AdvaMed to CMS: Slow Down on Competitive Bidding

WASHINGTON–Echoing concerns voiced by industry advocates for
months, the Advanced Medical Technology Association told CMS that,
with only a year left to prepare for Medicare DME competitive
bidding, it is concerned the agency is rushing work on the project
and fears that attempting to implement the program in January 2007
could be “counterproductive.”

In a Dec. 2 letter, AdvaMed Senior Executive Vice President
David Nexon said his biggest worry is that the proposed rule on
competitive bidding–originally expected to be released in the
spring of 2005–has yet to be published, although competitive
bidding is scheduled to begin in 10 of the country’s largest
metropolitan statistical areas at the start of 2007.

“We continue to be concerned that if CMS rushes to the finish
line to implement the competitive bidding program, there will be
increased potential for beneficiary and provider confusion, reduced
beneficiary access to critical health care services and unnecessary
disruption of the DME marketplace,” Nexon wrote to Herb Kuhn,
director of CMS’ Center for Medicare Management.

“Under the best circumstances, if CMS continues with a January
2007 implementation date, months of important work will be
condensed into a few short months,” he continued.

Some of the work still to be completed, Nexon pointed out,
includes: creating a process for accreditation of suppliers,
identifying the accreditation organizations and allowing suppliers
to complete the accreditation process; developing and issuing
requests for bids; assessing and selecting participating suppliers;
selecting the 10 MSAs where the program will take place; designing
and contracting for operational and systemic changes for CMS,
suppliers and manufacturers; and educating beneficiaries.

Nexon said he believes that the Medicare Modernization Act,
which mandated DME competitive bidding, gives CMS the flexibility
to begin the program any time during 2007. He also recommended that
the agency should carefully select the initial MSAs to avoid the
largest, most complicated areas that cross multiple state lines;
limit the number of products subjected to competitive bidding
during the early phases of the program; and allow as many suppliers
as possible to participate in the early phases of the program so
beneficiary access will not be compromised.

HME stakeholders are now pushing for support of H.R. 3559, the
Hobson-Tanner bill, which would make changes to the MMA’s
competitive bidding provision to ease some of its effects and
ensure beneficiary access under the program. Introduced earlier
this year by Reps. David Hobson, R-Ohio, and John Tanner, D-Tenn.,
the bill would require an exemption for low population areas,
ensure that DME providers have appeal rights on the bid amounts or
contracts and allow all qualified providers to participate at the
selected bid price.

The bill has picked up 55 co-sponsors, but the industry is
pushing for 100 by early 2006–the number political insiders say is
needed to get a companion bill introduced in the Senate.

To view the AdvaMed letter, click
here.

For a current list of co-sponsors of H.R. 3559 and for
information on contacting members of Congress about the bill, visit
www.aahomecare.org.