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CRE has provided CMS with a mechanism for making the Competitive Bidding Workable, simply by adopting the Small Business Enhancement Option.
Recognizing the statutory requirement that CMS proceed with a competitive bidding program, CRE has developed the Small Business Enhancement Option.
This option has three components:
l. A “single payment amount” which would be determined by the competitive bidding process.
2. Any qualified small business, as defined by SBA, would be able to supply product and services at the “single payment” amount.
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The CRE Discussion Forum has benefited from the written views of a number patients and DME providers In that it is easier for a number of DME program recipients to present their views through an audio Hotline, CRE has established a Hotline which can be accessed at 1-800-613-7678 .
Listen to the views of an elderly patient whose access to oxygen may be in jeopardy. Visit the Discussion Forum at http://www.thecre.com/Forum/
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Based upon a series of allegations made by DME suppliers and consultants in the CRE Discussion Forum, CRE is launching an investigation of the CMS Accrediation program. The allegations are set forth at http://www.thecre.com/Forum/?p=1420
The investigation will be conducted by experienced IG investigators and will be performed in a transparent manner, meaning CRE’s analyses and requests for information will be presented on the Discussion Forum at http://www.thecre.com/Forum/
CRE requests that its audience provide relevant background information to CRE through the Discussion Forum. http://www.thecre.com/Forum/
Annoymous submissions are accepted.
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CRE has had extensive discussions with CMS regarding accreditation. CMS has decided not to grant an extension to DME providers. In arriving at this decision, CMS has given serious consideration to several Congressional mandates, including patient access and Congressionally mandated deadlines.
CRE is not in a position to provide its readers with business advice; however we are in a position to inform you of your options regarding accreditation.
If you are likely not to be accredited you should give consideration to voluntarily terminating your enrollment in the Medicare program–please see page 4 of the CMS 855S. If you fail to voluntarily terminate your enrollment with the Medicare program you will lose your billing privileges which will bar you from re-enrolling for at least one year from the date of revocation.
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CRE has requested an extension of the DMEPOS supplier accreditation deadline because of the backlog at accrediting organizations. Failure to grant the extension will result in a serious curtailment of services to beneficiaries, particularly in rural areas. The CRE request lays out in painstaking detail the legal authority of CMS to grant the extension.
Please post your views on the Discussion Forum at http://www.thecre.com/Forum/
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A study released by the American Association for Homecare demonstrates that the CMS Competitive Bidding program decreases competition.
Conclusions drawn from the study include:
During its initial implementaton in 2008, the vast majority of providers were shut out of the program. Of the more than 4,000 providers in the initial bidding areas, only 376 were deemed to have met the bidding program requirements, which were not clearly defined. This “competitive” bidding program, in fact, depresses competition and limits patient access and choice.
During the bidding implementation, nearly 40 percent of companies awarded durable medical equipment contracts for Pittsburgh patients were located outside of Pennsylvania.
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CRE has compared the rules covering competitive bidding in the Medicare Advantage program with the competitive bidding rules governing the medical equipment program.
CRE concludes in correspondence to the Deputy Director of OMB that the competitive bidding proposal in the Medicare Advantage program is similar to that recommended by CRE in that it would be used to set prices but would not be used to determine which companies are eligible to compete within the program.
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CMS can not initiate the competitive bidding program until OMB approves its information collection request ( ICR) pursuant to the Paperwork Reduction Act. CRE has identified a number of deficiencies which demonstrate that the CMS ICR is not PRA compliant.
CRE also recommends a solution to the problem: allow all qualified small suppliers to provide equipment at the single payment amount if the suppliers meet the SBA definiton of a small business.
CRE comments are appended hereto.
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CRE Interactive Site Offers Venue For Debate On Competitive Bidding
Inside CMs
Stakeholders hoping to influence CMS’ restart of its controversial durable medical equipment competitive bidding effort now have a new outlet: An interactive, online “docket” unveiled Wednesday (May 27) by a veteran lobbyist who headed the Office of Management and Budget’s regulatory affairs shop during the Reagan administration. Jim Tozzi, now on the Board of Advisors for the Center for Regulatory Effectiveness, said CRE’s interactive docket allows a stakeholder to directly comment on another stakeholder’s post on the Web site, to interact online in a “discussion forum” about a particular rule or regulation and to e-mail CRE with comments that CRE can then highlight or expand upon, he said.
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CMS’ Durable Medical Equipment Competitive Bidding Program could eliminate as many as 90% of the providers from the market place, primarily small businesses. The loss of these many small firms would jeopardize patient care since the patient-provider relationship is crucial when using home medical equipment. Safeguards must be put in place so another industry is not dominated by “too big to fail” companies.
CMS has not yet demonstrated compliance with “good government” laws , the laws that “regulate the regulators”; these laws include the Paperwork Reduction Act, its companion, the Data Quality Act, and the Regulatory Flexibility Act.
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