Home Care Magazine

ATLANTA — HME providers found themselves on another competitive bidding roller coaster ride last week as the Centers for Medicare and Medicaid Services announced it was holding up announcement of the Round 1 rebid contract winners.

“I think a number of things are going on behind extremely closed doors,” said Cara Bachenheimer, senior vice president of government relations for Elyria, Ohio-based Invacare Corp. “Maybe something has gone awry, maybe our predictions have come true, but it’s very hard to say. Nothing is being confirmed by CMS. They just say that everything is on track.”

Everything, that is, except the list of companies that won competitive bidding contracts.

In July, the agency said it would offer 1,287 contracts to 364 suppliers with 622 locations. CMS was to have revealed the companies that were chosen in September, but during an Oct. 14 Open Door call, an agency representative said release of the names was pending based on examination of “red flags” that surfaced when the agency tested “a new program integrity tool.” (See story this issue.)

Nevertheless, CMS’ Michael Keane said the agency expected to move forward with announcement of the winners and implementation of the program — set for Jan. 1 — “very soon.” And despite industry speculation to the contrary, a Friday post on the CMS website noted there would “be more than enough qualified suppliers in all of the 9 sites to assure beneficiary access to equipment and supplies.”

But Waterloo, Iowa-based VGM isn’t buying it. The member services group reported late Friday that CMS was still trying to find providers to accept contracts and was offering them as little as 24 hours to accept or decline.

“If you’ve been recently contacted by CMS regarding competitive bidding contracting, and you’ve got a story to share, we’d like to hear it,” VGM said in a Legislative Update, adding that providers should e-mail their stories to brittany.terrell@vgm.com. “VGM is currently working with multiple legislators from several angles, and needs to know if unscrupulous tactics are taking place at CMS.”

The organization also advised providers that if CMS offered them anything less than the 10 days allowed to other suppliers, they should “respectfully request the same time period to contemplate financial viability based on contract terms.”

Provider Rob Brant said he also had a problem with CMS’ explanation of the announcement delay. “We’re in a holding pattern because the companies that are bid winners — and those that haven’t won — don’t know what is going to happen Jan. 1,” said Brant, who serves as president of the Accredited Medical Equipment Providers of America.

Brant said he believes the CMS delay was calculated. “My feeling is that [CMS] is aware — or starting to figure out — that some of the companies they have contracted with are under [Zone Program Integrity Contractor] audits or under 100 percent pre-pay audit … They intentionally delayed this announcement until it was too late for Congress to act.”

Even as the scenario was playing out last week, stakeholders were also speculating about reports of a meeting scheduled with White House economic advisors, CMS officials and Peter Cramton, a professor of economics at the University of Maryland and an outspoken critic of the bidding project’s design. But a CMS spokesman said Friday the agency had no knowledge of such a meeting.

“Will it occur? Will it change CMS’ actions?” Bachenheimer asked rhetorically. “We can hope, but I wouldn’t put a lot of money on it because there have been so many other instances where CMS has had the opportunity to make some changes and improve the program, but CMS has refused.”

Spearheaded by Cramton, a letter signed by 166 economists setting out the competitive bidding project’s flaws was sent to Rep. Pete Stark, D-Calif., chairman of the House Ways and Means Subcommittee on Health, who sent the letter on to CMS and asked for a response. Although CMS has not yet replied, the agency spokesman said, it planned to.

Added to the swirl of activity, Stark could hold a November hearing on the bidding program that could, Bachenheimer said, “illuminate some of the issues that we see. But those things are all up in the air at this point. That’s what makes it so bad.”

Providers must have time to ramp up for competitive bidding, Bachenheimer said. “You can’t just turn on the switch in 24 hours,” she said. “Depending on how long [the delay in announcing contract winners] goes, if it goes to Nov. 1, I think we have an extremely strong argument that CMS has got to delay it. Tick tock, tick, tock.”

But Provider Chris Rice of Diamond Respiratory Care in Riverside, Calif., said delaying the program again shouldn’t be an option. A contract winner in the original Round 1 and its rebid, Rice said he had made a significant investment in preparing for competitive bidding.

“When we did this the first time, we sat down and figured out what our expansion plan would be and we put that plan into place two years ago, so all that has been done and is in place,” Rice said last week, noting that preparation included buying trucks, arranging warehouse space, buying extra inventory and hiring people. “We still have the infrastructure. But it could get delayed again, so all that could be for naught.

“Eliminating [competitive bidding] would be good; another delay would be a concern,” Rice said. “How many times are we going to have to revisit this? It really needs to go away.”