WASHINGTON
As HME advocates gathered in the nation's capital earlier this
month to push for a delay of competitive bidding, a CMS official
said the agency plans to move forward with the first two rounds of
the program as scheduled.
“We have a legislative mandate, and we're not going to
approach it and plan to fail. We're going to approach it and plan
to succeed,” CMS' Laurence Wilson, director of the agency's
Chronic Care Policy Group, told some 350 attendees — a record
turnout — at the American Association for Homecare's
Legislative Conference March 4. “We will move forward with
the program and watch very closely to see if adjustments need to be
made.”
While the law does provide some “wiggle room” to
adjust implementation dates, Wilson said round-one contracts will
be enforced beginning July 1 and noted CMS does not anticipate the
major delays the industry is hoping for.
Although Wilson promoted competitive bidding as a way to set
more accurate prices, a number of conference attendees expressed
concern during a Q&A session after his presentation that the
bidding program will put providers out of business and that CMS
will not have time to evaluate the effects of round one before
moving on to round two.
“This is bad public policy,” said Tom Ryan,
president and CEO of Farmingdale, N.Y-based Homecare Concepts.
“We're moving too fast with this program … I've been in
business for 20 years. I want to make it to 25.”
The agency is evaluating round one in stages, Wilson explained,
and has already identified some areas that need improvement,
including boosting supplier education, streamlining financial
documentation requirements and upgrading the bidding software,
which caused major headaches for bidders in the first round.
After round one begins, DME contractors will survey
beneficiaries on whether or not they received the right products
and if their needs were met, he said. CMS also will monitor call
centers to become familiar with the problems beneficiaries and
providers are experiencing.
“There are a lot of things we haven't gotten to yet. We
hope to learn from round one and apply those lessons to round
two,” Wilson said. “I know it's not a popular program,
but it's the program we have to work with, and we want it to work
as smoothly as possible and be a success.”
Contract suppliers for round one should be announced soon, he
said, adding that an official timeline, exact Zip codes and
products for round-two implementation should be released in the
next “weeks or months.”
Wilson also said CMS is looking “very closely” at
implementing prices set under competitive bidding in non-bid areas.
A round three of competitive bidding also is a possibility, he
said.
In response to questions asked during the session, Wilson
also:
Said if a supplier won't accept the median bid, the contract
will be offered to the next supplier. When a provider in the
audience asked what would happen if suppliers keep rejecting the
contracts, he said, “If we cannot meet demand, we can't have
competitive bidding for that product.”
Expressed interest in a recently published study that analyzes
the competitive bidding demonstration projects in Polk County,
Fla., and San Antonio, Texas.
Authored by Brett Katzman, PhD, associate professor of economics
at Kennesaw State University near Atlanta, and Kerry Anne McGeary,
PhD, associate professor of economics at Drexel University in
Philadelphia, the study concludes that CMS' format for competitive
bidding is fatally flawed and, in many instances, results in higher
prices and poorer service.
Wilson said he is interested in reading the study on the
demonstration projects because it is peer-reviewed and has been
published in a journal.
Said CMS is not required to protect small businesses under the
Medicare Modernization Act; the agency is only required to make
sure small suppliers are included in the program.
“At the end of the day, this is a program that picks
winners and losers. Some are small and some are big.” Wilson
also could not offer a percentage of providers who will win or lose
out of those who placed bids.
Announced that CMS plans to hold a PAOC meeting early this
summer to get further feedback on the program.
