Discussion Forum

From: Home Care Magazine

WASHINGTON, June 21, 2012—An HME industry working group has asked the Centers for Medicare & Medicaid Services (CMS) to add practical guidelines for making claims on surety bonds. At issue is a recent decision by CMS to start making unannounced claims on surety bonds to collect relatively small overpayments from providers.

The working group—which includes AAHomecare, Bond Safeguard, Lexon Surety, The Wayne van Halem Group, US Rehab, VGM and VGM Insurance Group—made the following recommendations last week:

• Only allow DME MACs to trigger a surety bond if a threshold dollar amount is reached. • Provide better notice to … Continue Reading

PASADENA, Calif.—Medicare’s new method for buying medical supplies and equipment—everything from wheelchairs and hospital beds to insulin shots and oxygen tanks—is doomed to face severe difficulties, according to a new study by Caltech researchers.

The Center for Medicare and Medicaid Services (CMS) implemented the purchasing process—a novel type of auction—in nine metropolitan areas across the country last year and plans to expand it to 91 in 2013.

The competitive bidding process was designed to improve the efficiency of Medicare’s procurement system, potentially saving taxpayers hundreds of millions of dollars. But many experts have criticized the auction, pointing out fundamental flaws in its … Continue Reading

Editor’s Note:  Any program based on Medicare’s DME uncompetitive bidding program without taking into account the program’s fundamental flaws will not succeed.

From: Inside CMS

Researchers, an analyst and an industry expert said that while Medicare Part D has consistently fallen below Congressional Budget Office cost estimates, the program’s financial success does not directly correlate to financial models for larger Medicare reform using a premium support model. But others said during a recent panel discussion that Part D provides some good guidelines.

James Capretta, a fellow at the Ethics and Policy Center, said Part D could serve as a model … Continue Reading

A new study by researchers at the California Institute of Technology, attached below, blasts CMS’ “competitive” bidding auction for Durable Medical Equipment.  The study published in the Quarterly Journal of Economics, found that CMS’ decision to use non-binding bids and median bid pricing does NOT result in competitive prices.  Of particular concern to Medicare beneficiaries and their families, the paper also found that the auction “fails to satsify demand.”  Researchers has already shown based on CMS data that utilitzation of life-sustaining home medical equipment dropped sharply under the new acquisition program.  Specifically, the paper concluded that: “The CMS auction … Continue Reading