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CMS Fails to Respond to Crucial Public Comment in Competitive Bidding Final Rule
Over two-and-a-half years after the close of the comment period on the Interim Final Rule for competitive bidding, CMS has issued the Final Rule which failed to address many of the concerns expressed regarding the agency’s competitive bidding process. In refusing to respond to comments on the bidding process and how CMS evaluates bid, CMS stated:
We note that we received many comments on a wide range of issues that were not addressed in the interim final rule. We thank commenters for sharing their views on these issues; however, because these comments were outside the scope of the interim final rule, we do not address those comments in this final rule.
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“The Committee also must beware of programs masquerading as competition”
Editor’s Note: The following article rightly warns about the deep flaws in Medicare’s Uncompetitive Bidding Program that are disrupting patient access to needed DME supplies and services.
From: Huffington Post
For the Super Committee, an Option to Save Medicare
by Grace-Marie Turner, President, Galen Institute
The congressional Super Committee knows that entitlement programs, especially Medicare and Medicaid, are driving our nation’s ballooning budget deficit, yet both Republicans and Democrats fear they are politically untouchable.
But they must be changed to survive and for Congress to have any hope of controlling federal spending.
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Stakeholders find new ways to connect with beneficiaries
From: HME News
By Theresa Flaherty, Managing Editor
YARMOUTH, Maine – Industry stakeholders have ramped up efforts to get beneficiaries involved in the fight against competitive bidding.At Medtrade last week, the Accredited Medical Equipment Providers of America (AMEPA) unveiled a new patient advocacy line (PAL) that will make it easier for beneficiaries to contact their lawmakers, said Rob Brant, past president of AMEPA.Callers to the toll-free number listen to a brief message about the competitive bidding program and are given an opportunity to enter their zip code. Doing so connects them to a menu of their lawmaker’s offices so they can urge them to support H.R. 1041, the bill to repeal the program.“It’s important to get patients involved and reaching out,” said Brant. “The hardest part (now) is getting HME providers to participate and give flyers to patients.”PAL is based on a similar system used by the American Medical Association. AMEPA tested the program this summer in Florida and Texas, both of which have several Round 1 competitive bidding areas.With Round 2 starting, it’s time to ask providers and patients in other areas to step up to the plate, said Brant.“I think we’ve squeezed every drop we can out of those states,” he said. “I think everyone is (now really) starting to learn about competitive bidding, and they need to get involved and get patients involved.”Florida and Texas aren’t the only two states that have seen increased grassroots activity recently. The VGM Group’s People for Quality Care (PFQC) in October partnered with the Ohio Association of Medical Equipment Services on a town hall teleconference that targeted beneficiaries in the Cincinnati CBA. During the hour-long call, beneficiaries learned about competitive bidding, and were invited to “press through” to be connected directly to their congressional office and ask them to support H.R. 1041. A similar call was held in the Kansas City CBA in August. During the most recent call, about 200 listeners asked to be put through to lawmakers, said Beth Cox, director of communication and marketing specialist for PFQC.The calls have an added benefit in that they allow industry stakeholders to track the most interested beneficiaries, she pointed out.“They are willing to be politically active and are willing to voice their opinion against competitive bidding,” said Cox. “By targeting those who care about the issue, future communications and organization efforts are more efficient.” -
New study: HME saves billions
‘The return is so much greater than the dollars CMS is trying to save’
From: HME News
By John Andrews
GWCC – A new study that shows how the HME industry can save Medicare billions of dollars should have CMS, Congress and the general public intrigued and excited, its chief analyst says.
Brian Leitten, a Florida-based consultant who, with the help of VGM Group, spent four months compiling data to make “The Case For Medicare Investment in DME,” told Medtrade attendees Tuesday that CMS needs to “invest” in home medical equipment because it can save Medicare billions, along with generating handsome ROI for the program.
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Kansas City Beneficiaries Face Competitive Bidding Surprises, Loss of Suppliers, Service Decline
Editor’s Note: The following is first in a series of posts from competitive bidding’s front lines. The data is from a conference call sponsored by Last Chance for Patients Choice and facilitated by “People for Quality Care” of the VGM Group, in the Kansas 2nd Congressional district, part of the Kansas City Round 1 Rebid Competitive Bidding Area.
Almost three-quarters (73%) of nearly 1,000 beneficiaries surveyed in Kansas’ 2nd Congressional District were forced to change suppliers during the last eight months. Despite CMS’ education efforts preceding the Round 1 Rebid, only 15% of the beneficiaries were aware that the Kansas City area had been chosen as one of nine initial metropolitan areas for the competitive bidding project — a stunning failure of the CMS outreach efforts.
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12,000 Cincinnati Area Beneficiaries Join Town Hall On Consequences of Competitive Bidding Program
From: VGM
Cincinnati, OH – Thousands of concerned seniors and caregivers in Cincinnati joined a town hall teleconference call to learn how Medicare’s competitive bidding program will impact access to quality home medical equipment and timely service.
The call, hosted by Last Chance for Patient Choice in conjunction with People for Quality Care (PFQC) and the Ohio Association for Medical Equipment Services (OAMES), brought consumers and health care professionals together to discuss the consequences of Medicare’s program that eliminates local home medical equipment suppliers from providing service to beneficiaries.
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Panel Testimony Lays Powerful Grounds
From: Griffin Home Health Care, Inc.The panel of 5 DME industry representatives built a strong case for repeal of competitive bidding, which seemed to be strongly supported by the Small Business Committee members attending the hearing on February 11. Subcommittee Chairman Heath Shuler (D-N.C.) indicated that his intention of the hearing was to “…discuss the importance of ending the program entirely.” Bill Griffin, President/CEO of Griffin Home Health Care was one of the representatives providing testimony for the House Committee.
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Relief for original bid winners?
From: HME News
CardioSom’s lawsuit serves as a test case for 300-plus providers that were awarded contracts
By Theresa Flaherty, Managing Editor
WASHINGTON – A recent ruling by a federal appeals court could pave the way for HME providers who were awarded contracts in the original Round 1 of competitive bidding to sue for damages.CardioSom in 2008 filed a lawsuit for breach of contract in the Court of Federal Claims, after Congress delayed the competitive bidding program for 18 months and rescinded the contracts of winning suppliers. The Court of Federal Claims ruled CardioSom had no basis to sue, saying that when Congress terminated the contracts, it also barred lawsuits. But an appeals court has disagreed, saying that contract winners have the right to sue.“Companies like CardioSom started spending money, hiring people and getting space,” said attorney Jerry Stouck, a shareholder with Greenberg Traurig in Washington, D.C., which represents CardioSom. “They were expecting to be one of the exclusive providers in those areas for three years, which is worth something.”CardioSom, which won contracts for CPAP and oxygen in nine of the 10 competitive bidding areas is seeking damages, including lost profits for the three-year period of the contract.Now CardioSom will go back to the lower court and press forward with its lawsuit. Ultimately, CardioSom’s suit will serve as a test case for the more than 300 suppliers that were awarded contracts and who may want to sue for damages, said attorney Bill Eck, a shareholder with Greenberg Traurig.“Each company will have its own damages and expenses,” he said. “But in terms of the basic issues–did the government breach the contract? Is the government liable? Then the answer is the same for everyone.” -
HHS IG Plans Three Competitive Bidding-Related Program Reviews
The FY 2012 Work Plan from HHS’ Office of Inspector General calls for reviewing three aspects of the DME competitive bidding program including CMS’ process for conducting competitive bidding:
Competitive Bidding Process for Medical Equipment and Supplies
We will review the process CMS used to conduct competitive bidding and subsequent pricing determinations for certain DMEPOS items and services in selected competitive bidding areas under rounds 1 and 2 of the competitive bidding program. Federal law requires OIG to conduct postaward audits to assess this process. (MIPPA, § 154(a)(1)(E).) (OAS; W-00-11-35241; various reviews; expected issued date: FY 2012; new start)
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Rehberg, Rogers Ask GAO for Immediate Review of Bidding Program
From: VGM
Thanks to the efforts of the Big Sky Association of Home Medical Equipment Suppliers (Big Sky AMES) and VGM members, Appropriations Committee member Denny Rehberg (R-Mont.) has joined with Appropriations Committee Chairman Harold Rogers (R-Ky.) to request that the Government Accountability Office (GAO) make and “immediate and comprehensive review” of the competitive bidding program.
In their letter Oct. 5 letter, the congressmen ask the GAO to consider and answer the following questions:
- What is the impact on beneficiary access to quality and timely services?
- What is the impact on jobs generally?