Washington is broken. Really, really broken. You hear it all of the time from friends, neighbors and even elected officials serving in Washington who are a major part of the problem.  To no one’s surprise, Congressional job approval remains at historic lows with nearly 8 out of 10 people disapproving, according to a recent Real Clear Politics polling average.  Simply put, the American people don't trust or approve of Congress because too often elected officials in Washington say one thing and do another -- or just don’t do anything!

A stark example is Congress' recent failure to listen to thousands of small businesses around the country who provide medical equipment and high-quality services to Medicare patients in need, particularly in rural areas.


From Virginia to California, many rural medical equipment suppliers could soon be closing their doors, laying off thousands of employees and leaving patients with limited options and poor service.  This is the result of action taken by the same Members of Congress who claim to support small businesses and Seniors on Medicare.

In an effort to save taxpayer dollars, an important initiative, Congress and the Centers for Medicare and Medicaid Services (CMS) instituted a competitive bidding process for home medical equipment. While this competitive bidding process has demonstrated success in urban and suburban areas, it has not been studied sufficiently in rural communities.  CMS implemented a first phase of cuts for these rural areas on Jan. 1 of this year, reducing rates by 20-25 percent or more for many home medical equipment products vs. the prices in effect in 2015.

Despite warnings from home medical equipment providers that this first round of cuts was causing significant disruption for patients, CMS went ahead with another round of reductions for rural and other less-densely populated areas on July 1.The reimbursement rate for medical equipment supplies in rural areas has now been reduced by 50 percent or more in many cases because of bidding methodology where urban home medical equipment providers can take advantage of increased market share in winning exclusive rights to provide certain products. Rural providers get no such advantages or choice to help set rates on their areas. Now, the results from large-scale bidding areas are setting unsustainable prices for small town communities miles away.

The new reimbursement rates fail to consider the unique rural needs that add to the operational costs of the business, such as increased fuel costs and staff time associated with longer driving distances.  In addition, patients rely upon medical supplies when they are discharged from hospitals.  Without access to quality products and quality service in rural communities, many patients will be forced to stay in hospitals for longer periods, costing the Federal, State, and local governments more and more money.

The impact is being felt all over the place. A business open for 170 years in Danville, Ill., just announced it was closing its doors with the owner saying he ‘had not choice’ but to shut down because of the reimbursement cuts.

Congress is totally out of touch with reality when it comes to understanding both the costs and the quality of the necessary products and services provided.  Often times a senior is discharged from a hospital because they plan to receive the necessary medical equipment at home.  This provides seniors with much-desired independence and mobility through the use of medical supplies, such as motorized wheelchairs, walkers, oxygen, and other medical devices and related services.

Home medical equipment suppliers take pride in not only delivering these essential products, but also in assisting patients in setting up the product, and in educating them on how to use their equipment most effectively, helping seniors and people with disabilities stay in their homes and avoid trips to the hospital or other clinical interventions.  It will be increasingly harder, if not impossible, for medical suppliers in small towns and other less-populated areas to continue to maintain this level of care under the latest round of Medicare reimbursement cuts implemented by Congress.

If Congress waits to fix this problem, as it does with the budget and spending bills, it will be too late and the local suppliers will have closed their doors. Leaders in both the U.S. Senate and U.S. House of Representatives say they recognize the importance and urgency of fixing this aberration that is crippling small medical device businesses. It is way past time for both Houses to pass a final bill that can keep seniors in rural America on par with those in urban areas. It is the right and moral thing to do! 

Hon. Christopher D. Coursen spent 3 years working as Republican Majority Counsel for the Senate Commerce Committee, and Chief Counsel of the Communications Subcommittee, and currently is the Pres. & CEO of the Washington DC government consulting firm, The Status Group.

The views expressed by authors are their own and not the views of The Hill.