Bidding Timeline, Fraud Demo Discussed at CMS Open Door

BALTIMORE–While there were no big explanations at CMS’ Open
Door Forum last week, HME stakeholders did glean a few nuggets of
information on the agency’s national competitive bidding project
and its ongoing fraud demonstration.

But those who were anxious to hear the next deadline for
mandatory accreditation were disappointed. Rumors had circulated
within the industry that the accreditation deadline for Round Two
bidders–or maybe even the drop-dead date when all providers must
be accredited–would be revealed at the Wednesday afternoon Open
Door. It did not happen.

“We don’t have any deadlines to give you for Phase Two of
accreditation,” said Sandra Bastinelli, director of the Division of
Medical Review in the Office of Financial Management, in brief
comments.

Joel Kaiser, deputy director of DMEPOS policy for CMS, was
equally vague in his update on competitive bidding, advising
providers to check the competitive bidding Web site–www.dmecompetitivebid.com–for
a program timeline. He noted the agency is “in the middle of bid
evaluation” for Round One, but should conclude the process in
January when the actual contracting process for suppliers will
begin.

About expansion of the national bidding project, Kaiser would
say only that the next 70 cities selected for the program would be
announced “in the near future.” However, he added, “once we roll
out the MSAs and the product categories for Round Two, that will
begin the process of implementation. Shortly after that, we’ll be
announcing a timeline for Round Two with milestones and key
dates.”

Regarding the anti-fraud demonstration projects currently under
way in Southern California and South Florida–which mandate that
all HME providers in those areas reapply to the National Supplier
Clearinghouse to be Medicare providers–CMS’ Frank Whelan said
letters notifying providers about re-enrollment are being sent out
gradually.

“One-quarter of all DME suppliers in the targeted areas have
received letters,” said Whelan. A second batch of letters to the
next quarter of suppliers was supposed to go out by the end of
November, the third round by the end of December, he said. “By the
end of January, the final 25 percent of DME suppliers will have
received their letters,” Whelan said.

Whelan’s explanation, in response to a question about the fraud
demo from Walt Gorski, vice president of government relations for
the American Association for Homecare, was one of the few answers
HME stakeholders got during the forum. CMS officials asked most
inquirers to send emails, saying they would be routed to the
appropriate person for answers.

Gorski also asked for a status report on claims-processing
logjams in Jurisdiction C as a result of the transition from
Palmetto GBA to Cigna as the DME MAC, as well as an update on
maintenance and service payments for capped rental equipment. Those
issues should be addressed in the next Open Door Forum, which is
set for Jan. 9.