Apparent No Go on Early Release of Bidder Names; Sebelius to Look into Bidding Concerns

WASHINGTON — At press time, there had been no response to
a request from
136 members of the House of Representatives calling on CMS to
release the names of providers whose bids were used to calculate
the Round 1
competitive bidding payment rates.

And according to a CMS official on an Open Door call Wednesday,
there may not be.

“Are you still on schedule to make those announcements sometime
in September?” asked Apria Healthcare’s Kimberlie Rogers-Bowers
about the release of bid winners.

“I really can’t comment on that right now,” replied CMS’ Lorrie
Ballantine. “We are in the contracting process … it’s
forthcoming.”

While CMS has said it would announce the bid winners in
September, HME stakeholders have pointed out that may not help
much: If the agency waits until late in the month to reveal the
names, the industry will have only a short time to respond before
Congress adjourns until after the November general election. What’s
more, that list will only reveal those bidders who have accepted
contracts, not those who were offered contracts and whose bids were
used to formulate the single payment amounts.

Ballantine did say that “after the dust settles and the
contracting is done, we will have calls with contract suppliers and
not contract suppliers as we did in the first round.”

But House members don’t want to wait until then to be able to
analyze the contracting results, according to their Aug. 11
request.

“Without knowing the identity as well as the appropriate overall
qualifications of these providers, we cannot evaluate the program’s
impact in terms of quality and access to care for seniors we
represent,” read their letter, which was sent to newly appointed
CMS Administrator Dr. Donald Berwick.

“Given the concerns with this process in the past, we seek this
information now in order to evaluate the Round 1 rebid in an open
and transparent manner,” the representatives wrote.

They had asked for the list of names by Aug. 20.

According to Tyler Wilson, president of the American Association
for Homecare, “If CMS delays the release of information until fall,
it will impede the ability to assess the impact of the bidding
program on Medicare patients.

“One of our concerns is that providers who submitted low,
desperation bids out of their perceived need to remain a Medicare
supplier could well determine the government’s reimbursement rates
— even if those companies ultimately declined to actually
provide the equipment at those rates.”

Although Congress remains on its summer recess, the industry is
still working to get some action on
H.R. 3790 to repeal the bidding program. There is no companion
in the Senate, but the bill currently has 255 supporters signed on
in the House. Advocates believe getting the bill’s language
attached to another piece of legislation later this year —
either a doc fix bill or a larger Medicare bill that would address
a number of issues — remains a possibility.

Meanwhile, following a mid-month meeting with HHS Secretary
Kathleen Sebelius, Invacare Chairman Mal Mixon, AAHomecare’s Wilson
and VGM Group CEO and Founder Van Miller sent the HHS chief a
follow-up letter restating their concerns about the impending bid
program. According to a report from VGM, Sebelius indicated she
would look into some of the issues that were discussed at the
Cleveland meeting, among them: hospital discharges, emergency room
admittances for home oxygen and enteral nutrition patients before
and after the program is implemented and beneficiary access to the
same level of service and care.

With Round 1 of the program to be implemented in January and
Round 2 to be bid next spring, “These and other possible barriers
to beneficiary care are critical to measure and assess before CMS
moves forward with 91 additional large metropolitan areas,” the
powerhouse trio wrote in an Aug. 26 letter.

“We do not understand how CMS will have the ability to make any
meaningful impact assessments in Round 1 in order to make changes
for Round 2 if it maintains this accelerated schedule to implement
Round 2.”

Read the entire letter to Sebelius on the
VGM website.

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