“everyone involved with Medicare competitive bidding except CMS realizes this is a disaster waiting to happen”
Editor’s Note: The following article discusses some of the fatal flaws in CMS’ DME bidding program.
From: The Heartlander
Controversial Seven-State Medicare Bidding Program Set to Expand
by Kenneth Artz
A year after a controversial new procurement system was introduced, many Medicare beneficiaries are facing difficulties or delays as providers are squeezed by dramatically lower prices on lifesaving durable medical equipment and services.
From: Home Care Magazine
An article published March 19 in HomeCare Monday and entitled “CMS issues final rule revising DMEPOS supplier safeguards” used unclear language in stating licensing requirements for providers subcontracting through the Competitive Bidding Program. The article should have stated that the rule requires that suppliers who are awarded competitive bidding contracts must have all appropriate state licenses AND may use licensed subcontractors. An earlier version of the rule said that primary contractors were required to be licensed OR may use a licensed subcontractor. The rule clarifies that both parties must hold appropriate licenses. The article failed to state that clearly. The text of the rule is available in the Federal Register.
From: Home Care Magazine
by Larry Anderson
People who use oxygen can still travel the world, even by cruise ship. Just ask anyone who has been on a Sea Puffers Cruise, which caters to people who use oxygen.
Alaska is a popular destination for the Sea Puffers, as is the southern Caribbean. There have also been trips to Russia, the “Mexican Riviera,” Greece, Italy and the western Mediterranean.
The Center for American Progress (CAP) has embraced a Medicare competitive bidding program that was castigated by over two-hundred academicians, including several Nobel laureates, as “the antithesis of science” which “contradicts all that is known about proper market design.”
The 244 signatories to the letter to President Obama warned that the “problems with the CMS auction grow worse upon closer inspection” and that the “complete lack of transparency is inappropriate for a government auction.”
On Wednesday March 14th, CMS will publish a Final Rule (attached below) in the Federal Rule regarding Supplier Safeguards.
This final rule removes the definition of “direct solicitation” and allows DMEPOS suppliers, including DMEPOS competitive bidding program contract suppliers, to contract with licensed agents to provide DMEPOS supplies, unless prohibited by State law. It also removes the requirement for compliance with local zoning laws and modifies certain State licensure requirement exceptions.
Beneficiaries Cite Flaws in Medicare Bidding Program that Restrict Access to Medical Equipment and Services, Says American Association for Homecare
WASHINGTON, March 8, 2012 /PRNewswire via COMTEX/ — Many Medicare beneficiaries face obstacles that either delay or prevent them from obtaining critical durable medical equipment and services (DME) in nine regions of the country where a controversial procurement system was implemented a year ago, according to data collected by the American Association for Homecare (AAHomecare).
Medicare beneficiaries submitted comments to AAHomecare sharply contradicting assurances by the Centers for Medicare and Medicaid Services (CMS) that the well-being of Medicare patients wasn’t compromised by the competitive bidding system.
Editor’s Note: The OIG communication to CMS is attached below.
From: Inside Health Policy
CMS recently told the HHS Office of Inspector General it will issue a proposed rule by September laying out alternative sanctions that stop short of terminating home care organizations from Medicare when they fail to meet conditions of participation, but the OIG does not appear to be convinced. The OIG sent a sternly worded memo to CMS March 2 calling for prompt action on a 20-year-old congressional mandate that such regulatory steps be taken. One issue that CMS and stakeholders appear to be struggling with is how to deal with home care organizations that miss deadlines for submitting OASIS data, because currently the only option is to either do nothing or kick them out of Medicare.
From Home Care Magazine
Senate staff members are scheduled for an update next week on Medicare’s controversial Competitive Bidding Program.
Officials from the Centers for Medicare & Medicaid Services will brief U.S. Senate staffers on Rounds 1 and 2 of the program at 2 p.m., Wednesday, March 14, in the Dirksen Senate Office Building, Room SD-430.
The American Association for Homecare is urging HME providers to alert their senators about the importance of this briefing.
From: Home Care Magazine
A Kaiser Family Foundation poll released last week found that a strong majority of Americans want the traditional Medicare program to stay “as it is today.”
According to the poll, 70 percent of respondents—including 53 percent of Republicans—said Medicare should continue guaranteeing senior citizens health insurance and providing a defined set of benefits.
Recent proposals by Republicans would convert Medicare from a program that provides a set of benefits to one that would give beneficiaries a set amount of money to buy either a private health plan or traditional fee-for-service Medicare.