Competitive Bidding Still Talk of the Town

LAS VEGAS — As the reality of Round 1 grows closer —
CMS should release pricing in June — the hottest topics at
Medtrade Spring last week were competitive bidding, competitive
bidding and competitive bidding.

“It’s really appropriate that we’re talking about competitive
bidding in Las Vegas, because it’s one huge gamble,” said provider
Diana Guth, owner of Los Angeles-based Home Respiratory Care. “For
those of us who have run our companies so carefully and so
responsibly to have to participate in competitive bidding is bigger
than any gamble we can take at the poker tables or the slot
machines. It’s really sad.”

Alan Morris, regulatory analyst for Waterloo, Iowa-based VGM,
agreed. “Competitive bidding changes who gets to bill Medicare and
how much they get paid for it,” he told a packed room during a
session on accepting bid contracts (or not).

Providers are “really behind the eight ball,” Morris said,
adding that “it’s not unreasonable to say we might be looking at 25
percent cuts” resulting from Round 1. HME companies that rely on
Medicare are “basically being put in an impossible situation
because if they lose a bid, they’re out of business,” he said.

Continuing tension over the controversial program spilled over
as Medtrade Spring attendees — nearly 5,000 providers,
manufacturers and others attached to home health care —
crowded every session on the topic at the annual show, held May
11-13 at the Sands Expo & Convention Center.

At a CBIC update Wednesday morning, frayed emotions showed as
presenter Carmen Soto-Ortiz, competitive bidding ombudsman from
Palmetto GBA, was peppered with questions from a contentious
audience throughout the hour-long session. While little new
information emerged, Rob Brant of City Medical Services in North
Miami Beach, Fla., and president of the Accredited Medical
Equipment Providers of America, got one answer he didn’t want.

Brant explained that an AMEPA member had received a letter from
the CBIC questioning a low Round 1 bid for gastrostomy tubes, part
of the enteral nutrients, equipment and supplies category. The
provider realized he made a “typographical error” in submitting the
bid, Brant said, pointing out that the weight of the items in
question is only a minor part of the overall bid category.

“Ninety-nine percent of the enteral bid category is made up of
enteral feed formulas and feeding supply kits,” Brant told
Soto-Ortiz. “Even when the current reimbursement is multiplied by
the weight, the result to the overall bid is less than 1 percent
… Will this bid be disqualified?”

“At this time bids cannot be adjusted or re-submitted, and no
further changes can be permitted,” Soto-Ortiz responded, noting
that “the error will likely result in disqualification from that
category …

“Every item, no matter how small of a weight, affects the bid,”
she said.

Perhaps the only good news about the bidding program? “I think
that there’s almost a 100 percent chance that at some point in the
relatively near future, this program is going to fall on its face,”
said VGM’s Morris, pointing to the momentum H.R. 3790 to repeal
competitive bidding has gained in the House of Representatives. As
of Friday, the bill had 237 cosponsors.

Even if the bidding program does move forward, Morris said, “I
think that’s it going to be much like last time. It’s going to be
such a debacle … that it’s impossible to foresee a scenario
in which our legislators don’t step in,” he said. “They understand
it’s a bad program.”

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