Action on All Fronts

The bid window to submit bids in what is called the Round 1 rebid of the competitive acquisition program is now open and in full swing.

A bill was recently introduced in Congress to repeal the bid program and is gaining new sponsors almost daily. Providers in the initial nine bid areas are focused on submitting bids but also are engaged in activities to alert the local community of the likely effects of the bid program in their area. CMS has begun a public affairs campaign to tout the merits of the competitive bid program for DME. And Congress has proposals to expand and eliminate the program pending on Capitol Hill. In short, there’s activity on every front related to the so-called “competitive” bidding program.

It’s going to be a long 14 months between now and the January 2011 “go live” for the Medicare competitive bid program.

Bill to Repeal the Bid Program

On Oct. 13, Rep. Kendrick Meek, D-Fla., and 16 original cosponsors introduced a bill in the House that would repeal the controversial bidding program. Designed to be budget-neutral, the bill will continue into 2010 as we enter the second session of the 111th Congress.

Original cosponsors of the bill include representatives from virtually all the initial nine bid areas in Florida, Pennsylvania, Ohio, North Carolina, Kansas, Texas and California: Jason Altmire, D-Pa.; John Boccieri, D-Ohio; Jo Ann Emerson, R-Mo.; Sam Farr, D-Calif.; Marcia Fudge, D-Ohio; Alcee Hastings, D-Fla.; Eddie Bernice Johnson, D-Texas; Ron Klein, D-Fla.; Dan Maffei, D-N.Y.; John Murtha, D-Pa.; Tim Ryan, D-Ohio; Heath Shuler, D-N.C.; Glenn Thompson, R-Pa.; Patrick Tiberi, R-Ohio; Debbie Wasserman Schultz, D-Fla.; and Robert Wexler, D-Fla.

In order to pay for the savings the bid program had been projected to save, there are a series of changes to the CPI increases that are in current law. Specifically, the payment cuts would: eliminate the increases that are in current law for 2010 through 2012 and, instead, impose a payment cut of one-quarter percent in those three years; eliminate the current CPI bump of 2 percent in 2014; and take a one-half percent cut in 2015. Complex rehab wheelchairs (Group 3 and above) would not be subject to any of the CPI freezes or payment cuts.

CMS Opens 60-Day Bid Window

CMS opened the 60-day bid window on Oct. 21; bids are due by Dec. 21, 2009, at 9 p.m. ET. In the same week, the Competitive Bidding Implementation Contractor posted a number of clarifications and additional fact sheets on its Web site at www.dmecompetitivebid.com. The site includes updated utilization charts for each of the nine bid areas as well as detailed information about financial documents and other critical information for bidders to understand before developing and submitting bids.

CMS Public Relations Campaign

Over the last several of months, you likely have noticed a surge in the number of articles in the mainstream press that focus on Medicare fraud and abuse — particularly fraud in the DME sector. From CNN to Fox News to C-SPAN to “60 Minutes,” all have had significant coverage focusing on DME fraud in Miami, Los Angeles and elsewhere in the country. I fully expect this stream of media attention to continue over the next year as CMS moves forward with its implementation of competitive bidding.

Expansion of Round 2 and Beyond

The Senate Finance Committee health reform package contains a provision that would expand Round 2 of bidding and expedite the application of bid rates nationwide. This provision would increase Round 2 by 21 additional metropolitan areas and would require the HHS Secretary to bid all areas of the country or apply bid rates nationwide by 2016.

This provision signals strong support for the bid program among the committee members, so it ‘is likely to stick and remain in the final health care reform package that Congress is working to pass by the end of the year.

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A specialist in health care legislation, regulations and government relations, Cara C. Bachenheimer is vice president, government relations, for Invacare Corp., Elyria, Ohio. Bachenheimer previously worked at the law firm of Epstein, Becker & Green in Washington, D.C., and at the American Association for Homecare and the Health Industry Distributors Association. You can reach her at 440/329-6226 or [email protected].