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In brief: Watchdog group pushes bidding review
From: HME News
WASHINGTON – The Center for Regulatory Effectiveness (CRE) sent a letter to the Department of Health and Human Services (DHHS) Tuesday requesting that the department place the “highest” priority on reviewing the competitive bidding program. President Obama on Jan. 18 issued an executive order, “Improving Regulation and Regulatory Review,” which seeks examples of problematic rules. In its letter, the CRE said the competitive bidding rule will result in a loss of jobs, create needless burdens, strips beneficiaries of freedom of choice and violates accepted auction principles.
Editor’s Note: CRE’s letter may be found here
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CRE Letter to HHS: Adhere to the President’s Regulatory Initiative by Reforming Competitive Bidding
CRE has sent a letter to the General Counsel of the Department of Health and Human Services stating that “HHS needs to provide highest priority to conducting a retrospective review of CMS’ Durable Medical Equipment (DME) Competitive Bidding regulations” under President Obama’s Executive Order 13563.
The letter explains that the DME competitive bidding regulations contradict “the President’s regulatory goals by needlessly sacrificing thousands of small businesses and tens of thousands of jobs.”
The President wrote in the Wall Street Journal that “Small firms drive growth and create most new jobs in this country. We need to make sure nothing stands in their way.” CRE wrote that “CMS competitive bidding rule stands squarely in the way of saving tens of thousands of small business and their jobs.”
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Obama Budget Lands DME Sucker Punch
From: Home Care Magazine
WASHINGTON — With a proposal that would limit federal Medicaid payments to Medicare’s competitive bidding rates, President Obama’s 2012 budget left home care advocates reeling after its Monday morning release. A second proposal would require prepayment review for all power wheelchairs.
Overall, the administration budget would wrench a reported $62 billion from government health programs to offset a Medicare “doc fix,” delaying a scheduled 25 percent physician pay cut until the end of 2013.
Responding in an afternoon message to its members, the American Association for Homecare said the budget tightens the squeeze on an “already strapped” industry and “puts home medical equipment at risk.”
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New System Limits Medicare Patients’ Provider Choices
From: WSOCTV.com/Channel 9 Charlotte
About a quarter-million people in the Charlotte area are Medicare patients, and many of them have been or will be affected by a new system that significantly limits their provider choices for certain services.
Members of Congress, caretakers and patients are already raising red flags, claiming the new system is flawed.
Marilyn Graham said she is concerned about how well Medicare patients will be able to navigate the new system. She has a condition called sleep apnea and uses a continuous positive airway pressure machine — known as a CPAP machine — to help her breathe at night.
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Brown Sticks by Study: Bidding Kills Jobs, Access in Rural Areas
From: Home Care Magazine
It’s the ‘regulatory process run amok,’ says VGM’s Gallagher
WATERLOO, Iowa — According to VGM VP John Gallagher, a CMS official who pooh-poohed economist Ken Brown’s study of the impact of competitive bidding on rural areas may need to wipe some egg off his face. Only weeks into the project, Gallagher said, the negative effects are already being seen.“People have gone out of business because of credit issues, we’ve lost probably six members in the competitive bidding areas and several outside,” said John Gallagher, vice president of government relations for the Waterloo, Iowa-based member services group.
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Competitive Bidding ‘Antithesis’ of Obama’s Executive Order
From: Home Care Magazine
WASHINGTON — Could a presidential executive order be the key to revising, if not repealing, the DMEPOS competitive bidding program? The answer could depend on whether or not President Obama is keen on enforcing the order, according to a spokesman for the Center for Regulatory Effectiveness.
“We hope it is a mechanism that can be used. A lot depends on how interested the [Centers for Medicare and Medicaid Services] is in following the administration’s new policy,” said Bruce Levinson of the CRE, a watchdog organization that has challenged CMS on its implementation of competitive bidding, as well as its failure to divulge financial requirements for bidders. “And a second part is, how willing is the administration in enforcing the new policy?”
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President Unveils New Regulatory Strategy: Will CMS Adhere?
The White House released a series of documents, including an Executive Order and two Memoranda, presenting the Administration’s regulatory strategy. Transparency, flexibility, scientific integrity, and small business protection are cornerstones of the strategy — none of which are embodied in CMS’ DME competitive bidding program.
For example, the Administration’s Fact Sheet for the new strategy states that “Agencies must consider approaches that maintain freedom of choice and flexibility, including disclosure of relevant information to the public.” In contrast to the new policy, the competitive bidding program strips freedom of choice and flexibility from millions of Medicare beneficiaries. Instead of disclosing relevant information about the competitive bidding program, such as the agency’s specific financial standards that are required by law to be “specified,” CMS keeps them a secret.
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Repeal bidding program, say poll respondents
From: HME News
By Theresa Flaherty Managing Editor – 01.14.2011
YARMOUTH, Maine – HME providers may differ on what’s the best strategy for dealing with competitive bidding, but a majority still support efforts to repeal the program.
In a recent HME NewsPoll, 62% of respondents said they favored repealing competitive bidding over supporting an alternative to the program or letting Round 1 play out.
“They should strive to get competitive bidding stopped immediately, before they create undue chaos,” said Brent Smith, president of Smith Medical in Edmond, Okla., a Round 2 bid area. “Patients will be left on their own and not get what they need.”
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Repeal Competitive Bidding—Please!
From: Home Care Magazine
WASHINGTON—Competitive bidding may have started, but the industry hasn’t stopped its efforts to get the program repealed.On Thursday, the American Association for Homecare sent a letter to leaders in the House of Representatives asking them to include repeal of the DMEPOS bidding program in H.R. 2, the bill that would repeal the entire health care reform law.
The GOP has titled its legislation “Repealing the Job-Killing Health Care Law Act.” The AAHomecare letter pounds home the job loss theme in the HME sector under competitive bidding, stating:
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Code red: CMS notifies non-contract suppliers of problem
From: HME News
BALTIMORE – Within days of competitive bidding’s start date, CMS notified non-contract, grandfathered suppliers that there might be a “problem” when they submit claims for purchased accessories and supplies for use with grandfathered equipment.
CMS did not detail the problem, stating only that it was discovered “through testing of the Medicare claims processing system.”
The agency has created a temporary solution that will allow suppliers to continue to receive payment for these items: They have to append affected HCPCS codes with the “KY” modifier. The affected codes are, for CPAP, A4604, A7030-39, A7044-46 and E0561-62; for hospital beds, E071-72, E0280 and E0310; and for walkers, E0154-58.