Note to Providers: Don’t Miss Out on CMS Education

BALTIMORE–Providers who are not tapping into CMS’ educational
articles might be missing critical information that could help them
do business better in the competitive bidding environment,
according to Mark Higley, vice president of development for
Waterloo, Iowa-based VGM Group.

On April 2, CMS launched a series of articles via its Medicare
Learning Network. The MLN Matters articles focus on round one
implementation of the bidding program and offer tips to providers
who are involved.

“Personally, I am impressed by these initial
articles,” said Higley, who for the past two months has been
traversing the country for a series of VGM-sponsored competitive
bidding seminars. He has heard providers’ questions and concerns.
“The material is presented in an articulate manner. It is not
too lengthy or full of legalese … If Medicare continues to
distribute the information to the provider community in a timely
and straightforward manner, it will be one of the first instances
in which CMS’ implementation of the competitive bidding program
appears appropriate.”

The educational campaign is scheduled to continue up to the
implementation of round one on July 1.

The three articles released so far have provided helpful
information, Higley said. He noted one of the articles, an overview
on how competitive bidding might affect beneficiaries, gives a good
summary of the grandfathering process and also contains some key
clarifications.

“For example, many [providers] were under the impression
that, as non-contract providers in a certain product category, they
would be unable to service Medicare beneficiaries other than
completing current rental agreements via the grandfathering
procedures,” he said.

But according to the article, Higley said, “[providers]
can continue to service some of their Medicare-eligible patients
who wish to remain with the provider (outside of the scope of the
grandfathering terms) via a cash transaction, an [advance
beneficiary notice] and a waiver of the Medicare claim. This was
somewhat of a revelation to many during our recent VGM competitive
bidding seminars.”

Higley has also found value in the articles not only for
providers in round one but also for future bidders. A third article
introduces providers to the new IACS, or the CMS security system
known as the Individuals Authorized Access to CMS Computer
Services.

“As many [providers] in the first round are aware, dozens
of potential bidders were locked out of the 2007 CBSS application
process to obtain bidder numbers, user IDs and passwords due to
problems associated with the data not matching certain fields on
the provider’s 855S forms,” Higley said. “This MLN
Matters article clearly sets forth which staff members of the
provider are eligible to access the system and bid.”

For example, according to the article, suppliers wishing to bid
in round two must register in the IACS before the opening of the
bidding window. Three user roles will be available:

1) Authorized Official (AO). Each supplier’s organization will
be allowed one AO. The AO role can approve all other users
associated with their organization who are requesting access to the
bidding system. The AO will be able to input bid data, approve Form
A and certify Form B in the bidding system.

2) Backup Authorized Official (BAO). Each supplier organization
will be allowed to designate one or more Backup Authorized
Officials (BAOs). In this role, the BAO can approve the supplier’s
End User registration for access to the bidding system. Like the
AO, the BAO can also input bid data, approve Form A and certify
Form B in the bidding system.

3) End User. Each supplier organization will be allowed one or
more End User(s). The End User can input bid data, but cannot
approve Form A or certify Form B.

The article also “offers good tips to ensure there will
not be an access rejection,” Higley said.

While he is impressed with the content of the materials, Higley
said, he is concerned about providers’ ability to access it.

“I remain concerned … that many in the home care
community do not have the proper information as to accessing these
Internet documents and that CMS may need additional distribution
outlets,” he said. “I would also hope that, once the
array of providers that have accepted contract offers is finalized,
these companies will receive similar hard-copy documents or direct
emails that are applicable to the round one procedures.”

Click the followng links for PDFs of all three MLN Matters
articles:

Click here for Medlearn Matters article SE0805.

Click here for Medlearn Matters article SE0806.

Click here for Medlearn Matters article SE0811.

CMS has also created a fact sheet that providers can hand out to
Medicare beneficiaries. Called “What You Should Know if You
Need Medicare-Covered Equipment or Supplies,” the fact sheet
is available by
clicking here.