Skip to content

Competitive Bidding Complaints Continue

Since June 18, 2013, People for Quality Care (PQC) has collected information from beneficiaries about their experiences with the Medicare Competitive Bidding Program to better understand the impact of the program on the health and well-being of senior citizens and people with disabilities.

The Medicare Beneficiary Complaint Hotline was established out of concern that beneficiary issues caused by the competitive bidding program were not being properly reported to the public or the important decision makers who can make a difference. While CMS reports just over 30 unresolved complaints, PQC information varies greatly from that report.

Below is a snapshot of the information they gathered from frustrated medical equipment users throughout the country. This information is shared with Congress regularly.

1888 Complaints Received As of Sept 5, 2013
- 37% of calls are general frustration about losing access to a provider of choice
- 63% of calls relate to a specific problem resulting from the program that inhibits access to medical equipment and service
- 67% of callers choose to be transferred to the congressional switchboard
- Busiest week (7/29/13) = 54 complaints per day
- Average weekday since July 1 = 44 complaints per day

Each call is organized into one of 16 issue categories. The top five issues include:
1. Change of provider, including was happy with old provider and quality of care received, old provider was local to the area, being denied rights and choice, don't deserve this treatment after contributing to Medicare for so many years
2. Difficulty receiving supplies/repairs
3. Difficulty finding a new provider
4. Increased cost to beneficiary
5. Product of choice is now unavailable

Competitive Bidding Complaints by State

States with more than 100 beneficiary complaints include New York, Florida, California, Illinois, and Texas. Complaints have been received from 45 different states, Puerto Rico, and the District of Columbia.

If you or a loved one relies on home care, chances are you understand the role of a medical equipment provider in your life. Millions of oxygen users, wheelchair users, and those who rely on a feeding tube understand that not having a reliable provider available to you greatly impacts your quality of life.

For those who do not understand this, including some Congressional members, we must work to educate them in order to prevent detrimental programs such as the Medicare Competitive Bidding Program and others from threatening patient quality of life.

Pro2 LLC Buffalo NY CPAP

New York State of Health: The Official Health Plan Marketplace

Man WaitingWhat is NY State of Health?

Under the Affordable Care Act, a Health Benefit Exchange will be operating in every state starting in 2014. States have the option to set up an Exchange themselves or to allow the federal government to set up an Exchange in their state. New York has chosen to set up its own Exchange, named the NY State of Health.

NY State of Health lets you shop for, compare, and buy a health plan online, in person, or over the phone. Individuals and families with incomes below certain levels ($45,960 for individuals and $94,200 for a family of four) may be eligible for financial assistance in the form of federal tax credits only available through NY State of Health. Federal tax credits limit the amount a person pays for insurance each month. Monthly payments will be far below the cost of buying insurance today.

Why does New York need a Health Plan Marketplace? Nearly 2.7 million New Yorkers under age 65 do not have a health plan. That is approximately 16% of people in NY.

Who can use the Marketplace? NY State of Health can be used by individuals, families, and small businesses with 50 or fewer employees.

Who can I call for help? You can reach NY State of Health Customer Service by calling 1-855-355-5777 (toll free).

Important Dates: October 1, 2013: exchange begins accepting insurance coverage applications. January 1, 2014: exchange coverage becomes effective.

To learn more, please visit the official NY State of Health website: http://www.nystateofhealth.ny.gov/.

Pro2 LLC Buffalo NY

Competitive Bidding Complaints Roll-in

Beneficiaries, caregivers, and health care professionals from around the country have been calling People for Quality Care's Complaint Hotline to discuss the issues they're experiencing as a result of the Medicare Competitive Bidding Program.

So far, they've fielded more than 900 calls which has resulted in over 400 complaints being categorized and sent to Congress and Medicare Ombudsmen!

The most frequent complaint heard so far is general disgust over the need to change providers. See the table below for a full breakdown of the complaints received to date.

CBA Complaints to Date

The most powerful weapon in the fight against the recent changes to home medical equipment policies for Medicare beneficiaries is you.

Are you a Medicare beneficiary or caregiver? Do you have a Medicare complaint that needs to be heard?

Medicare Complaint Hotline

The Medicare Complaint Hotline was created so you can share your concerns and complaints with Congress and important Medicare officials. People for Quality Care's Medicare complaint reports will be sent biweekly to those officials who have the power to amend the program and return choice and access to better equipment and service to those who need it most.

If you have a Medicare complaint, please call the Medicare Complaint Hotline at 800-404-8702 today and make your voice heard.

Pro2 LLC

New Insurance Plans Accepted

Man Reading Bills by Pro2 LLCPro2 LLC is pleased to announce that we are now a participating provider with the following insurance plans:

United Healthcare Empire Plan
The Empire Plan is a unique health insurance program developed by New York State and its employee unions for employees of New York State and their families. It is the most selected group health insurance option under the NYS Health Insurance Program (NYSHIP), covering over 1 million employees, retirees, and dependents.

United Healthcare administers the Empire Plan's medical/surgical portion, which includes the home health care/DME benefit.

Wellcare
The largest Medicaid and Medicare-only contractor in the nation, they offer affordable health care plans to individuals eligible for government-sponsored programs.

Fidelis
Fidelis Care is the New York State Catholic Health Plan, providing quality, affordable health coverage to children and adults in 59 counties statewide. Fidelis Care offers free or low-cost comprehensive health insurance through the Family Health Plus, Child Health Plus, and Medicaid Managed Care programs.

Click here to see a list of all the plans that Pro2 LLC participates in.
Pro2 LLC

Introducing Snooze News

Snooze News by Pro2 LLC Your PAP NewsletterWe've worked long and hard behind the scenes on something that we're proud to finally reveal... introducing Snooze News!

Snooze News is our very own e-newsletter for our patients receiving CPAP, BiPAP, and AutoPAP therapies. It's emailed to patients about once every month- the inaugural newsletter having just gone out last week.

We're filling it with educational articles and tidbits to help make using PAP therapy easier for you. Plus we're adding information on the latest advancements in the field including product advancements, and you'll even find coupons and discounts, too!

To sign up to receive Snooze News, click this link and fill out the form. We'll add your name to our mailing list. [Keep in mind that since our e-newsletter is sent out monthly, it may be a few weeks before you receive one.]

Pro2 LLC