please post a comment after you do — it will help encourage others to follow our lead. I also encourage you to ask your family and friends to use this blog post as a guideline to contact their senators and representative, as well. Contacting senators and representatives and becoming part of the solution feels pretty cool!
Dear Senator __________,
As a registered voter in your district I am against Round II of CMS (Centers for Medicare and Medicaid Services) competitive bidding program.
I am a 51-year-old paraplegic — paralyzed for 26 years. Like many wheelchair users, I sit on a wheelchair cushion — the proper cushion is crucial to avoid getting a pressure ulcer (skin breakdown). A pressure ulcer is life threatening and commonly results in months of hospitalization at an average cost to tax payers of $50,000–$70,000 (average costs for a full-tissue depth pressure ulcer).
Currently I can choose which DME (durable medical equipment) dealer I use to get my cushion. I choose a dealer that provides me the best DME (wheelchair, cushion etc.) for my needs within Medicare reimbursement guidelines.
The cushion that I require to prevent pressure ulcers is approved by Medicare, assigned to HCPCS code E2622 and reimbursable by Medicare with an allowable of $347.69, of which I am responsible for at least 20% of the payment.
However, under competitive bidding, the incentive for DME dealers to strive to provide the best equipment for their clients is replaced with the necessity of reducing their costs as much as possible. In addition, competitive bidding opens the door for a DME dealer who is only interested in profit to make easy, quick and massive profits by submitting a “lowball bid.” An example of how this can be done is: there are more than 900 cushions under code E2622 on the PDAC list, including one that lists on the internet for $39.95. A “profit only” business could fit unsuspecting clients with this type of cushion, make large profits and still be within government guidelines — resulting in countless life threatening pressure ulcers, and massive hospital bills that will be passed on to the taxpayer.
When I first left the spinal cord rehabilitation hospital, I was placed on an inferior cushion that caused a tiny pressure ulcer (about the size of a pimple). I immediately saw the pressure ulcer because I check my skin with a mirror each day, but this could have resulted in a massive pressure ulcer within a few days. Instead, I was able to resolve the issue with bed rest and the proper cushion. The average wheelchair user would not have noticed the red spot before it became a life-threatening pressure ulcer — requiring a lengthy and expensive hospital stay. This is why I urge you to speak out against Round II of competitive bidding.
Robert H. Vogel
Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.