Editor’s Note: Every independent expert who has examined Medicare’s “competitive bidding” program for home medical equipment has determined that it will fail. Hundreds of economists, including Nobel laureates, and researchers working under a National Science Foundation grant and the Congressional Budget Office have all reached a similar conclusion. HHS/CMS has been deaf to the science community and pursued their own deeply flawed plan. Now the human toll is starting to be felt. The article below explains why Congress must pass H.R. 6490 – The Medicare DMEPOS Market Pricing Program Act of 2012.
Editor’s Note: Widespread ethical behavior by DME providers is no surprise to anyone familiar with the industry. The OIG is deeply wrong, however, in claiming that the uncompetitive bidding program reduces negative behavoir when what the CMS bidding program really does is reduce consumer choice and the supply security of life-sustaining home medical equipment for Medicare beneficiairies.
From: HME News
WASHINGTON – The drastic reimbursement cuts that went into effect as part of Round 1 of competitive bidding haven’t caused HME providers to solicit physicians to prescribe a different brand or mode of delivery, according to a new government study.
From: HME News
by: Theresa Flaherty
WASHINGTON – The week before Christmas, HME industry stakeholders wrapped up seven more co-sponsors for H.R. 6490, bringing the total to 87.
“This demonstrates significant strength for this bill,” said Walt Gorski, vice president of government affairs for AAHomecare. “It’s not easy to get 80 or 90 co-sponsors on anything. Everyone is working hard to move the bill in any legislative vehicle this year.”
As the long holiday weekend advanced, it was looking like the industry might get a little extra time to do just that. The latest attempt by lawmakers to avert a looming fiscal crisis failed Dec. 20, leaving open the possibility that a solution could be pushed into the new year.
From: HME News
OIG: CMS pays too much for bracesby: HME News Staff
WASHINGTON – The Office of Inspector General (OIG) recommends in a new report that CMS lower the fee schedule amount for certain back braces through competitive bidding or inherent reasonableness.
Medicare paid more than $96 million for L0631 back orthoses in 2011, nearly four times what providers paid to acquire them. Between July 1, 2010, and June 30, 2011, the average Medicare allowable for the orthoses was $919; the average supplier acquisition cost was $191, according to the report.
Editor’s Note: The Center for Regulatory Effectiveness filed a FOIA request with CMS for documents regarding the development of the DMEPOS competitive bidding program. Specifically, CRE is seeking:
All agency records concerning the National Technical Expert Panel (NTEP) that was convened by the Health Care Financing Agency (HCFA, now CMS) to gather feedback regarding the design of the Durable Medical Equipment (DME) competitive bidding project and to engage in communication with interested members of the public. This FOIA request concerns the HCFA/CMS expert panel referred to on pages 1-5 to 1-6 of the report on CMS’s website, “Evaluation of Medicare’s Competitive Bidding Demonstration for DMEPOS: First-Year Annual Evaluation Report HCFA Contract No. 500-95-0061/T.O. #3” available at https://www.cms.gov/Medicare/Demonstration-Projects/DemoProjectsEvalRpts/downloads/karon_2001_1.pdf
Medicare’s Bidding Program for Home Medical Equipment Is Shutting Down Montana Homecare Providers and Threatens to Cut Care for Beneficiaries
From: Big Sky Association of Home Medical Equipment Suppliers
Stakeholders Push for Proposed Market Pricing Program as a Smarter Alternative
HELENA, Montana, Dec. 14, 2012 /PRNewswire-USNewswire/ — Medicare’s controversial bidding system for durable medical equipment (DME) used at home is pushing Montana homecare companies out of business years before it is even implemented in the state. The bidding system is also making it harder for vulnerable seniors and people with disabilities to receive required home medical equipment that has been prescribed for them.
The National Coalition on Health Care (NCHC), which describes itself as “America’s oldest, most diverse, and broadest based group working to achieve comprehensive health system reform” has proposed a major expansion of CMS’ competitive bidding program to “to the categories of durable medical equipment not included in the current program, including items such as nebulizers and ventilators.” NCHC also supports “reducing the rate at which the federal government reimburses state Medicaid programs for DME” to Medicare levels.
By Mike Vogel
The feds are considering a new Medicare law that leaves some people with disabilities very worried. It’s a move that people who rely on anything from wheelchairs to prescriptions say could literally kill them.
“On paper, we’re just a number. It basically removes a voice for those that need health services,” said Hernan Reyes, a paraplegic mouth artist.
Hernan Reyes has been in a wheelchair for 20 years, after a car wreck left him paraplegic. A federal mandate has him pretty worried. The law would require medical equipment companies to bid for the medicare contracts.
Editor’s Note: The following illustrates the dangers of action without analysis. No informed group could support expansion of CMS’ competitive bidding program in the face of unified oppostiion from every independent expert who has analyzed the program.
From: National Journal
By Meghan McCarthy
After President Obama’s reelection win, you might think that talk of competition in Medicare—a cornerstone of Mitt Romney’s campaign—would fall by the wayside. But introducing greater competition into the health program for older Americans is an idea that could prove ripe for a bipartisan compromise in any “Grand Bargain” on the budget.
Editor’s Note. CMS has previous attempted to institute a competitive bidding service for clinical laboratory services. The effort failed. Now the Office of Inspector General report on unimplemented recommendations suggests that the agency may try again.
From: HHS OIG — Compendium of Unimplemented Recommendations, December 2012 Edition
CMS said it would consider our recommendation as it continues to monitor the effects of its payment policies for laboratories. Options may include instituting competitive bidding for laboratory services.