From: HME News
by: Theresa Flaherty
BALTIMORE – CMS seems to have left no stone unturned when it comes to the products included in a “recompete” of Round 1 of competitive bidding, say industry stakeholders.
The Round 2 product categories comprised about 200 codes; the Round 1 “recompete” product categories comprise just more than 300 codes.
“It’s pretty much everything under the sun that a typical DME uses,” said Rob Brant, founder of AMEPA. “I don’t think there’s anything they left out except for orthotics.”
CMS announced the product categories for the “recompete” April 17. The agency plans to announce a schedule and begin registration this summer, with bidding expected to open in the fall.
Despite an increase in the number of overall codes, CMS has reduced the number of total product categories from nine to six, essentially lumping numerous products into larger categories. For example, a new general home medical equipment and related supplies and accessories product category covers everything from urinals to patient lifts to TENS devices.
“It’s clearly geared to accommodate a larger provider who can provide a full range of everything,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “CMS will say they can subcontract but that’s not a financially viable model.”
Another new product category that could be problematic: respiratory, which includes oxygen equipment and related supplies, CPAP and related supplies, respiratory assist devices and standard nebulizers.
“There are a considerable number of CPAP suppliers who don’t do oxygen,” said Wayne Stanfield, president and CEO of NAIMES. “If in fact they intend to go with this, it would certainly be a way of forcing many of those CPAP suppliers out.”
The other product categories are: standard mobility equipment and related accessories; enteral nutrients, equipment and supplies; negative pressure wound therapy pumps and related supplies and accessories; and external infusion pumps and supplies.
That last category was a surprise to stakeholders who have long fought to keep the service-intensive therapy out of competitive bidding.
“The decision to include infusion in the Round One re-bid is very surprising and disappointing, given CMS’ previous decision to exclude home infusion therapy from the initial Round One, the re-start of Round One, and most recently Round Two of the competitive bidding program,” said Russell Bodoff, president and CEO of the National Home Infusion Association, in a release.
The announcement of the “recompete,” along with a report from the U.S. Department of Health and Human Services outlining Round 1 savings, should light a fire under the HME industry to continue educating lawmakers on problems with the program and pushing for the market-pricing program, say stakeholders.
“We need to do a better job of keeping our voice in the mix,” said Bachenheimer. “If Congress doesn’t hear from providers and their constituents, then Congress believes everything CMS tells them is working 100%.”