CMS Warns: Get Ready for DMEPOS Competitive Bidding
Editor’s Note: The following information is from CMS. The notice appears incomplete since it makes no mention of the harm that Round 2 would do to Medicare beneficiaries and their families, DME suppliers, and the economy which stands to lose tens of thousands of jobs from CMS’ ill-conceived and unsustainable plan which, despite the moniker “competitive bidding” is neither competitive nor a true auction.Get Ready for DMEPOS Competitive BiddingThe Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Round 2 and the national mail-order competitions are coming soon!
- CMS begins pre-bidding supplier awareness program
It’s ‘full-steam ahead’ for Round 2
From: HME News
‘There was a general perception that they would address some of these issues’
By Liz Beaulieu, EditorBALTIMORE – Any hope that CMS, of its own volition, would revise competitive bidding for Round 2 has gone up in smoke.The agency, in a press release announcing the affected zip codes and product categories for Round 2, bragged about the success of Round 1, which it says has resulted in 35% less spending, no changes in beneficiary health and few complaints.“It’s disappointing that, even with overwhelming evidence from bidding experts that this is a fundamentally flawed program, CMS is not making any changes,” said Walt Gorski, vice president of government affairs for AAHomecare. “There was a general perception that they would address some of these issues.”One of the biggest issues with competitive bidding in its current form, according to bidding experts, including Prof. Peter Cramton, and industry stakeholders: The bids that providers submit are not binding.A CMS official told Inside Health Policy that the agency didn’t have the authority to make the bids binding. Industry stakeholders beg to differ–the secretary of the Department of Health and Human Services has full discretion, they say–but now they know where CMS stands and they will seek to make changes legislatively.“The silver lining is that it strengthens the case for the industry to get a member of Congress to introduce legislation to, at a minimum, get that change included in the structure of the program,” said Seth Johnson, vice president of government affairs for Pride Mobility Products.These efforts should be well received by lawmakers, who, all along, have believed CMS was listening to industry stakeholders and bidding experts, and considering changes to Round 2.“Staffers have been under the impression that CMS would do something in a meaningful way,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “We’ve been telling them not to believe it. It’s full-steam ahead”For some, the tone of CMS’s announcement makes not only the industry’s goal of revising competitive bidding more difficult, but also the ultimate goal of repealing the program nearly impossible.“The days of hoping this program would go away are over,” said Wayne Stanfield, president and CEO of NAIMES.Still, the industry has introduced numerous bills to repeal competitive bidding over the years, including this year’s H.R. 1041, which has 145 co-sponsors, and it isn’t about to throw in the towel now, stakeholders say.“We’re going to have to pick up our efforts,” said John Gallagher, vice president of government relations for The VGM Group. “We’re going to have to pick up the robo-calls, like those in Kansas City, and the push-backs, like those in Iowa. We’re going to have to pick up the talk of the impact of this program on jobs.”
Consumer Power Report: Competitive Bidding Isn’t Competitive Enough
From: The Heartland Institute
Another August week, another Friday news dump: The Centers for Medicare and Medicaid Services announced last week it would dramatically expand its competitive bidding program, which has been criticized strongly by device manufacturers and auction experts. While the program is well-intentioned, critics claim (accurately, in my view) that the auction process is inherently flawed, designed to create disincentives for real competition. Here’s a report on the decision from The Hill , which indicates CMS is considering expanding the process beyond the current DME limits.
CMS Announces Round 2 Expansion of “Competitive Bidding”
Editor’s Note: The CMS “Facts” about so-called “competitive bidding” presnted in their materials below are misleading. Specifically, the DME program does not replace the fee-schedule amount with a competitively determined market price. As hundreds of economists and other auction experts, including Nobel Laureates, and a senior official from the Congressional Budget Office have explained, the CMS program is not a true auction, does not result in competitively determined prices, and is not sustainable. As patient advocates have detailed, older Americans are already being hurt by CMS’ ill-conceived program.
From: CMS Press Release andf “Fact Sheet”
DME Round 2 Timing
From: Inside CMS
CMS might release as early as this week the product categories and timelines for the second round of the controversial durable medical equipment competitive bidding program, industry sources say. Some had expected the announcement last week but have heard nothing since. CMS’ next routine open-door forum for home health and hospice is Wednesday (Aug. 17), and an industry source suggests that event might be a convenient way to make the announcement.
Provider wants auditor to pay: ‘They can’t just put me out on the street’
From: HME News
By Liz Beaulieu
PHILADELPHIA – An HME provider who fought an audit and won is now suing TriCenturion, the CMS contractor that conducted the audit, for $10 million in damages.
Nichole Medical Equipment & Supply’s civil lawsuit was dismissed by the U.S. district court for the eastern district of Pennsylvania in March, but the provider has appealed and it must submit a brief to the U.S. court of appeals for the third district by Sept. 7.
Providers, Patients Frustrated by CMS Competitive Bidding Program
From: The Heartland Institute
The Centers for Medicare & Medicaid Services claim their new competitive bidding program has not resulted in any changes in beneficiary health outcomes. But CMS’s observations differ significantly from those of patients and providers of home health care.
On January 1, 2011, CMS launched the first phase of its competitive bidding program in nine different areas of the United States: Charlotte, Cincinnati, Cleveland, Dallas-Fort Worth, Kansas City, Miami, Orlando, Pittsburgh, and Riverside, California. Later this year the program will begin in another 91 regions, with the aim of cutting Medicare costs through an auction approval process for home medical equipment and services.
A Disaster Waiting to Happen
Editor’s Note: The following column from The Weekly Standard highlights that Medicare beneficiaries have already begun to suffer harm from CMS’ fundamentally flawed competitive bidding program.
Medicare bureaucrats wreck the medical equipment market.
August 15 – August 22, 2011, Vol. 16, No. 45
‘We’re all in this together’ — MED launches Competitive Bidding Institute
From: HME News
By Liz Beaulieu, Editor
LUBBOCK, Texas – When it comes to competitive bidding, The MED Group wants HME providers to have all of their bases covered.
That’s why MED has formed the Competitive Bidding Institute to school providers on not only how to submit a bid, but also how to stay in the game, whether they become a contract or non-contract provider.
“The primary focus is to stop competitive bidding,” said Wayne Grau, MED’s vice president of supplier relations and government affairs. “But we have an obligation to put together tools and services that our members can access so that they’re ready to compete.”
GAO Report Highlights Need for Judicial Action and IG Investigation of Competitive Bidding
In a report on improper Medicare payments, the US General Accountability Organization (GAO) highlighted the need for judicial action to compel CMS to adhere to the law and use transparent standards and processes for evaulating DME providers seeking to win competitively bid contracts. Specifically, GAO stated that CMS’ DME competitive bidding