‘The return is so much greater than the dollars CMS is trying to save’
From: HME News
By John Andrews
GWCC – A new study that shows how the HME industry can save Medicare billions of dollars should have CMS, Congress and the general public intrigued and excited, its chief analyst says.
Brian Leitten, a Florida-based consultant who, with the help of VGM Group, spent four months compiling data to make “The Case For Medicare Investment in DME,” told Medtrade attendees Tuesday that CMS needs to “invest” in home medical equipment because it can save Medicare billions, along with generating handsome ROI for the program.
Editor’s Note: The following is first in a series of posts from competitive bidding’s front lines. The data is from a conference call sponsored by Last Chance for Patients Choice and facilitated by “People for Quality Care” of the VGM Group, in the Kansas 2nd Congressional district, part of the Kansas City Round 1 Rebid Competitive Bidding Area.
Almost three-quarters (73%) of nearly 1,000 beneficiaries surveyed in Kansas’ 2nd Congressional District were forced to change suppliers during the last eight months. Despite CMS’ education efforts preceding the Round 1 Rebid, only 15% of the beneficiaries were aware that the Kansas City area had been chosen as one of nine initial metropolitan areas for the competitive bidding project — a stunning failure of the CMS outreach efforts.
Cincinnati, OH – Thousands of concerned seniors and caregivers in Cincinnati joined a town hall teleconference call to learn how Medicare’s competitive bidding program will impact access to quality home medical equipment and timely service.
The call, hosted by Last Chance for Patient Choice in conjunction with People for Quality Care (PFQC) and the Ohio Association for Medical Equipment Services (OAMES), brought consumers and health care professionals together to discuss the consequences of Medicare’s program that eliminates local home medical equipment suppliers from providing service to beneficiaries.
From: Griffin Home Health Care, Inc.
The panel of 5 DME industry representatives built a strong case for repeal of competitive bidding, which seemed to be strongly supported by the Small Business Committee members attending the hearing on February 11. Subcommittee Chairman Heath Shuler (D-N.C.) indicated that his intention of the hearing was to “…discuss the importance of ending the program entirely.” Bill Griffin, President/CEO of Griffin Home Health Care was one of the representatives providing testimony for the House Committee.
From: HME News
CardioSom’s lawsuit serves as a test case for 300-plus providers that were awarded contracts
By Theresa Flaherty, Managing EditorWASHINGTON – A recent ruling by a federal appeals court could pave the way for HME providers who were awarded contracts in the original Round 1 of competitive bidding to sue for damages.CardioSom in 2008 filed a lawsuit for breach of contract in the Court of Federal Claims, after Congress delayed the competitive bidding program for 18 months and rescinded the contracts of winning suppliers. The Court of Federal Claims ruled CardioSom had no basis to sue, saying that when Congress terminated the contracts, it also barred lawsuits. But an appeals court has disagreed, saying that contract winners have the right to sue.“Companies like CardioSom started spending money, hiring people and getting space,” said attorney Jerry Stouck, a shareholder with Greenberg Traurig in Washington, D.C., which represents CardioSom. “They were expecting to be one of the exclusive providers in those areas for three years, which is worth something.”CardioSom, which won contracts for CPAP and oxygen in nine of the 10 competitive bidding areas is seeking damages, including lost profits for the three-year period of the contract.Now CardioSom will go back to the lower court and press forward with its lawsuit. Ultimately, CardioSom’s suit will serve as a test case for the more than 300 suppliers that were awarded contracts and who may want to sue for damages, said attorney Bill Eck, a shareholder with Greenberg Traurig.“Each company will have its own damages and expenses,” he said. “But in terms of the basic issues–did the government breach the contract? Is the government liable? Then the answer is the same for everyone.”
The FY 2012 Work Plan from HHS’ Office of Inspector General calls for reviewing three aspects of the DME competitive bidding program including CMS’ process for conducting competitive bidding:
Competitive Bidding Process for Medical Equipment and Supplies
We will review the process CMS used to conduct competitive bidding and subsequent pricing determinations for certain DMEPOS items and services in selected competitive bidding areas under rounds 1 and 2 of the competitive bidding program. Federal law requires OIG to conduct postaward audits to assess this process. (MIPPA, § 154(a)(1)(E).) (OAS; W-00-11-35241; various reviews; expected issued date: FY 2012; new start)
Thanks to the efforts of the Big Sky Association of Home Medical Equipment Suppliers (Big Sky AMES) and VGM members, Appropriations Committee member Denny Rehberg (R-Mont.) has joined with Appropriations Committee Chairman Harold Rogers (R-Ky.) to request that the Government Accountability Office (GAO) make and “immediate and comprehensive review” of the competitive bidding program.
In their letter Oct. 5 letter, the congressmen ask the GAO to consider and answer the following questions:
- What is the impact on beneficiary access to quality and timely services?
- What is the impact on jobs generally?
Editor’s Note: The map discussed below is available at http://www.dmecompetitivebid.com/palmetto/cbic.nsf/CBAMap
The Competitive Bidding Implementation Contractor (CBIC) has posted an updated interactive United States (U.S.) map and ZIP code look-up tools on the CBIC website. The interactive U.S. map now displays the Round 1 Rebid, Round 2, and national mail-order competition competitive bidding areas (CBAs) included in the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program. The ZIP code look-up tool has also been updated to include the ZIP codes for Round 2 and the national mail-order competition.A fact sheet, which lists the 100 CBAs included in the Round 2 competition, is also posted on the CBIC website. The CBA for the national mail-order competition for diabetic testing supplies includes all ZIP codes in all parts of the U.S., including the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam and American Samoa.Please call the CBIC customer service center at 877-577-5331 for more information or assistance.
Editor’s Note: In the press release below, Josie Badger, Ms. Wheelchair America, discusses her concerns about how competitive bidding threatens patient quality of care.
PITTSBURGH, Oct. 4, 2011 /PRNewswire via COMTEX/ — Ensuring Power Mobility is Available for People Living with Disabilities
Most toddlers go from strollers to taking their first steps, but Josie Badger had a more complicated transition. Now 27, Badger recalls that she went from a stroller to her first wheelchair, beginning a lifelong dependence on medical equipment to provide her mobility.