Discussion Forum

From: HME News

POTOSI, Mo. – CMS’s Jonathan Blum on May 21 visited Healthcare Equipment & Supply and participated in a roundtable discussion about competitive bidding issues in rural areas. Blum, deputy administrator of CMS and director of its Center for Medicare, heard concerns about Missouri’s rural Washington County being included in Round 2 of the program. The added expense of traveling more miles to serve patients for reduced rates under competitive bidding may mean patients will have to pay out of pocket, attendees told Blum. Rep. Jo An Emerson, R-Mo., arranged and attended the visit.

From Inside CMS

On the eve of a House hearing on the Medicare competitive bidding program for durable medical equipment, the Center for Regulatory Effectiveness last Tuesday (May 8th) sent John Holdren, assistant to the president for science and technology, a paper that recommended CMS pay for a laboratory simulation of the DME bidding rules to assess their efficiency and determine how they should be changed. The paper, which is critical of the bidding effort, analyzes the program and compares CMS’ design to that of auctions developed by the Federal Communications Commission (FCC). The purpose of such a trial, which is … Continue Reading

Editor’s Note: In the following release from CMS, the agency states that their contractor “is the official information source for bidders” and encourages industry members to “stay informed” by obtaining information from the contractor. CRE encourages industry members to stay informed by reading and posting on the Competitive Bidding Interactive Public Docket, by reading the trade press, and by following and participating in the activities of industry and patient advocates working to protect beneficiaries from the evolving impacts of CMS’ not-so-competitive bidding program.

From: CMS/Competitive Bidding Implementation Contractor (CBIC)
The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program … Continue Reading

One of the critical failings of CMS’ bid-based acquisition program for DME is that it prices only goods, not the services which are an integral part of life-sustaining home medical equipment.

The problems from CMS’s failure to include services as part of the DME they put out for bids started to become apparent at a hearing of the Health Subcommittee of the House Ways and Means Committee.

A member of the Committee, Rep. Gerlach asked a senior CMS official official whether the national mail order competition for diabetes testing supplies could mean that nursing homes may not be able to receive the … Continue Reading

CMS’ competitive bidding program for Durable Medical Equipment (DME) has, as has been explained by over two hundred economists including several Nobel laureates, two fatal flaws:

1. The bids are not binding B people can game the system by bidding low and then raising their price after the lower price was accepted.
2. Since the low-ball bids are not binding, CMS ends up setting DME prices, not bidders – a continuation of fee-for-service under another name.

The health community at large should be concerned about CMS’ covert price manipulation since, in this era of ever-tighter budgets, CMS is likely to expand their “competitive bidding” price-setting … Continue Reading

From:  Home Care Magazine

Federal fraud investigators testified last week said they are shifting focus from durable medical equipment to home health while implementing more methods and systems to prevent fraud.

Speaking to a Senate Finance Committee on April 24, Daniel Levinson, inspector general of the Department of Health and Human Services, said that federal officials are now focusing largely on home care fraud in South Florida—an area once known for DME fraud. He noted a recent case involving ABC Home Health and Florida Home Health in which 50 people were convicted in connection with $25 million in fraudulent billing.