Weems Shines Up Bidding Program in Press Briefing on Beneficiary Education

BALTIMORE–In a press briefing last week, acting CMS
Administrator Kerry Weems used high gloss to paint the picture of
DMEPOS competitive bidding, and, aside from a few queries
concerning timing and grandfathering, most of the consumer media
had no questions about problems that might surface come July 1. In
his opening remarks, Weems told reporters that competitive bidding
will make changes that, CMS contends, are long overdue.

“Today we pay fee schedule amounts based on supplier
charges from the mid-80s,” Weems said. “The new program
represents another way to use the competitive marketplace to bring
the best possible and most efficient care and services to
beneficiaries.”

In an accompanying press release, Weems said, “Beginning July 1,
Medicare beneficiaries will see lower costs for some of their
durable medical equipment and supplies–as much as a 43 percent
savings for certain items–and the assurance they will have
accredited and financially sound suppliers providing them with
equipment and supplies.”

Weems called the briefing to outline CMS’ educational outreach
in the first 10 competitive bidding areas, including sending a
letter that explains competitive bidding via U.S. Mail to each
beneficiary–nearly four million people, according to the release.
Weems said the letters would be sent on or “around June 20,” just
10 mail days before the round one implementation date.

One reporter asked if that would allow enough time for
beneficiaries to gather an understanding of the program and whether
they would have enough time to find, if necessary, a new,
contracted provider. The reporter said she knew of one patient who
receives diabetic supplies and who was having a difficult time
locating a contracted provider.

Weems responded that the letters would address all beneficiary
concerns.

“We wanted to mail this in time so beneficiaries had time
to educate themselves but also so that it is topical. We always
walk a fine line between making sure that we provide information in
time and making sure that we provide it in a way that is actionable
by the beneficiary,” he said.

Weems said the mailing would also include a brochure and a list
of the contract winners in each bid area, along with their
telephone numbers.

“Similar packets are also being sent to hospital discharge
planners, physicians, physician office staff, home health agencies
[and] social workers,” Weems said. “On the ground in
the 10 areas, CMS regional staff is meeting with provider
organizations, beneficiary advocate organizations, area agencies on
aging and others to tell them about the changes.”

Further questions to CMS included: “Who is grandfathered?
Who is not? And how does anyone know if they are?”

The answer: “To be grandfathered, you simply have to take
advantage of the opportunity … There are different rules for
different pieces of equipment. The one that is substantially high
volume is oxygen. If you have an oxygen concentrator and you are
still within the rental period, the 36-month period established by
statute for rental of oxygen equipment, if your supplier chooses to
grandfather, you will simply stay with that supplier but they will
fall under the new rate … We suspect that many, many will
[grandfather].”

The questioner followed up with: “So the customer has to
contact the provider to find out if they are
grandfathered?”

“Or it can work the other way around,” CMS answered.
“That’s one of the reasons we are educating both sides of the
equation, the beneficiaries and the suppliers
themselves.”

Weems said beneficiaries could get further information by
calling 1-800-MEDICARE or from the Medicare Web site at www.medicare.gov.

A copy of the beneficiary letter and brochure is available by
clicking here.