The bid window to submit bids in what is called the Round 1
rebid of the competitive
acquisition program is now open and in full swing.
A bill was recently introduced in Congress to repeal the bid
program and is gaining new sponsors almost daily. Providers in the
initial nine bid areas are focused on submitting bids but also are
engaged in activities to alert the local community of the likely
effects of the bid program in their area. CMS has begun a public
affairs campaign to tout the merits of the competitive bid program
for DME. And Congress has proposals to expand and eliminate the
program pending on Capitol Hill. In short, there's activity on
every front related to the so-called “competitive”
bidding program.
It's going to be a long 14 months between now and the January
2011 “go live” for the Medicare competitive bid
program.
Bill to Repeal the Bid Program
On Oct. 13, Rep. Kendrick Meek, D-Fla., and 16 original
cosponsors introduced a bill in the House that would repeal the
controversial bidding program. Designed to be budget-neutral, the
bill will continue into 2010 as we enter the second session of the
111th Congress.
Original cosponsors of the bill include representatives from
virtually all the initial nine bid areas in Florida, Pennsylvania,
Ohio, North Carolina, Kansas, Texas and California: Jason Altmire,
D-Pa.; John Boccieri, D-Ohio; Jo Ann Emerson, R-Mo.; Sam Farr,
D-Calif.; Marcia Fudge, D-Ohio; Alcee Hastings, D-Fla.; Eddie
Bernice Johnson, D-Texas; Ron Klein, D-Fla.; Dan Maffei, D-N.Y.;
John Murtha, D-Pa.; Tim Ryan, D-Ohio; Heath Shuler, D-N.C.; Glenn
Thompson, R-Pa.; Patrick Tiberi, R-Ohio; Debbie Wasserman Schultz,
D-Fla.; and Robert Wexler, D-Fla.
In order to pay for the savings the bid program had been
projected to save, there are a series of changes to the CPI
increases that are in current law. Specifically, the payment cuts
would: eliminate the increases that are in current law for 2010
through 2012 and, instead, impose a payment cut of one-quarter
percent in those three years; eliminate the current CPI bump of 2
percent in 2014; and take a one-half percent cut in 2015. Complex
rehab wheelchairs (Group 3 and above) would not be subject to any
of the CPI freezes or payment cuts.
CMS Opens 60-Day Bid Window
CMS opened the 60-day bid window on Oct. 21; bids are due by
Dec. 21, 2009, at 9 p.m. ET. In the same week, the Competitive
Bidding Implementation Contractor posted a number of clarifications
and additional fact sheets on its Web site at www.dmecompetitivebid.com. The site includes updated
utilization charts for each of the nine bid areas as well as
detailed information about financial documents and other critical
information for bidders to understand before developing and
submitting bids.
CMS Public Relations Campaign
Over the last several of months, you likely have noticed a surge
in the number of articles in the mainstream press that focus on
Medicare fraud and abuse — particularly fraud in the DME
sector. From CNN to Fox News to C-SPAN to “60 Minutes,”
all have had significant coverage focusing on DME fraud in Miami,
Los Angeles and elsewhere in the country. I fully expect this
stream of media attention to continue over the next year as CMS
moves forward with its implementation of competitive bidding.
Expansion of Round 2 and Beyond
The Senate Finance Committee health reform package contains a
provision that would expand Round 2 of bidding and expedite the
application of bid rates nationwide. This provision would increase
Round 2 by 21 additional metropolitan areas and would require the
HHS Secretary to bid all areas of the country or apply bid rates
nationwide by 2016.
This provision signals strong support for the bid program among
the committee members, so it 'is likely to stick and remain in the
final health care reform package that Congress is working to pass
by the end of the year.
Read more Washington Wit & Wisdom
columns.
A specialist in health care legislation, regulations and
government relations, Cara C. Bachenheimer is vice president,
government relations, for Invacare Corp., Elyria, Ohio.
Bachenheimer previously worked at the law firm of Epstein, Becker
& Green in Washington, D.C., and at the American Association
for Homecare and the Health Industry Distributors Association. You
can reach her at 440/329-6226 or cbachenheimer@invacare.com.
