House Members Ask for One-Year Delay of NCB

WASHINGTON–Following a congressional hearing on national
competitive bidding that opened up grave questions about the
program, Reps. John Tanner, D-Tenn.; David Hobson, R-Ohio; and
Jason Altmire, D-Pa., are urging their colleagues to sign on to a
letter asking for a one-year delay of the Medicare DMEPOS bidding
program.

In explaining the request to other House members, the
representatives said “multiple concerns have been raised that
should be addressed before this program is allowed to go
forward.”

The letter, addressed to Rep. Fortney “Pete” Stark, chairman of
the House Ways and Means Health Subcommittee, which convened the
May 6 hearing, follows:

“We write to bring to your attention our continuing and serious
concerns with the Medicare durable medical equipment, prosthetics,
orthotics, and supplies (DMEPOS) competitive bidding program and
ask that you support legislation this year to delay the
implementation of this program until outstanding issues can be
resolved.

“Our overall concern is focused on the implementation of the
program thus far and its implications for Medicare beneficiaries
receiving high quality health care. Almost four million Medicare
beneficiaries will be impacted by round one of the competitive
bidding program scheduled to take effect July 1. Eighteen million
beneficiaries will be affected by round two, which is scheduled for
implementation in July 2009. Our request is legislation that would
delay the implementation of this program until outstanding issues
are resolved.

“Our first concern is the alleged discrepancies between
information submitted by bidders and received by the Centers for
Medicare and Medicaid Services (CMS). We have all heard from
long-standing companies who have offered quality home care services
for decades, but who have been excluded from the bidding program,
apparently through no fault of their own. The vast majority of
rejected bidders were informed that they have not submitted
sufficient financial information, when in many cases, bidders have
evidence they had. These rejected bidders have no appeal
rights.

“In other examples, reputable home oxygen providers were
disqualified for allegedly bidding too low on certain individual
items subject to bidding, while other providers based outside the
market area were offered contracts for similarly-priced bids.
Another serious concern is the reports of companies who won bids to
serve beneficiaries in areas where the company has no proximate
physical location and where the company has no history of serving.
It is possible that contract suppliers may be able to quickly
subcontract with local home care providers, but we are very
concerned that the suppliers will not be able to meet the needs of
Medicare beneficiaries in bidding areas effective July 1, 2008.

“Finally, we are seeking more transparency from CMS as to how
bidders’ financial information and service capacity were
evaluated and how the single payment amount was calculated. We have
heard about numerous data anomalies and believe this information is
critical to the bidding program’s success. At the very least
an internal review should be conducted to ensure the accuracy and
effectiveness of the criteria for future bidding. We all agree that
it is of the utmost importance that we protect access to quality
medical supplies for all of Medicare beneficiaries and people with
disabilities. Therefore, we urge that the implementation of round
one be delayed for at least a year.”

In an action alert sent last week, the American Association for
Homecare said asking members of the House to sign on to the letter
will be one of the requests industry advocates take to Capitol Hill
during its Washingon lobbying fly-in Wednesday.

“The Medicare bidding program must be significantly delayed so
Congress can take a careful look at the program,” AAHomecare said.
“If you can’t attend [the fly-in] in person, please call your
senators’ and representatives’ offices and ask them to support
congressional efforts to delay the Medicare bidding program for
durable medical equipment and ask them to instruct [CMS] to
immediately delay implementation of round one.

“This issue affects everyone in the home care community, whether
you are in round one, round two or beyond.”

For a report on the House Ways and Means Health Subcommittee
hearing, see
HomeCare Monday, May 12.

For information on the AAHomecare fly-in, visit
www.aahomecare.org.