Pull the IFR, Says HELP Committee’s Brown

WASHINGTON — With Congress scrambling to put together
health care reform — a draft bill circulated Friday by
Massachusetts Democrat Sen. Edward Kennedy’s health committee would
guarantee all Americans health insurance — stakeholders are
uncertain how HME will be treated as the reform takes shape.

But Sen. Sherrod Brown, D-Ohio, told HHS last week DMEPOS competitive bidding
shouldn’t be a part of it unless the program is fixed.

In a June 2 letter to HHS Secretary Kathleen Sebelius, Brown
said he was concerned because CMS has not made the changes
necessary “to avoid the problems that occurred during last year’s
bid process.

“In both the Cincinnati and Cleveland markets, two-thirds of the
DME providers that bid to serve the areas were rejected,” Brown
wrote. “Moreover, many of the bid winners did not have a physical
location proximate to the service area, nor did many of the winners
have a track record of the product and services [they] won
…

“These counterproductive bid results occurred in all of the bid
areas, not just Ohio’s, and are the reasons Congress delayed the
bid program last year.”

Brown also told the HHS secretary that CMS should consider
implementing an “any willing qualified provider” provision to
“avoid massive business closures and consumer access problems.”

Brown, who serves on the Senate Health, Education, Labor and
Pensions (HELP) Committee, which Kennedy chairs, urged Sebelius to
rescind the competitive bidding Interim Final Rule “and understand
how the bid program must be changed to be successful.”

The text of Brown’s letter follows in its entirety:

Dear Secretary Sebelius:

On January 16, 2009, the Centers for Medicare and Medicaid
Services (CMS) published in the Federal Register an interim final
rule on the durable medical equipment (DME) competitive bidding
program. The rule took effect on April 18, 2009, and is related to
Congress’ July 15, 2008 enactment of the Medicare Improvements for
Patients and Providers Act of 2008 (MIPPA).

I am writing because I am concerned that CMS has not made
changes to the competitive bidding program to avoid the problems
that occurred during last year’s bid process. In both the
Cincinnati and Cleveland markets, two-thirds of the DME providers
that bid to serve the areas were rejected. The job losses
associated with such extreme business disruption contravene the
goal shared by the Obama Administration and Congress to stem U.S.
job loss during these challenging economic times.

Moreover, many of the bid winners did not have a physical
location proximate to the service area, nor did many of the winners
have a track record of the product and services [they] won.
Furthermore, many of the winners were not in compliance with state
licensure requirements.

These counterproductive bid results occurred in all of the
bid areas, not just Ohio’s, and are the reasons Congress delayed
the bid program last year. We wanted CMS to reconsider some of the
fundamental decisions that drove these outcomes.

I understand that when CMS issued the January 16, 2009
interim final rule, it was developed without input by affected
parties. I urge you to take a close look at this rule and meet with
affected parties and gain their input on how the bid program should
be modified to avoid the problems of the 2008 bid program. For
example, CMS should consider implementing an “any willing qualified
provider” provision to avoid massive business closures and consumer
access problems.

While the MIPPA provisions addressed near-term concerns with
the program, we expected that CMS would conduct a more thorough,
collaborative rulemaking process given the overwhelming level of
Congressional and stakeholder concern during initial
implementation. Congress intended that CMS actively engage all
stakeholders to make substantive changes to the bid program before
any further implementation of the program, including
rulemaking.

I urge you to consider rescinding the January 16,2009
interim final rule and engaging stakeholders to understand how the
big program must be change to be successful. I would be glad to
discuss my concerns with you more in depth, and I look forward to
working with you on this important issue.

Sincerely,
Sherrod Brown
United States Senate