Proposed Competitive Bidding Rule in ‘Clearance Stage;’ AAHomecare Gears Up to Work on Small Provider Protection

WASHINGTON–The proposed rule on national competitive bidding
for DME is now in the “clearance stage,” a CMS official announced
last Wednesday at a Home Health, Hospice & DME Open Door
Forum.

The official did not comment on exactly when the proposal–which
will detail how the bidding program will be implemented when it
begins in 2007–might be released, but some insiders say it could
be before September, when it is slated for publication.

Also last week–gearing up for a push to soften effects of the
coming bid program– the American Association for Homecare held the
first meeting of its newly created Small Business Committee, formed
to focus on issues that will affect small providers under
competitive bidding. The organization has argued that any qualified
provider should be able to compete in the bid process and that “CMS
should not limit the number of providers if they can meet
prescribed prices and quality standards.”

“We’re looking to use this as a grassroots group [to influence
change on the policy],” said AAHomecare Chair Tom Ryan. According
to Ryan, the committee will work with the association’s regulatory,
legislative policy and executive committees, as well as with the
government’s Program Advisory and Oversight Committee–a 22-member
industry panel that is charged with advising CMS on competitive
bidding implementation.

“We need to work with the PAOC on competitive bidding, but we
also need to look at legislative proposals to protect small
providers,” Ryan said.

Among possible legislative fixes, AAHomecare is soliciting
support for forthcoming legislation from Rep. David Hobson, R-Ohio,
that would amend several sections of the Medicare Modernization Act
and make a series of changes to its DME bidding mandate. Among
other things, the bill is expected to include small provider
protection by allowing any Medicare Part B supplier that meets the
quality standards and submits a bid for an item to provide that
item at the final bid rate.

The MMA mandates competitive bidding to begin in 10 top
metropolitan statistical areas in 2007 and expand to 80 MSAs in
2009. “If you have all of your business in [one of these] MSAs and
rely on Medicare, you’re going to be taking a lot of providers and
putting them out of business,” Ryan said.

Members of the AAHomecare committee include: Ryan, president and
CEO, Homecare Concepts, Farmingdale, N.Y.; Kay Cox, president and
CEO, AAHomecare, Washington; Ray Darcey, AAHomecare vice chair and
vice president, Sentara Enterprises, Chesapeake, Va.; Asela Cuervo,
attorney and AAHomecare consultant, Washington; Karyn Estrella,
executive director, New England Medical Equipment Dealers
Association, New Bedford, Mass.; Jeff Wills, CFO, Canadian Valley
Medical Solutions, Oklahoma City; George Kucka, president, Fair
Meadows Home Health, Schererville, Ind.; James Clark, president,
Clark Respiratory, Catskill, N.Y.; Tim Pederson, president and CEO,
WestMed Rehab, Rapid City, S.D.; John Gallagher, vice president,
government relations, The VGM Group, Waterloo, Iowa; Jeff Woodham,
vice president, information, The Med Group, Lubbock, Texas; and
Georgetta Blackburn, director of compliance, Blackburn’s Physicians
Pharmacy, Tarentum, Pa.

The ad hoc committee will meet again this week. The next meeting
of the PAOC is scheduled for the fall.