Competitive Bidding Panel Lays Groundwork at First Meeting

Baltimore

CMS is considering using the four DMERCs to implement DME competitive bidding — an announcement that raised the eyebrows of some members of the Program Advisory and Oversight Committee (PAOC), which held its first meeting last month.

The possibility was mentioned as just one of several implementation options for the massive bidding program by CMS and its contractor, North Carolina-based Research Triangle Institute (RTI). Committee member Lawrence Higby, president and CEO of Lake Forest, Calif.-based Apria Healthcare, objected to the option, explaining that the DMERCs are already overburdened with their current responsibilities, the Bureau of National Affairs reported.

RTI also outlined other implementation options, including running the competitive bidding program in-house or contracting with a single entity to run the program.

Attendees at CMS’ first PAOC meeting said the issue was just one of many constructive discussions and informative presentations that, overall, set a positive tenor for future committee meetings.

“I’m convinced CMS and its contractors take [competitive bidding] very seriously,” said committee member Asela Cuervo of Washington, D.C.-based Law Offices of Asela Cuervo, and previously vice president and senior counsel for the American Association for Homecare. “It was a very well-run meeting … and CMS staff tried very hard to be responsive.”

Mandated by the Medicare Modernization Act, the committee, made up of a broad array of stakeholders, will advise CMS on the implementation of competitive bidding as well as quality standards for suppliers participating in the program. The law mandates that the government phase in DME competitive bidding beginning in 2007.

According to attendees, the meeting covered three key issues: the structure of bid implementation, quality standards for suppliers and how to educate referral sources and beneficiaries about the program.

Of all the issues discussed, education may require the most detailed planning, said PAOC member Rita Hostak, vice president of government relations for Longmont, Colo.-based Sunrise Medical, and president of the National Coalition for Assistive and Rehab Technology (NCART). Educational outreach, she said, must be established for all parties involved: suppliers, beneficiaries, physicians and therapists. “How do you educate them prior to and after the bidding process? What does [the bidding process] mean — and not mean — for beneficiaries?”

CMS used this first meeting to “lay the groundwork,” Hostak continued. “There is a lot CMS wants to address [and] a lot that needs to be thought through.”

The agency also revealed a tentative implementation timeline for the program. By the spring of 2005, the agency hopes to submit a Notice of Proposed Rule Making (NPRM) that will include regulatory provisions for implementing competitive bidding, including the designation of bidding sites, the selection of products, the design of the bidding process and the structure for implementation.

The provisions should be available for public comment by the summer of 2005, and a final regulation will be published by the spring of 2006.

Given that no agenda was available before the meeting, “the responses and questions from committee members were very impressive,” added Hostak. “It’s a very well-rounded committee.”

CMS has scheduled the next PAOC meeting to take place Dec. 6-7. The group will meet periodically through the end of 2009. Materials from the meeting, as well as a roster of PAOC members, are available on CMS’ competitive bidding Web site. Visit www.cms.gov for details.